Download Up in Smoke - Marijuana Today - Burns M. Brady

UP IN SMOKE – MARIJUANA TODAY
I. INTRODUCTION AND REVIEW
A. Current challenge
1) Information
2) Education
II. DRUGS OF REWARD AND THE BRAIN
Neuropharmacology of Marijuana
1) Dopamine agonist
dopamine with stimulant effect (speed)
2) Opiate agonist
affinity MU receptor site (narcotic)
3) Interaction with opioid receptors in the CNS
New York Daily News March 10, 2003
AN OPEN LETTER TO PARENTS:
HERE’S WHAT THE EXPERTS SAY ABOUT MARIJUANA AND TEENS.

“Marijuana is not a benign drug. Use impairs learning and judgment, and may lead to the development of mental health problems.”
- American Medical Association

“Smoking marijuana can injure or destroy lung tissue. In fact, marijuana smoke contains 50 to 70 percent more of some cancer causing chemicals than does
tobacco smoke.”
- American Lung Association

“Teens who are high on marijuana are less able to make safe, smart decisions about sex – including saying no. Teens who have used marijuana are four times
more likely to have been pregnant or gotten someone pregnant than teens who haven’t.”
- National Campaign to Prevent Teen Pregnancy

“Marijuana can impair perception and reaction time, putting young drivers, their passengers and others on the road in danger. Teens, the highest risk driving
population, should avoid anything that might impair their ability to operate a vehicle safely.”
- American Automobile Association

“Marijuana use may trigger panic attacks, paranoia, and even psychoses, especially if you are suffering from anxiety, depression or having thinking
problems.”
- American Psychiatric Association

“Marijuana can impair concentration and the ability to retain information during a teen’s peak learning years.”
- National Education Association

