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The Grassroots of Grass: Cannabis Legalization Ballot Initiative Campaign Contributions and Outcomes, 2004-2016. 11/04/2019	Conclusion: These results underscore the importance of health advocate participation in developing cannabis legalization frameworks. legalization, ncbi
Legalized Cannabis in Colorado Emergency Departments: A Cautionary Review of Negative Health and Safety Effects 07/24/2019	Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. ED and urgent care (UC) visits with cannabis-associated International Classification of Diseases (ICD) codes or positive urine drug screens for teenagers and young adults have increased since legalization, and the majority require behavioral health evaluation. A subsequent retrospective review by Wang et al. from 2005–2015 identified 4202 such visits for patients 13 to <21 years old to a tertiary-care children’s hospital system. Behavioral health evaluation was obtained for 2813 (67%) and a psychiatric diagnosis was made for the majority (71%) of the visits. Colorado, ncbi, suicide
Why Marijuana Will Not Fix the Opioid Epidemic 01/20/2019	In 2017 Colorado had a record number of opioid overdose deaths from any opioid, including heroin and Colorado has had a medical marijuana program since 2001.6 There are several reasons as to why any reported benefit will be outstripped by lack of benefit and increased risk of harm, and why cannabis is contributing to ongoing opioid use, and subsequently, the opioid epidemic. There is evidence in animal models showing adolescent rats exposed to THC will develop enhanced heroin self administration as adults11 which may be due to activation of mesolimbic transmission of dopamine by a common mu opioid receptor mechanism.11,12 More than 90% of heroin users report a prior history of marijuana use compared to a prior history of painkiller use (47%).13 Prospective twin studies demonstrated that early cannabis use was associated with an increased risk of other drug abuse.14 This particular study was conducted when the THC content was much lower than todays products which can reach 95% THC. Currently there is no widely available or accepted medical literature showing any benefit for pain with dispensary cannabis in common pain conditions.17 There is currently a large and growing body of evidence showing that cannabis use increases, rather than decreases non-medical prescription opioid use and opioid use disorder, based on followup of more than 33,000 people.19 Concurrent use of cannabis and opioids by patients with chronic pain appears to indicate a higher risk of opioid misuse.20 Closer monitoring for opioid-related aberrant behaviors is indicated in this group of patients and it suggests that cannabis use is a predictor of aberrant drug behaviors in patients receiving chronic opioid therapy. There is sufficient and expanding evidence demonstrating that medical marijuana use will not curb the opioid epidemic. There is further evidence that marijuana is a companion drug rather than substitution drug and that marijuana use may be contributing to the opioid epidemic rather than improving it. opioid, Finn, ncbi
Nonmedical prescription opioids and pathways of drug involvement in the US: Generational differences. 01/01/2018	RESULTS: Alcohol/cigarettes followed by marijuana was the most common sequence. NMPO or cocaine use after marijuana, and heroin use after NMPO or cocaine, differed by generation. Among successively younger generations, NMPO after marijuana and heroin after NMPO increased. Millennials were more likely to initiate NMPO than cocaine after marijuana; Generation X and Baby Boomers were less likely (odds ratios = 1.4;0.3;0.2). Millennials were more likely than Generation X and Baby Boomers to use heroin after NMPO (hazards ratios = 7.1;3.4;2.5). In each generation, heroin users were far more likely to start heroin after both NMPO and cocaine than either alone. Sequences were similar by gender. Fewer paths were significant among African-Americans. CONCLUSIONS: NMPOs play a more prominent role in drug initiation sequences among Millennials than prior generations. Among Millennials, NMPO use is more likely than cocaine to follow marijuana use. In all generations, transition to heroin from NMPO significantly occurs only when both NMPO and cocaine have been used. Delineation of drug sequences suggests optimal points in development for prevention and treatment efforts. gateway, initiation sequence, ncbi
Marijuana use and physical dating violence among adolescents and emerging adults: A systematic review and meta-analysis. 03/18/2017	Findings suggest that marijuana use is associated with a 54% increase in the odds PDV (physical dating violence) victimization, and a 45% increase in the odds of perpetration. CONCLUSIONS: Findings suggest that dating violence is a correlate of marijuana use, and that association is strongest among adolescents (vs. emerging adults) and girls (vs. boys). meta-analysis, PDV, adolescent, Studies, Research, ncbi
Long lasting effects of chronic heavy cannabis abuse. 03/18/2017	The existence of hallucinations, delusions, and organic brain dysfunction in heavy cannabis users seems to be associated with cannabinoid levels in hair. The continuation of persistent symptoms 3 months after the discontinuation of cannabis abuse, was a remarkable finding. SCIENTIFIC SIGNIFICANCE: We provide evidence that chronic and heavy cannabis abuse results in long-lasting brain dysfunction in all users and in long-lasting schizophrenia-like psychotic symptoms in more than half of all users. These findings suggest a reevaluation of the current classification of cannabis as a "soft narcotic" which erroneously, therefore, is typically considered harmless. (Am J Addict 2017;XX:1-8). ncbi, chronic, impaired, delusions, Long-term, Studies, Research
Cannabis and psychosis: Neurobiology 03/23/2014	Cannabis is involved in approximately 50% of psychosis, schizophrenia, and schizophreniform psychosis cases Cannabis is a known risk factor for schizophrenia, although the exact neurobiological process through which the effects on psychosis occur is not well understood. Cannabis is also of particular interest in both the first-episode psychosis (FEP) and the ultra high risk (UHR) populations. This is mainly due to their increased susceptibility to cannabis abuse. cannabis-induced psychosis, ncbi, Psychosis
Doubly illegal: Qualitative accounts of underage alcohol access through theft 12/01/2011	In addition to 9% of respondents who reported stealing alcohol from commercial outlets themselves, a total of 26% respondents reported occasions when their close friends stole alcohol. Our findings unveiled that teens had a body of knowledge that some drew upon for stealing alcohol. Youths revealed detailed knowledge about store layout, theft protection devices and store policies. In particular, respondents disclosed knowledge about which aisles have blind spots, how to remove security tops on bottles, and no-chase policies. As one 17 year old female described: “in a liquor store the cashier’s gonna be watching you and in a big supermarket it’s more open. [...] it’s just some open place and there’s no one around, you can just steal it more easily than in a small business.” Youths also reported knowing the layout of large commercial stores, in particular the locations of security cameras and blind sports. Youths used blind spots to slip a bottle of alcohol into a pocket or backpack unnoticed. A 17 year old boy discussed how he and his friend strategized: “We had a whole system. As it turns out, the only aisle in every store that doesn’t have security cameras is the pet food aisle. So my friend looks really old, and I’d have the backpack. He’d go and he’d grab the handle [1.75 liter liquor bottle], walk into the pet food aisle, put it into my backpack and we’d walk out.” alcohol, ncbi