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Ask a neurologist about marijuana and Neurology
New dosage limits for medical marijuana: but where's the science?
CMAJ. 2007 Sep 11;177(6):556-7
Authors: Comeau P
PMID: ( marijuana and neurology ) 17846434 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Predictors of marijuana use in adolescents before and after licit drug use: examination of the gateway hypothesis.
Am J Psychiatry. 2006 Dec;163(12):2134-40
Authors: Tarter RE, Vanyukov M, Kirisci L, Reynolds M, Clark DB
OBJECTIVE: The authors investigated whether the transition from licit drug use to marijuana use is determined by particular risk factors, as specified by the gateway hypothesis. They also evaluated the accuracy of the "gateway sequence" (illicit drug use following licit drugs) for predicting a diagnosis of substance use disorder. METHOD: Boys who consumed licit drugs only (N=99), boys who consumed licit drugs and then transitioned to marijuana use (gateway sequence) (N=97), and boys who used marijuana before using licit substances (alternative sequence) (N=28) were prospectively studied from ages 10-12 years through 22 years to determine whether specific factors were associated with each drug use pattern. The groups were compared on 35 variables measuring psychological, family, peer, school, and neighborhood characteristics. In addition, the utility of the gateway and alternative sequences in predicting substance use disorder was compared to assess their clinical informativeness. RESULTS: Twenty-eight (22.4%) of the participants who used marijuana did not exhibit the gateway sequence, thereby demonstrating that this pattern is not invariant in drug-using youths. Among youths who did exhibit the gateway pattern, only delinquency was more strongly related to marijuana use than licit drug use. Specific risk factors associated with transition from licit to illicit drugs were not revealed. The alternative sequence had the same accuracy for predicting substance use disorder as the gateway sequence. CONCLUSIONS: Proneness to deviancy and drug availability in the neighborhood promote marijuana use. These findings support the common liability model of substance use behavior and substance use disorder.
PMID: ( marijuana and neurology ) 17151165 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Cut to marijuana research sends strong message.
CMAJ. 2006 Dec 5;175(12):1507-8
PMID: ( marijuana and neurology ) 17146080 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
The association between marijuana smoking and lung cancer: a systematic review.
Arch Intern Med. 2006 Jul 10;166(13):1359-67
Authors: Mehra R, Moore BA, Crothers K, Tetrault J, Fiellin DA
BACKGROUND: The association between marijuana smoking and lung cancer is unclear, and a systematic appraisal of this relationship has yet to be performed. Our objective was to assess the impact of marijuana smoking on the development of premalignant lung changes and lung cancer. METHODS: Studies assessing the impact of marijuana smoking on lung premalignant findings and lung cancer were selected from MEDLINE, PSYCHLIT, and EMBASE databases according to the following predefined criteria: English-language studies of persons 18 years or older identified from 1966 to the second week of October 2005 were included if they were research studies (ie, not letters, reviews, editorials, or limited case studies), involved persons who smoked marijuana, and examined premalignant or cancerous changes in the lung. RESULTS: Nineteen studies met selection criteria. Studies that examined lung cancer risk factors or premalignant changes in the lung found an association of marijuana smoking with increased tar exposure, alveolar macrophage tumoricidal dysfunction, increased oxidative stress, and bronchial mucosal histopathologic abnormalities compared with tobacco smokers or nonsmoking controls. Observational studies of subjects with marijuana exposure failed to demonstrate significant associations between marijuana smoking and lung cancer after adjusting for tobacco use. The primary methodologic deficiencies noted include selection bias, small sample size, limited generalizability, overall young participant age precluding sufficient lag time for lung cancer outcome identification, and lack of adjustment for tobacco smoking. CONCLUSION: Given the prevalence of marijuana smoking and studies predominantly supporting biological plausibility of an association of marijuana smoking with lung cancer on the basis of molecular, cellular, and histopathologic findings, physicians should advise patients regarding potential adverse health outcomes until further rigorous studies are performed that permit definitive conclusions.
PMID: ( marijuana and neurology ) 16832000 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Marijuana use by tobacco smokers and nonsmokers: who is smoking what?
CMAJ. 2006 May 9;174(10):1399
Authors: Leatherdale ST, Ahmed R, Kaiserman M
PMID: ( marijuana and neurology ) 16682703 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Challenges of marijuana research.
Brain. 2006 May;129(Pt 5):1081-3
Authors: Ponto LL
PMID: ( marijuana and neurology ) 16627464 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Marijuana use is associated with a reorganized visual-attention network and cerebellar hypoactivation.
Brain. 2006 May;129(Pt 5):1096-112
Authors: Chang L, Yakupov R, Cloak C, Ernst T
Attention and memory deficits have been reported in heavy marijuana users, but these effects may be reversible after prolonged abstinence. It remains unclear whether the reversibility of these cognitive deficits indicates that chronic marijuana use does not alter cortical networks, or that such changes occur but the brain adapts to the drug-induced changes. Blood oxygenation-level dependent (BOLD) functional MRI (fMRI) was performed in 24 chronic marijuana users (12 abstinent and 12 active) and 19 age-, sex- and education-matched control subjects during a set of visual-attention tasks with graded levels of difficulty. Neuropsychological tests were also administered on each subject. The two marijuana user groups showed no significant difference in usage pattern (frequency or duration of use, age of first use, cumulative joints used, averaged >2000 joints) or estimated cumulative lifetime exposure of Delta-9-tetrahydrocannabinol (THC) (mean 168 +/- 45 versus 244 +/- 135 g). Despite similar task and cognitive test performance compared with control subjects, active and abstinent marijuana users showed decreased activation in the right prefrontal, medial and dorsal parietal, and medial cerebellar regions, but greater activation in various frontal, parietal and occipital brain regions during the visual-attention tasks (all with P < or = 0.001, corrected, cluster level). However, the BOLD signals in the right frontal and medial cerebellar regions normalized with duration of abstinence in the abstinent users. Active marijuana users, with positive urine tests for THC, showed greater activation in the frontal and medial cerebellar regions than abstinent marijuana users and greater usage of the reserve network (regions with load effect), suggesting a neuroadaptive state. Both earlier age of first use and greater estimated cumulative dose of THC exposure were related to lower BOLD signals in the right prefrontal region and medial cerebellum. The altered BOLD activation pattern in the attention network and hypoactivation of the cerebellum suggest neuroadaptive processes or alteration of brain development in chronic marijuana users. These changes also may be related to marijuana-induced alteration in resting cerebral blood volume/flow or downregulation of cannabinoid (CB1) receptors. The greater activation in the active compared with abstinent marijuana users demonstrates a neuroadaptive state in the setting of active marijuana use, while the long-term chronic effect of marijuana on the altered brain network may be reversible with prolonged abstinence.
