08 May 2014
Like people addicted to a range of other substances, people addicted to cannabis (marijuana, hashish or hashish oil) can develop symptoms of withdrawal when their brains don’t receive the expected amount of the drug. The presence of significant withdrawal symptoms can potentially stop a habitual cannabis user from successfully discontinuing his or her drug intake. In a study published in March 2014 in the American Medical Association journal JAMA Psychiatry, researchers from several Australian institutions investigated the potential effectiveness of a multiple sclerosis medication, called nabiximols (Sativex), as a treatment for people going through cannabis withdrawal. Nabiximols is derived from certain types of cannabis plants.
I Thought Marijuana Wasn’t Addictive?
The American Psychiatric Association acknowledges cannabis withdrawal as a distinct and diagnosable mental health condition. People going through this form of drug withdrawal can develop symptoms that include a prominent urge to consume more cannabis, increased levels of anxiety, an unusually agitated or irritated mental state, a reduced ability to fall asleep or stay asleep and a reduced interest in food. As a rule, doctors consider officially diagnosing these symptoms when they substantially impair the day-to-day functionality of affected individuals or produce a notable decline in mental/emotional well-being. As of early 2014, there are no medications available in the U.S. designed to treat people affected by cannabis withdrawal.
Nabiximols is an oral spray chemically extracted from flowers harvested from a cannabis species known as Cannabis sativa. Rather than using plants grown through usual methods (which can have highly varying amounts of THC and other active ingredients), manufacturers of the medication use plants cloned in tightly controlled conditions. Compared to the THC derived from smoking cannabis, the THC contained in nabiximols produces its drug effects more slowly and also reaches a lower overall peak inside the bloodstream. Still, the medication has a fairly rapid impact and typically triggers noticeable effects in 15 to 40 minutes. Together, these properties make nabiximols a potential option for treating people affected by the autoimmune nerve disorder multiple sclerosis. As of 2014, the medication is not available in America; however, Canada and several European countries have approved its use. Currently, pharmaceutical companies are seeking approval for use of the medication in the U.S. as a treatment for certain forms of cancer-related pain.
In the study published in JAMA Psychiatry, researchers from the University of Sydney, the University of New South Wales and several other Australian institutions used a monthlong project to assess the effectiveness of nabiximols as a treatment for the symptoms of cannabis withdrawal in people affected by cannabis dependence/addiction. Half of the 51 participants in this project received the medication for six days; the other half received a placebo that mimicked the appearance of nabiximols for the same amount of time. Four weeks later, the researchers conducted a follow-up examination of each participant in both the nabiximols group and the placebo group. This examination included a test (called the Cannabis Withdrawal Scale) designed to measure the intensity of withdrawal symptoms, as well as assessments of such things as length of stay in a treatment program, involvement in cannabis use after going through withdrawal and experiences with cannabis-related harm.
After comparing the two groups, the researchers concluded that use of nabiximols does contribute substantially to the general reduction of withdrawal symptoms in physically dependent cannabis users. Specifically, the medication helps lower the intensity of cannabis cravings and ease the impact of the mood alteration commonly associated with cannabis withdrawal. In addition, nabiximols use has a smaller but detectable impact on the severity of several other withdrawal symptoms. Compared to the study participants who did not receive nabiximols, the participants who received the medication also stayed in treatment longer during the project’s initial phase.
The authors of the study published in JAMA Psychiatry note that nabiximols apparently only helps extend participation in cannabis treatment during its active use. Once that use came to an end, the individuals who received the medication did not stay in treatment any longer than the individuals who received a placebo. All told, the study’s authors believe that their findings support the potential usefulness of the medication as a cannabis withdrawal treatment and point toward a need for additional research.
21 Apr 2014
In the November 2013 elections, Colorado voted to legalize recreational marijuana sales, and the first stores licensed to sell marijuana opened for business Jan. 1. Nevertheless, Colorado’s new laws do not mean that marijuana use is now free from regulation. On the contrary — the process of selling, purchasing and using marijuana is tightly controlled, especially as the state evaluates the manageability and success of legalization.
