Matt Simon vía WIRED
Cannabis is a hell of a drug. It can treat inflammation, pain, nausea, and anxiety, just to name a few ailments. But like any drug, cannabis comes with risks, chief among them something called cannabis use disorder, or CUD.
Studies show that an estimated 9 percent of cannabis users will develop a dependence on the drug. Think of CUD as a matter of the Three C’s, “which is loss of control over use, compulsivity of use, and harmful consequences of use,” says Itai Danovitch, chair of the department of psychiatry and behavioral neurosciences at Cedars-Sinai. A growing tolerance can also be a sign.
Compared to a drug like heroin, which can hook a quarter of its users, the risk of dependency with cannabis is much lower. The symptoms of withdrawal are also far less severe: irritability and depression with cannabis, compared to seizures and hallucinations with heroin. Plus, an overdose of cannabis can’t kill you.But as medicine and society continue to embrace cannabis, we risk losing sight of the drug’s potential to do harm, especially for adolescents and their developing brains.
Far more people use cannabis than heroin, meaning that the total number of users at risk of dependence is actually rather high. And studies are showing that the prevalence of CUD is on the rise—whether that’s a consequence of increased use due to legalization, a loss of stigma in seeking treatment, or some other factor isn’t yet clear. While cannabis has fabulous potential to improve human physical and mental health, understanding and then mitigating its dark side is an essential component.
Dependence is not the same as addiction, by the way. Dependence is a physical phenomenon, in which the body develops tolerance to a drug, and then goes into withdrawal if you suddenly discontinue use. Addiction is characterized by a loss of control; you can develop a dependence on drugs, for example steroids, without an accompanying addiction. You can also become addicted without developing a physical dependence—binge alcohol use disorder, for instance, is the condition in which alcohol use is harmful and out of control, but because the use isn't daily, significant physical dependence may not have developed. “An important similarity that all addictive substances tend to have is a propensity to reinforce their own use,” says Danovitch.
Figuring out such details improves the odds that we’ll be able to detect and treat cannabis use disorder. “Early intervention is important to address substance use before it progresses to a substance use disorder,” says Iowa State University psychologist Brooke Arterberry, coauthor of the study. But to pull that off, she says, we need to better understand when and why symptoms emerge.
Those answers will likely be especially important in intervening with adolescent users, whose brains continue to develop into their mid-20s. Studies suggest that heavy cannabis use among this demographic can lead to changes in the brain. Particularly concerning is the apparent link between cannabis and schizophrenia, the onset of which can happen in the early 20s.
It’s also important to keep in mind that in the grand scheme of drugs, cannabis is nowhere near as risky as opioids. But because of prohibition, scientists have been hindered in their ability to gather knowledge of how cannabis works on the human body, and how different doses affect different people (and potentially the development of CUD). Once acquired, those insights can inform how people should be using the drug. Groups like the National Organization for the Reform of Marijuana Laws, for example, want proper labeling to keep cannabis out of the hands of children. And we need clear communication of the potency of products that can be very powerful—a chocolate bar containing 100 milligrams of THC is not meant to be consumed all at once.
“The reasons we demand proper labeling is all because of an awareness that cannabis is a mood-altering substance,” says Paul Armentano, the organization’s deputy director. “It possesses some potential level of dependence and it carries potential risk. And we believe prohibition exacerbates those potential risks, while regulation potentially mitigates those risks.” Like other substance disorders, cannabis use disorder is treatable. And as scientists develop a better understanding of CUD, we can intervene with appropriate therapies.
Cannabis has big potential to treat a range of ills. And it’ll benefit users even more once we’ve characterized its risks more precisely.
12/17/2018 0 Comments
NEW YORK (CBSNewYork) – Gov. Andrew Cuomo will announce major policies Monday which will set the priorities for his first 100 days in office for his new term.
Sources tell CBS2 that Cuomo will include legalizing recreational marijuana and funding the MTA as among those top initiatives.
Cuomo and state health officials released a report during the summer recommending the legalization of marijuana in New York State.
The report, commissioned by the governor, concludes that “taxing and regulating marijuana far outweighs any potential negative consequences.” The report recommends allowing recreational marijuana be made available to adults across the state and claims taxes would bring in over $1.3 billion each year from sales of the controversial substance.
The race for state revenue from marijuana is in part driven by competition from across the Hudson River. New Jersey’s Gov. Phil Murphy has said legalization of marijuana could be ready in New Jersey by January.
Funding and fixing the troubled MTA system for commuters is another matter. Earlier this year Cuomo said lawmakers have to pass congestion pricing to raise $30 billion to fix the system, but officials say that would not be enough.
By BERA DUNAU vía Daily Hampshire Gazette
NORTHAMPTON – A total of $2,218,208.47 in gross sales was made from legal recreational marijuana and marijuana products last week.
The week three total was slightly more than the week one total of $2,217,621 in gross sales, but less than week two’s total of $2,586,863, according to data released by the Cannabis Control Commission.
Combined with the first two weeks of sales, over $7 million of legal recreational marijuana and marijuana products have been sold.
All of these sales took place in only two locations: New England Treatment Access in Northampton and Cultivate in Leicester. Both dispensaries were first opened, and also continue to operate, as medical marijuana dispensaries.
