Is it inevitable that legalization of recreational cannabis will result in more dependence and psychosis? In theory, it is possible to legalize cannabis in ways that do not increase potency and prevalence of use but, so far, experience with commercialization in North America is not encouraging. Governments that decide to legalize cannabis should use some of the tax revenue to monitor cannabis price, consumption, and potency levels and to carefully evaluate the long term repercussions for mental health in different US states and Canadian provinces. Such monitoring would enable policies to be developed to minimize harm. In the absence of such an approach, it seems likely that the current commercialization of recreational cannabis in North America will be followed in a few years by a rise in the incidence of new cases of psychosis and in the prevalence of people with more chronic psychoses. (To find out why even this will fail, and only harms will increase see Then There Were Three – Marijuana Markets)
Date: September 15, 2020 Source: University of Cambridge
Summary: Migrants arrested for tending plants in the flats, houses and attics where cannabis is grown in bulk are often victims of trafficking and 'debt bondage' - yet many are not recognized as such by police, according to a new study
While growers -- often Vietnamese nationals -- are not always imprisoned within farms, many work under threat of extreme violence towards themselves or family back home, with little in the way of language or contacts in the UK.
As such, migrants end up serving years in UK prisons despite being forced to commit the cultivation crimes by gangs who seize passports and threaten -- and administer -- violence.
"The abuses of freedom in cannabis farm cases do not tally with traditional perceptions of slavery. Victims may be held against their will, forced to work and unable to leave, despite an unlocked door," said Prof Heather Strang, the study's senior author.
Dalgarno Institute Comment: What’s egregious about all this, and Dalgarno has been highlighting is grotesque social injustice for years through it’s RIPPED OFF Seminars to schools and communities, is that not only severe environmental harms are done via these illegal grows with shocking misuse of power and water, but that human trafficking and slavery are part of this, and for what? So that carnage creating addiction for profit industries can meet the ‘demand’ of cashed up consumers, who continue to self-indulge or (now hooked) self-medicate their various ‘felt needs’ or perceived ills, and all to an ever diminishing and dysfunctional end.
These new ‘faux freedom rights’ and shameless profiteering not only harm the user, but the ripple effect on their families and communities is also devastating.
Do you know what will put the toxic ‘cherry’ on all this chaos? The pro-drug sector will attempt to harness these atrocities via misapplied drug policy to recommend that making these toxins legal and commercialize them for tax purposes will ‘solve the problem’ of crime and trafficking. That of course is now a completely busted myth, with jurisdictions doing this very thing, seeing their black-markets grow and slavery flourish.
Time to address the real issues. Time to reduce demand and facilitate drug use exiting recovery. #RecoveryMonth
The findings are reported as use of cannabis during pregnancy has 'skyrocketed'
Date: September 23, 2020 Source: Washington University in St. Louis
While cannabis use during pregnancy is on the rise, researchers at Washington University in St. Louis have found evidence that the resulting children are more likely to have psychopathology in middle childhood.
"There have been increasingly permissive and lenient attitudes toward cannabis use among pregnant people," said Sarah Paul, a clinical psychology graduate student. "It has skyrocketed in the past few years," she added, with data indicating a quick rise from 3% to 7% past-month use.
"Unfortunately, despite the increase in use, we know remarkably little about the potential consequences of prenatal cannabis exposure," Paul said. "Prior studies have linked prenatal cannabis exposure to birth-related outcomes such as lower birth weight and infant characteristics like disrupted sleep and movement. Relatively fewer studies have examined behavior and problems as children age," and, she said, "findings have been tenuous due to inconsistent replication and an inability to account for potential confounding variables."
Their findings were published today in JAMA Psychiatry.
They looked at data from the Adolescent Brain and Cognitive Development Study (ABCD Study), an ongoing longitudinal study of nearly 12,000 children ages 9-11 and their parent or caregiver from 22 sites across the United States that began in 2016.
The researchers grouped participants into three mutually exclusive groups: Children who were not exposed to cannabis prenatally; children who were prenatally exposed to cannabis before the pregnancy was known, but not after; and children who had been exposed to cannabis after the pregnancy was known, regardless of exposure before.
