The Pharmacologic and Clinical Effects of Medical Cannabis

Cannabis was used for medicinal purposes dating back to 2737 BC. Since then eighteen states and the District of Columbia have allowed the use of medical marijuana. Currently two states, Colorado and Washington, have legalized the use of recreational marijuana.

Different forms of medical marijuana have had positive effects on treating pain for neuropathic, chronic, postoperative, and that related to fibromyalgia, rheumatoid arthritis, multiple sclerosis, and cancer. Some side effects noted were dry mouth, sedation, dizziness, tachycardia, conjunctive irritation, and hypotension. Additionally, medical marijuana decreases muscle spasms in people with multiple sclerosis.  

Marijuana causes psychiatric implications. Some people experience anxiety, disorientation, paranoia, and psychosis. Regular adolescent users are more prone to getting schizophrenia. Cannabis use is associated with impairments in memory and cognition. Extreme marijuana users have trouble in the encoding, storage, and retrieval of memory. Cannabis is also associated with depression and suicide.

The problems associated with medical marijuana depend greatly on the persons underlying conditions and the way they use marijuana. Additionally, the lack of quality control makes it hard for physicians to prescribe a certain formula of the drug. Also, patients that use medical marijuana need to be monitored for fear of addiction.  However, to make sure this does not happen, patients need to go through training programs, which most health systems do not have.

Cannabis is the most used and abused illicit drug. Although it does greatly help people with medical conditions, medical evidence is still lacking and should be used with caution.

http://onlinelibrary.wiley.com.ezaccess.libraries.psu.edu/doi/10.1002/phar.1187/full

Marijuana and Driving

The article is about a study on fatal car accidents and involves a study group of clean individuals and a group of drug users. Alcohol is considered a drug in this study. Drugs were detected in almost half of all the accidents. The study used risk factors as well as determining who was responsible for the accident and determining what they had in their system. Unlike other studies that included anyone in the car that had drugs or alcohol in their system which wouldn’t be that much of a factor in the crash. The risk is “defined as the odds ratio of a drug group over the drug-free control group.” The study, as you can expect, confirmed that alcohol will greatly increase the chance of a fatal accident. Drugs, other than alcohol, had much less of an effect then alcohol.  Subjects who had several drugs in their system tended to be more responsible for accidents. However, they saw that marijuana actually showed a negative impact on risk, unlike all other drugs that had a slight positive impact. They believe this may be to drivers under the influence of marijuana being more cautious and driving slower. I believe that you shouldn’t drive under the influence of marijuana, although I don’t think it is anywhere as dangerous as driving under the influence of alcohol. As we learned in class, in Colorado and Washington you can get a DUI for driving under the influence of marijuana. I don’t think that is fair, and that instead you should only get a fine and nothing on your record since as the study shows driving under the influence of alcohol and marijuana is completely different. If you get pulled over and fail a field sobriety test however then I wouldn’t be against harsher penalties since you are impaired and most likely couldn’t operate the vehicle as well. I also don’t think that they should determine if you fail based on a certain amount in your system since people can handle their high better then others.

H. Jick, J. R. Hunter, B. J. Dinan, S. Madsen and A. Stergachis. Sedating drugs and automobile accidents leading to hospitalization. Am. J. Pub. Health 7: 1399-1400 (1981).
Lagier et al, Benzodiazepine/Driving Collaborative Group. Are benzodiazepines a risk factor for road accidents. Drug and Alcohol Dependence, 33: 19-23 (1993).
M. D. Robertson and O. H. Drummer. A methodology to study the effect of drugs in driving. Accid. Anal. and Prev. 26: 243-7 (1994).
J. J. Schleselman. In: "Case-control studies". New York Oxford University Press (1982).
D. C. G. Skegg, S. M. Richards and R. Doll. Minor tranquillisers and road accidents. Br. Med. J. 1: 917-9 (1979).
K.W. Terhune, C. A. Ippolito, D. L. Hendricks, J. G. Michalovic, S. C. Bogema, P. Santinga, R. Blomberg and D. F. Preusser . The incidence and role of drugs in fatally injured drivers. US Department of Transportation, National Highway Traffic Safety Administration, Report DOT HS 808 065; (1992).
A. F. Williams, M. J. Peat, D. J. Crouch, J. K. Wells and B. S. Finkle. Drugs in fatally injured young male drivers. Public Health Reports. 100: 19-25 (1985).

