Epidemiology of Drug Use Among Adolescents

This review of the epidemiology of adolescent drug use focuses on typical stages of the drug use career and assesses the diversity of experience that my characterize special subgroups of youth. As shown by earlier longitudinal studies (), drug use during the adolescent years is a dynamic, multistage phenomenon which my best be understood by a conceptualization of progressive stages of involvement. The most recent data on dominant patterns of drug use in the 12 to 21 age group are provided by two series of nationwide surveys: the national survey of high school seniors () and the national survey of household population aged 12 and older (). Both of these surveys are cross-sectional, but because many of the data consist of retrospective drug use histories, nationwide patterns of use in 1979 can be described in terms of sequential stages of drug experience. As Kandel has noted, the study of stages of adolescent drug use does not imply “that the use of a drug causes the progression to the next level. Nor can we assume that once started adolescents will progress through the entire sequence” (). Rather, during the adolescent years, each stage of the drug use career represents a risk factor with regard to more serious stages Read more […]

Harvesting and Preparing Marijuana and Hashish

Scientific Foundations To obtain maximum potency, the timing of the harvest is critical. Sometime after the seed has become fully mature, the plant will begin to senesce and die. Cetrahydrocannabinol production begins to decrease and cetrahydrocannabinol begins to degrade into cannabinol (this happens in the living plant as well as after harvest). Unfortunately, a reliable, scientifically-proven method of determining exactly when to harvest in order to maximize cetrahydrocannabinol and minimize cannabidiol has yet to be developed. One approach is to harvest the plants continually by pinching off or pruning the flowering tops. Another is to cut them back severely to within a foot or so of the ground, leaving some leafy branches, which are removed several weeks later when the new branches have sprouted. Outdoor growers who have to deal with climatic fluctuations tend to harvest their whole crop as soon as it’s mature, but in areas where the climate remains mild, large outdoor crops can also be harvested continually for as long as six months. Farmers in Asia sometimes bend the stem of the plant near the base or cut it and insert a small stone or a piece of opium a few days before harvest. They believe that this Read more […]

Marijuana: Harvesting and Hashmaking in India

The terms charas, ganja and bhang are roughly equivalent to hashish, flowering tops and leaves, respectively. As will be seen, the preparation methods vary considerably. The manufacture of round ganja is not completed till the fourth day after the plants are cut. The plants are gathered somewhat later in the day and laid out under the open sky for the night. The sorting is done the next morning, a great deal more of the woody portion being rejected than in the case of flat ganja. The twigs are laid out in the sun till noon, when the men return to the “chator” and rolling is begun. A horizontal bar is lashed on to uprights about four feet from the ground, and mats are placed on the ground on each side of it. Bundles of twigs, either tied together by the stem ends or not, according to the skill of the treader, are set out on the mats. The men range themselves on each side of the bar, and, holding on to it for support, proceed to roll the bundles with their feet. One foot is used to hold the bundle and the other to roll it, working down from the stems to the flower heads. This process goes on for about ten minutes, and during it the bundles are taken up and shaken from time to time to get rid of leaf. The bundles are Read more […]

Cannabis Psychosis

Cannabis smoking, especially of preparations with a high concentration of THC, can cause a toxic and short-lived (between a few days and six weeks) psychosis. Not infrequently, this psychosis has dramatic symptoms and requires hospitalisation, sometimes under constraint. If the individual concerned stops smoking, the condition has a good prognosis. If he or she continues to use cannabis, however, the psychotic condition can probably remain for a very long time. Different assessments and calculations to determine the frequency of this side-effect have yielded surprisingly similar results. As a “rule of thumb” it is considered that, on average, a person who smokes cannabis runs a 10 per cent risk of being affected at one time or another by cannabis psychosis or delirium. Toxic cannabis-caused short-lived psychosis can sometimes be difficult to distinguish from the toxic cannabis-caused delirium described above; moreover, in the initial stage, the two conditions sometimes merge into each other. The essential difference between the delirium and the psychosis is the clouding of consciousness that accompanies the del irium; in the psychotic condition, the individual’s consciousness is by and large clear. Since Read more […]

Cannabis-Caused Delirium (Acute Confusional State)

Cannabis smoking can cause an acute and short-lasting (between a few hours and a few days) state of profound delirium. The individuals affected experience complete or partial loss of their orientational ability, their memory and their sense of their own identity. An element of delirium is a common occurrence in cannabis psychosis. This condition is probably more likely to arise if high doses of THC are involved or if the individual is in a weakened condition, for example owing to lack of sleep or to withdrawal symptoms relating to alcohol or other drugs. Certain experts have calculated that delirium or cannabis psychosis occurs at one time or another in 10 per cent of all cannabis abusers. There is widespread agreement that the use of cannabis, especially in high doses, can cause delirium (), which is also known as acute brain syndrome or delirium. This is a short-lived condition, lasting from a few hours up to a few days. One characteristic of this condition is unclear consciousness: the persons affected have difficulty with spatial and temporal orientation, are unable to perceive correctly the situation in which they find themselves, and may fail to recognise close acquaintances. Not infrequently, this condition Read more […]