Selling And Purchasing Marijuana
In addition to applying for and receiving an official license to sell recreational marijuana, there are other regulations by which retail locations have to abide. The state has mandated that marijuana retailers cannot open earlier than 8 a.m., or remain open after midnight. Many cities are setting even more restrictive hours; for example, Denver stores that sell recreational marijuana are required to close at 7 p.m.
These stores also have to abide by security camera regulations. Each location is required to have a security camera pointed at the register with a picture that is clear and close enough for facial recognition.
Marijuana retailers are required to check the state-issued I.D. of customers to confirm their state of residence. They may sell up to one ounce of marijuana to Colorado residents, and one-quarter ounce to out-of-state residents.
State law does not permit any private individual to possess more than one ounce of store-bought recreational marijuana at a time. However, there are no regulations in place that prohibit people from purchasing marijuana from multiple stores in one day. One of the biggest concerns for law enforcement officers is how to prevent people from acquiring much more than the legal limit by visiting multiple stores and purchasing the full legal amount each time. This is part of the reason that stores are required to have security cameras through which individuals can be clearly identified.
The regulations about where customers are permitted to use their products are also fairly restrictive, and a bit confusing. Smoking marijuana is forbidden wherever cigarette smoking is banned, and any consumption of marijuana is forbidden in public areas like parks. Hotels and apartments are permitted to allow or ban smoking marijuana just as they can regulate cigarette smoking. Currently, it’s not clear whether private establishments like restaurants or coffee shops will be allowed to have discreet areas for marijuana use.
Consuming marijuana on federal land within Colorado is also forbidden. This includes most ski slopes, and all national parks and national forests. People who decide that these wide-open spaces seem ideal for discreetly consuming marijuana products should be aware that they would be subject to federal penalties if they were caught.
For the moment, privately owned residences in Colorado are the only places where recreational marijuana use is definitely permitted.
Some Cities Refuse To License Marijuana Sales
Under the new state regulations governing recreational marijuana, individual communities (cities and counties) in Colorado are allowed to refuse to license marijuana dealers and therefore prohibit recreational marijuana sales within their city or county limits.
Cities that have chosen to ban recreational marijuana sales include Colorado Springs, the state’s second largest city. Several other major cities, including Aurora and Boulder, are provisionally banning marijuana sales until local leaders make decisions about licensing regulations and monitoring. Many of these communities feel that the weeks between the November 2013 elections and the official start of marijuana sales on the first day of 2014 did not give them enough time to make decisions about intelligent implementation.
Some cities have not explicitly banned marijuana sales, but have created regulations that make it practically impossible for marijuana retailers to open. For example, at least one community requires prospective marijuana retailers to be so far away from any school property that they would be pushed to the very edges of town, where a new business would almost certainly fail.
Some of the approximately two-dozen cities that do not currently permit recreational marijuana sales have issued two-year moratoriums, and will reconsider the issue when those two years are up. Many of these communities want to wait to see how effective the state can be at regulating, licensing and monitoring establishments before potentially giving the go-ahead to marijuana sales.
Federal-level drug laws in the U.S. prohibit the sale or use of the plant-based, mind-altering drug marijuana. Despite this fact, as of 2014, the drug has been decriminalized or legalized in roughly a third of all U.S. states, and the trend toward decriminalization and/or legalization may continue in future years. In a study published in 2012 in the journal Drug and Alcohol Dependence, researchers from Columbia University investigated the question of whether decriminalization or legalization in all 50 U.S. states would lead to a rise in the diagnosis of cannabis use disorder (the combined term for cannabis abuse and cannabis addiction).
The Laws Of Marijuana
The federal status of marijuana is mandated by a law called the Controlled Substances Act, which categorizes drugs and medications according to both their medical usefulness and their potential to trigger cases of substance abuse or substance addiction. Marijuana is classified as a Schedule 1 substance; substances with this designation officially have no verified usefulness in a medical context and come with substantial risks for abuse and addiction in all users. It’s important to note that federal law distinguishes marijuana from its main active ingredient, THC (tetrahydrocannabinol). In limited circumstances, doctors can use standardized THC products for such purposes as nausea control, pain relief and appetite encouragement. However, since the THC content of marijuana can vary widely, the allowance for THC use does not extend to marijuana use.