Marijuana is a dangerous drug?

Fahad B. Iqbal

Throughout the years, there has been research on the negative and positive effects of marijuana on the human body and the brain. Marijuana is frequently beneficial to the treatment of AIDS, cancer, glaucoma, multiple sclerosis, and chronic pain. However, researchers have been working to explain how marijuana has harmful effects on the functions of central nervous system and hinders the memory and movement of the user's brain. Marijuana impinges on the central nervous system by attaching to brain's neurons and interfering with normal communication between the neurons. These nerves respond by altering their initial behavior. For example, if a nerve is supposed to assist one in retrieving short-term memory, cannabinoids receptors make them do the opposite. So if one has to remember what he did five minutes ago, after smoking a high dose of marijuana, he/she has trouble (Costandi, 2012). Marijuana plant contains 400 chemicals and 60 of them are cannabinoids, which are psychoactive compounds that are produced inside the body after cannabis is metabolized or is extorted from the cannabis plant. Cannabinoids is an active ingredient of marijuana (Costandi, 2012). The most psychoactive cannabinoids chemical in marijuana that has the biggest impact on the brain is tetrahydrocannibol, or THC. THC is the main active ingredient in marijuana because it affects the brain by binding to and activating specific receptors, known as cannabinoid receptors. These receptors control memory, thought, concentration, time and depth, and coordinated movement. THC also affects the production, release or re-uptake (a regulating mechanism) of various neurotransmitters.

When one's memory is affected by high dose of marijuana, short-term memory is the first to be triggered. Marijuana's damage to short-term memory occurs because THC alters the way in which information is processed by the hippocampus, a brain area responsible for memory formation. When a user has a high dose of marijuana, new information does not register into their brain and this may be lost from memory and they are not able to retrieve new information for more than a few minutes (Costandi, 2012).

There is also a decrease in the activity of nerve cells. Marijuana also impairs emotions. When smoking marijuana, the user may have uncontrollable laughter one minute and paranoia the next. This instant change in emotions has to do with the way that THC affects the brain's limbic system. The limbic system is another region of the brain that governs one's behavior and emotions. The chemicals in marijuana bring cognitive impairment and troubles with learning for the user. Smoking marijuana causes some changes in the brain that are like those caused but cocaine, heroin, and alcohol. Some researchers believe that has changes may put a person more at risk of becoming addicted to other drugs such a cocaine and heroin (Costandi, 2012). 

To prevent such harm, one must be cautious of their actions. Even though marijuana has its positives, sometimes the negatives can outweigh them. People just have to be careful about marijuana and use it in moderation.

Costandi, Mo. (March 1, 2012). How marijuana make you forget. Retrieved from             http://www.nature.com/news/how-marijuana-makes-you-forget-1.10152

Ethanol and Brain Damage

Ethanoland Brain Damage

            Alcohol abuse and dependence is one of the most socially and economically expensive health problems in the world. The United States is estimated to spend $184.6 billion on alcohol abuse per year. Excessive drinking causes a plethora of brain-damaging effects and impairments in cognitive function including neurological deficits, structural changes in the brain, and other alcohol-related diseases.

            Alcoholics are especially prone to deficits such as, “abstract problem solving, visuo-spatial and verbal learning, memory function, perceptual motor skills and even motor function.”  The general pattern of such deficits have classically been classified as “frontal.” The nodes of frontocerebellar circuitry were studied via quatitative neuroimaging in order to determine volume deficits seen in alcoholics. Such deficiencies in the brain imply, “alcoholism-related neuropsychological deficits, either through abnormalities in individual nodes or by disconnection and interruption of selective circuitry.”

