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CORK Bibliography: Marijuana

121 citations. September 2012 to present

Prepared: December 2012

Abalo R; Vera G; Lopez-Perez AE; Martinez-Villaluenga M; Martin-Fontelles MI. The gastrointestinal pharmacology of cannabinoids: Focus on motility. Pharmacology 90(1/2): 1-10, 2012. (80 refs.)

The marijuana plant Cannabis sp. and its derivatives and analogues, known as cannabinoids (CBs), induce many effects throughout the whole body. Herein we briefly review the gastrointestinal (GO pharmacology of CBs, with special focus on motor function. Some drugs are available to treat nausea and emesis, and evidences in humans and animal models suggest that other GI motility alterations (gastro-oesophageal reflux, inflammatory bowel conditions or paralytic ileus) might benefit from modifications of the CB tone throughout the gut. However, central and peripheral (including GI) side effects may occur upon acute and chronic CB administration. Hopefully, the ongoing worldwide intense research on CBs will soon provide new, safer CB-based medicines.

Copyright 2012, Karger

Afifi TO; Henriksen CA; Asmundson GJG; Sareen J. Victimization and perpetration of intimate partner violence and substance use disorders in a nationally representative sample. Journal of Nervous and Mental Disease 200(8): 684-691, 2012. (43 refs.)

The aim of this study was to examine the relationship between perpetration and victimization of physical and sexual intimate partner violence (IPV) in the past year and substance use disorders (SUDs) in the past year, including alcohol, sedatives/tranquilizers, cocaine, cannabis, and nicotine stratified according to sex. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions. A series of adjusted logistic regression models were conducted. Among men and women, all types of SUDs were associated with increased odds of IPV perpetration (odds ranging from 1.4 to 8.5 adjusting for sociodemographic variables). IPV victimization increased the odds of having all types of SUDs for male and female victims, with the exception of sedatives/tranquilizer abuse/dependence among women (odds ranging from 1.5 to 6.0 adjusting for sociodemographic variables). Substances that had the most robust relationship with perpetration and victimization of IPV included alcohol and cannabis, after adjusting for sociodemographic variables, mood disorders, anxiety disorders, personality disorders, and mutual violence.

Copyright 2012, Lippincott, Williams & Wilkins

Aksoy UM; Aksoy SG; Akpinar A; Maner F. Attention deficit hyperactivity disorder (ADHD) symptoms and Adult ADHD Diagnosis in adult men with cannabis dependence. Healthmed 6(6): 1925-1929, 2012. (24 refs.)

Objective: We aimed to demonstrate the existence and intensity of Adult Attention Deficit Hyperactivity (A-ADHD symptoms) in cannabis dependent individuals compare them with healthy controls and discuss the importance of comorbidity of A-ADHD. Methods: Seventy patients participated with informed consent. The participants were selected from patients who underwent inpatient treatment in the Department for Addiction at Samsun Neuropsychiatry Hospital. Diagnostic interviews were conducted for cannabis dependence syndrome (ICD 10; DSM-IV); the earliest interview was after 21 days of detoxification therapy. For assessment, the Adult ADD/ADHD DSM IV based Diagnostic Screening and Rating Scale developed by Prof. Dr. Turgay, former Director of the Toronto ADHD Clinic, Ontario, Canada was used. Mean ADHD total and subscale scores were compared by using the group variable independent t test. The analyses were conducted using SPSS for Windows 16.00. Results:. Considerably higher scores were observed in cannabis dependent individuals. Twenty-four patients were re-evaluated and interviewed and Adult ADHD was diagnosed. All three sub-dimensions of the Turgay Adult ADHD Scale were found to be statistically higher in the cannabis dependent patients. Conclusions: As this study shows, Adult ADHD is highly represented in cannabis dependent patients, (in our sample 35% of patients were diagnosed with Adult ADHD). This study underline importance of the ADHD diagnosis in Turkey.

Copyright 2012, Drunpp-Sarajevo

Ballard ME; Bedi G; de Wit H. Effects of delta-9-tetrahydrocannabinol on evaluation of emotional images. Journal of Psychopharmacology 26(10): 1289-1298, 2012. (65 refs.)

There is growing evidence that drugs of abuse alter processing of emotional information in ways that could be attractive to users. Our recent report that Delta(9)-tetrahydrocannabinol (THC) diminishes amygdalar activation in response to threat-related faces suggests that THC may modify evaluation of emotionally-salient, particularly negative or threatening, stimuli. In this study, we examined the effects of acute THC on evaluation of emotional images. Healthy volunteers received two doses of THC (7.5 and 15 mg; p.o.) and placebo across separate sessions before performing tasks assessing facial emotion recognition and emotional responses to pictures of emotional scenes. THC significantly impaired recognition of facial fear and anger, but it only marginally impaired recognition of sadness and happiness. The drug did not consistently affect ratings of emotional scenes. THC's effects on emotional evaluation were not clearly related to its mood-altering effects. These results support our previous work, and show that THC reduces perception of facial threat. Nevertheless, THC does not appear to positively bias evaluation of emotional stimuli in general.

Copyright 2012, Sage Publications

Barakauskas VE; Davis R; Krasowski MD; McMillin GA. Unresolved discrepancies between cannabinoid test results for infant urine. Clinical Chemistry 58(9): 1364-1367, 2012. (9 refs.)

Background: False-positive drug screen results for tetrahydrocannabinol (THC) have been observed. This study investigated the rate of unconfirmed positive screen results in infant and noninfant urine samples and evaluated possible reasons for differences. Methods: The rate of unconfirmed positive THC screen results for urine samples was determined retrospectively in 2 independent data sets (n = 14 859, reference laboratory; n = 21 807, hospital laboratory) by comparing positive immunoassay-based drug screen results with the associated results of confirmation tests. We then assessed the rate of positive THC screens for samples with varying likelihoods of cannabinoid presence to evaluate the contribution of infant-specific urine constituents to positive results. Finally, a method to detect a THC metabolite (11-hydroxy-Delta(9)-THC) that occurs in meconium was developed to determine its prevalence in infant urine. Results: Positive screen results failed to confirm more frequently in samples from infants (47%) than in non-infants (0.8%). The hospital laboratory observed a similar discrepancy with a different immunoassay. Infant samples with a high likelihood of containing cannabinoids despite negative confirmatory results had a similar rate of positive screening results (50%, n = 20), whereas all samples with a low likelihood of containing cannabinoids screened negative (n = 23). 11-Hydroxy-Delta(9)-THC was not detected in any infant urine sample tested (n = 16). Conclusions: Conventional confirmatory methods for THC may be inappropriate for urine samples from infants. Our results suggest that one or more currently unrecognized THC-associated compounds are responsible for positive THC screen results for infant urine, as opposed to an infant-associated interference.

Copyright 2012, American Association of Clinical Chemistry

Barrio G; Jimenez-Mejias E; Pulido J; Lardelli-Claret P; Bravo MJ; de la Fuente L. Association between cannabis use and non-traffic injuries. Accident Analysis and Prevention 47(July): 172-176, 2012. (22 refs.)

Background: This study aimed to assess the association between cannabis use and unintended non-fatal injuries other than those caused by road crashes. Methods: Cross-sectional data were collected from a nationwide sample of 27,934 subjects surveyed in 2005 in Spain: 14,699 persons aged 15-34 years and 13,235 aged 35-64 years. Logistic regression was used to obtain odds ratios (OR) between patterns of cannabis use and frequency of non-traffic injuries, adjusted for socio-demographic factors and for the use of alcohol, tobacco and other drugs. Results: Cannabis use in the last 12 months was associated with a higher frequency of injuries (OR = 1.4; 95% CI: 1.2-1.7). The OR in older adults (35-64 year age group) was 1.8 and 1.3 in younger people (15-34 year age group). The strongest associations found were between weekly use of cannabis and injuries from knocks and bumps (OR = 5.1; 95% CI 2.9-8.9) and those occurring outside work (OR = 3.0; 95% CI 1.8-4.9) in the older adult population. Conclusion: Although our analysis did not control for behavioural factors, cannabis use is independently associated with an increased frequency of non-traffic injuries, especially in the older adult population. These associations emphasise the need to carry out longitudinal studies addressing the causal links between cannabis use and unintended injuries.

Copyright 2012, Elsevier Science

Bauermeister JA; Zimmerman MA; Johns MM; Glowacki P; Stoddard S; Volz E. Innovative recruitment using online networks: Lessons learned from an online study of alcohol and other drug use utilizing a web-based, respondent-driven sampling (webRDS) strategy. Journal of Studies on Alcohol and Drugs 73(5): 834-838, 2012. (17 refs.)

Objective: We used a web version of Respondent-Driven Sampling (webRDS) to recruit a sample of young adults (ages 18-24) and examined whether this strategy would result in alcohol and other drug (AOD) prevalence estimates comparable to national estimates (National Survey on Drug Use and Health [NSDUH]). Method: We recruited 22 initial participants (seeds) via Facebook to complete a web survey examining AOD risk correlates. Sequential, incentivized recruitment continued until our desired sample size was achieved. After correcting for webRDS clustering effects, we contrasted our AOD prevalence estimates (past 30 days) to NSDUH estimates by comparing the 95% confidence intervals of prevalence estimates. Results: We found comparable ADD prevalence estimates between our sample and NSDUH for the past 30 days for alcohol, marijuana, cocaine, Ecstasy (3,4-methylenedioxymethamphetamine, or MDMA), and hallucinogens. Cigarette use was lower than NSDUH estimates. Conclusions: WebRDS may be a suitable strategy to recruit young adults online. We discuss the unique strengths and challenges that may be encountered by public health researchers using webRDS methods.

Copyright 2012, Alcohol Research Documentation

Becker SJ; Nargiso JE; Wolff JC; Uhl KM; Simon VA; Spirito A et al. Temporal relationship between substance use and delinquent behavior among young psychiatrically hospitalized adolescents. Journal of Substance Abuse Treatment 43(2): 251-259, 2012. (43 refs.)

There is considerable evidence linking substance use and delinquent behavior among adolescents. However, the nature and temporal ordering of this relationship remain uncertain, particularly among early adolescents and those with significant psychopathology. This study examined the temporal ordering of substance use and delinquent behavior in a sample of psychiatrically hospitalized early adolescents. Youth (N = 108) between the ages of 12 and 15 years completed three assessments over 18 months following hospitalization. Separate cross-lagged panel models examined the reciprocal relationship between delinquent behavior and two types of substance use (e.g., alcohol and marijuana). Results provided evidence of cross-lagged effects for marijuana: Delinquent behavior at 9 months predicted marijuana use at 18 months. No predictive effects were found between alcohol use and delinquent behavior over time. Findings demonstrate the stability of delinquent behavior and substance use among young adolescents with psychiatric concerns. Furthermore, results highlight the value of examining alcohol and marijuana use outcomes separately to better understand the complex pathways between substance use and delinquent behavior among early adolescents.