Eighteen states in the U.S. (as well as the District of Columbia) have passed laws that make it possible to prescribe medical marijuana for their patients. Essentially, these laws decriminalize marijuana use in a medical context and take away the legal penalties otherwise associated with possession or consumption of the drug. In addition, both Colorado and Washington State have gone beyond decriminalization for medical marijuana and passed laws making it permissible for adults to possess and use small amounts of the drug in a recreational context not based on perceived medical need. These laws make marijuana use legal instead of merely decriminalized. However, in terms of ultimate jurisdiction, none of the state laws regarding medical marijuana or recreational marijuana take precedence over federal law.
Marijuana Abuse And Addiction
Like any other classic substance of abuse, marijuana produces rewarding sensations in the brain’s pleasure centers and, when used repeatedly, also makes long-term changes in brain chemistry that support the onset of physical dependence and addiction. According to figures compiled by the National Institute on Drug Abuse, one-quarter to one-half of all regular users of the drug will ultimately develop a cannabis addiction and meet the terms for diagnosing cannabis use disorder. Significant numbers of occasional marijuana users will also get addicted. As a rule, teenagers are substantially more susceptible to the drug’s addiction-promoting effects than adults.
A Rise In Abuse And Addiction Rates?
In the study published in Drug and Alcohol Dependence, the Columbia University researchers used information gathered from a large-scale, nationwide project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to explore the issue of how the passage of medical marijuana laws in all U.S. states might impact rates for the diagnosis of cannabis abuse and cannabis addiction. After analyzing the information from NESARC, the researchers checked their findings against recent figures gathered from another nationwide project, called the National Survey on Drug Use and Health, which explores drug use trends in all American adults and teenagers.
Using the results gathered from the National Epidemiologic Survey on Alcohol and Related Conditions, the researchers concluded that, compared to people living in states that have not passed medical marijuana laws, people living in states that have decriminalized the use of medical marijuana are more likely to use marijuana, and also more likely to experience cannabis-related problems with abuse and addiction. Using the results gathered from the National Survey on Drug Use and Health, the researchers again concluded that people in pro-medical marijuana states use marijuana more often than people living in other states. However, neither survey indicated that the overall percentage of people affected by cannabis abuse and addiction is higher in medical marijuana states than in non-medical marijuana states. Instead, the number of affected individuals apparently goes up because the increase in total users leads to a larger pool of individuals at-risk for developing problems.
The authors of the study published in Drug and Alcohol Dependence did not offer a reason for the increase in marijuana users in states that allow medical marijuana. Since diagnosable problems appear in a certain percentage of all occasional and regular marijuana users, it seems logical to assert that a spread of medical marijuana throughout the U.S. and a subsequent increase in marijuana users would lead to increased numbers of cannabis use disorder diagnoses. However, continual future research will be needed to prove or disprove this assertion.
Marijuana as a recreational drug is now legal in Washington and Colorado, and it’s legal medicinally in 18 other states. But a recent research paper raises legitimate questions about the drug’s safety. One of proponent’s main arguments in favor of legalized marijuana has been the absence of overdose deaths associated with sole use of the drug. The article calls that assertion into question.
Public perception is that a person who uses marijuana on its own is safe. In fact, a 2011 U.K. Department of Health report said “no cases of fatal overdose have been reported” due to marijuana use and “no confirmed cases of human deaths” had been found.
The new report suggests that marijuana is not quite that safe. In the study, German researchers took a look at 15 individuals whose deaths were somehow related to use of marijuana. The investigators performed careful post-mortem tests to identify and rule out other factors which may have been responsible for the deaths.
Scientists ran genetic tests, examined organs, performed an autopsy and asked for a toxicology report to screen for possible problems, such as liver disease, alcohol abuse or other conditions which could seriously compromise health and life.
Is Marijuana Overdose Possible?