PMID: ( marijuana and neurology ) 16585053 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Response to the American Academy of Pediatrics report on legalization of marijuana.
Pediatrics. 2005 Nov;116(5):1256-7; author reply 1257
Authors: Warf C
PMID: ( marijuana and neurology ) 16264017 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
New medicinal marijuana rules ease onus on physicians.
CMAJ. 2005 Aug 30;173(5):473
Authors: Sibbald B
PMID: ( marijuana and neurology ) 16129861 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
US Supreme Court says no to medical marijuana.
BMJ. 2005 Jun 18;330(7505):1408
Authors: Hopkins Tanne J
PMID: ( marijuana and neurology ) 15961803 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
The epidemiology of alcohol, marijuana, and cocaine use among Mexican American, Puerto Rican, Cuban American, and other Latin American eighth-grade students in the United States: 1991-2002.
Am J Public Health. 2005 Apr;95(4):696-702
Authors: Delva J, Wallace JM, O'Malley PM, Bachman JG, Johnston LD, Schulenberg JE
OBJECTIVES: We compared trends in and correlates of marijuana use, cocaine use, and heavy alcohol use for adolescents of Mexican American, Puerto Rican, Cuban, and other Latin American heritage in the United States. METHODS: We used/examined data from nationally representative samples of eighth-grade Hispanic students who participated in the Monitoring the Future study during the years 1991-2002 (n=24235). RESULTS: Drug use was significantly higher among boys and adolescents of almost all Hispanic ethnicities who did not live with both parents. In addition, drug use differed considerably according to ethnic group on language first spoken, parental education, urbanicity, and region. CONCLUSIONS: A better understanding of the homogeneity and heterogeneity of drug use patterns within and between Hispanic groups should assist in the development of prevention programs.
PMID: ( marijuana and neurology ) 15798132 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Risk factors predicting changes in marijuana involvement in teenagers.
Arch Gen Psychiatry. 2005 Mar;62(3):311-9
Authors: van den Bree MB, Pickworth WB
BACKGROUND: Marijuana use during adolescence has various adverse psychological and health outcomes. It is poorly understood whether the same risk factors influence different stages in the development of marijuana involvement. OBJECTIVE: To establish which risk factors best explain different stages of marijuana involvement. DESIGN: Data were collected at 2 points using computer-assisted personal interview (wave 1 and wave 2 were separated by 1 year). Twenty-one well-established risk factors of adolescent substance use/abuse were used to predict 5 stages of marijuana involvement: (1) initiation of experimental use, (2) initiation of regular use, (3) progression to regular use, (4) failure to discontinue experimental use, and (5) failure to discontinue regular use. Data were analyzed using logistic regression analysis. PARTICIPANTS: Middle school and high school students (N = 13 718, aged 11-21 years) participating in the National Longitudinal Study of Adolescent Health (Add Health). RESULTS: Three risk factors (own and peer involvement with substances, delinquency, and school problems) were the strongest predictors of all stages. Their combined presence greatly increased risk of initiation of experimental (odds ratio, 20) and regular (odds ratio, 87) marijuana use over the next year. Personality, family, religious, and pastime factors exerted stage-specific, sex-specific, and age-specific influences. CONCLUSIONS: Assessment of substance, school, and delinquency factors is important in identifying individuals at high risk for continued involvement with marijuana. Prevention and/or intervention efforts should focus on these areas of risk.
PMID: ( marijuana and neurology ) 15753244 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Legalization of marijuana: potential impact on youth.
Pediatrics. 2004 Jun;113(6):e632-8
Authors: Joffe A, Yancy WS, ,
This technical report provides historical perspectives and comparisons of various approaches to the legal status of marijuana to aid in forming public policy. Information on the impact that decriminalization and legalization of marijuana could have on adolescents, in addition to concerns surrounding medicinal use of marijuana, are also addressed in this report. Recommendations are included in the accompanying policy statement.
PMID: ( marijuana and neurology ) 15173547 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Pediatrics. 2004 Jun;113(6):1825-6
Authors: Joffe A, ,
As experts in the health care of children and adolescents, pediatricians may be called on to advise legislators concerning the potential impact of changes in the legal status of marijuana on adolescents. Parents, too, may look to pediatricians for advice as they consider whether to support state-level initiatives that propose to legalize the use of marijuana for medical purposes or to decriminalize possession of small amounts of marijuana. This policy statement provides the position of the American Academy of Pediatrics on the issue of marijuana legalization, and the accompanying technical report (available online) reviews what is currently known about the relationship between adolescents' use of marijuana and its legal status to better understand how change might influence the degree of marijuana use by adolescents in the future.
PMID: ( marijuana and neurology ) 15173518 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Prevalence of marijuana use disorders in the United States: 1991-1992 and 2001-2002.