“Recent research has indicated that for some people there is a correlation between frequent marijuana use and aggressive or violent behavior. This should be a
concern to parents, community leaders, and to all Americans.”
- The National Crime Prevention Council
And, according to the National Institute on Drug Abuse, marijuana can be addictive. In fact, more teens are in treatment with a primary diagnosis of
marijuana dependence than for all other illicit drugs combined.
Teens say their parents are the single most important influence when it comes to drugs. Know their friends. Ask them where they are going and when they
will be home. Take time to listen. Talk to your teens about marijuana. To learn more about marijuana and how to keep your teens drug-free, visit
www.theantidrug.com or call 800-788-2800
ASAM BOARD ADOPTS NEW POLICY STATEMENTS ON MARIJUANA, OPIOIDS, PAIN AND PATIENT SCREENING
G. Douglas Talbott, MD
July 1997
At its approval, these statements become the official policy of the Society. April meeting, the ASAM Board of Directors approved four Public Policy Statements at the recommendation of the
Public Policy committee, chaired by Sheila Blume, MD. With the board’s
The Public Policy Statement on Marijuana, first adopted in 1987, was revised by the Public Policy Committee to respond to issues recently raised in public ballots on the use of marijuana in
medical care, as well as by the responses of federal and state law enforcement agencies to those ballot initiatives.
The Public Policy Statement on the Rights and Responsibilities of Physicians in the use of Opioids for the Treatment of Pain was adopted to elucidate issues that have emerged in recent years in
relation to the management of acute and chronic pain, for whom physicians specializing in addiction medicine increasingly are asked to provide expert consultation. A related statement on
Definitions Related to the Use of Opioids in Pain Treatment clarifies concepts such as dependence and preoccupation as they relate to pain patients managed on opioids.
The Public Policy Statement on Screening for Addiction in Primary Care Settings responds to issues raised by the growing focus on use of primary caregivers to provide a majority of patient care.
The full text of the policy statement on marijuana follows.
Public Policy Statement on Marijuana
Marijuana is a mood-altering drug capable of producing dependency. Its chief active ingredient is delta-9-tetrahydrocannabinol.
Marijuana has been shown to have adverse effects on various organ systems, on perception, behavior and functioning, and on fetal development. Because of the widespread use of this drug, its effects on mind and
body, and the increasing potency of available supplies, ASAM strongly recommends:
1.
Education about drugs, beginning in the earliest grades of elementary school and continuing through university level. Drug education should contain scientifically accurate information on
the dangers and harmful effects of marijuana, and on the disease of marijuana dependence.
2.
Health and human service professionals should be educated about marijuana and marijuana dependence as a required part of their curriculum.
3.
Persons suffering from alcoholism and other drug dependencies should be educated about the need for abstinence from marijuana and its role in precipitating relapse, even if their original
drug of choice is other than marijuana.
4.
Marijuana dependent persons, like other drug dependent people, should be offered treatment rather than punishment for their illness. Treatment of marijuana dependence should be part of
the plan for rehabilitation of any person convicted of a drug-related offense, including driving under the influence of alcohol and/or drugs, who is found to be marijuana dependent.
5.
Approved medical use of marijuana or delta-9-tetrahydrocannabinol for the treatment of glaucoma, illnesses associated with wasting such as AIDS, the emesis associated with
chemotherapy, or other uses should be carefully controlled. The drug should be administered only under the supervision of a knowledgeable physician.
6.
Research on marijuana, including both basic science and applied clinical studies, should receive increased funding and appropriate access to marijuana for study. The mechanisms of
action of marijuana, its effect on the human body, its addictive properties, and any appropriate medical applications should be investigated, and the results made known for clinical and
policy applications. In addition, ASAM strongly encourages research related to the potential and actual effects of marijuana-related public policy.
7.
ASAM encourages the study of the potential impact of making cannabis available for approved medical uses, and the consideration of what changes might result from moving cannabis
from Schedule I to another Schedule.
8.
Physicians should be free to discuss the risks and benefits of medical use of marijuana, as they are free to discuss any other health-related matters.
Adopted by the ASAM Board of Directors in April 1987 and revised in April 1997.
MARIJUANA
Delta – 9 – T.H.C. 1964
(fat soluble)
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Psyche
Brain
Lungs
Reproduction
Genes and Chromosomes
Immune System
Tolerance
Addiction
I. PSYCHE
A) confusion -
attention span – inability to concentrate
B) emotional disorders
1) aggression – irritability – impulsivity
2) panic
3) paranoid ideation
4) depression – isolation – suicide
5) grandiosity – special insights
possible
overt
psychosis
C) short term memory impairment – time and space concept
D) persistent organic brain syndrome
1) impairment of orientation
2) memory impairment
3) intellectual impairment
E) amotivational syndrome
massive and chronic passivity
F) delayed maturation in adolescence !!!
coping skills
G) permanent impairment and/or long-term recovery
II.
BRAIN
A) limbic system – EEG – receptor site
1) permanent – dose and time related
2) electron microscope evidence
B) brain weight decrease (rats)
C) protein synthesis (rats)
D) brain atrophy (humans – CT scan)
Air ECP
III. RESPIRATORY
TREE
A) lungs
1) cancer risk increased
2) COPD
B) sinusitis
ALL findings substantially increased over tobacco
IV. REPRODUCTION
A) female process
1) menstrual cycle effect
B) fetal development
1) teratogenic effects
2) embryocidal effect
a) resorption
b) abortion
3) fetal syndrome weight
ovulation – sterility
development
C) male process
1)
testosterone -
sperm count -
sterility
impotence – gynecomastia
2)
3)
sperm motility
abnormal sperm morphology
hydrocephalus
V.
GENES AND
CHROMOSOMES
A) breakage – somatic cells sperm cells
B) sperm cells
1) DNA RNA synthesis 50%
C) chromosome reduction (lymph cells) 5 - 30
D) long term, multigeneration, birth defects in mice
VI. IMMUNE SYSTEM
A) lymphocytes (T-Lym)
1) division (41%)
2) abnormal DNA
3) cancer potential
B) granulacytes
1) infection
VII.
TOLERANCE
A) marked increase and cumulative (fat soluble)
pathway to harder drugs
VIII. THERAPEUTICS
A) bronchial asthma
B) glaucoma
C) antiemetic – cancer patients