One of the German researchers involved with the study said he believes marijuana overdose to be rare but possible. They discovered that two of the 15 persons were found to have the psychoactive ingredient THC in blood samples in amounts that indicated they had been using marijuana just hours before they died. In both cases the men’s hearts had experienced arrhythmia, meaning their hearts were beating either too quickly or too slowly. The change was drastic enough that it killed the two men, ages 23 and 28. One was found to have a significant but formerly undetected heart condition, and the other had a personal history of substance abuse apart from marijuana use. The study did not determine how marijuana caused the deadly arrhythmias.
The report is considered the first proof that deadly marijuana overdose is possible, even if infrequent. It suggests that further investigation is warranted into cases where marijuana use took place near to the time of death. Other risks, such as impaired memory, schizophrenia and depression have been associated with use of marijuana. Now it’s time to re-evaluate whether deadly overdose is another potential risk.
Not all people get involved in substance abuse for the same reason. Broadly speaking, some people are motivated primarily by the desire to increase their experience of pleasure, while others are motivated primarily by the desire to escape or avoid painful experiences. According to the results of a study published in March 2014 in the journal Addictive Behaviors, the underlying reasons for marijuana use have a significant impact on the results of treatments designed to address cannabis addiction. It appears that addicts motivated by pain avoidance have a harder time maintaining their recovery than their peers motivated by pleasure-seeking.
What Is Cannabis Use Disorder?
Marijuana or cannabis addiction is officially classified as part of a larger condition called cannabis use disorder. Some people affected by this disorder are not addicted to marijuana or other forms of cannabis, but still experience serious life impairment as a result of their drug use. Other affected individuals have undergone the long-term changes in brain chemistry that set the stage for marijuana/cannabis addiction and all other forms of substance addiction. Many people think that marijuana/cannabis addiction is a rare phenomenon. However, current evidence indicates that nine out of every 100 users of marijuana will develop symptoms that qualify them for an addiction diagnosis. Teenage marijuana users develop diagnosable addiction symptoms at close to twice this rate. In addition, addiction rates skyrocket among daily users of all ages; one-quarter to one-half of these individuals will eventually develop diagnosable symptoms.
Much of human behavior stems from the conscious or unconscious impact of various emotions and emotion-based motivations. Psychologists commonly refer to pleasure-seeking motivations as “positive” reasons for engaging in a behavior. Conversely, they commonly refer to pain-avoidance motivations as “negative” reasons. When it comes to substance intake, the terms “positive” and “negative” don’t mean that some people have “good” reasons for using drugs or alcohol while others have “bad” reasons. Instead, they simply mean that some people use drugs and alcohol because they believe that substance use will enhance their pleasurable experiences, while others use drugs or alcohol because they believe that substance use will help them avoid feeling bad or escape current bad feelings. Individuals with “positive” motivations for substance use can develop problems with abuse and/or addiction just like people with “negative” motivations. However, the two groups of substance users typically hold distinctly different mental/emotional points of view about themselves, their surroundings and their experiences.
Impact On Treatment Outcomes
In the study published in Addictive Behaviors, researchers from the University of Washington and Virginia Polytechnic Institute and State University looked at the treatment outcomes of marijuana addicts whose drug use stems from “negative” motivations. They conducted their work with information gathered from 87 adults who underwent treatment for issues related to a chemical reliance on marijuana. These participants provided information on the reasons they used marijuana in any given situation. In turn, for each participant, the researchers matched these motivations to three known markers of diminished mental well-being: lack of belief in the ability to control one’s behavior, use of ineffective coping strategies to deal with unpleasant emotions and an impairing state called psychological distress.
The researchers concluded that marijuana addicts who use the drug for “negative” reasons have increased chances of believing they can’t control their actions, using ineffective coping mechanisms to deal with their emotions and developing substantial amounts of psychological distress. The researchers also concluded that each of these adverse impacts develops independently of the others, which means that attempts to address one of the three issues will not reduce risks for the other two. In addition, the researchers found that, compared to marijuana addicts who don’t use the drug for “negative” reasons, marijuana addicts who do use the drug for these reasons have greater problems achieving or maintaining abstinence from marijuana intake after they complete their treatment programs.