JAMA. 2004 May 5;291(17):2114-21
Authors: Compton WM, Grant BF, Colliver JD, Glantz MD, Stinson FS
CONTEXT: Among illicit substance use disorders, marijuana use disorders are the most prevalent in the population. Yet, information about the prevalence of current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) marijuana use disorders and how prevalence has changed is lacking. OBJECTIVE: To examine changes in the prevalence of marijuana use, abuse, and dependence in the United States between 1991-1992 and 2001-2002. DESIGN, SETTING, AND PARTICIPANTS: Face-to-face interviews were conducted in 2 large national surveys conducted 10 years apart: the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey ([NLAES] n = 42,862) and the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions ([NESARC] n = 43,093). MAIN OUTCOME MEASURES: Rates of past year marijuana use, abuse, and dependence. RESULTS: Among the adult US population, the prevalence of marijuana use remained stable at about 4.0% over the past decade. In contrast, the prevalence of DSM-IV marijuana abuse or dependence significantly (P =.01) increased between 1991-1992 (1.2%) and 2001-2002 (1.5%), with the greatest increases observed among young black men and women (P<.001) and young Hispanic men (P =.006). Further, marijuana use disorders among marijuana users significantly increased (P =.002) in the absence of increased frequency and quantity of marijuana use, suggesting that the concomitant increase in potency of delta-9-tetrahydrocannabinol (Delta9-THC) may have contributed to the rising rates. CONCLUSIONS: Despite the stability in the overall prevalence of marijuana use, more adults in the United States had a marijuana use disorder in 2001-2002 than in 1991-1992. Increases in the prevalence of marijuana use disorders were most notable among young black men and women and young Hispanic men. Although rates of marijuana abuse and dependence did not increase among young white men and women, their rates have remained high. The results of this study underscore the need to develop and implement new prevention and intervention programs targeted at youth, particularly minority youth.
PMID: ( marijuana and neurology ) 15126440 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Cerebellar infarction in adolescent males associated with acute marijuana use.
Pediatrics. 2004 Apr;113(4):e365-70
Authors: Geller T, Loftis L, Brink DS
OBJECTIVE: To demonstrate the clinical characteristics, radiologic findings, and neuropathological features of tetrahydrocannabinol-related posterior fossa ischemic stroke in adolescent patients. DESIGN: A retrospective case and chart review of 3 cases encountered at a tertiary care institution over a span of 5 years. SETTING: Inpatient and intensive care hospitalization units managing children and adolescents. SUBJECTS: Male adolescent patients with ischemic cerebellar stroke after use of marijuana. DIAGNOSTIC INVESTIGATIONS: Computed tomography brain scans (3 subjects), magnetic resonance imaging brain study (1 subject), cerebral arteriography (1 subject), cerebellar biopsy (1 subject), and necropsy (2 subjects). RESULTS: Three adolescent males had similar presentations of headache, fluctuating level of consciousness or lethargy, visual disturbance, and variable ataxia after self-administration of marijuana. They developed primary cerebellar infarctions within days after the exposure that could not be attributed to supratentorial herniation syndromes and only minimally involved brainstem structures. CONCLUSIONS: Episodic marijuana use may represent a risk factor for stroke in childhood, particularly in the posterior circulation. Early recognition of the cerebellar stroke syndrome may allow prompt neurosurgical intervention, reducing morbidity.
PMID: ( marijuana and neurology ) 15060269 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Sustained increased consumption of cigarettes, alcohol, and marijuana among Manhattan residents after september 11, 2001.
Am J Public Health. 2004 Feb;94(2):253-4
Authors: Vlahov D, Galea S, Ahern J, Resnick H, Kilpatrick D
We compared reports of increased substance use in Manhattan 1 and 6 months after the September 11, 2001, terrorist attacks. Data from 2 random-digit-dial surveys conducted 1 and 6 months after September 11 showed that 30.8% and 27.3% of respondents, respectively, reported increased use of cigarettes, alcohol, or marijuana. These sustained increases in substance use following the September 11 terrorist attacks suggest potential long-term health consequences as a result of disasters.
PMID: ( marijuana and neurology ) 14759935 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Pharmacies, not MDs, should distribute medicinal marijuana: chair.
CMAJ. 2003 Oct 14;169(8):823
PMID: ( marijuana and neurology ) 14557332 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Summaries for patients. Does marijuana affect viral loads in people with HIV?
Ann Intern Med. 2003 Aug 19;139(4):I44
Authors:
PMID: ( marijuana and neurology ) 12965999 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Canadian doctors question marijuana for medicinal use.
BMJ. 2003 Jul 19;327(7407):122
Authors: Spurgeon D
PMID: ( marijuana and neurology ) 12869437 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Canadian government is attacked for plan to legalise marijuana.
BMJ. 2003 Jun 7;326(7401):1232
PMID: ( marijuana and neurology ) 12791726 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Shared genetic risk of major depression, alcohol dependence, and marijuana dependence: contribution of antisocial personality disorder in men.
Arch Gen Psychiatry. 2002 Dec;59(12):1125-32
Authors: Fu Q, Heath AC, Bucholz KK, Nelson E, Goldberg J, Lyons MJ, True WR, Jacob T, Tsuang MT, Eisen SA
BACKGROUND: Little is known about genetic factors that underlie the interrelationships among antisocial personality disorder (ASPD), major depression (MD), alcohol dependence (AD), and marijuana dependence (MJD). We examined the contribution of genetic effects associated with ASPD to the comorbidity of MD and substance use disorders. METHODS: The Vietnam Era Twin Registry is a general population registry of male veteran twins constructed from computerized Department of Defense files and other sources. A telephone diagnostic interview was administered to eligible twins from the Registry in 1992. Of 5150 twin pairs who served on active military duty during the Vietnam era, 3360 pairs (1868 monozygotic and 1492 dizygotic) in which both members completed the pertinent diagnostic interview sections were included. The main outcome measures were lifetime DSM-III-R ASPD, MD, AD, and MJD. RESULTS: Structural equation modeling was performed to estimate additive genetic, shared environmental, and nonshared environmental effects common and specific to each disorder. The heritability estimates for lifetime ASPD, MD, AD, and MJD were 69%, 40%, 56%, and 50%, respectively. Genetic effects on ASPD accounted for 38%, 50%, and 58% of the total genetic variance in risk for MD, AD, and MJD, respectively. After controlling for genetic effects on ASPD, the partial genetic correlations of MD with AD and with MJD were no longer statistically significant. Genetic effects specific to MD and AD and familial effects specific to MJD remained statistically significant. Nonshared environmental contributions to the comorbidity in these disorders were small. CONCLUSIONS: In this sample, the shared genetic risk between MD and both AD and MJD was largely explained by genetic effects on ASPD, which in turn was associated with increased risk of each of the other disorders.