Copyright 2012, Elsevier Science

Beckmann YY; Seckin M; Manavgat AI; Zorlu N. Headaches related to psychoactive substance use. Clinical Neurology and Neurosurgery 114(7): 990-999, 2012. (31 refs.)

Aim: To investigate a possible association between headache and psychoactive substance use. Methods: 1055 psychoactive substance abusers were consecutively admitted. All patients filled out a detailed headache questionnaire and 1015 patients were included. Results: Twenty seven percent of patients reported having headache. Eighteen percent of patients reported having headache attributed to a substance or its withdrawal and 1.4% had unclassified headache. The most commonly used substances were cannabis (80.5%), alcohol (74.6%), methylamphetamine (18.7%), benzodiazepine (10.4%), volatile solvent (5.8%), cocaine (4.4%), heroin (2.1%), opioids (0.5%), and other substances (1.7%). Fifteen patients reported that onset of headache occurred prior to onset of substance use, while 94.5% had headaches occurred after substance abuse. A higher incidence of headache was found in the benzodiazepine, methylamphetamine, cocaine, heroin, volatile solvent abusers. Seventy-eight percent of headache patients have never sought help from a physician despite the severity and frequency of headache. Conclusions: In our study, the prevalence of headache among all psychoactive substance abusers was 26.9%. Although this is one-group study without any comparison with non-addict population and associational data must be interpreted with caution, the results of this study indicate a possible relationship may exist between headache and substance use since 94.5% of substance users described headaches after the onset of substance use. The younger start and the longer duration of cannabis use caused the higher incidence of headache, but this correlation was not observed in other substance use. Migraine was far more prevalent in the abusers than in previously reported community populations.

Copyright 2012, Elsevier Science

Begg D; Sullman M; Samaranayaka A. The characteristics of young pre-licensed drivers: Evidence from the New Zealand Drivers Study. Accident Analysis and Prevention 45(March): 539-546, 2012. (29 refs.)

Aim: The aim of this study was to identify demographic and behavioural factors associated with pre-licensed driving. Method: A cohort comprising 3526 newly licensed drivers aged 15-24 years old from throughout New Zealand completed a questionnaire which sought information on pre-licensed driving behaviour and factors thought to be related to this. Results: Almost half of the participants had driven on-road prior to passing their learner license theory test; 14% had driven more than 20 times; and 7.5% had driven more than 200 km. Multivariate logistic regression showed the results differed depending on the outcome examined. In general pre-licensed driving was significantly higher among males, among Maori, those living in a rural area, and those living in an area of high deprivation. Furthermore, those who drove pre-licensed were more likely to engage in other risky behaviours such as hazardous drinking and cannabis use, and have medium to high scores for sensation seeking and aggression/hostility. Conclusion: The young people who were pre-licensed drivers displayed a range of demographic and behavioural characteristics that indicate they may be at higher crash risk than their peers who did not drive before licensing. Identifying those who drive before licensing and targeting road safety interventions towards this group may help reduce the high crash risk among novice drivers.

Copyright 2012, Elsevier Science

Blomqvist J. Perceptions of addiction and recovery in Sweden: The influence of respondent characteristics. Addiction Research & Theory 20(5): 435-446, 2012. (46 refs.)

Respondents to a representative population survey were asked to rate four psychoactive substances (tobacco, alcohol, cannabis and 'hard' drugs) with regard to their severity to society and addictiveness, as well as the options for recovery, with and without treatment, from an addiction to the same substances. This article explores if and how these ratings differ with regard to respondents' socio-demographic characteristics, their own and close persons' substance use experiences, and, their attitudes towards people with substance use problems. Data were analysed using descriptive statistics and logistic or linear regressions. Although the main difference goes between respondents' perceptions of various substances and addictions, the results also point to some interesting differences with regard to respondents' experiences and characteristics. Thus for example, women and respondents with no personal substance use experiences, tend to play up the severity and addictiveness of most substances, and to play down the options for untreated recovery from an addiction, whereas current risk users tend to take an opposite view. Main interpretations are that there is a general tendency to exaggerate the hazards of and risks with habits that are perceived as unfamiliar and alien, that current risk users at the same time dwell on a 'false hope' of being able to quit, and that women are, for various reasons, more inclined than men to worry about their own substance use habits, as well as those in their close environment. Potential implications, for further research as well as for policy and prevention, are discussed.

Copyright 2012, Informa Healthcare

Bosker WM; Kuypers KPC; Theunissen EL; Surinx A; Blankespoor RJ; Skopp G et al. Medicinal Delta(9)-tetrahydrocannabinol (dronabinol) impairs on-the-road driving performance of occasional and heavy cannabis users but is not detected in Standard Field Sobriety Tests. Addiction 107(10): 1837-1844, 2012. (27 refs.)

Aims: The acute and chronic effects of dronabinol [medicinal ?9-tetrahydrocannabinol (THC)] on actual driving performance and the Standard Field Sobriety Test (SFST) were assessed. It was hypothesized that occasional users would be impaired on these tests and that heavy users would show less impairment due to tolerance. Design, setting and participants Double-blind, placebo-controlled, randomized, three-way cross-over study. Twelve occasional and 12 heavy cannabis users (14 males/10 females) received single doses of placebo, 10 and 20 mg dronabinol. Measurements: Standard deviation of lateral position (SDLP; i.e. weaving) is the primary measure of road-tracking control. Time to speed adaptation (TSA) is the primary reaction-time measure in the car-following test. Percentage of impaired individuals on the SFST and subjective high on a visual analogue scale were secondary measures. Findings: Superiority tests showed that SDLP (P?=?0.008) and TSA (P?=?0.011) increased after dronabinol in occasional users. Equivalence tests demonstrated that dronabinol-induced increments in SDLP were bigger than impairment associated with BAC of 0.5 mg/ml in occasional and heavy users, although the magnitude of driving impairment was generally less in heavy users. The SFST did not discriminate between conditions. Levels of subjective high were comparable in occasional and heavy users. Conclusions: Dronabinol (medicinal tetrahydrocannabinol) impairs driving performance in occasional and heavy users in a dose-dependent way, but to a lesser degree in heavy users due possibly to tolerance. The Standard Field Sobriety Test is not sensitive to clinically relevant driving impairment caused by oral tetrahydrocannabinol.

Copyright 2012, Wiley-Blackwell

Bourgain C; Falissard B; Blecha L; Benyamina A; Karila L; Reynaud M. A damage/benefit evaluation of addictive product use. Addiction 107(2): 441-450, 2012. (20 refs.)

Aims To obtain damage/benefit assessments of eight commonly used addictive products and one addictive behaviour from French addiction experts and link these to overall evaluations. Design and setting: Criteria-based evaluation by experts in addiction. Specific statistical modelling to estimate the relative contribution of various criteria to formulating expert general opinion on products. Participants: Forty-eight French experts in addiction. Measurements Twelve criteria covering the whole spectrum of damages and benefits to users and to society evaluated using visual analogue scales (VAS). Direct measure of expert overall subjective opinions on products from user and from social perspectives. Findings: Damage scoring identified alcohol (damage score = 48.1), heroin (damage score = 44.9) and cocaine (damage score = 38.5) as the most harmful products to users and to society; gambling was considered the least harmful (score = 22.5), replicating previous results. Damage scoring correlated poorly with legal status or with overall subjective expert opinions of products. Benefit perception scores indicated alcohol as a clear outlier (benefit score = 45.5) followed by tobacco (benefit score = 34.3) and cannabis (benefit score = 31.1). Statistical modelling suggested that experts attributed 10 times more importance to benefit perception than to damages when making their subjective opinion from a user perspective and two times more importance to benefit perception than to damages in formulating their opinion from a social perspective. Conclusions The perceived benefits of addictive products appear to have a major impact on the opinion of those products expressed by a number of French addiction experts.

Copyright 2012, Society for the Study of Addiction to Alcohol and Other Drugs

Bramness JG. Commentary on Bosker et al. (2012): Driving under the influence of cannabinoids. Addiction 107(10): 1845-1846, 2012. (17 refs.)

Brook JS; Rubenstone E; Zhang C; Brook DW. Maternal predictors of comorbid trajectories of cigarette smoking and marijuana use from early adolescence to adulthood. Addictive Behaviors 37(1): 139-143, 2012. (24 refs.)

This is the first study to examine maternal predictors of comorbid trajectories of cigarette smoking and marijuana use from adolescence to adulthood. Participants (N=806) are part of an on-going longitudinal psychosocial study of mothers and their children. Mothers were administered structured interviews when participants were adolescents, and participants were interviewed at six time waves, from adolescence to adulthood. Mothers and participants independently reported on their relationships when participants were age 14.1 years. At each time wave, participants answered questions about their cigarette and marijuana use from the previous wave to the present. Latent growth mixture modeling determined the participants' membership in trajectory groups of comorbid smoking and marijuana use, from ages 14.1 to 36.6 years. Multivariate logistic regression was used to assess the association of maternal factors (when participants were adolescents) with participants' comorbid trajectory group membership. Findings showed that most maternal risk (e.g., mother-child conflict, maternal smoking) and protective (e.g., maternal affection) factors predicted participants' membership in trajectory groups of greater and lesser comorbid substance use, respectively. Clinical implications include the importance of addressing the mother-child relationship in prevention and treatment programs for comorbid cigarette smoking and marijuana use.

Copyright 2012, Elsevier Science

Bruci Z; Papoutsis I; Athanaselis S; Nikolaou P; Pazari E; Spiliopoulou C et al. First systematic evaluation of the potency of Cannabis sativa plants grown in Albania. Forensic Science International 222(1-3): 40-46, 2012. (43 refs.)

