Policy Implications of Multiple Drug Use

Public policies that deal with the use and abuse of alcohol and drugs are very fragmented, reflecting in many ways the history of various substances as well as the role played by the substances in this society. Alcohol is a good example. Because the impact of alcohol on traffic fatalities is so painfully obvious, public interest in the control of alcohol has increased in the recent past. There have been a number of initiatives at Federal, state, and local levels concerning enforcement of minimum age drinking and dram shop liability laws and a push in some areas for raising the driving age. However, very little public policy attention has been directed toward the other control strategies that might have a larger impact on alcohol consumption and its relationship to traffic accidents and fatalities (i.e., changes in laws that would eliminate tax deductions for advertising, restriction of advertising of various types of alcoholic beverages, or substantial increases in the tax placed on alcoholic beverages and thus on the price). After all, when the economics of alcohol is examined it is easy to see how thoroughly interwoven alcohol is in society. The value of alcohol in the advertising, trucking, and agricultural sectors Read more […]

Consequences of Multiple Drug Use: Specifying the Causes

In order to illustrate these points, three specific consequences of drug use will be discussed in some detail below. These three consequences are traffic accidents, involvement in delinquent/criminal acts by youth and young adults, and emergency room visits related to drug abuse. Traffic Accidents The Monitoring-the-Future surveys contain several questions concerning traffic accidents. The seniors are first asked how many accidents (i.e., a collision involving property damage or personal injury — not bumps or scratches in parking lots) they had while they were driving in the past 12 months. If the answer is one or more, the senior is asked how many occurred after he/she was drinking alcoholic beverages and then how many occurred after he/she was smoking marijuana or hashish. By piecing together the information from these separate questions, it is possible to estimate the proportion that would be due to alcohol, to marijuana, and to alcohol and marijuana. The data in Table “Motor Vehicle Accidents and Their Connection to Use of Alcohol, Use of Marijuana, and Use of Both Alcohol and Marijuana” are for seniors in the class of 1980 classified according to the extent of alcohol and marijuana use reported during the Read more […]

The Epidemiology of Multiple Drug Use

How much multiple drug use is there? What proportion of the population at any one point in time is using/abusing multiple substances? Has use of multiple substances become more normative in the recent past as opposed to exclusive use of a favorite drug? What are the principal consequences of multiple drug use? Do these consequences differ according to pharmacological parameters for interactive potential or are there other parameters of almost equal predictive value? To what extent are the consequences attributed to single drugs (traffic accidents labeled as alcohol related) really the result of impaired judgment and performance from ingestion of multiple substances? These are just a few of the questions that need to be addressed within the scientific and public policy communities. In the following section some epidemiological data pertinent to understanding the “extent” of multiple drug use are presented. Monitoring-the-Future Studies Each year since 1975, researchers at the Institute for Social Research at the University of Michigan have administered questionnaires to about 17,000 high school seniors attending schools randomly chosen to be representative of all high schools in the continental United States. These Read more […]

Measuring the Developmental Nature of Multiple Drug Use

There have been a number of studies in which attempts have been made to measure or assess multiple drug use. Some of these are from general populations while others are focused on specific subpopulations of users. The studies are grouped more on the basis of the approach taken to assessing multiple drug use than on the patterns uncovered. There are at least four different groupings of studies and some studies fit into more than one grouping. Developmental Patterns of Onset of Use One of the most influential attempts to describe patterns of multiple drug use is the “stages of drug use” model developed by Kandel. Kandel posited that persons proceed from licit to illicit drugs and from use of less to more serious drugs. The stages of drug use involvement that she identified were: (1) no use of any drugs; (2) use of beer or wine; (3) use of cigarettes and/or hard liquor; (4) use of marijuana; and (5) use of illicit drugs other than marijuana. Although it is not made explicit by Kandel, there is an implication that the drugs from the earlier stages of development are “carried forward” into the later stages of drug involvement. Thus, a marijuana user is likely to continue his or her use of cigarettes/hard liquor and beer Read more […]

Marijuana, Affect and Tolerance: A Study of Subchronic Self-Administration in Women

The study of differential tolerance development has important implications for evaluation of the abuse potential of a particular drug. Tolerance to the disruptive behavioral and physiological effects of marijuana could make it possible for experienced users to function at their “normal” level of efficiency, even after heavy, daily consumption. On the other hand, tolerance to the positive psychological effects that users variously describe as euphoric, pleasurable and consciousness-expanding, would diminish the reinforcing value of the drug at a given dose, and thereby increase the necessity of more intense or more frequent consumption to achieve previous levels of intoxication. In the light of evidence that chronic marijuana consumption may be related to impaired respiratory function and other health consequences, tolerance to these effects might prove detrimental to the user (Institute of Medicine). To demonstrate that tolerance to THC leads to increased consumption, it would be necessary to establish that: 1) reliable changes are produced by acute doses of marijuana to psychological states, behavioral performance, or physiological function; 2) these effects diminish over a period of time when marijuana is administered Read more […]