            Neuroimaging techniques have demonstrated the existence of structural and functional abnormalities in alcoholics that are proven to be cognitively impaired. The question of whether or not “moderate” consumers of alcohol are exposed to the same risk has yet to be answered. Data analyzed from the Atherosclerotic Risk in Communities study (ARIC) and suggests that alcohol consumption is directly related to the size of the cerebrospinal fluid filled spaces of the brain. Another neuropathological study that suggests an increase in the cerebrospinal fluid filled spaces in moderate drinkers is supported by this analysis.

            The degree of brain atrophy is also directly related to the amount of alcohol consumed over a lifetime. Changes in mylenation and axonal integrity as well as a down regulation of myelin-associated genes may be to blame for the amount of white matter lost due to excessive drinking and brain atrophy. Neuronal dendritic, and synaptic changes in addition to receptor and transmitter changes may also be to blame for functional changes and cognitive impairment seen in alcoholics.

Prenatal alcohol exposure

I was interested in this article because it talked about prenatal alcohol use in a place outside of the United States of America.  It focuses on women in Brazzaville, Congo and pulled from a sample size of 3099 women from 10 prenatal care clinics.  This study is interested with women in Africa because it says that data from Africa is often incomplete.  This study was undertaken in order to obtain some concrete and complete data on the prenatal effects of alcohol use by mothers in a part of the world where health education is still not widespread.  Prenatal alcohol exposure (PAE) has been found to be a marker for increased risks like maternal mortality, fetal mortality, infant and child mortality, premature births, and morbidity.  Congo has the second highest premature birth rate in the world and the nineteenth highest maternal mortality ratio.  This study found that of its 3099 women sampled, 23% drank during pregnancy.  87.4% of these women reported binge drinking.  Only one in six women stopped drinking after realizing they were pregnant.  The rest continued to use alcohol while knowingly pregnant.  The study states that it had several limitations that stemmed from it being a study done outside the United States.  Unlike in the United States, there is no concrete concept of what one drink is in Brazzaville, which skewed some of the data collected.  It was found that many of the women in this study were in their third trimester and still did not know the full risks of drinking alcohol while being pregnant.  This study closes with a call for more PAE education in Africa, particularly in the Republic of Congo.     

Alcohol Tolerance

                                                              Alcohol Tolerance

   Alcohol consumption interferes with many bodily functions and affects behavior. After chronic alcohol consumption, the drinker often develops tolerance to at least some of alcohol's effects. Tolerance means that after continued drinking, consumption of a constant amount of alcohol produces a lesser effect or increasing amounts of alcohol are necessary to produce the same effect

  Alcohol tolerance is increased by regular drinking.This reduced sensitivity requires that higher quantities of alcohol be consumed in order to achieve the same effects as before tolerance was established. Alcohol tolerance may lead to alcohol dependency

    Direct alcohol tolerance is largely dependent on body size. Large bodied people will require more alcohol to reach insobriety than lightly built people.Therefore men, being larger than women on average, will have a higher alcohol tolerance. The alcohol tolerance is also connected with activity of alcohol dehydrogenase which are a group of enzymes responsible for the breakdown of alcohol in the liver, and in the bloodstream.

    The tolerance to alcohol is not equally distributed throughout the world's population, and genetics of alcohol dehydrogenase indicate resistance has arisen independently in different ethnic groups. People of European descent on average have a high alcohol tolerance and are less likely to develop alcoholism compared to Aboriginal Australians, and Native Americans.

Binge Drinking and Exam Performance

The effects of binge drinking on college students' next-day academic test-taking performance and mood state.

Contrary to popular belief, college students do not drink as much as people the same age who do not attend college; however, studies have shown that college students binge drink more than non college young adults.  This aggressive drinking behavior leads problems, such as injury, death, legal problems, property damage, and physical confrontations, but among all of these none are as frequent and prominent as poor academic performance.