Cannabis products (marijuana, hashish, cannabis oil) are the most frequently abused illegal substances worldwide. Delta-9-tetrahydrocannabinol (THC) is the main psychoactive component of Cannabis sativa plant, whereas cannabidiol (CBD) and cannabinol (CBN) are other major but no psychoactive constituents. Many studies have already been carried out on these compounds and chemical research was encouraged due to the legal implications concerning the misuse of marijuana. The aim of this study was to determine THC, CBD and CBN in a significant number of cannabis samples of Albanian origin, where cannabis is the most frequently used drug of abuse, in order to evaluate and classify them according to their cannabinoid composition. A GC-MS method was used, in order to assay cannabinoid content of hemp samples harvested at different maturation degree levels during the summer months and grown in different areas of Albania. This method can also be used for the determination of plant phenotype, the evaluation of psychoactive potency and the control of material quality. The highest cannabinoid concentrations were found in the flowers of cannabis. The THC concentrations in different locations of Albania ranged from 1.07 to 12.13%. The influence of environmental conditions on cannabinoid content is discussed. The cannabinoid content of cannabis plants were used for their profiling, and it was used for their classification, according to their geographical origin. The determined concentrations justify the fact that Albania is an area where cannabis is extensively cultivated for illegal purposes.

Copyright 2012, Elsevier Science

Bryan AD; Schmiege SJ; Magnan RE. Marijuana use and risky sexual behavior among high-risk adolescents: Trajectories, risk factors, and event-level relationships. Developmental Psychology 48(5): 1429-1442, 2012. (77 refs.)

Adolescents involved with the juvenile justice system have a high incidence of risky sexual behaviors resulting in unintended pregnancy and sexually transmitted infections. Substance use may be particularly important as a risk factor for unsafe sexual behavior for this group, and recent evidence suggests a possible association between marijuana use and risky sexual behavior. Adolescents (n = 728; 33% female) on probation were followed for 2 years, at intervals of 6 months, to explore the association of marijuana use and condom use longitudinally and at a specific intercourse occasion. Latent growth curve modeling indicated that greater marijuana use at baseline was associated with a steeper decline in condom use over the 2-year period of the study. In-depth analysis of the most recent intercourse occasion suggested that condom use was less likely if marijuana was being used by the participant or his/her partner and that this association was more pronounced if intercourse occurred with someone the participant had just met. Implications for the prevention of risky sexual behavior in this population are discussed.

Copyright 2012, American Psychological Association

Buckner JD; Zvolensky MJ; Schmidt NB. Cannabis-related impairment and social anxiety: The roles of gender and cannabis use motives. Addictive Behaviors 37(11): 1294-1297, 2012. (31 refs.)

Social anxiety appears to be especially related to cannabis-related problems, yet the nature of this association remains unclear. Some data suggest that socially anxious men may be especially vulnerable to problematic cannabis use. The current study examined the relations between social anxiety, cannabis use and use-related problems, and motives for cannabis use by gender among 174 (42.5% female) current (past-month) cannabis users. Among men, social anxiety was significantly, positively related to the number of cannabis-related problems and coping and conformity motives. Coping and conformity motives mediated the relation between social anxiety and cannabis-related problems. Among women, social anxiety was significantly related only to social motives, and was unrelated to cannabis-related problems. These findings suggest that socially anxious men may be especially vulnerable to using cannabis as a means of avoidance coping (avoiding scrutiny and negative affect), which may contribute to the high rates of cannabis-related problems among socially anxious individuals.

Copyright 2012, Elsevier Science

Bujarski SJ; Feldner MT; Lewis SF; Babson KA; Trainor CD; Leen-Feldner Ellen et al. Marijuana use among traumatic event-exposed adolescents: Posttraumatic stress symptom frequency predicts coping motivations for use. Addictive Behaviors 37(1): 53-59, 2012. (49 refs.)

Contemporary comorbidity theory postulates that people suffering from posttraumatic stress symptoms may use substances to cope with negative affect generally and posttraumatic stress symptoms specifically. The present study involves the examination of the unique relation between past two-week posttraumatic stress symptom frequency and motives for marijuana use after accounting for general levels of negative affectivity as well as variability associated with gender. Participants were 61 marijuana-using adolescents (M(age)=15.81) who reported experiencing lifetime exposure to at least one traumatic event. Consistent with predictions, past two-week posttraumatic stress symptoms significantly predicted coping motives for marijuana use and were not associated with social, enhancement, or conformity motives for use. These findings are consistent with theoretical work suggesting people suffering from posttraumatic stress use substances to regulate symptoms.

Copyright 2012, Elsevier Science

Bujarski SJ; Norberg MM; Copeland J. The association between distress tolerance and cannabis use-related problems: The mediating and moderating roles of coping motives and gender. Addictive Behaviors 37(10): 1181-1184, 2012. (38 refs.)

Recent research has linked distress intolerance to a greater incidence of cannabis use-related problems. Additionally, individuals reporting coping motives for cannabis use might be particularly vulnerable to use-related problems, and tendencies to use coping motives may be influenced by gender. The current study sought to extend the literature by examining the role of distress tolerance on cannabis use-related problems and the potential influences of coping motives for use and gender. Participants were 118 cannabis-using adults (Mage = 29.84). As hypothesized, highly distress intolerant individuals reported more cannabis-use related problems. Further, coping motives mediated the relationship between distress tolerance and cannabis use-related problems, and this effect was more powerful for women than for men. The current study adds to our understanding of the impact of distress tolerance and problematic patterns of cannabis use.

Copyright 2012, Elsevier Science

Bukstein OG. Taking note of over-the-counter remedies for adolescents with cannabis dependence. (editorial). American Journal of Psychiatry 169(8): 771-773, 2012. (9 refs.)

Calabria B; Swift W; Slade T; Hall W; Copeland J. The perceived health risks of cannabis use in an Australian household survey. Drug and Alcohol Review 31(6): 809-812, 2012. (17 refs.)

Introduction and Aims. Perceived risks of cannabis use have rarely been researched in Australia. This paper reports on the beliefs about the adverse effects of cannabis use on health, social well-being, driving, mental health and changes in cannabis over time. Design and Methods. Survey of 918 Australian adults was conducted as part of a quarterly omnibus self-report survey of an established panel. Results. Respondents believed that cannabis use can cause health and social problems, can adversely affect a person's ability to drive a car, can be addictive, and can lead to use of other illicit drugs. They were uncertain as to whether cannabis can cause schizophrenia and depression, and whether cannabis had become more potent over time. Implications. Prevention efforts should focus on educating the Australian people about the nature of cannabis-related harms.

Copyright 2012, Wiley-Blackwell

Carroll KM; Nich C; LaPaglia DM; Peters EN; Easton CJ; Petry NM. Combining cognitive behavioral therapy and contingency management to enhance their effects in treating cannabis dependence: Less can be more, more or less. Addiction 107(9): 1650-1659, 2012. (60 refs.)

Aims: To evaluate reciprocal enhancement (combining treatments to offset their relative weaknesses) as a strategy to improve cannabis treatment outcomes. Contingency management (CM) with reinforcement for homework completion and session attendance was used as a strategy to enhance cognitive-behavioral therapy (CBT) via greater exposure to skills training; CBT was used as a strategy to enhance durability of CM with rewards for abstinence. Setting: Community-based out-patient treatment program in New Haven, Connecticut, USA. Design: Twelve-week randomized clinical trial of four treatment conditions: CM for abstinence alone or combined with CBT, CBT alone or combined with CM with rewards for CBT session attendance and homework completion. Participants A total of 127 treatment-seeking young adults (84.3% male, 81.1% minority, 93.7% referred by criminal justice system, average age 25.7 years). Measurements: Weekly urine specimens testing positive for cannabis, days of cannabis use via the time-line follow-back method. Findings: Within treatment, reinforcing homework and attendance did not significantly improve CBT outcomes, and the addition of CBT worsened outcomes when added to CM for abstinence (75.5 versus 57.1% cannabis-free urine specimens, F = 2.25, P = 0.02). The CM for abstinence condition had the lowest percentage of cannabis-negative urine specimens and the highest mean number of consecutive cannabis-free urine specimens (3.3, F = 2.33, P = 0.02). Attrition was higher in the CBT alone condition, but random effect regression analyses indicated this condition was associated with the greatest rate of change overall. Cannabis use during the 1-year follow-up increased most rapidly for the two enhanced groups. Conclusions: Combining contingency management and cognitive-behavioural therapy does not appear to improve success rates of treatment for cannabis dependence in clients involved with the criminal justice system.

Copyright 2012, Wiley-Blackwell

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. The DAWN Report: Emergency Department Visits Involving Drug Misuse or Abuse by Children Aged 12 to 14. (May 24, 2012). Rockville MD: Substance Abuse and Mental Health Administration, 2012

Children undergo dramatic physical, mental, and emotional changes and establish important health and behavior patterns as they transition between childhood and adolescence. Research findings indicate that early initiation of substance misuse or abuse is associated with changes in brain functioning, substance abuse or dependence in adolescence or adulthood, and numerous negative behaviors.1,2,3 In 2009, public health surveillance measures showed that an estimated 627,000 children aged 12 to 14 reported past month alcohol use, and about 560,000 reported past month illicit drug use.4 The majority of young adolescent users report receiving alcohol and marijuana for free from friends or their own family members.5,6 In 2009, approximately 23,760 substance abuse treatment admissions were young adolescents aged 12 to 14.7 This issue of The DAWN Report focuses on emergency department (ED) visits involving misuse or abuse by children aged 12 to 14. In 2009, an estimated 28,068 visits to the emergency department (ED) involved misuse or abuse of drugs by children aged 12 to 14; 58% of these visits involved girls, and 42% involved boys. Prescription and over-the-counter medications were involved in 50% of ED visits for misuse or abuse of drugs by children aged 12 to 14. Overall, 37% of ED visits made by children aged 12 to 14 involved alcohol; alcohol in combination with medications or illicit drugs was involved in 11% of visits. About one quarter (22% ) of ED visits made by children aged 12 to 14 involved marijuana, and boys made more such visits than girls (33 vs. 15% ).