The CCC has not released sales data for individual store locations. However, lines outside the building continue to be seen at NETA at all hours of operation.
Alternative Therapies Group, a Salem medical marijuana dispensary, was recently cleared to begin recreational marijuana sales by the CCC, and it is set to start them Saturday. This will make it the third location in the Bay State, and the third east of the Mississippi to sell legal recreational marijuana.
ATG was the first medical marijuana dispensary to begin serving patients in Massachusetts.
(VIA - NYTIMES.COM - Paula Span)
Shari Horne broke her toes a decade ago, and after surgery, “I have plates and pins and screws in my feet, and they get achy at times,” she said.
So Ms. Horne, 66, applies a salve containing cannabidiol, derived from the cannabis, or marijuana, plant. It eases the pain.
The salve didn’t help when she developed bursitis in her shoulder, but a tincture of cannabidiol mixed with T.H.C., the psychoactive ingredient in cannabis, provided relief.
Using a pipe, she also smokes “a few hits” of a cannabis brand called Blue Dream after dinner, because “I think relaxing is healthy for you.”
Many of her neighbors in Laguna Woods, Calif., a community of mostly older adults in Orange County, where she serves on the City Council, have developed similar routines.
“People in their 80s and 90s, even retired Air Force colonels, are finding such relief” with cannabis, said Ms. Horne. “Almost everybody I know is using it in one form or another” — including her husband Hal, 68, a retired insurance broker, who says it helps him sleep.
In fact, so many Laguna Woods seniors use medical cannabis — for ailments ranging from arthritis and diabetes nerve pain to back injuries and insomnia — that the local dispensary, Bud and Bloom, charters a free bus to bring residents to its Santa Ana location to stock up on supplies. Along with a catered lunch, the bus riders get a seniors discount.
Physicians who treat older adults expect their cannabis use to increase as the number of states legalizing medical marijuana keeps growing.
After the midterm elections, when Utah and Missouri voters approved medical use, 33 states and the District of Columbia have legalized medical marijuana, along with ten states that also have legalized recreational use.
Though the federal government still outlaws cannabis, classified as a Schedule I drug along with heroin (meaning that it has no therapeutic value), public support has swung sharply in favor of legalization, polls have found.
That support may rise as the baby boomers, often no strangers to marijuana, succeed their more leery parents as the oldestcohort. People aged 50 to 64 are more likely to report recent marijuana use than their elders.
Bud and Bloom, a dispensary in Santa Ana, Calif., picks up senior customers on a chartered bus. The riders get a discount and a catered lunch.
“You might not like it,” Dr. David Casarett, chief of palliative care at Duke University Medical Center, tells fellow physicians. “You might not believe in it. But your patients are using this stuff.”
He and Dr. Joshua Briscoe, a psychiatrist at Duke also trained in palliative care, have mixed feelings about that.
Co-authors of a recent article on medical marijuana and older adults in the Journal of the American Geriatrics Society, they support legalization for medical use. They hope the federal government will reclassify cannabis (“a huge undertaking,” Dr. Briscoe admitted), reducing obstacles to much-needed research.
“We’re always searching for a better medication that can treat pain and a host of other symptoms without burdensome side effects, and cannabis is promising” as a treatment for a number of conditions, Dr. Briscoe said.
Their overview — along with a major report last year from the National Academies of Sciences, Engineering and Medicine — points out disorders for which cannabis does appear to have therapeutic effects.
But the researchers are uneasy about the fact that older people essentially are undertaking self-treatment, with scant guidance from medical professionals.
Cannabis consumers face a confusing array of options, including various strains and brands and many methods of ingestion: smoking, vaping, tinctures, edibles, topical creams or patches. Users can also experience potentially harmful side effects.
When Joy Kavianian, 55, a Laguna Woods resident with Parkinson’s disease, wanted to reduce her right-side tremors so that she could continue making ceramics, a cherished pursuit, she had lots of questions about cannabis.
Studies have also shown that cannabis alleviates the nausea and vomiting that often follows chemotherapy. In fact, the Food and Drug Administration has approved two synthetic T.H.C. drugs for that purpose, though some patients insist that smoking the real thing works better.
Cannabis appears to relieve muscle spasms in people with multiple sclerosis, though that research is less extensive, and to improve appetite for patients with cancer or AIDS, Dr. Briscoe said.
“Plenty of patients swear it’s the only thing that helps them sleep,” he added. But while drowsiness often accompanies cannabis use, the evidence that it reliably improves sleep remains modest. Its effects on anxiety and depression are also unclear.
And like any drug, cannabis has side effects, some of particular concern for older users, who metabolize medications differently from younger adults.
Dizziness, for instance, can lead to injurious falls. Marijuana use is also associated with an increased risk of motor vehicle accidents, so Dr. Casarett and Dr. Briscoe advise counseling older patients not to drive for six to nine hours after use, depending on ingestion method.
Moreover, “the jury is very much out about long-term cognitive effects in adults,” Dr. Casarett said. But there’s no evidence that medical marijuana users are at increased risk of abusing the drug.
Cannabis products in Ms. Horne's home, within easy reach. Her husband, a retired insurance broker, also uses them.CreditRozette Rago for The New York Times