Adolescent Drug Abuse: Discussion and Recommendations

The problem of adolescent drug abuse has received a great deal of attention during the past decade. Beginning in the late 1960s the prevalence of drug use has increased dramatically. This steady upward trend which lasted until the late 1970s has been called “The Drug Epidemic” by the popular press. This epidemic has spread largely among adolescents (12 to 17 years) although young adults (18 to 25 years) were also affected. Despite a decline in adolescent drug use since the late 1970s, drug abuse among youth remains a problem. For example, the 1982 National Institute on Drug Abuse (NIDA) National High School Survey, conducted by the University of Michigan, revealed that 6% of high school seniors reported daily use of marijuana in 1982, which is down from 11% in 1978 (). In an effort to counteract this epidemic, during the 1970s drug abuse prevention needs were identified, and a variety of prevention programs were initiated. Many of these programs were funded at the State level. The early programs included four types of strategies: information, education, alternatives, and early intervention. Values clarification and decision making were popular program components. These two components were generally utilized in generic Read more […]

Alternatives to Drug Abuse: Some Are and Some Are Not

The purpose of this paper is to discuss the current state of the art of alternatives to substance abuse as one of several approaches to prevention. This paper defines four different approaches to prevention that have been proposed and reviews the literature related to each approach. Two recent studies of alternative programs and activities will be presented and the paper will conclude with recommendations for further research. The concept of alternatives to substance abuse was one of the first responses to the problem (). The early advocates of this strategy recommended substituting positive experiences for the experiences reported to be associated with substance abuse. Some early workers in the field were aware that not all alternatives would automatically provide an acceptable substitute for some of the pleasures sought and perceived by drug-using and-abusing individuals. For example, Swisher and Horman () discovered, upon completion of a program for college student leaders, that one individual had been very impressed by the emphasis on alternatives; and even though he was only an experimenter with some drugs, he decided to pursue a viable alternative–skydiving, which may have been a greater health risk. Four Read more […]

Endocrine Effects of Marijuana in the Male: Preclinical Studies

The research efforts of many investigators in the recent past have made it abundantly clear that exposure to marijuana has significant effects upon the reproductive system and the effects of cannabinoid treatment are equally significant on both male and female reproductive systems. Among the effects of cannabinoid treatment on the male reproductive system that have been reported arc altered testicular function, in the form of depressed male hormone secretion, and changes in both the quantity and quality of the sperm produced by the seminiferous tubules. There have been changes reported in the weight and in certain of the enzymes associated with the reproductive organs. Much research effort focused on the ability of THC to depress the secretion of the gonadotropins from the pituitary that are responsible for stimulating testosterone production by the Leydig cells of the testis and the action on the hypothalamus to depress gonadotropic releasing hormone (GnRH). Maintenance and regulation of normal reproductive capacity in the male is a complex and highly integrated phenomenon. It requires proper nutritional and hormonal support, not only by the hormones directly involved in reproduction, hut also by the synergistic Read more […]

The effect of marijuana on gonadotropin releasing hormone

The hypothalamus contains neurosecretory neurons which are responsible for the synthesis and secretion of factors that regulate the release of the hormones elaborated by the anterior lobe of the pituitary gland. A single hypothalamic factor seems to be responsible for the release of both LH and FSH and this factor is gonadotropin releasing hormone. The secretion of GnRH is affected by a variety of factors including neural, chemical, sensory, hormonal, and various drug treatments of the animal. Normally, release of GnRH is regulated by the neural transmitters of the hypothalamus. Thus, factors which alter dopamine and norepinephrine concentrations also alter GnRH release. As a general rule, things which enhance the release of adrenergic or dopaminergic substances in the hypothalamus should stimulate the release of GnRH, and those substances, such as drugs, which antagonize adrenergic and dopaminergic release should inhibit the release of GnRH. Several studies have indicated that the pharmacological effect of THC on gonadotropin levels involves the alteration of gonadotropin releasing hormone. Smith et al. () using the overiectomized monkey, showed that administration of GnRH to monkeys that had received THC 6 hours Read more […]

Effect of marijuana on the testis and accessory reproductive organs

Roth crude marijuana extract (CME) and THC produced a decrease in the weight of the reproductive organs of rats when given over a prolonged period of time and over several dosage ranges. The greatest effects were reported for high dosages (15 and 75 mg/kg orally daily for 77 days). Fujimoto et al. () showed significant reduction in ventral prostate, seminal vesicles, and epididymal weight, which was correlated with a decrease in plasma testosterone levels and was accompanied by a reduced number of sperm in the fluids of the epididymus. Treatment of the rats for only 5 days produced none of these changes. The effects of the cannabinoids appeared to be reversible, because there was a return to control levels of organ weights 30 days after cessation of drug treatment. Similarly, Dixit and Lohiya () report that cannabis extract produced a marked reduction in the weights of seminal vesicles, ventral prostate, epididymus, and preputial glands of castrated adult male mice. Further, if cannabis extract was administered in combination with testosterone propionate, the growth stimulation produced by testosterone propionate alone was inhibited, indicating that cannabis extract may be antiandrogenic. However, there was no indication Read more […]