Public Domain

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. The TEDS Report: Marijuana Admissions Reporting Daily Use at Treatment Entry. (February 2, 2012). Rockville MD: Substance Abuse and Mental Health Administration, 2012

Marijuana use, especially long-term frequent use, can have serious adverse effects on physical and mental health, and negatively affect functioning within the context of school, work, and family. Marijuana use has been associated with cognitive problems, such as distorted perceptions, impaired coordination, difficulty with thinking and problem solving, and problems with judgment, learning, and memory. Because the effects of marijuana use on learning and memory can last for days or weeks after the acute effects have worn off, frequent users may be continually functioning at reduced cognitive levels. The effects of frequent marijuana use on adolescents and older adults are of particular concern. Because the adolescent brain is still developing, frequent use by persons in this age group may lead to lasting consequences on cognitive processes and may affect functional and structural development in areas of the brain that are critical for the development of higher intellectual capabilities. Among older adults in particular, daily marijuana use may exacerbate cardiac or other health problems. Among adults in general, heavy cannabis use is associated with several unhealthy behaviors, such as a high-calorie diet, tobacco smoking, and other illicit drug use. Marijuana use can also lead to dependence; it has been estimated that about 9% of marijuana users become dependent, and this proportion increases among individuals who initiate use at a young age (17%) and among daily users (25 to 50%). Individuals who are addicted to marijuana often have a difficult time quitting on their own and need substance abuse treatment. However, relatively little is known about the characteristics of substance abuse treatment admissions that use marijuana on a daily basis. This report examines the characteristics of substance abuse treatment admissions reporting daily marijuana use (hereafter referred to as "daily marijuana admissions") at treatment entry. Among the central findings; Marijuana was reported as a substance of abuse by approximately 740,800 treatment admissions in 2009; of these, 170,100 (23.0%) reported daily marijuana use at treatment entry. Daily marijuana admissions were primarily male (72.2 percent) and never married (77.1%); they were also predominately non-Hispanic White (55.1 percent) and either young or middle-aged adults (34.2% were aged 18 to 25, and 46.3% were aged 26 to 49). Nearly one fifth (17.3%) of daily marijuana admissions indicated that marijuana was their primary and only substance of abuse, but the majority (82.7%) reported marijuana and an additional substance of abuse. One third (33.0%) of daily marijuana admissions had a co-occurring psychiatric problem.

Public Domain

Chabrol H; Chauchard E; Goutaudier N; van Leeuwen N. Exploratory study of the psychopathological profiles of adolescent cannabis users. Addictive Behaviors 37(10): 1109-1113, 2012. (28 refs.)

Although adolescent cannabis users have been reported not to be a homogeneous group, they are few typological studies and only one based on psychopathological variables. A better knowledge of the typology of cannabis users might contribute to the identification of specific needs concerning prevention or treatment. Among 199 adolescents using cannabis at least monthly during the last six month, cluster analysis yielded three clusters based on depressive symptoms, social anxiety, borderline personality traits, and psychopathic traits (impulsivity and callous-unemotional traits). The largest cluster, called 'ordinary' was well below the mean on all measures. Another cluster, labeled 'borderline' was distinguished by high levels of borderline traits, depressed mood, and social anxiety. The smallest cluster, called 'impulsive' was well above the mean in impulsivity and callous traits but low on all other measures. Frequency of cannabis use was higher in the borderline and impulsive clusters than in the ordinary cluster. Multiple regression analyses suggested that the contributions of psychopathological variables to cannabis use varied across clusters.

Copyright 2012, Elsevier Science

Cheadle JE; Hartshorn KJS. Marijuana use development over the course of adolescence among North American Indigenous youth. Social Science Research 41(5): 1227-1240, 2012. (95 refs.)

This study investigated the links between marijuana use trajectories and marijuana abuse/dependence (DSM-IV) using five waves of data from 718 North American Indigenous adolescents between 10 and 17 years from eight reservations sharing a common language and culture. Growth mixture models indicated that 15% of youth began using by 11-12 years of age and that another 20% began shortly thereafter. These early users had odds of abuse/dependence 6.5 times larger than abstainers. Girls were also unexpectedly found to be particularly at risk of early use, and this did not reflect other background and psychosocial factors, including friend use. While the timing, patterns, and consequences of use were similar to those reported for alcohol use previously, the social influences on use differed in important ways.

Copyright 2012, Elsevier Science

Chu DC. The links between religiosity, childhood sexual abuse, and subsequent marijuana use: An empirical inquiry of a sample of female college students. International Journal of Offender Therapy and Comparative Criminology 56(6): 937-954, 2012. (49 refs.)

A number of studies indicate that childhood sexual abuse (CSA) has a negative impact on later psychological well-being. It is well documented that experiences of CSA are associated with depression, self-destructiveness, and subsequent substance abuse or alcohol consumption. Compared with women who experienced no such sexual abuse in childhood, women who were victims of sexual abuse in childhood were more likely to be depressed and use drugs or consume alcohol in later life. Analyzing data of 1,569 females derived from the "Longitudinal Study of Violence Against Women," this study examines whether the strain caused by sexual victimization leads to a higher level of subsequent marijuana use and whether religiosity moderates the negative effects of CSA. It was found that CSA was associated with an increased level of marijuana use in high school. However, more proximate sexual victimization (victimization in college) seemed to override the impact of CSA on subsequent marijuana use. Religiosity was found to moderate the effect of CSA on marijuana use in high school. Religiosity was negatively associated with marijuana use in high school as well as the second and fourth collegiate years. Policy implications and promising directions for future research are discussed.

Copyright 2012, Sage Publications

Corey-Bloom J; Wolfson T; Gamst A; Jin S; Marcotte TD; Bentley H et al. Smoked cannabis for spasticity in multiple sclerosis: A randomized, placebo-controlled trial. Canadian Medical Association Journal 184(10): 1143-1150, 2012. (30 refs.)

Background: Spasticity is a common and poorly controlled symptom of multiple sclerosis. Our objective was to determine the short-term effect of smoked cannabis on this symptom. Methods: We conducted a placebo-controlled, crossover trial involving adult patients with multiple sclerosis and spasticity. We recruited participants from a regional clinic or by referral from specialists. We randomly assigned participants to either the intervention (smoked cannabis, once daily for three days) or control (identical placebo cigarettes, once daily for three days). Each participant was assessed daily before and after treatment. After a washout interval of 11 days, participants crossed over to the opposite group. Our primary outcome was change in spasticity as measured by patient score on the modified Ashworth scale. Our secondary outcomes included patients' perception of pain (as measured using a visual analogue scale), a timed walk and changes in cognitive function (as measured by patient performance on the Paced Auditory Serial Addition Test), in addition to ratings of fatigue. Results: Thirty-seven participants were randomized at the start of the study, 30 of whom completed the trial. Treatment with smoked cannabis resulted in a reduction in patient scores on the modified Ashworth scale by an average of 2.74 points more than placebo (p < 0.0001). In addition, treatment reduced pain scores on a visual analogue scale by an average of 5.28 points more than placebo (p = 0.008). Scores for the timed walk did not differ significantly between treatment and placebo (p = 0.2). Scores on the Paced Auditory Serial Addition Test decreased by 8.67 points more with treatment than with placebo (p = 0.003). No serious adverse events occurred during the trial. Interpretation: Smoked cannabis was superior to placebo in symptom and pain reduction in participants with treatment-resistant spasticity. Future studies should examine whether different doses can result in similar beneficial effects with less cognitive impact.

Copyright 2012, Canadian Medical Association

Costello MJE; Leatherdale ST; Ahmed R; Church DL; Cunningham JA. Co-morbid substance use behaviors among youth: Any impact of school environment? Global Health Promotion 19(1): 50-59, 2012. (36 refs.)

Background. Substance use is common among youth; however, our understanding of co-morbid tobacco, alcohol and marijuana use remains limited. The school-environment may play an important role in the likelihood a student engages in high risk substance use behaviors, including co-morbid use. Purpose. This study aims to: (i) describe the prevalence of co-morbid substance use behaviors among youth; (ii) identify and compare the characteristics of youth who currently use a single substance, any two substances, and all three substances; (iii) examine if the likelihood of co-morbid use varies by school and; (iv) examine what factors are associated with co-morbid use. Methods. This study used nationally representative data collected from students in grades 9 to 12 (n = 41, 886) as part of the 2006-2007 Canadian Youth Smoking Survey (YSS). Demographic and behavioral data were collected including, current cigarette, alcohol and marijuana use. Results. 6.5% (n = 107, 000) reported current use of all three substances and 20.3% (n = 333, 000) of any two substances. Multi-level analysis revealed significant between school variability in the odds a student used all three substances and any two substances; accounting for 16.9% and 13.5% of the variability, respectively. Co-morbid use was associated with sex, grade, amount of available spending money and perceived academic performance. Conclusions. Co-morbid substance use is high among youth; however, not all schools share the same prevalence. Knowing the school characteristics that place particular schools at risk for student substance use is important for tailoring drug and alcohol education programs. Interventions that target the prevention of co-morbid substance use are required.

Copyright 2012, Sage Publications

Cunningham JA; Blomqvist J; Koski-Jannes A; Raitasalo K. Societal images of cannabis use: Comparing three countries. Harm Reduction Journal 9: article 21, 2012. (6 refs.)

Background: Differences in beliefs about cannabis were compared between Canada, Sweden and Finland using nationally representative population surveys containing similar items. Findings: Compared to Finnish and Swedish respondents, Canadians were both more likely to have tried cannabis and to view cannabis as a less serious problem for society. Conclusions: These findings emphasize the extent to which views about cannabis can vary. It is possible that views about cannabis are, at least in part, a social construction influenced by media, social policy and exposure to the drug that varies from country to country.

Copyright 2012, Biomed Central

de Silva VA; Jayasekera NELW; Hanwella R. Smoking among troops deployed in combat areas and its association with combat exposure among navy personnel in Sri Lanka. Substance Abuse Treatment, Prevention and Policy 7(article 27), 2012. (31 refs.)

Background: Among military personnel alcohol consumption and binge-drinking have increased but cigarette smoking has declined in the recent past. Although there is a strong association between smoking and PTSD the association between combat exposure and smoking is not clear. Methods: This cross sectional study was carried out among representative samples of SLN Special Forces and regular forces deployed in combat areas. Both Special Forces and regular forces were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to end of combat operations were included in the study. Females were not included in the sample. The study assessed several mental health outcomes as well as alcohol use, smoking and cannabis use. Sample was classified according to smoking habits as never smokers, past smokers (those who had smoked in the past but not within the past year) and current smokers (those smoking at least one cigarette within the past 12 months). Results: Sample consisted of 259 Special Forces and 412 regular navy personnel. Prevalence of current smoking was 17.9% (95% CI 14.9-20.8). Of the sample 58.4% had never smoked and 23.7% were past smokers. Prevalence of current smoking was significantly higher among Special Forces personnel compared to regular forces. (OR 1.90 (95% CI 1.20-3.02). Personnel aged >= 35 years had the lowest prevalence of smoking (14.0%). Commissioned officers had a lower prevalence (12.1%) than non commissioned officers or other ranks. After adjustment for demographic variables and service type there was significant association between smoking and combat experiences of seeing dead or wounded [OR 1.79 (95% CI 1.08-2.9)], handling dead bodies [OR 2.47(95% CI 1.6-3.81)], coming under small arms fire [OR 2.01(95% CI 1.28-3.15)] and coming under mortar, missile and artillery fire [OR 2.02 (95% CI 1.29-3.17)]. There was significant association between the number of risk events and current smoking [OR 1.22 (95% CI 1.11-1.35)]. Conclusions: There was significant association between current smoking and combat experiences. Current smoking was strongly associated with current alcohol use. Prevalence of current smoking was less among military personnel than in the general population. Prevalence of smoking was significantly higher among Special Forces personnel.