The authors of the study published in Addictive Behaviors note that their new findings echo previous research efforts that indicate that “negative” reasons for drug or alcohol use produce more problems during recovery than “positive” reasons for drug or alcohol use. Current psychotherapeutic approaches for people affected by marijuana addiction typically focus on dealing with unpleasant or unwanted emotional states. The study’s authors believe that their work validates this approach and serves as an additional reason for continuing to focus on treating “negative” emotions in people who develop cannabis-related addiction issues.
On Jan. 1, 2014, legal recreational marijuana sales began in Colorado, with remarkably little fuss. Long lines appeared at the 37 stores across the state—mostly in the Denver area—that were fully licensed in time for the New Year, but any worries that the crowds might become disorderly proved to be unfounded.
Law enforcement was a major presence around the newly licensed establishments throughout the day to ensure that the crowds did not get out of hand, and to check the establishments for compliance. Stores selling marijuana must check IDs to ensure each customer is 21 years of age or older, and to determine each customer’s state of residence. Under the new laws, Colorado residents are permitted to buy up to one ounce of marijuana, while out-of-state customers are permitted to buy up to one-quarter of an ounce.
Setting The Precedent Of Legalizing Marijuana
Colorado is not just the first U.S. state to legalize the sale of recreational marijuana—it is the first state or city anywhere in the world to open stores officially licensed to sell recreational marijuana. Both Colorado and Washington voted to legalize marijuana in the November elections of 2012, but Washington stores will not begin selling recreational marijuana until later in 2014.
As the months and years pass, Colorado will be the vanguard in other ways as well. The rest of the U.S. will be looking to Colorado to evaluate the success of the state’s regulatory measures that are designed to restrict marijuana sales to licensed establishments, and restrict marijuana purchases to people of legal age. Federal and state officials will be watching to see what effects marijuana legalization has on marijuana abuse and dependence, on underage use of marijuana and on the suddenly legitimate marijuana industry.
Some opponents of the legalization of marijuana fear that the marijuana industry could become a second “Big Tobacco”—an industry that earns huge profits by causing people to become addicted to their products.
Legalized Marijuana Prices
On Jan. 1st, most stores were charging $30 to $50 for an eighth of an ounce of marijuana, although some were charging slightly more. This is significantly higher than the price of legal marijuana in Colorado at the more than 300 dispensaries licensed to sell marijuana for medical purposes to people with a prescription.
Some stores had raised their prices for opening day, and others limited purchases to smaller amounts than the law’s limit for fear of running out of stock. Average prices may drop after the first months of sales and as the stores react to the market. However, legal buyers will still have to deal with an expense that has never before factored into recreational marijuana sales: taxes. Colorado has placed a 15 percent excise tax and a 10 percent sales tax on marijuana purchases, for a total of 25 percent of the cost of the purchase.
Some early customers did express dismay over the prices, and compared them negatively to the cost of purchasing marijuana from non-licensed sources. Even so, sales at the 37 stores across Colorado totaled more than $1 million on New Year’s Day alone, and more than $5 million in the first week.
Colorado has estimated that the marijuana industry could generate around $600 million in sales per year. The state expects to collect around $70 million in taxes from these sales.
Unique Challenges For Marijuana Retailers
While the new marijuana retailers were buoyed by the early sales, there are still many challenges for those in the legal marijuana business. Although the U.S. Department of Justice has decided not to interfere with recreational marijuana sales in Colorado and Washington, these retailers are still impacted by the federal ban on recreational marijuana sales.
Marijuana retailers are not able to get traditional services from banks (who fear criminal proceedings for money laundering), and do not qualify for federal tax write-offs that assist many small business. Furthermore, many establishments are limited to cash transactions because they are not able to accept credit cards. This can make them more vulnerable to robbery, and can make it more challenging to file taxes and manage the employee payroll.
Learn About The Pros And Cons Of Legalizing Marijuana
03 Feb 2014
Marijuana is in the news a lot these days. Nearly half of all states have legalized medical marijuana. Two states now allow for recreational use of the drug. And yet, this substance is still illegal across the country according to federal law. There are many contradictions and confusions related to cannabis. Is it safe to use? Can it really help treat illnesses? When your child starts asking these questions, be sure you have the right answers. And consider having a talk about this controversial subject before your child gets the wrong answers at school.
Is Marijuana Safe?