PMID: ( marijuana and neurology ) 12470129 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
US government cannot revoke licences of doctors who recommend marijuana.
BMJ. 2002 Nov 9;325(7372):1058
Authors: Josefson D
PMID: ( marijuana and neurology ) 12428610 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Effects of marijuana on young adults.
CMAJ. 2002 Aug 6;167(3):233; author reply 234
Authors: Shrier I
PMID: ( marijuana and neurology ) 12186161 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Authors: Yong PJ
PMID: ( marijuana and neurology ) 12186160 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Authors: Mamen M
PMID: ( marijuana and neurology ) 12186159 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Current and former marijuana use: preliminary findings of a longitudinal study of effects on IQ in young adults.
CMAJ. 2002 Apr 2;166(7):887-91
Authors: Fried P, Watkinson B, James D, Gray R
BACKGROUND: Assessing marijuana's impact on intelligence quotient (IQ) has been hampered by a lack of evaluation of subjects before they begin to use this substance. Using data from a group of young people whom we have been following since birth, we examined IQ scores before, during and after cessation of regular marijuana use to determine any impact of the drug on this measure of cognitive function. METHODS: We determined marijuana use for seventy 17- to 20-year-olds through self-reporting and urinalysis. IQ difference scores were calculated by subtracting each person's IQ score at 9-12 years (before initiation of drug use) from his or her score at 17-20 years. We then compared the difference in IQ scores of current heavy users (at least 5 joints per week), current light users (less than 5 joints per week), former users (who had not smoked regularly for at least 3 months) and non-users (who never smoked more than once per week and no smoking in the past two weeks). RESULTS: Current marijuana use was significantly correlated (p < 0.05) in a dose-related fashion with a decline in IQ over the ages studied. The comparison of the IQ difference scores showed an average decrease of 4.1 points in current heavy users (p < 0.05) compared to gains in IQ points for light current users (5.8), former users (3.5) and non-users (2.6). INTERPRETATION: Current marijuana use had a negative effect on global IQ score only in subjects who smoked 5 or more joints per week. A negative effect was not observed among subjects who had previously been heavy users but were no longer using the substance. We conclude that marijuana does not have a long-term negative impact on global intelligence. Whether the absence of a residual marijuana effect would also be evident in more specific cognitive domains such as memory and attention remains to be ascertained.
PMID: ( marijuana and neurology ) 11949984 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Should physicians support the medical use of marijuana? No: evidence of its safety and efficacy is weak. Counterpoint.
West J Med. 2002 Mar;176(2):77
Authors: Voth EA
PMID: ( marijuana and neurology ) 11897722 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Should physicians support the medical use of marijuana? Yes: it can be effective when all else fails. Point.
West J Med. 2002 Mar;176(2):76
Authors: Eidelman WS
PMID: ( marijuana and neurology ) 11897721 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Marijuana: a decade and a half later, still a crude drug with underappreciated toxicity.
Pediatrics. 2002 Feb;109(2):284-9
Authors: Schwartz RH
In 1984, I published in this journal a review entitled "Marijuana: A Crude Drug With a Spectrum of Underappreciated Toxicity." In the introduction to that article, I disclosed that our son Keith, who was 15 years old at the time, was in a long-term, modified outpatient adolescent drug and alcohol rehabilitation program because he had become dependent on marijuana with its associated behavioral, interpersonal, scholastic, and antisocial problems. Keith and most of his friends had experimented several times with LSD, beer, and several other drugs but never used injection drugs. Marijuana was clearly Keith's drug of choice and the only drug he used with regularity. Approximately 1 year later, Keith graduated from the treatment program. He completed the early aftercare component, relapsed several times, and completed a 4-month refresher drug rehabilitation program in another state. Nine years after admission to the first rehabilitation program, Keith finally attained some adult goals. Now 34 years old, he has been drug-free for 10 years. He is the president and owner of a successful discount cellular phone business that he started. More important, a decade ago, he reestablished an excellent and close relationship with his parents. As far as I can tell, Keith remains drug-free except for an occasional beer.
PMID: ( marijuana and neurology ) 11826208 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
CMPA warns doctors of risks associated with prescribing marijuana.
CMAJ. 2002 Jan 8;166(1):83
Authors: Wharry S
PMID: ( marijuana and neurology ) 11800259 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Guidelines for prescribing medical marijuana.
West J Med. 2001 Nov;175(5):305-6
PMID: ( marijuana and neurology ) 11694470 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Marijuana abstinence effects in marijuana smokers maintained in their home environment.
Arch Gen Psychiatry. 2001 Oct;58(10):917-24
Authors: Budney AJ, Hughes JR, Moore BA, Novy PL
BACKGROUND: Although withdrawal symptoms are commonly reported by persons seeking treatment for marijuana dependence, the validity and clinical significance of a marijuana withdrawal syndrome has not been established. This controlled outpatient study examined the reliability and specificity of the abstinence effects that occur when daily marijuana users abruptly stop smoking marijuana. METHODS: Twelve daily marijuana smokers were assessed on 16 consecutive days during which they smoked marijuana as usual (days 1-5), abstained from smoking marijuana (days 6-8), returned to smoking marijuana (days 9-13), and again abstained from smoking marijuana (days 14-16). RESULTS: An overall measure of withdrawal discomfort increased significantly during the abstinence phases and returned to baseline when marijuana smoking resumed. Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other. Collateral observers confirmed participant reports of these symptoms. CONCLUSIONS: This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal.
PMID: ( marijuana and neurology ) 11576029 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Much ado about marijuana.