Copyright 2012, Biomed Central

Dekker N; Meijer J; Koeter M; van den Brink W; van Beveren N; Kahn RS et al. Age at onset of non-affective psychosis in relation to cannabis use, other drug use and gender. Psychological Medicine 42(9): 1903-1911, 2012. (44 refs.)

Background. Cannabis use is associated with an earlier age at onset of psychotic illness. The aim of the present study was to examine whether this association is confounded by gender or other substance use in a large cohort of patients with a non-affective psychotic disorder. Method. In 785 patients with a non-affective psychotic disorder, regression analysis was used to investigate the independent effects of gender, cannabis use and other drug use on age at onset of first psychosis. Results. Age at onset was 1.8 years earlier in cannabis users compared to non-users, controlling for gender and other possible confounders. Use of other drugs did not have an additional effect on age at onset when cannabis use was taken into account. In 63.5% of cannabis-using patients, age at most intense cannabis use preceded the age at onset of first psychosis. In males, the mean age at onset was 1.3 years lower than in females, controlling for cannabis use and other confounders. Conclusions. Cannabis use and gender are independently associated with an earlier onset of psychotic illness. Our findings also suggest that cannabis use may precipitate psychosis. More research is needed to clarify the neurobiological factors that make people vulnerable to this precipitating effect of cannabis.

Copyright 2012, Cambridge University Press

Dickerson DL; Fisher DG; Reynolds GL; Baig S; Napper LE; Anglin MD. Substance use patterns among high-risk American Indians/Alaska Natives in Los Angeles County. American Journal on Addictions 21(5): 445-452, 2012. (37 refs.)

Background: Substance abuse among American Indians/Alaska Natives (AI/ANs) is a significant and long-standing health problem in the U.S. Two-thirds of American AIs/ANs reside in the urban setting. However, studies analyzing substance use characteristics among urban AI/ANs are very limited. Methods: Substance use patterns among a sample of AI/ANs (n = 77) and other ethnic/racial groups in Los Angeles County at high risk of substance abuse were analyzed utilizing three datasets from programs targeting individuals at high risk for substance abuse and risky sexual behaviors. Results: Compared to all other ethnic/racial groups, AI/ANs demonstrated significantly younger age of onset of alcohol, marijuana, methamphetamine, and other drug use, higher correlations of age of first use of amphetamine with a measure of the drug's reinforcement, and higher mean number of illicit drug injections in the 30 days before being interviewed. Conclusions: Results from this study highlight a critical need for furthering our understanding of substance abuse problems among urban AI/ANs

Copyright 2012, Wiley-Blackwell

Dillon P; Copeland J. Synthetic Cannabinoids: The Australian Experience. Bulletin 13. Sydney: National Cannabis Prevention and Intervention Centre (NCPIC), 2012. (46 refs.)

A wide range of legal 'herbal' products, claiming to have similar effects to cannabis, have been available in Australia for many years. This Bulletin provides a background of is known about synthetic cannabinoids. What are they, who uses them and why, and what harms have been identified in their use? Cannabinoids' are a structurally diverse family of compounds with a large number of biological targets and can be classified into three groups: phytocannabinoids, endocannabinoids and synthetic cannabinoids. The effects of all three groups of cannabinoids reflect the areas of the brain where they interact. Phytocannabinoids are only found in significant quantity in the cannabis plant. The synthetic cannabinoids act like THC; they bind to the same receptors In Australia, some synthetic cannabinoids have been used for medicinal purposes and have been scheduled as controlled substances (Rimonabant, subsequently removed from the market due to severe side effects, Nabilone, and Dronabinol.) Since 2004, herbal mixtures marketed as incense or air freshener became widely available worldwide via the Internet or head shops, and became marijuana substitutes. Product warnings state they were not intended for human consumption, but inconsistent with broad marketing presenting them as a cannabis alternative, undetectable by conventional drug testing. Spice was a well known product; and studies found that there is also variability in the combinations and concentrations of the synthetic cannabinoids within them. Thus Spice products, whether different brands, or different batches, can produce dramatically different effects. In terms of who uses synthetic cannabinoids and why, there is limited epidemiological data which can shed light on this. The major reports come from emergency room encounters. This indicates there was a diverse profile of use patterns -- but primarily male with more than 12 years of education, with 21% identifying Spice products as their preferred drug. The primary reasons for use were curiosity, positive drug effect, relaxation and to get high without having a positive drug test. Another study identified five possible reasons prompting use; that they induce psychoactive effects; they are legal (even though many products have been controlled in some countries, they are still legal in many, and this leads to heavy global marketing); they are readily available and highly attractive; they are perceived as safe; and they are not easily detectable in urine and blood samples. Of note, synthetic cannabinoids are often classified as 'research chemicals', thus not approved for human consumption. The majority have only been recently synthesized and little, if any data has been available on their effects, adverse reactions, long-term damage, or dependence potential. In Australia, synthetic cannabinoid products have been available for some time by Internet and specialist adult stores (e.g., 'sex shops' or 'head shops') or tobacconists. Although Spice is certainly the most well-known product, other products including Kalma, Voodoo, Kaos and Mango Kush are believed to contain synthetic cannabinoids. It was not until early 2011, that, following the growing media interest in the product 'Kronic', that Australian authorities began to focus their attention on this rapidly emerging class of drugs. The dominant brand of 'Kronic,' is produced and distributed by a New Zealand firm,. with the synthetic cannabinoids thought to be imported from China. Some workplaces -- particularly in the mining industry -- have reported impairments from synthetic cannabinoids. These helped prompt governmental responses. In New Zealand, synthetic cannabinoids were declared controlled substances. On the heels of that Australia took similar steps.

Copyright 2012, Project Cork

Doherty EE; Robertson JA; Green KM; Fothergill KE; Ensminger ME. A longitudinal study of substance use and violent victimization in adulthood among a cohort of urban African Americans. Addiction 107(2): 339-348, 2012. (41 refs.)

Aims: This paper examines the effects of experiencing violent victimization in young adulthood on pathways of substance use from adolescence to mid-adulthood. Design Data come from four assessments of an African American community cohort followed longitudinally from age 6 to 42 years. Setting:All first graders from the public and parochial schools were asked to participate (n = 1242). Measurement: Dependent variables-alcohol, marijuana and cocaine use-came from self-reports at age 42. Young adult violent victimization was reported at age 32, as were acts of violence, substance use, social integration and socio-economic resources. First grade risk factors came from mothers' and teachers' reports; adolescent substance use was self-reported. Findings: Structural equation models indicate a pathway from adolescent substance use to young adult violent victimization for females and those who did not grow up in extreme poverty (betas ranging from 0.15 to 0.20, P < 0.05). In turn, experiencing violent victimization in young adulthood increased alcohol, marijuana and cocaine use, yet results varied by gender and early poverty status (betas ranging from 0.12 to 0.15, P < 0.05). Conclusions: Violent victimization appears to play an important role in perpetuating substance use among the African American population. However, within-group variations are evident, identifying those who are not raised in extreme poverty as the most negatively affected by violence.

Copyright 2012, Society for the Study of Addiction to Alcohol and Other Drugs

Duff C; Asbridge M; Brochu S; Cousineau MM; Hathaway AD; Marsh D et al. A Canadian perspective on cannabis normalization among adults. Addiction Research & Theory 20(4): 271-283, 2012. (56 refs.)

Once associated with 'deviant' subcultures, the use of cannabis is now common across Canadian society. This has led some to argue that cannabis use is becoming normalized in Canada with important implications for drug policy, law enforcement and public health. This article takes up these issues, reporting the results of a qualitative study involving 165, socially integrated, adult cannabis users in four Canadian cities (Vancouver, Montreal, Toronto and Halifax). The aims of this study were twofold; first, we sought to contribute to recent efforts to extend the analysis of normalization and its associated features from adolescent and young adult populations to older adults, with a particular focus on cannabis. Second, we wished to respond to recent calls for greater analysis of both the social and structural determinants of normalization, as well as its contingent, 'micro-level' features. Our examination of these diverse dimensions revealed significant changes in the meaning and status of cannabis use in Canada. Although some social and personal stigmas remain, our research suggests they are largely confined to the immoderate, 'irresponsible' use of cannabis, while more 'controlled' use among adults appears all but de-stigmatized. This process has involved changes in the ways risks associated with cannabis use are characterized and managed; shifts in the ways adult cannabis users seek to moderate their use; as well as broader social and cultural shifts in the meanings associated with cannabis in Canada. We conclude with a discussion of the potential impacts of these developments for drug policy debates in Canada and elsewhere.

Copyright 2012, Informa Healthcare

Ernst L; Kruger K; Lindigkeit R; Schiebel HM; Beuerle T. Synthetic cannabinoids in "spice-like" herbal blends: First appearance of JWH-307 and recurrence of JWH-018 on the German market. Forensic Science International 222(1-3): 216-222, 2012. (15 refs.)

Herbal smoking blends, available on the German market were analyzed and several known synthetic cannabinoids were identified (JWH-122 and JWH-018). In addition, we isolated a new active ingredient by silica gel column chromatography and elucidated the structure by nuclear magnetic resonance (NMR) methods. The compound was identified as JWH-307, a synthetic cannabinoid of the phenyl-pyrrole subclass with known in vitro binding affinities for cannabinoid receptors. To date, this is the first appearance of this subclass of cannabimimetics in such products. JWH-307 has been further characterized by gas chromatography accurate mass spectrometry (GC-HRMS), electrospray tandem mass spectrometry (ESI-MS/MS), ultraviolet (UV) and infrared (IR) spectroscopy. JWH-018 was among the first compounds banned by many countries world-wide including Germany. The identification of JWH-018 was striking, since this is the first report where JWH-018 recurred on the German market thus violating existing laws. A generic method was established to quantify synthetic cannabinoids in herbal smoking blends. Quantification was achieved using an isotopically labeled standard (JWH-018-D-3). JWH-018 was found at a level of 150 mg/g while JWH-122 and JWH-307 occurred as a mixture at a total level of 232 mg/g.