Attitudes regarding marijuana have shifted considerably in this country. As legalization for marijuana has occurred, many people have begun to assume that the drug must be safe. If it is considered a medicine, and is prescribed by doctors, it must be safe to use is a common misconception that you should correct for your child.
Marijuana is safer than many other drugs, but emphasize to your child that there are risks associated with using it. Smoking marijuana leads to impaired thinking and coordination, memory problems, and distorted perceptions in the short term. It can also cause paranoia, depression and anxiety. Using marijuana also increases the risk of having a heart attack and of developing a respiratory problem.
What Is Medical Marijuana?
Medical marijuana is no different from the drug that people use recreationally. It is simply marijuana that is prescribed by doctors to patients. Medical marijuana is most often smoked, but can also be consumed. Marijuana can be used to ease the symptoms of chemotherapy for cancer patients and those that are struggling with HIV and AIDS. It also helps people with the eye disease glaucoma and with multiple sclerosis. Chronic pain caused by any condition can be relieved by marijuana use.
Is Marijuana Addictive?
Another misconception that your child may have about this drug is that it is not addictive. The truth is that it does have the potential to lead to dependence, although the risk is much less than other substances, like cocaine, heroin, and even tobacco and alcohol. Make sure your child understands that addiction is always a risk when using a mind-altering substance.
Can You Get In Trouble For Using Marijuana?
Be sure that your child understands very clearly that even in states where marijuana has been decriminalized to any extent that it is illegal everywhere for anyone under the age of 21 to use marijuana. The exception to this rule is if a young person has a medical need for the drug. Just because marijuana is becoming legal in some places does not mean that teenagers can use the drug without consequences.
Isn’t Everyone Smoking Marijuana?…Maybe Not
The prevalence of marijuana in public discussion may make your child feel as if everyone is using this drug. It is important for your child to understand that this is not true. The vast majority of people, adults and teens, choose not to use marijuana. Among teenagers, fewer than eight percent report using the drug in the past month. Among people of all ages, this number drops to seven percent. The perception that everyone is doing something is powerful, so emphasize to your child that this is not the case with marijuana.
Provide The Answers About Marijuana Before Your Child Asks
Talking to your child about drugs is important and could be life-saving. With marijuana in the public consciousness and with perceived risk so low among young people, it is crucial that you have the answers your child needs to hear. Don’t wait for him to ask you. Start the conversation now and be sure that your child hears about this drug from you and not from his peers.
Read More About Why You Should Believe That Marijuana Is Dangerous
21 Jan 2014
A US government study on drugs in the workplace has caused some business owners and community activists to raise questions about medical marijuana policies.
Annie Short, the manager of a Wisconsin-based wellness program, recently gave a talk called “Drug Abuse and the Cost to Businesses” at a wellness council luncheon. She urged her community to rethink the state’s consideration of legalizing marijuana. Because over 70 percent of individuals using illegal drugs are employed, the manager’s discussion posed a thought-provoking question: Are employers willing to let those drug abusers perform public services, such as bus drivers, police officers and pilots?
Short shared some statistics from a U.S. Department of Labor, Small Business Administration and the National Institute on Drug Abuse survey.
Workplace Drug-Use Stats:
- Employees who are substance abusers cause 40 percent of accidents that happen on the job
- Due to lost time, health care cost, worker’s compensation and accidents, drug abusers cost employers an estimated $81 billion annually
- Drug users are more likely to ask for time off, have repeated absences and be late for work
- Drug users are five times more likely to make a worker’s compensation claim
Employees Using Drugs And Stealing At Work?
Statistics from a national cocaine helpline reported that 75 percent of callers admitted to using drugs while working. They also reported that drugs had a noticeably adverse effect on their ability to complete their jobs. Eighteen percent of callers reported stealing from co-workers and employers to support their drug habits.
Drug-Free Changes For The Workplace
Community leaders and advocates against the legalization of marijuana have a clear message: Employers and companies must make a drug-free workplace a top priority. Employers should implement policies that have clear and strict discipline, with termination for employees who are found to be using drugs while working.
In order to have a workplace that is drug-free, employers should implement employee education, a substance abuse support program, training and regular drug testing.