Reckless drinking behavior results in missing classes, poor attentiveness when students attend class, and less time spent towards classwork.  While tolerance and amount of alcohol consumed vary from student to student, the average effects of academic performance are noticeable; however, a surprising characteristic of student binge drinking and test taking, based on the study, indicates that binge drinking the night before an exam does not have a serious impact on the result of the test.  While the study indicates this odd observation, student motivation, attentiveness, and awareness are all lower than students who were in the control group.  This is most likely the group of sleep deprivation and poor REM sleep when sleep is attained.  In conclusion, even though the study indicates that test taking skills are not downgraded by excessive drinking the night before exams, the time spent drinking could be better allocated towards additional test preparation or additional sleep to benefit exam performance.  Another key characteristic of participants in the study is all of the people were over the age of twenty one, which suggests that they have been exposed to alcohol in the past and their bodies were suit to handle the alcohol better than younger college students.

Works Cited:

John Hermos, et al. "The Effects Of Binge Drinking On College Students' Next-Day Academic Test-Taking Performance And Mood State." Addiction 105.4 (2010): 655-665. Academic Search Alumni Edition. Web. 27 May 2013.

Relationship between sexual orientation and substance abuse

This article explores the relationship between sexual orientation and substance abuse. A survey was conducted on a random sample of people in Washington State, where there were several questions asked, including past month and past year marijuana use, past month and year hard drug use, past year binge drinking, and past year drinking problem or addicted to alcohol. The results were positively correlated; the LGB population was reported to have higher rates of substance abuse than the homosexual population. The paper talks about several factors affecting these rates. One factor is psychological. LGB individuals are more prone to suffer from prejudice, discrimination, and abuse, due to their sexual orientation and the society’s response to them. The LGB population had also reported depression, anxiety, and suicidal thoughts. These factors were shown to lead to increased substance abuse to help them overcome their low self-esteem and psychosexual issues that they go through due to the treatment they receive and the psychological hardships that they suffer from. Another major factor is social norms. The LGB community is more accepting of the use of drugs, especially what is referred to as “club drugs”. A final major factor is social bonding, where many LGB individuals find it difficult to form strong relationships with family members, colleagues, or classmates. These individuals were also found to be more likely to be abused as children. The LGB community is also unable to commit to marriage since most US states do not allow it, so it is harder for them to form stable households, which are found to be correlated with reduced deviant and criminal behavior. This study does come with a few limitations, such as not taking into account transgender individuals, or only having the study limited to the western part of the US.

Article: http://www.tandfonline.com.ezaccess.libraries.psu.edu/doi/full/10.1080/01639625.2012.749149#.UaQN_SvwLAV  

Baseline Research for Action: Adolescent Alcohol Consumption in Los Palacios Municipality, Cuba

The drinking rate in Cuba has been among one of the lowest in Latino countries. However, recently adolescent teen drinking has increased greatly among the past fifteen years in Cuba. In the Los Palacios Municipality of the westernmost province of Pinar del Río, Cuba, alcohol abuse and alcoholism have contributed to many health problems.  “Family doctors have identified 571 alcoholics and 7,861 high-risk consumers in a population of 38,786.” 

A study was conducted in this municipality on 109 adolescents aged ten to nineteen during the months of March and April. 67% of adolescents that were studied consumed alcohol. It was found that in areas with limited recreational areas, more alcohol was consumed. Another observation was that young women drank more in social situations than young men. Additionally, beer was the most consumed beverage. However, being the most expensive drink in Cuba, many wonder how these teens can afford beer.  The most concerning observation is that fourteen to sixteen year olds had the highest rate of at-risk use.

This study concluded that drinking habits were already established in adolescence men and women. They modeled their drinking habits after older members in their family. This is dangerous because these adolescents already have adult drinking habits, which will only increase as they get older. Another alarming conclusion is that most parents buy their children the alcohol.

This study concludes with recommendations to the Los Palacios Municipality. The authors suggest having a community workshop in alcohol awareness or a neighborhood debate where everyone including teens and adults can communicate their opinion on the matter.

http://www.medicc.org/mediccreview/articles/mr_303.pdf

Looking at reasons behind alcohol abuse in recently deployed veterans

There is a growing correlation between alcohol abuse and posttraumatic stress disorder in veterans who fought in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq.  Males who enlist into the army at a young age tend to be more likely to abuse alcohol and suffer from symptoms of posttraumatic stress disorder (Jaupcak).  Alcohol use by veterans is often looked at as a form of self-medicating to deal with the symptoms of posttraumatic stress disorder.  Studies have shown that individuals who suffer from posttraumatic stress disorder are more likely to chronically abuse alcohol and are more likely to have negative consequences from there alcohol use (Ouimette, Finney, & Moos).