Copyright 2012, Elsevier Science

Filbey FM; DeWitt SJ. Cannabis cue-elicited craving and the reward neurocircuitry. Progress in Neuro-Psychopharmacology & Biological Psychiatry 38(1, special issue): 30-35, 2012. (45 refs.)

Cue-elicited craving or the intense desire to consume a substance following exposure to a conditioned drug cue is one of the primary behavioral symptoms of substance use disorders (SUDs). While the concept of cue-elicited craving is well characterized in alcohol and other substances of abuse, only recently has it been described in cannabis. A review of the extant literature has established that cue-elicited craving is a powerful reinforcer that contributes to drug-seeking for cannabis. Further, emergent research has begun to identify the neurobiological systems and neural mechanisms associated with this behavior. What research shows is that while theories of THC's effects on the dopaminergic-reward system remain divergent, cannabis cues elicit neural activation in the brain's reward network.

Copyright 2012, Elsevier Science

Fine D. Too High to Fail. Los Angeles: Gotham, 2012

The nation's economy is in trouble, but there's one cash crop that has the potential to turn it around: cannabis (also known as marijuana and hemp). It has been estimated that the legal medicinal cannabis economy already generates $200 million annually in taxable proceeds from a mere two hundred thousand registered medical users in just fourteen states. However, at the federal level cannabis largely remains synonymous with heroin even though it has won mainstream acceptance nationwide. The underground cannabis sales are estimated to be in the vicinity of $35.8 billion annually. Thus revenues exceed the combined value of corn ($23.3 billion) and wheat ($7.5 billion). Considering the economic impact of Prohibition -- and its repeal -- the book isn't a commune-dweller's utopian rant, it's an objectively (if humorously) reported account of how one plant can drastically change the shape of our country, culturally, politically, and economically. The author covers everything from a brief history of hemp to an insider's perspective on a growing season in Mendocino County, where cannabis drives 80% of its economy. The author, an investigative journalist, follows one plant from seed to patient in the first American county to fully legalize and regulate cannabis farming.

Copyright 2012, Project Cork

Fitzcharles MA; McDougall J; Ste-Marie PA; Padjen I. Clinical implications for cannabinoid use in the rheumatic diseases: Potential for help or harm? Arthritis and Rheumatism 64(8): 2417-2425, 2012. (74 refs.)

This article addresses the potential use of medical marijuana in the care of rheumatic disease. Conclusion: Although use of cannabinoids and a clear understanding of the endocannabinoid and a clear understanding of the endocannabinoid system may be pertinent to the mechanisms and management of the rheumatic diseases, there remains limited evidence to support the therapeutic use of cannabinoids to date, and unanswered questions remain with regard to their true clinical efficacy and long-term risks. The ubiquitous distribution of cannabinoid receptors throughout the body, coupled with the known effects of cannabinoids on inflammation, pain, and even joint damage, should prompt further study in the rheumatic diseases. Indeed, preclinical studies look promising, with future protocols perhaps involving peripherally restricted cannabinoids or agents that boost endocannabinoid tone. Well-controlled clinical studies in the rheumatic diseases are lacking, and much of the reported therapeutic use has been based on anecdotal reports and advocacy. Unfortunately, the tainted image of cannabinoids, which stems from worldwide recreational use of marijuana, has negatively influenced stakeholders at all levels when medicinal use of cannabinoids is under consideration, and thus evidence-based therapeutic evaluation has stalled. Clearly, an agent with such diverse effects could potentially hold great promise for symptom management in the rheumatic disorders. At this time, however, there is insufficient evidence available to support a recommendation for the use of cannabinoids in the management of pain in the rheumatic diseases.

Copyright 2012, Wiley-Blackwell

Gagnon H; Tessier S; Cote J; April N; Julien AS. Psychosocial factors and beliefs related to intention to not binge drink among young adults. Alcohol and Alcoholism 47(5): 525-532, 2012. (37 refs.)

Aims: The objective of the study was to identify psychosocial factors and salient beliefs associated with the intention of young people to not binge drink in the next month, applying an extended version of the theory of planned behavior. Methods: Among 200 youths randomly recruited from adult education centers in the province of Quebec, Canada, 150 completed a questionnaire. Of these, 141 youths reported having used alcohol in the last year-analyses were performed on this sub-sample. Results: The prediction model demonstrated that perceived behavioral control (odds ratio, OR = 2.60, 95% confidence interval, CI 1.59-4.23; P = 0.0001), attitude (OR = 2.49, 95% CI 1.14-5.43; P = 0.02) and moral norm (OR = 1.88, 95% CI 1.23-2.88; P = 0.004) are three determinant variables of intention to not binge drink in the next month. The intention is also related to cannabis use in the last month (OR = 0.17 95% CI 0.05-0.53; P = 0.002). Young people who believe that if they do not binge drink in the next month, they will have a lower risk of getting depressed (OR = 1.53, 95% CI 1.23-1.90; P = 0.0001), and those who believe they will be able to not binge drink even if they are at a party (OR = 1.58, 95% CI 1.29-1.94; P < 0.0001), are more likely to have a positive intention. Conclusion: Despite some methodological limitations, this study revealed several options for helping young people to not binge drink during their school career.

Copyright 2012, Oxford University Press

Gonzalez R; Swanson JM. Long-term effects of adolescent-onset and persistent use of cannabis. (editorial). Proceedings of the National Academy of Sciences of the United States of America 109(40): 15970-15971, 2012. (22 refs.)

Gonzalez-Lopez JR; Rodriguez-Gazquez MD; Lomas-Campos MD. Prevalence of alcohol, tobacco and street drugs consumption in adult Latin American immigrants. Revista Latino-Americana de Enfermagem 20(3): 528-535, 2012. (25 refs.)

To estimate the prevalence of alcohol, tobacco and illicit drug consumption (through the self-report) in adult Latin-American immigrants of Seville, a cross-sectional descriptive study was carried out in a representative sample of 190 immigrants. The results showed that 61.4% of the participants had consumed alcohol in previous month before data collection, although 13.2% of them were at risk of alcoholism. Moreover, 30.0% were smokers. In addition, 5.3% of the interviewed people had consumed illicit psychoactive substances in the previous six months (Marihuana: 3.7%, hashish: 1.1% and cocaine: 0.5%). For all substances under analysis, the consumption prevalence was much higher in men from 25 to 39 years of age. In conclusion, prevalence levels of this consumption were high among the studied immigrants. Nurses could train the population in the prevention of these risk behaviors through preventive practices.

Copyright 2012, University Sao Paulo, Escola De Enfermagem De Ribeirao Preto

Gray KM; Carpenter MJ; Baker NL; DeSantis SM; Kryway E; Hartwell KJ et al. A double-blind randomized controlled trial of n-acetylcysteine in cannabis-dependent adolescents. American Journal of Psychiatry 169(8): 805-812, 2012. (40 refs.)

Objective: Preclinical findings suggest that the over-the-counter supplement N-acetylcysteine (NAC), via glutamate modulation in the nucleus accumbens, holds promise as a pharmacotherapy for substance dependence. The authors investigated NAC as a novel cannabis cessation treatment in adolescents, a vulnerable group for whom existing treatments have shown limited efficacy. Method: In an 8-week double-blind randomized placebo-controlled trial, treatment-seeking cannabis-dependent adolescents (ages 15-21 years; N=116) received NAC (1200 mg) or placebo twice daily as well as a contingency management intervention and brief (< 10 minutes) weekly cessation counseling. The primary efficacy measure was the odds of negative weekly urine cannabinoid test results during treatment among participants receiving NAC compared with those receiving placebo, in an intent-to-treat analysis. The primary tolerability measure was frequency of adverse events, compared by treatment group. Results: Participants receiving NAC had more than twice the odds, compared with those receiving placebo, of having negative urine cannabinoid test results during treatment (odds ratio=2.4, 95% CI=1.1-5.2). Exploratory secondary abstinence outcomes favored NAC but were not statistically significant. NAC was well tolerated, with minimal adverse events. Conclusions: This is the first randomized controlled trial of pharmacotherapy for cannabis dependence in any age group to yield a positive primary cessation outcome in an intent-to-treat analysis. Findings support NAC as a pharmacotherapy to complement psychosocial treatment for cannabis dependence in adolescents.

Copyright 2012, American Psychiatric Publishing

Green KM; Zebrak KA; Fothergill KE; Robertson JA; Ensminger ME. Childhood and adolescent risk factors for comorbid depression and substance use disorders in adulthood. Addictive Behaviors 37(11): 1240-1247, 2012. (86 refs.)

The comorbidity of major depression and substance use disorders is well documented. However, thorough understanding of prevalence and early risk factors for comorbidity in adulthood is lacking, particularly among urban African Americans. With data from the Woodlawn Study, which follows a community cohort of urban African Americans from ages 6 to 42, we identify the prevalence of comorbidity and childhood and adolescent risk factors of comorbid depression and substance use disorders, depression alone, and substance use disorders alone. Prevalence of comorbid substance use disorders and major depression in adulthood is 8.3% overall. Comorbidity in cohort men is twice that for women (11.1% vs. 5.7%). Adjusted multinomial regression models found few differences in risk factors for comorbidity compared to either major depression or a substance use disorder on its own. However, results do suggest distinct risk factors for depression without a substance use disorder in adulthood compared to a substance use disorder without depression in adulthood. In particular, low socioeconomic status and family conflict was related to increased risk of developing major depression in adulthood, while dropping out of high school was a statistically significant predictor of adult-onset substance use disorders. Early onset of marijuana use differentiated those with a substance use disorder with or without depression from those with depression without a substance use disorder in adjusted models. In conclusion, comorbid substance use disorders and depression are highly prevalent among these urban African Americans. Insight into the unique childhood and adolescent risk factors for depression compared to substance use disorders is critical to intervention development in urban communities. Results suggest that these programs must consider individual behaviors, as well as the early family dynamic.

Copyright 2012, Elsevier Science

Griffith-Lendering MFH; Huijbregts SCJ; Vollebergh WAM; Swaab H. Motivational and cognitive inhibitory control in recreational cannabis users. Journal of Clinical and Experimental Neuropsychology 34(7): 688-697, 2012. (56 refs.)