CMAJ. 2001 Sep 4;165(5):525
Authors: Howlett M
PMID: ( marijuana and neurology ) 11563199 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Authors: Carranza J
PMID: ( marijuana and neurology ) 11563198 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
CMAJ. 2001 Sep 4;165(5):523, 525
Authors: Jones C
PMID: ( marijuana and neurology ) 11563197 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
CMAJ. 2001 Sep 4;165(5):523
PMID: ( marijuana and neurology ) 11563196 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Authors: Hajela R
PMID: ( marijuana and neurology ) 11563195 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
A primer for patients' use of medicinal marijuana.
CMAJ. 2001 Aug 7;165(3):329
PMID: ( marijuana and neurology ) 11517655 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Medical marijuana: the continuing story.
Ann Intern Med. 2001 Jun 19;134(12):1159-62
Authors: Kane B
PMID: ( marijuana and neurology ) 11412075 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Triggering myocardial infarction by marijuana.
Circulation. 2001 Jun 12;103(23):2805-9
Authors: Mittleman MA, Lewis RA, Maclure M, Sherwood JB, Muller JE
BACKGROUND: Marijuana use in the age group prone to coronary artery disease is higher than it was in the past. Smoking marijuana is known to have hemodynamic consequences, including a dose-dependent increase in heart rate, supine hypertension, and postural hypotension; however, whether it can trigger the onset of myocardial infarction is unknown. METHODS AND RESULTS: In the Determinants of Myocardial Infarction Onset Study, we interviewed 3882 patients (1258 women) with acute myocardial infarction an average of 4 days after infarction onset. We used the case-crossover study design to compare the reported use of marijuana in the hour preceding symptoms of myocardial infarction onset to its expected frequency using self-matched control data. Of the 3882 patients, 124 (3.2%) reported smoking marijuana in the prior year, 37 within 24 hours and 9 within 1 hour of myocardial infarction symptoms. Compared with nonusers, marijuana users were more likely to be men (94% versus 67%, P<0.001), current cigarette smokers (68% versus 32%, P<0.001), and obese (43% versus 32%, P=0.008). They were less likely to have a history of angina (12% versus 25%, P<0.001) or hypertension (30% versus 44%, P=0.002). The risk of myocardial infarction onset was elevated 4.8 times over baseline (95% confidence interval, 2.4 to 9.5) in the 60 minutes after marijuana use. The elevated risk rapidly decreased thereafter. CONCLUSIONS: Smoking marijuana is a rare trigger of acute myocardial infarction. Understanding the mechanism through which marijuana causes infarction may provide insight into the triggering of myocardial infarction by this and other, more common stressors.
PMID: ( marijuana and neurology ) 11401936 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Marijuana: federal smoke clears, a little.
CMAJ. 2001 May 15;164(10):1397, 1399
PMID: ( marijuana and neurology ) 11387904 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Blockade of effects of smoked marijuana by the CB1-selective cannabinoid receptor antagonist SR141716.
Arch Gen Psychiatry. 2001 Apr;58(4):322-8
Authors: Huestis MA, Gorelick DA, Heishman SJ, Preston KL, Nelson RA, Moolchan ET, Frank RA
BACKGROUND: SR141716, a recently developed CB1 cannabinoid receptor antagonist, blocks acute effects of Delta-9-tetrahydrocannabinol (THC) and other CB1 cannabinoid agonists in vitro and in animals. These findings suggest that CB1 receptors mediate many of the effects of marijuana, but this has not been evaluated in humans. METHODS: Sixty-three healthy men with a history of marijuana use were randomly assigned to receive oral SR141716 or a placebo in an escalating dose (1, 3, 10, 30, and 90 mg) design. Each subject smoked an active (2.64% THC) or placebo marijuana cigarette 2 hours later. Psychological effects associated with marijuana intoxication and heart rate were measured before and after antagonist and marijuana administration. RESULTS: Single oral doses of SR141716 produced a significant dose-dependent blockade of marijuana-induced subjective intoxication and tachycardia. The 90-mg dose produced 38% to 43% reductions in visual analog scale ratings of "How high do you feel now?" "How stoned on marijuana are you now?" and "How strong is the drug effect you feel now?" and produced a 59% reduction in heart rate. SR141716 alone produced no significant physiological or psychological effects and did not affect peak THC plasma concentration or the area under the time x concentration curve. SR141716 was well tolerated by all subjects. CONCLUSIONS: SR141716 blocked acute psychological and physiological effects of smoked marijuana without altering THC pharmacokinetics. These findings confirm, for the first time in humans, the central role of CB1 receptors in mediating the effects of marijuana.
PMID: ( marijuana and neurology ) 11296091 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Canada acts on marijuana and tobacco.
BMJ. 2001 Apr 21;322(7292):948
PMID: ( marijuana and neurology ) 11312223 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
US considers medical role for marijuana.
BMJ. 2001 Apr 7;322(7290):817
PMID: ( marijuana and neurology ) 11290630 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Television campaigns and adolescent marijuana use: tests of sensation seeking targeting.
Am J Public Health. 2001 Feb;91(2):292-6
Authors: Palmgreen P, Donohew L, Lorch EP, Hoyle RH, Stephenson MT
OBJECTIVES: This study evaluated the effectiveness of targeted televised public service announcement campaigns in reducing marijuana use among high-sensation-seeking adolescents. METHODS: The study used a controlled interrupted time-series design in 2 matched communities. Two televised antimarijuana campaigns were conducted in 1 county and 1 campaign in the comparison community. Personal interviews were conducted with 100 randomly selected teenagers monthly in each county for 32 months. RESULTS: All 3 campaigns reversed upward developmental trends in 30-day marijuana use among high-sensation seekers (P < .002). As expected, low-sensation seekers had low use levels, and no campaign effects were evident. CONCLUSIONS: Televised campaigns with high reach and frequency that use public service announcements designed for and targeted at high-sensation-seeking adolescents can significantly reduce substance use in this high-risk population.
PMID: ( marijuana and neurology ) 11211642 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Variation in youthful risks of progression from alcohol and tobacco to marijuana and to hard drugs across generations.