A recent study done by Christy Capone, Ashlee C. McGrath, Madhavi K. Reddy, and M. Tracie Shea sought to examine the trauma related predictors for alcohol abuse of veterans who suffered from posttraumatic stress disorder who had fought in Operation Enduring Freedom or Operation Iraqi Freedom.  The population for this study was 238 veterans from the Rhode Island National Guard and Army Reserve.  The average time for the participants to complete their evaluation was 6 months after deployment.  The majority of the sample was white (92.43%) and male (88%), and the average age 33.  Alcohol use was assessed total number of drinks, drinks per drinking day and number of heavy drinking days, a day where five or more standard drinks were consumed.  Posttuarmatic stress was assessed by the Clinician-Administered PTSD Scale. 

There results found that posttraumatic stress symptoms rather than combat exposure were a key predictor in alcohol abuse.  It was found that re-experiencing symptoms were the strongest predictor in total alcohol use and heavy drinking days.  They believe that increased alcohol use could be used to cope with painful memories or to reduce the frequency of nightmares.

Work Cited

http://onlinelibrary.wiley.com.ezaccess.libraries.psu.edu/doi/10.1002/jts.21817/pdf

Jakupcak, M., Tull, M. T., McDermott, M. J., Kaysen, D., Hunt, S., & Simpson,

T. (2010). PTSD symptom clusters in relationship to alcohol misuse among

Iraq and Afghanistan war veterans seeking post-deployment VA health care.

Addictive Behaviors, 35, 840–843. doi:10.1016/j.addbeh.2010.03.023

Ouimette, P. C., Finney, J. W., & Moos, R. H. (1999). Two-year posttreatment functioning and coping of substance abuse patients with posttraumatic stress disorder. Psychology of Addictive Behaviors, 13, 105–114.  doi:10.1037/0893-164x.13.2.105

Withdrawing from Alcoholism and its Dangers

  Alcohol is probably considered the most popular social interaction drug in our society.  Part of it being that it is a legal drug, and also part of it being how it is so integrated with who we are as a society.  What many people do not take into account however, is just how dangerous this drug can be for those who are serve alcoholics, and stop drinking cold turkey.

   Several different drugs produce withdraw symptoms when a user stops using a substance.  Alcohol however, is one of the few well know drugs out there that can actually have a withdraw effect that can be fatial to ones health.  Being college students, most of us have experienced what a bad hangover feels like.  It can make for a horrible next day, but usually for most typical people, they feel fine within a day after they have stopped drinking.  This however, may not be the case for heavy alcoholic drinkers.

   Withdraw symptoms for those who are considered to have alcoholism may experience much worse symptoms then a typical hangover.  Heavy hangover symptoms may be shaking hands, mild anxiety, nausea, and vomiting.  This symptoms usually do not last longer than a day or two at the most.  However, if an extreme alcoholic withdraws from drinking, these symptoms can turn much worse.  This symptoms could consist of hallucinations, seizures, and delirium tremens.  Delirium Tremens cause a fever, confusion, and a rapid heartbeat, and can be fatial in approximately one to five percent of of cases.