Substance use disorders have been associated with impaired decision making and increased impulsive behavior. Lack of inhibitory control may underlie such higher order cognitive difficulties and behavior problems. This study examined inhibitory control in 53 recreational cannabis users and 48 controls. Inhibitory control was tested with two computer tasks, one with a motivational component and one without such a component. Impulsive behavior was assessed using the Barratt Impulsiveness Scale. Results showed that the recreational cannabis users had poorer motivational inhibition (i.e., were more inclined to "gamble") than controls. There were no group differences in the cognitive inhibition task. Cannabis users also reported more impulsive behavior in daily life. This behavior was related to response style in the motivational inhibition task, but not to performance in the cognitive inhibition task. It is concluded that, among recreational cannabis users, lack of inhibitory control depends on contextual or situational factors-that is, it becomes evident only when situations or tasks involve a motivational component.

Copyright 2012, Taylor & Francis

Gruber SA; Sagar KA; Dahlgren MK; Racine M; Lukas SE. Age of onset of marijuana use and executive function. Psychology of Addictive Behaviors 26(3): 496-506, 2012. (53 refs.)

Marijuana (MJ) remains the most widely abused illicit substance in the United States, and in recent years, a decline in perceived risk of MJ use has been accompanied by a simultaneous increase in rates of use among adolescents. In this study, the authors hypothesized that chronic MJ smokers would perform cognitive tasks, specifically those that require executive function, more poorly than control subjects and that individuals who started smoking MJ regularly prior to age 16 (early onset) would have more difficulty than those who started after age 16 (late onset). Thirty-four chronic, heavy MJ smokers separated into early and late onset groups, and 28 non-MJ smoking controls completed a battery of neurocognitive measures. As hypothesized, MJ smokers performed more poorly than controls on several measures of executive function. Age of onset analyses revealed that these between-group differences were largely attributed to the early onset group, who were also shown to smoke twice as often and nearly 3 times as much MJ per week relative to the late onset smokers. Age of onset, frequency, and magnitude of MJ use were all shown to impact cognitive performance. Findings suggest that earlier MJ onset is related to poorer cognitive function and increased frequency and magnitude of MJ use relative to later MJ onset. Exposure to MJ during a period of neurodevelopmental vulnerability, such as adolescence, may result in altered brain development and enduring neuropsychological changes.

Copyright 2012, American Psychological Association

Hadland SE; Marshall BDL; Kerr T; Lai C; Montaner JS; Wood E. Ready access to illicit drugs among youth and adult users. American Journal on Addictions 21(5): 488-490, 2012. (16 refs.)

Background: Current drug-control strategies in Canada focus funding and resources predominantly on drug law enforcement, often at the expense of preventive, treatment, and harm reduction efforts. This study aimed to examine the availability of the most commonly used substances in Vancouver, Canada after the implementation of such strategies. Methods: Using data from two large cohorts of drug-using youth and adults in Vancouver from the calendar year 2007, we assessed perceived availability of heroin, crack, cocaine, crystal methamphetamine, and marijuana. Results: Compared to youth (n= 330), a greater proportion of adults (n= 1,160) reported immediate access (ie, within 10 minutes) to heroin (81.0% vs. 55.9%, p < .001), crack (90.4% vs. 69.3%, p < .001), and cocaine (83.7% vs. 61.1%, p < .001). Conversely, larger proportions of youth reported immediate access to crystal methamphetamine (62.8% vs. 39.4%, p < .001) and marijuana (88.4% vs. 73.2%, p < .001) compared to adult users. Conclusions: Regardless of differences in illicit drug availability by age, all drugs are readily accessed in Vancouver despite drug law enforcement efforts. This includes drugs that are frequently injected and place users at risk of human immunodeficiency virus (HIV) infection and transmission of other blood-borne disease.

Copyright 2012, Wiley-Blackwell

Harrington M; Baird J; Lee C; Nirenberg T; Longabaugh R; Mello M et al. Identifying subtypes of dual alcohol and marijuana users: A methodological approach using cluster analysis. Addictive Behaviors 37(1): 119-123, 2012. (19 refs.)

Alcohol is the most common psychoactive substance used with marijuana. However, little is known about the potential impact of different levels of use of both alcohol and marijuana and their influence on risky behaviors, injuries and psychosocial functioning. A systematic approach to identifying patterns of alcohol and marijuana use associated with increased risks has not yet been identified in the literature. We report on the secondary analysis of data collected from a RCT conducted in a busy urban emergency department. Cluster analysis was performed on the patterns of past 30-day alcohol and marijuana use in two random subsamples N(1)=210 and N(2)=217. Four distinct subtypes of those who use both alcohol and marijuana were identified: (1) Daily Marijuana and Weekly Alcohol users; (2) Weekly Alcohol and Weekly Marijuana users; (3) Daily Alcohol and Daily Marijuana users; and (4) Daily Alcohol, Weekly Marijuana users. The four subtypes were replicated in both subsamples and examination of the external validity using ANOVA to determine cluster differences on psychosocial and behavioral variables confirmed the theoretical relevance of different patterns of alcohol and marijuana use. There were significantly different psychosocial negative consequences and related risky behaviors among subtypes. We found that Daily Alcohol and Daily Marijuana users are at the highest risk to experience more negative consequences and engage in a broader spectrum of risky behaviors related to both substances, than the other three types of alcohol and marijuana users.

Copyright 2012, Elsevier Science

Hazekamp A; Fischedick JT. Cannabis - from cultivar to chemovar. Drug Testing and Analysis 4(7-8): 660-667, 2012. (35 refs.)

The medicinal use of Cannabis is increasing as countries worldwide are setting up official programs to provide patients with access to safe sources of medicinal-grade Cannabis. An important question that remains to be answered is which of the many varieties of Cannabis should be made available for medicinal use. Drug varieties of Cannabis are commonly distinguished through the use of popular names, with a major distinction being made between Indica and Sativa types. Although more than 700 different cultivars have already been described, it is unclear whether such classification reflects any relevant differences in chemical composition. Some attempts have been made to classify Cannabis varieties based on chemical composition, but they have mainly been useful for forensic applications, distinguishing drug varieties, with high THC content, from the non-drug hemp varieties. The biologically active terpenoids have not been included in these approaches. For a clearer understanding of the medicinal properties of the Cannabis plant, a better classification system, based on a range of potentially active constituents, is needed. The cannabinoids and terpenoids, present in high concentrations in Cannabis flowers, are the main candidates. In this study, we compared cultivars obtained from multiple sources. Based on the analysis of 28 major compounds present in these samples, followed by principal component analysis (PCA) of the quantitative data, we were able to identify the Cannabis constituents that defined the samples into distinct chemovar groups. The study indicates the usefulness of a PCA approach for chemotaxonomic classification of Cannabis varieties.

Copyright 2012, Wiley-Blackwell

Hendricks PS; Delucchi KL; Humfleet GL; Hall SM. Alcohol and marijuana use in the context of tobacco dependence treatment: Impact on outcome and mediation of effect. Nicotine & Tobacco Research 14(8): 942-951, 2012. (56 refs.)

Introduction: Alcohol and marijuana are among the most commonly used substances together with tobacco worldwide, but their relationship to smoking cessation is unclear. Although alcohol use decreases the likelihood of abstinence from tobacco, mechanisms of this effect have not been identified. Moreover, a small literature has yielded inconsistent findings regarding the effect of marijuana use on tobacco dependence treatment outcome. The aims of this study were to test increased positive-reinforcement smoking urge as a mediator of the relationship between alcohol and cigarette use and evaluate the impact of marijuana use on abstinence from tobacco. Methods: Participants were adult cigarette smokers (N = 739) from 3 randomized clinical trials of smoking cessation treatment. Alcohol consumption and marijuana use were assessed at pretreatment and postcessation. Biochemically verified, 7-day point prevalence smoking abstinence was determined at Weeks 12, 24, 36, and 52, as were urges to smoke as measured by the Questionnaire of Smoking Urges. Results: Increased positive-reinforcement urge mediated the effect of postcessation alcohol use on smoking abstinence. Although pretreatment alcohol use was associated with a decreased likelihood of abstinence from tobacco, increased positive-reinforcement urge did not account for this relationship. Marijuana use was not associated with abstinence from tobacco. Conclusions: Smoking cessation treatments should provide those who drink during a quit attempt techniques designed to mitigate positive-reinforcement urge to smoke. Additional research is needed to determine how pretreatment alcohol consumption exerts its effect on cigarette use. Modifying the use of marijuana might not be critical to the success of tobacco interventions.

Copyright 2012, Oxford University Press

Hendriks V; van der Schee E; Blanken P. Matching adolescents with a cannabis use disorder to multidimensional family therapy or cognitive behavioral therapy: Treatment effect moderators in a randomized controlled trial. Drug and Alcohol Dependence 125(1-2): 119-126, 2012. (59 refs.)

Background: In a recent randomized controlled trial (Hendriks et al., 2011), multidimensional family therapy (MDFT) and cognitive behavioral therapy (CBT) were equally effective in reducing cannabis use in adolescents (13-18 years old) with a cannabis use disorder (n = 109). In a secondary analysis of the trial data, we investigated which pretreatment patient characteristics differentially predicted treatment effect in MDFT and CBT, in order to generate hypotheses for future patient-treatment matching. Methods: The predictive value of twenty patient characteristics, in the area of demographic background, substance use, substance-related problems, delinquency, treatment history, psychopathology, family functioning and school or work related problems, was investigated in bivariate and subsequent multivariate linear regression analyses, with baseline to month 12 reductions in cannabis use days and smoked joints as dependent variables. Results: Older adolescents (17-18 years old) benefited considerably more from CBT, and younger adolescents considerably more from MDFT (p < 0.01). Similarly, adolescents with a past year conduct or oppositional defiant disorder, and those with internalizing problems achieved considerably better results in MDFT, while those without these coexisting psychiatric problems benefited much more from CBT (p < 0.01, and p = 0.02, respectively). Conclusions: The current study strongly suggests that age, disruptive behavior disorders and internalizing problems are important treatment effect moderators of MDFT and CBT in adolescents with a cannabis use disorder. If replicated, this finding suggests directions for future patient-treatment matching in adolescent substance abuse treatment.

Copyright 2012, Elsevier Science

Hoertel N; Dubertret C; Schuster JP; Le Strat Y. Sex differences in shoplifting: Results from a national sample. Journal of Nervous and Mental Disease 200(8): 728-733, 2012. (12 refs.)