Am J Public Health. 2001 Feb;91(2):225-32
Authors: Golub A, Johnson BD
OBJECTIVES: Much research has documented that youthful substance use typically follows a sequence starting with use of alcohol or tobacco or both and potentially proceeding to marijuana and then hard drug use. This study explicitly examined the probabilities of progression through each stage and their covariates. METHODS: A secondary analysis of data from the National Household Survey on Drug Abuse (1979-1997) was conducted with particular sensitivity to the nature of substance use progression, sampling procedures, and reliability of self-report data. RESULTS: Progression to marijuana and hard drug use was uncommon among persons born before World War II. The stages phenomenon essentially emerged with the baby boom and rose to a peak among persons born around 1960. Subsequently, progression risks at each stage declined. Progression risks were also higher among younger initiators of alcohol, tobacco, or marijuana use. CONCLUSIONS: The recent increase in youthful marijuana use has been offset by lower rates of progression to hard drug use among youths born in the 1970s. Dire predictions of future hard drug abuse by youths who came of age in the 1990s may be greatly overstated.
PMID: ( marijuana and neurology ) 11211630 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Ottawa seeks source of medical marijuana.
CMAJ. 2000 Jul 11;163(1):74
Authors: Sullivan P
PMID: ( marijuana and neurology ) 10920737 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Self-reported medical use of marijuana: a survey of the general population.
CMAJ. 2000 Jun 13;162(12):1685-6
Authors: Ogborne AC, Smart RG, Adlaf EM
PMID: ( marijuana and neurology ) 10870496 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Necrotizing pulmonary granulomata in a marijuana smoker.
Chest. 2000 May;117(5):1511-5
Authors: Cunnington D, Teichtahl H, Hunt JM, Dow C, Valentine R
We describe the case of a heavy marijuana and tobacco smoker who presented with progressive exertional dyspnea of 2 months' duration, and bilateral nodular lung infiltrates. Examination of the lung fields was normal, and lung function tests showed mild airflow obstruction with moderately reduced gas transfer. BAL returned green-black fluid consisting predominantly of macrophages laden with carbon pigment. Thoracoscopic lung biopsy showed miliary necrotizing granulomata with an alveolar exudate of carbon-laden macrophages within macroscopically blackened lung. The differential diagnosis of pulmonary granulomata in this patient is discussed.
PMID: ( marijuana and neurology ) 10807846 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
The dynamics of alcohol and marijuana initiation: patterns and predictors of first use in adolescence.
Am J Public Health. 2000 Mar;90(3):360-6
Authors: Kosterman R, Hawkins JD, Guo J, Catalano RF, Abbott RD
OBJECTIVES: This study, guided by the social development model, examined the dynamic patterns and predictors of alcohol and marijuana use onset. METHODS: Survival analysis and complementary log-log regression were used to model hazard rates and etiology of initiation with time-varying covariates. The sample was derived from a longitudinal study of 808 youth interviewed annually from 10 to 16 years of age and at 18 years of age. RESULTS: Alcohol initiation rose steeply up to the age of 13 years and then increased more gradually; most participants had initiated by 13 years of age. Marijuana initiation showed a different pattern, with more participants initiating after the age of 13 years. CONCLUSIONS: This study showed that: (1) the risk of initiation spans the entire course of adolescent development; (2) young people exposed to others who use substances are at higher risk for early initiation; (3) proactive parents can help delay initiation; and (4) clear family standards and proactive family management are important in delaying alcohol and marijuana use, regardless of how closely bonded a child is to his or her mother.
PMID: ( marijuana and neurology ) 10705852 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Marijuana: medical implications.
Am Fam Physician. 1999 Dec;60(9):2583-8, 2593
Authors: Hubbard JR, Franco SE, Onaivi ES
Over 50 percent of people will use marijuana sometime in their life. While intoxication lasts two to three hours, the active ingredient in marijuana, delta-9-tetrahydro-cannabinol, can accumulate in fatty tissues, including the brain and testes. Adverse effects from marijuana use include decreased coordination, epithelial damage to the lungs, increased risk of infection, cardiovascular effects and cognitive deficits. Unexplained behavior changes, altered social relationships and poor performance at school or work can signify a drug problem. Treatment requires a combination of education, social support, drug monitoring and attention to comorbid medical and psychiatric conditions.
PMID: ( marijuana and neurology ) 10605993 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
A step ahead of the law, "Compassion Club" sells marijuana to patients referred by MDs.
CMAJ. 1999 Oct 19;161(8):1024
Authors: Kent H
PMID: ( marijuana and neurology ) 10551203 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
The risks for late adolescence of early adolescent marijuana use.
Am J Public Health. 1999 Oct;89(10):1549-54
Authors: Brook JS, Balka EB, Whiteman M
OBJECTIVES: The purpose of this study was to assess the relation of early adolescent marijuana use to late adolescent problem behaviors, drug-related attitudes, drug problems, and sibling and peer problem behavior. METHODS: African American (n = 627) and Puerto Rican (n = 555) youths completed questionnaires in their classrooms initially and were individually interviewed 5 years later. Logistic regression analysis estimated increases in the risk of behaviors or attitudes in late adolescence associated with more frequent marijuana use in early adolescence. RESULTS: Early adolescent marijuana use increased the risk in late adolescence of not graduating from high school; delinquency; having multiple sexual partners; not always using condoms; perceiving drugs as not harmful; having problems with cigarettes, alcohol, and marijuana; and having more friends who exhibit deviant behavior. These relations were maintained with controls for age, sex, ethnicity, and, when available, earlier psychosocial measures. CONCLUSIONS: Early adolescent marijuana use is related to later adolescent problems that limit the acquisition of skills necessary for employment and heighten the risks of contracting HIV and abusing legal and illegal substances. Hence, assessments of and treatments for adolescent marijuana use need to be incorporated in clinical practice.
PMID: ( marijuana and neurology ) 10511838 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
American Academy of Pediatrics. Committee on Substance Abuse. Marijuana: A continuing concern for pediatricians.