Cannabis and Psychose

A great many studies show that the group of cannabis smokers exhibits an increased prevalence both of psychotic symptoms and of short-lived psychotic illness in the strict sense. Cannabis smoking can cause psychosis, activate latent psychosis and exacerbate manifest psychotic conditions. This post discusses the following relationships between cannabis smoking and (near-) psychotic conditions: – Cannabis-caused delirium (acute confusional state) – Cannabis-caused toxic psychosis (cannabis psychosis) – Cannabis-caused functional – non-schizophrenic – psychosis – Can cannabis smoking cause schizophrenia? – Interaction between the effects of cannabis and manifest schizophrenia The interaction of cannabis with psychotic conditions is doubtless one of the most alarming aspects of what is gathered under the heading “harmful effects of cannabis”. I will here report on the prevailing scientific view of this interaction. Occasionally, I will also take my own clinical experience into account. The principal point to be made, though, is that several studies have found not only a statistical association but also a causal link between cannabis smoking and psychoses or psychotic symptoms. At Read more […]

Survey of Methamphetamine Cases Evaluated in a Court Clinic

Although assessment and treatment options in the county from which the below cases were reviewed are better than many, they are generally available only to defendants for whom a mandatory prison sentence is not involved. The general inclination of judges at this court is to refer whenever they perceive questions about treatment-related issues. It is the impression of the court psychologist that defendants referred for a pre-sentence psychological evaluation often are seen as having greater potential for treatment than incarceration. The focus for psychological evaluations as the psychologist reported it is to develop information relevant to the mitigation and sentencing issues and to the risk of violation of probation where a treatment package is recommended. In his opinion, further evaluation of the substance-related and other treatment aspects of referred defendants should be a component of any ongoing treatment facility. The major sources of referral are the judges on their own initiatives, motions by defense counsel, or the request of the probation department where initial psychosocial history leads to a question of psychological status. The majority of referred persons with substance-related issues attend Read more […]

Health Consequences of Marijuana Use

Marijuana smoking remains the most prevalent form of illicit drug use in the United States, Canada, Australia, New Zealand, and some European countries, and rates of heavy marijuana smoking are high in other countries where accurate epidemiological data are not available (Substance Abuse and Mental Health Services Administration [SAMHSA]). In the United States, conservative estimates indicate that more than 11 million people smoked marijuana during the last month, and approximately 20 percent of these smoke almost daily. The types of problems associated with regular marijuana use have been well documented. Heavy use has been linked to impairment in memory, concentration, motivation, health, interpersonal relationships, and employment, as well as decreased participation in conventional roles of adulthood, history of psychiatric symptoms and hospitalizations, and participation in deviant activities. Given the large cohort of frequent marijuana users, it is vital that we have available clear, scientific information concerning the risks and consequences of acute and chronic use of marijuana and other forms of cannabis. Cannabis is the generic name for the psychoactive substance(s) derived from the plant Cannabis saliva. Read more […]

Consequences of Marijuana Use: Respiratory System

Perhaps the most significant health effects of cannabis are those that impact the respiratory system. Smoking is the primary method for use of cannabis, and almost all chronic users smoke either marijuana cigarettes (“joints”) or use pipes to smoke marijuana or hashish. Chronic cannabis smoking has potential for significant respiratory health consequences comparable to tobacco cigarette smoking. The smokes of marijuana and tobacco have similar levels of tar and respiratory toxic chemicals. Marijuana smoke contains up to 50 percent more carcinogens and results in substantially greater tar deposits in the lungs than filtered tobacco cigarettes. Such increased effects likely occur because marijuana users smoke unfiltered material, inhale the smoke more deeply, and hold the smoke longer in their lungs than tobacco smokers. However, marijuana smokers tend to smoke significantly less material per day than tobacco smokers, which serves to counter its impact on the lungs. Acute Effects The most significant acute effect of smoking marijuana is its action as a bronchodilator, which increases vulnerability to the smoke by decreasing airway resistance and increasing specific airway conductance. Marijuana-induced bronchodilation Read more […]

Cannabis-Related Disorders

The main psychoactive constituent in marijuana is delta-9-tetrahydrocannabinol (Δ9-THC), one of 60 cannab-inoids. Marijuana sold on the street contains 5%-17% Δ9-THC (Drug Enforcement Administration 2001). Hashish is a resin from the cannabis plant that contains a higher percentage of Δ9-THC than does marijuana. Δ9-THC binds to cannabinoid receptors, located primarily in hippocampal and striatal regions. An endogenous ligand for these receptors, anandamide, has been identified. Results of several studies suggested that there is a genetic vulnerability to cannabis use and dependence. Medical use of marijuana is still a hotly debated scientific and political issue. Laboratory Findings Cannabinoids can be detected in the urine of chronic abusers 21 days or more after cessation of chronic, heavy use, because of slow release from fat stores. In most occasional users, urine drug screen results remain positive for 1-5 days. Intoxication Peak intoxication after smoking cannabis generally occurs in 10-30 minutes. Intoxication usually lasts 2-4 hours, depending on the dose; however, behavioral and psychomo-tor impairment may continue several hours longer. Δ9-THC and its metabolites, which are highly liquid soluble, tend Read more […]