    The recent death of the popular artist, Amy Winehouse was believed to be a cause of withdraw symptoms from long-term heavy drinking. Her family beliefs this was the case, especially since there was no sign of other drugs present in her body.  Its amazing to think that one of our nations most popular, as well as legal drugs, can have such a harmful, and even fatial effect due to the withdraw of this substance after substantial abuse.

http://www.jonbarron.org/article/dangers-alcohol-withdrawal



 




 

Alcohol Mixed Energy Drinks

Energy drinks have taken off over the last decade, as has the practice of mixing energy drinks with alcohol. The consumption of alcohol mixed energy drinks, referred to as AmED, has become so common among teens and young adults that in November 2010, the FDA issued warnings to several major AmED manufacturers, informing them that their products were a "public health concern" and should either be reformulated or taken off the shelves. These drinks are more dangerous that other alcoholic beverages because they mix various stimulants with alcohol, masking the effects of the alcohol and leading the binge drinking. There is also concern that these drinks are being marketed specifically to young people and teenagers.The most notorious of these drinks, Four Loko, comes in a brightly colored aluminum can in a variety of different flavors. Four Loko is one of the few drinks to survive the onslaught FDA complaints and parent lawsuits by changing it's formula to remove the stimulants caffeine, taurine, and guarana from it's ingredients. A recent lawsuit by the Federal Trade Commission claimed that the company who manufactures Four Loko, Phusion Projects, LLC, made false statements about the alcohol content and the safe consumption of their beverage. As a result, Phusion Projects is required to include an "Alcohol Facts panel" on all of their products starting May 12, 2013.

An article in the December 2011 edition of the academic journal "Addictive Behaviors" titled "Drinking patterns and risk behaviors associated with combined alcohol and energy drink consumption in college drinkers" sought to establish a relationship between drinking AmEDs and other risky behaviors. A group of 465 students from a Western Canadian university participated in the survey. The study found that about one is every four participants had consumed an AmED within the past 30 days. It concluded that more the frequent AmED drinkers were twice as likely to experience negative effects of drinking than their non-AmED drinking counterparts. In my opinion, this study is flawed in that it included students who did not drink at all in the survey results. This makes the effects of AmEDs appear far worse by not accounting for other factors. It attributed the increased risk of negative drinking effects to those that drink AmEDs to be caused by the drinking of AmEDs, ignoring the notion that correlation does not cause causation and that other factors may be involved, such as those who consume AmEDs are by nature more inclined to risky behavior. It tries to account for the participant's risk taking inertia through a number of survey questions including: "Have you ever gone scuba diving?" and "Would you like to pilot your own airplane?" I feel that the questions asked by the survey to determine a participants inclination for risk can be attributed to other variable, including family income and class.  

Jazzmine Myers

Sweet preferences and analgesia during childhood:

effects of family history of alcoholism and depression

 

Jazzmine Myers

A study was performed on children ages 5-12 to determine if one’s family history of alcoholism and depression are related to sweet preferences and analgesia during childhood¹. The mothers of the children had to complete the Michigan Alcohol Screening Test. The Michigan Alcohol screening tested for alcoholism and depressive symptoms. There was also a Structure Assessment of Genetics of Alcohol for every biological member up to the second degree of relatives. The children in the study were given a 23 item Pictorial Depression Scale to determine if they had depressive symptoms or not. A force choice tracking technique was used to test the level of sweetness preferred in the study subjects.  The analgesic properties of intra-oral sucrose were tested via a cold presser test. It was found that sucrose at a concentration of 24% wt. /vol is an effective analgesic in infants and children. The results showed a co-occurrence of having a family history of self-reports of depression and alcoholism is linked significantly with a preference for a higher concentration of sucrose. It was also found that increased pain sensitivity and greater liking for sweet tasting food is correlated with depressive symptomatology. This study opened the door for the discovery of early signs alcoholism. If this study is any indication that sweets help predicate individuals with/or at risk for developing alcohol related problems.  This discovery is important because it can help reduce alcoholism and depression in the world.

 

 

 

Reference:

 

1.       Julie A. Mennella, M. Yanina Pepino*, Sara M. Lehmann-Castor & Lauren M. Yourshaw. "Sweet Preferences and Analgesia during Childhood: Effects of Family History of Alcoholism and Depression." Web.ebsohost.com. Blackwells Publishing, 2013. Web. 26 May 2013. <http://web.ebscohost.com.ezaccess.libraries.psu.edu/ehost/detail?sid=38205aaf-e168-48ba-bf30-b53618363515@sessionmgr111&vid=1&hid=103&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ==#db=a2h&AN=48489513>.