Pediatrics. 1999 Oct;104(4 Pt 1):982-5
Authors: Heyman RB, Anglin TM, Copperman SM, Joffe A, McDonald CA, Rogers PD, Shah RZ, Armentano M, Boyd GM, Czechowicz D
Marijuana, the common name for products derived from the plant Cannabis sativa, is the most common illicit drug used by children and adolescents in the United States.(1) Despite growing concerns by the medical profession about the physical and psychological effects of its active ingredient, Delta-9-tetrahydrocannabinol, survey data continue to show that increasing numbers of young people are using the drug as they become less concerned about its dangers.(1)
PMID: ( marijuana and neurology ) 10506247 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Sexually transmitted diseases in a health maintenance organization teen clinic: associations of race, partner's age, and marijuana use.
Arch Pediatr Adolesc Med. 1999 Aug;153(8):838-44
Authors: Boyer CB, Shafer MA, Teitle E, Wibbelsman CJ, Seeberg D, Schachter J
OBJECTIVE: To determine the role of sociodemographic risk markers and behavioral risk factors associated with sexually transmitted diseases (STDs) in sexually experienced youth seeking care at an urban, general health maintenance organization teen clinic. DESIGN: Cross-sectional. PARTICIPANTS: A consecutive, racially and ethnically diverse sample of 285 sexually experienced youth who were preponderantly female (58.6%) and who were aged 16.7 years on average. METHODS: All participants completed a self-report questionnaire and were screened for Chlamydia trachomatis using the ligase chain reaction technique and for Neisseria gonorrhoeae and other STDs using conventional methods. RESULTS: Many of these youth were at high risk for STDs, having a self-reported history of sex with multiple partners (49.1%), sex with a new partner (42.5%), inconsistent use of condoms (71.9%), and frequent substance use (24.5% used marijuana 1-2 times per week or more). Sexually transmitted disease screening revealed that 11.6% of the participants had 1 or more STDs. A logistic regression analysis to determine the best model for predicting STDs indicated that youth who are African American (odds ratio, 3.34; 95% confidence interval, 1.52-7.35), had sexual partners who were 2 or more years older (odds ratio, 2.63, 95% confidence interval, 1.22-5.67), and used marijuana 1 to 2 times or more per week (odds ratio, 2.27; 95% confidence interval, 1.01-5.13) were more likely to have STDs at screening. CONCLUSIONS: A brief sociodemographic and behavioral risk assessment that includes these factors may be useful for clinicians in deciding when to screen for STDs in sexually active youth seeking care for reasons not related to reproductive health.
PMID: ( marijuana and neurology ) 10437757 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
The role of parents in protecting Colombian adolescents from delinquency and marijuana use.
Arch Pediatr Adolesc Med. 1999 May;153(5):457-64
Authors: Brook JS, Brook DW, De La Rosa M, Whiteman M, Montoya ID
OBJECTIVES: To identify general and differentiating risk and protective factors from domains of culture and ecology, peer, family, and personality, related to adolescent delinquency and marijuana use, and to study the protective role of the parent-child mutual attachment in offsetting cultural and ecological risk factors, leading to less delinquency and marijuana use. DESIGN: Cross-sectional analyses of interview data collected in Colombia. PARTICIPANTS: A total of 2837 Colombian adolescents, 12 to 17 years of age. SETTING: Adolescents were interviewed in their homes. MAIN MEASURES: Independent variables included measures from 4 domains: culture and ecology, peer, family, and personality. The dependent variables were delinquency and marijuana use. RESULTS: Several risk factors, such as tolerance of deviance and sensation seeking, were similarly related to both delinquency and marijuana use, suggesting that a common cause underlies the propensity to engage in different deviant behaviors. Some risk factors were more involved in delinquency and other risk factors were more highly related to the adolescent's marijuana use. Finally, when violence is endemic and illegal drugs are readily available, a close parent-child bond was capable of mitigating these risk factors, leading to less marijuana use and delinquency. CONCLUSIONS: The findings have implications for public health policy related to interventions in countries in which violence and drug use are prevalent. The results point to interventional procedures aimed at adolescents vulnerable to marijuana use and delinquency as well as efforts aimed at specific vulnerabilities in these areas. For example, reducing the risk factors and enhancing the protective factors for marijuana use and delinquency may result in less adolescent marijuana use and delinquency.
PMID: ( marijuana and neurology ) 10323624 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Familial transmission of substance dependence: alcohol, marijuana, cocaine, and habitual smoking: a report from the Collaborative Study on the Genetics of Alcoholism.
Arch Gen Psychiatry. 1998 Nov;55(11):982-8
Authors: Bierut LJ, Dinwiddie SH, Begleiter H, Crowe RR, Hesselbrock V, Nurnberger JI, Porjesz B, Schuckit MA, Reich T
BACKGROUND: Alcoholism and substance dependence frequently co-occur. Accordingly, we evaluated the familial transmission of alcohol, marijuana, and cocaine dependence and habitual smoking in the Collaborative Study on the Genetics of Alcoholism. METHODS: Subjects (n=1212) who met criteria for both DSM-III-R alcohol dependence and Feighner definite alcoholism and their siblings (n=2755) were recruited for study. A comparison sample was also recruited (probands, n=217; siblings, n=254). Subjects were interviewed with the Semi-Structured Assessment for the Genetics of Alcoholism. The familial aggregation of drug dependence and habitual smoking in siblings of alcohol-dependent and non-alcohol-dependent probands was measured by means of the Cox proportional hazards model. RESULTS: Rates of alcohol, marijuana, and cocaine dependence and habitual smoking were increased in siblings of alcohol-dependent probands compared with siblings of controls. For siblings of alcohol-dependent probands, 49.3% to 50.1% of brothers and 22.4% to 25.0% of sisters were alcohol dependent (lifetime diagnosis), but this elevated risk was not further increased by comorbid substance dependence in probands. Siblings of marijuana-dependent probands had an elevated risk of developing marijuana dependence (relative risk [RR], 1.78) and siblings of cocaine-dependent probands had an elevated risk of developing cocaine dependence (RR, 1.71). There was a similar finding for habitual smoking (RR, 1.77 in siblings of habitual-smoking probands). CONCLUSIONS: Alcohol, marijuana, and cocaine dependence and habitual smoking are all familial, and there is evidence of both common and specific addictive factors transmitted in families. This specificity suggests independent causative factors in the development of each type of substance dependence.