The data showed children who were exposed to cannabis in the womb (regardless of when that exposure occurred) were slightly more likely to have adverse outcomes. They had elevated psychopathology -- more psychotic-like experiences; more problems with depression and anxiety as well as impulsivity and attention; and social problems as well as sleep disturbance. They also had lower cognitive performance, lower indices of global brain structure during middle childhood as well as lower birth weight.
"Cutting to the chase ... clinicians and dispensaries should discourage cannabis use among those who are pregnant or are considering becoming pregnant.
"However, when we look at exposure after maternal knowledge of pregnancy, which corresponds to when endocannabinoid type 1 receptors are expressed in the fetal brain, the associations with child psychopathology largely remain -- these children tend to have more psychotic-like experiences, more impulsivity and attention problems, and social problems," he said. "This raises the intriguing possibility that prenatal cannabis exposure may plausibly impact child behavior. It in no way shows causation, but documenting that effects are independent of common confounding factors provides incremental support for potential causation."
"Being attentive to substance use problems among family members and providing them with support and access to help is critical for anyone regardless of pregnancy status," Bogdan said. "Learning of one's pregnancy may produce additional reason to stop use. Someone who has just learned of a pregnancy and has previously used cannabis, might think, well I have already exposed the fetus to cannabis, so I may as well not stop. The current data might provide the clinician and parent-to-be with evidence that stopping after learning of the pregnancy may reduce the likelihood of negative outcomes among their children."
From a public health perspective, Bogdan suggested looking to the highly effective public health campaigns and clinician attention directed at reducing the use of tobacco and alcohol during pregnancy. In fact, he said, "This study found that prenatal cannabis exposures were more strongly and consistently associated with adverse child outcomes than prenatal tobacco or alcohol exposure."
A new study led by researchers from the University of Colorado School of Medicine compares adolescent siblings to determine the impact of early and frequent use of marijuana on cognitive function.
This study, published in the journal Addiction, contrasts with previous studies by finding that moderate adolescent cannabis use may have adverse effects that cannot be explained by the genetic or environmental factors that siblings may have in common.
"We wanted to expand our understanding of whether cannabis use is related to lower cognitive functioning," said lead author Jarrod M. Ellingson, Ph.D., assistant professor of psychiatry at the CU School of Medicine. "There's a large body of evidence that cannabis use is linked to cognitive functioning, but we know that cannabis use is not isolated from other important risk factors. That was the primary motivation behind this study, in which we compared siblings to account for many of these risk factors."
Such possibilities include environmental risk factors, such as peer group influence, parental behavior, and socioeconomic status. In addition, by designing the study to look at siblings, researchers could consider whether genetic factors explain a shared risk for worse cognitive functioning and earlier or heavier cannabis use.
With this study, Ellingson and his colleagues were able to establish comparisons between siblings and then determine that differential levels of cannabis use were related to poorer cognitive functioning, particularly verbal memory.
In the article, Ellingson and his co-authors state, "Due to changes in the legality of recreational and medical cannabis and widespread access in many states, valid empirical data must be available to inform policy and public health decisions, including how cannabis use may affect the developing brain."
Interactive effects of PTSD and substance use on suicidal ideation and behavior in military personnel: Increased risk from marijuana use
Background: The current study examines the unique and interactive effects of posttraumatic stress disorder (PTSD) symptoms and days using alcohol, opioids, and marijuana on PTSD symptoms, suicidal ideation, and suicidal behavior up to 1 year, later in a high‐risk sample of military personnel not active in mental health treatment.
Conclusions: Results suggest marijuana, especially for military personnel experiencing elevated PTSD symptoms may negatively impact suicidal thoughts and behavior. These results are relevant to suggestions that medical marijuana could be used in treating or augmenting treatment for PTSD.
(Source: Published Depression & Anxiety https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22954)
Marijuana Use is Associated with Worse Outcomes in Symptom Severity and Violent Behavior in Patients with PTSD
Conclusions: The above limitations notwithstanding, our study has suggestive implications for clinical practice and public policy. The results of our study provide no support for the hypothesis that marijuana is associated with general improvement in PTSD symptoms and the observed associations suggest that it may actually worsen PTSD symptoms or nullify the benefits of specialized, intensive treatment. Especially in light of the adverse health effects of marijuana use,1 these data indicate that providers should be cautious or even avoidant in using this agent to treat PTSD. Given that our study only shows associations and not causation, it remains possible that more severe PTSD symptoms drive people to seek marijuana to transiently self-medicate symptoms. Prospective randomized clinical trials would be needed to establish a more definitive understanding of the impact of marijuana use on individuals with PTSD
The Impact of Cannabis Use Disorder on Suicidal and Nonsuicidal Self-Injury in Iraq/Afghanistan-Era Veterans with and without Mental Health Disorders
Abstract: The objective of the present study was to assess the association between cannabis use disorder (CUD) and self-injury among veterans. As expected, after adjusting for sex, age, sexual orientation, combat exposure, traumatic life events, traumatic brain injury, posttraumatic stress disorder, depression, alcohol use disorder, and non-cannabis drug use disorder, CUD was significantly associated with both suicidal (OR=3.10, p=0.045) and nonsuicidal (OR=5.12, p=0.009) self-injury. CUD was the only variable significantly associated with self-injury in all three models examined. These findings are consistent with prior research among civilians and suggest that CUD may also increase veterans’ risk for self-injurious behavior. Keywords: Nonsuicidal self-injury, suicide, suicide attempts, posttraumatic stress disorder, depression, veterans
Despite the strong political push for legalization of cannabis, many questions and concerns have been raised regarding the safety of the drug, as heavy cannabis use has been associated with an array of physical and mental health problems, including pulmonary problems, cognitive impairment, lower levels of educational attainment, unemployment, and increased risk for mental health disorders, such as cannabis use disorder (CUD) and psychotic disorders (e.g., Borges et al., 2016; Curran et al., 2016; Gentes et al., 2016; Goldman et al., 2010; Hoch et al., 2015; Joshi et al., 2014; Sherman & McRae-Clark, 2016).
One area of research particularly important to the debate concerning cannabis legalization is the relationship between heavy cannabis use and self-injury. There has been only limited research on this association to date (e.g., Borges et al., 2016; Giletta et al., 2012; Moller et al., 2012), none of which has focused on veterans with mental health disorders—a population known to be at markedly increased risk for both suicidal and nonsuicidal self-injury (e.g., Bullman & Kang, 1994; Kimbrel et al., 2014a, 2014b, 2016a, 2016b). The present study aimed to address this gap in the literature by conducting the first comprehensive assessment of the association between CUD and self-injury among veterans with and without mental health disorders.
Cannabis Use and Self-injury in Veterans: Taken together, the findings from the literature reviewed above suggest that cannabis use is likely to be associated with increased risk for both suicidal and nonsuicidal self-injury in civilians. Unfortunately, the association between cannabis use and self-injury has been largely overlooked among veterans to date. The lack of research on this topic is surprising, given that a recent study found that rates of CUD had increased by over 50% among veterans who received their care from the Veterans Affairs (VA) Health Care System between 2002 and 2009 (Bonn-Miller et al., 2012). Other recent studies have shown that veterans with PTSD, depression, and other mental health disorders are at elevated risk for both suicidal (e.g., Kimbrel et al., 2014b e.g., Kimbrel et al., 2016b) and nonsuicidal self-injury (Kimbrel et al., 2014a, 2015a, 2016a). However, to our knowledge, no study has examined the relationship between CUD and self-injury in veterans to date, although one recent study did find that self-reported cannabis use was positively associated with self-reported suicidal ideation in a large sample of male veterans seeking treatment for PTSD (Gentes et al., 2016). This study did not, however, evaluate the relationship between cannabis use and actual self-injury (i.e., actual suicide attempts or nonsuicidal self-injury).