PMID: ( marijuana and neurology ) 9819066 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Medical marijuana.
West J Med. 1998 Jun;168(6):540-3
Authors: Marmor JB
Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several conditions for which there may be therapeutic benefit from marijuana use and that merit further research. Marijuana should be held to the same evaluation standards of safety and efficacy as other drugs (a major flaw in Proposition 215) but should not have to be proved better than current medications for its use to be adopted. The therapeutic window for marijuana and THC between desired effect and unpleasant side effects is narrow and is a major reason for discontinuing use. Although the inhaled route of administration has the benefit of allowing patients to self-titrate the dose, the smoking of crude plant material is problematic. The NIH panel recommended that a high priority be given to the development of a controlled inhaled form of THC. The presence of a naturally occurring cannabinoid-receptor system in the brain suggests that research on selective analogues of THC may be useful to enhance its therapeutic effects and minimize adverse effects.
PMID: ( marijuana and neurology ) 9656007 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Explaining recent increases in students' marijuana use: impacts of perceived risks and disapproval, 1976 through 1996.
Am J Public Health. 1998 Jun;88(6):887-92
Authors: Bachman JG, Johnson LD, O'Malley PM
OBJECTIVES: Marijuana use among high school seniors increased during most of the 1970s, decreased throughout the 1980s, and has been increasing again during the 1990s. Earlier analyses of the classes of 1976 through 1986 attributed the historic trends during that period to specific changes in views about marijuana. This study examined whether recent increases in marijuana use among seniors and among students in earlier grades reflect similar processes. METHODS: Multivariate regression analyses were conducted on data from large annual nationwide surveys of high school seniors from 1976 through 1996 (approximate n = 61,000) and 8th and 10th graders from 1991 through 1996 (n's = 87,911 and 82,475, respectively). RESULTS: Individual lifestyle factors (grades, truancy, religious commitment, evenings out for recreation) correlated substantially with marijuana use but did not explain the historic changes in marijuana use. Rather, decreases in perceived risk of harmfulness and in disapproval can account for the recent increases in all 3 grades and for earlier decreases among seniors. CONCLUSIONS: These findings indicate that perceived risks and disapproval are important determinants of marijuana use. Accordingly, prevention efforts should include realistic information about risks and consequences of marijuana use.
PMID: ( marijuana and neurology ) 9618614 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Initiation of use of alcohol, cigarettes, marijuana, cocaine, and other substances in US birth cohorts since 1919.
Am J Public Health. 1998 Jan;88(1):27-33
Authors: Johnson RA, Gerstein DR
OBJECTIVES: This study examined recent trends in initiation of psychoactive drug use. METHODS: Data from the 1991 through 1993 National Household Surveys on Drug Abuse were used to compare the percentages of US cohorts born from 1919 through 1975 who began using drugs before the ages of 15, 21, and 35. RESULTS: Initiation of cigarette smoking by males peaked in the 1941-1945 cohort, then declined steadily. For females, early smoking initiation rose through the 1951-1955 cohort and then stabilized. Initiation of alcohol use was less common than smoking for pre1950 cohorts but increased steadily, approaching cigarette use for cohorts born in the early 1970s. Only 2% of teenagers born in 1930-1940 tried marijuana; half the teenagers born in 1956-1965 did so. The percentage initiating marijuana use declined in the 1980s, more so among young adults than among teenagers. The use of cocaine and other illicit drugs echoed the rise of marijuana use but peaked later and showed less evidence of subsequent decline. Sex differences declined over time for every drug. CONCLUSIONS: Cohorts born since World War II have had much higher rates of illicit drug use initiation, but trends have varied by drug type, possibly reflecting changes in relative prices.
PMID: ( marijuana and neurology ) 9584029 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Airway inflammation in young marijuana and tobacco smokers.
Am J Respir Crit Care Med. 1998 Mar;157(3 Pt 1):928-37
Authors: Roth MD, Arora A, Barsky SH, Kleerup EC, Simmons M, Tashkin DP
Forty healthy young subjects, ages 20 to 49 yr, underwent videobronchoscopy, mucosal biopsy, and bronchial lavage to evaluate the airway inflammation produced by habitual smoking of marijuana and/or tobacco. Videotapes were graded in a blinded manner for central airway erythema, edema, and airway secretions using a modified visual bronchitis index. The bronchitis index scores were significantly higher in marijuana smokers (MS), tobacco smokers (TS), and in combined marijuana/tobacco smokers (MTS), than in nonsmokers (NS). As a pathologic correlate, mucosal biopsies were evaluated for the presence of vascular hyperplasia, submucosal edema, inflammatory cell infiltrates, and goblet cell hyperplasia. Biopsies were positive for two of these criteria in 97% of all smokers and for three criteria in 72%. By contrast, none of the biopsies from NS exhibited greater than one positive finding. Finally, as a measure of distal airway inflammation, neutrophil counts and interleukin-8 (IL-8) concentrations were determined in bronchial lavage fluid. The percentage of neutrophils correlated with IL-8 levels and exceeded 20% in 0 of 10 NS, 1 of 9 MS, 2 of 9 TS, and 5 of 10 MTS. We conclude that regular smoking of marijuana by young adults is associated with significant airway inflammation that is similar in frequency, type, and magnitude to that observed in the lungs of tobacco smokers.
PMID: ( marijuana and neurology ) 9517614 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
Legalize use of marijuana for medical purposes, MDs and patients plead.
CMAJ. 1998 Feb 10;158(3):373-5
Authors: Gray C
As debate about the legalization of marijuana continues in Canada, physicians are joining the fray. Ottawa family physician Don Kilby is working hard to make it easier for ill patients to use the marijuana that alleviates their symptoms. A recent case in Toronto indicates that the courts are starting to share these views.
PMID: ( marijuana and neurology ) 9484265 [PubMed - indexed for MEDLINE ( marijuana and neurology )]