This study presents the sex differences in sociodemographics and in psychiatric correlates of shoplifting in the United States. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults. Shoplifting was associated with numerous psychiatric and addictive disorders with significant sex effects. Women with a lifetime history of shoplifting were significantly more likely than men with a lifetime history of shoplifting to have a lifetime diagnosis of alcohol abuse or dependence, nicotine dependence, cannabis, amphetamine, cocaine, or inhalant use disorder, and antisocial personality disorder, whereas men were significantly more likely than women to have a lifetime diagnosis of generalized anxiety disorder. The findings suggest that shoplifting could be better understood as a behavioral manifestation of a broader impaired impulse control spectrum in women. Shoplifting could be more a part of the externalizing spectrum disorders rather than the internalizing spectrum disorders in women compared to men.

Copyright 2012, Lippincott, Williams & Wilkins

Hoyte CO; Jacob J; Monte AA; Al-Jumaan M; Bronstein AC; Heard KJ. A characterization of synthetic cannabinoid exposures reported to the National Poison Data System in 2010. Annals of Emergency Medicine 60(4): 435-438, 2012. (13 refs.)

Study objective: Delta-9-Tetrahydrocannabinol homologs have been increasingly abused since their introduction in 2004. Such products were used as a "legal high" for those wishing to experience cannabinoid effects while evading basic drugs-of-abuse testing. We describe a series of exposures to products marketed as synthetic cannabinoids to better characterize the clinical effects in these patients. Methods: All Delta-9-tetrahydrocannabinol homolog exposures reported to the National Poison Data System between January 1, 2010, and October 1, 2010, were extracted with National Poison Data System generic codes and product codes for Delta-9-tetrahydrocannabinol homologs. Only cases involving a single-agent exposure to Delta-9-tetrahydrocannabinol homologs as the major category were analyzed. Descriptive statistics were generated for demographic data, management site, products involved, symptoms, duration of effects, treatments, and severity of clinical effects. Results: During the 9-month study period, there were 1,898 exposures to Delta-9-tetrahydrocannabinol homologs; 1,353 of these cases were single-agent exposures. The mean age was 22.5 years (SD 8.86 years). Most cases were reported in men (n = 1,005; 74.3%). The majority of exposures were acute (88.2%; n = 1,193). The most common clinical effect was tachycardia (37.7%; n = 510). Seizures were reported in 52 patients (3.8%). The majority of clinical effects lasted for fewer than 8 hours (n = 711; 78.4%) and resulted in 1,011 non-life-threatening clinical effects (92.9%). The most common therapeutic intervention was intravenous fluids (n = 343; 25.3%). There was 1 death (0.1%). Conclusion: The majority of cases were in young men intentionally abusing spice. Most exposures resulted in non life-threatening effects not requiring treatment, although a minority of exposures resulted in more severe effects, including seizures.

Copyright 2012, Elsevier Science

Ilgen M; Edwards P; Kleinberg F; Bohnert ASB; Barry K; Blow FC. The prevalence of substance use among patients at a dental school clinic in Michigan. Journal of the American Dental Association 143(8): 890-896, 2012. (28 refs.)

Background. Problematic alcohol use and illicit drug use are associated with a number of physical health consequences, including poor oral health. The authors evaluate the prevalence of problematic alcohol use and illicit drug use in . adults who visited a dental school clinic. Methods. The authors recruited patients from the waiting area of the clinic. During recruitment, 85.9 percent of patients (n = 384) who the authors approached consented to participate in the study. Results. Overall, 20.6 percent of the participants reported either recent problematic alcohol use or illicit drug use; 7.4 percent of reported problematic alcohol use and 18.6 percent reported illicit drug use. The most common illicit drugs participants reported that they used were marijuana (16.8 percent), amphetamines (2.6 percent) and cocaine (1.1 percent). Participants who reported recent problematic alcohol use or illicit drug use were more likely to identify as white, were younger and did not have a spouse or partner. Conclusions. There was a high prevalence of illicit drug use and problematic alcohol use among the patients seen at dental school clinic. These rates were higher than those in the general population. Clinical Implications. The findings suggest that dental clinics are appropriate settings in which to identify and provide interventions for adults at risk of experiencing problems due to alcohol or drug use.

Copyright 2012, American Dental Association

Jacobus J; Goldenberg D; Wierenga CE; Tolentino NJ; Liu TT; Tapert SF. Altered cerebral blood flow and neurocognitive correlates in adolescent cannabis users. Psychopharmacology 222(4): 675-684, 2012. (60 refs.)

The effects of adolescent marijuana use on the developing brain remain unclear, despite its prevalence. Arterial spin labeling (ASL) is a noninvasive imaging technique that characterizes neurovascular status and cerebral blood flow (CBF), potentially revealing contributors to neuropathological alterations. No studies to date have looked at CBF in adolescent marijuana users. This study examined CBF in adolescent marijuana users and matched healthy controls at baseline and after 4 weeks of monitored abstinence. Heavy adolescent marijuana users (n = 23, > 200 lifetime marijuana use days) and demographically matched controls (n = 23) with limited substance exposure underwent an ASL brain scan at an initial session and after 4 weeks of sequential urine toxicology to confirm abstinence. Marijuana users showed reduced CBF in four cortical regions including the left superior and middle temporal gyri, left insula, left and right medial frontal gyrus, and left supramarginal gyrus at baseline; users showed increased CBF in the right precuneus at baseline, as compared to controls (corrected p values < 0.05). No between group differences were found at follow-up. Marijuana use may influence CBF in otherwise healthy adolescents acutely; however, group differences were not observed after several weeks of abstinence. Neurovascular alterations may contribute to or underlie changes in brain activation, neuropsychological performance, and mood observed in young cannabis users with less than a month of abstinence.

Copyright 2012, Springer

Johnston LD; O'Malley PM; Bachman JG; Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975-2011. Volume II: College Students & Adults Ages 19-50. Bethesda MD: National Institute on Drug Abuse, 2012. (69 refs.)

This is the second volume of the three part 2011 report of findings from the Monitoring the Future Survey. It presents data on drug use among college students and adults, ages 19-50. There report is organized in nine chapters. The first three provide an introduction, key findings, and an overview of the study design and procedures. The next six address prevalence of drug use in early and middle adulthood; trends in drug use in early and middle adulthood; attitudes; beliefs about drugs among young adults; and the social context. The last two chapters deal with the prevalence of drug use among college students and trends in drug use among the college population. There is also consideration of sub-groups, regional differences, differences by various demographic characteristics, and cohort differences. Data is summarized in 30 tables and 84 figures.

Copyright 2012, Project Cork

Kalapatapu RK; Bedi G; Haney M; Evans SM; Rubin E; Foltin RW. Substance use after participation in laboratory studies involving smoked cocaine self-administration. Drug and Alcohol Dependence 120(1-3): 162-167, 2012. (31 refs.)

Objective: Laboratory studies in which drugs of abuse are self- or experimenter-administered to non-treatment-seeking research volunteers provide valuable data about new pharmacotherapies for substance use disorders, as well as behavioral and performance data for understanding the neurobiology of drug abuse. This paper analyzed follow-up data from six smoked cocaine self-administration laboratory studies, in order to determine whether changes in substance use occurred 1 and 3 months after study participation compared to pre-study baseline. Methods: Ninety-eight healthy, non-treatment-seeking cocaine users were admitted to inpatient and combined inpatient/outpatient studies lasting from 12 to 105 days. The studies allowed participants to self-administer repeated doses of smoked cocaine (0, 6, 12, 25, and/or 50 mg per dose) on multiple occasions. Participants returned for follow-up at 1 and 3 months, at which time self-reported consumption of cocaine, alcohol, marijuana, and nicotine was assessed. Results: Compared to baseline ($374.04/week, S.D. $350.09), cocaine use significantly decreased at 1 month ($165.13/week, S.D. $165.56) and 3 months ($118.59/week, S.D. $110.48) after study participation (p < 0.001; results based on the 39 participants who completed all 3 time points). This decrease was not accompanied by a change in other drug use, e.g., a compensatory increase in alcohol, marijuana or nicotine use. Conclusion: Study participation was not associated with increased post-study cocaine, alcohol, marijuana, or nicotine use. Thus, human laboratory models of cocaine self-administration, conducted in non-treatment-seeking research volunteers, are relatively safe, and study participation does not exacerbate ongoing drug use.

Copyright 2012, Elsevier Science

Kelly TM; Daley DC; Douaihy AB. Treatment of substance abusing patients with comorbid psychiatric disorders. (review). Addictive Behaviors 37(1): 11-24, 2012. (148 refs.)

To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence-based process that enhances treatment effectiveness in comorbid patients. Articles were extracted from Pubmed using the search terms "dual diagnosis," "comorbidity" and "co-occurring" and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity. Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions. Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological treatments.

Copyright 2012, Elsevier Science

Khan MK; Usmani MA; Hanif SA. A case of self amputation of penis by cannabis induced psychosis. Journal of Forensic and Legal Medicine 19(6): 355-357, 2012. (14 refs.)

Self-mutilation, self-injuring or self-harming behaviour has been defined as deliberate destruction or alteration of body tissue in the absence of conscious suicidal intention. Persons suffering from mental disorder may inflict hundred of small wounds upon themselves which may be added to the actual cause of death. Another recognized syndrome is self mutilation of genitals almost invariably in males suffering from paranoid schizophrenia and often with strong religious flavour to their delusion. Here we present a case of a 35-year-old male who self mutilated his penis due to dependence on cannabis for the past few years that led to a condition called cannabis induced psychosis.

Copyright 2012, Faculty of Forensic and Legal Medicine

Kinner SA; Dietze PM; Gouillou M; Alati R. Prevalence and correlates of alcohol dependence in adult prisoners vary according to Indigenous status. Australian and New Zealand Journal of Public Health 36(4): 329-334, 2012. (49 refs.)

Objective: To estimate the prevalence and identify independent correlates of alcohol dependence among Indigenous and non-Indigenous adult prisoners in Queensland. Methods: A confidential, cross-sectional survey of 1,155 adult prisoners (n=274 Indigenous, n=881 non-Indigenous) in seven adult prisons in Queensland. The usual alcohol consumption in the year before prison was assessed using the Alcohol Use Disorders Identification Test (AUDIT); scores =20 are considered consistent with alcohol dependence. Results: Indigenous prisoners were significantly more likely than non-Indigenous prisoners to report patterns of alcohol consumption consistent with dependence. Separate multivariable analyses revealed different independent correlates of alcohol dependence according to Indigenous status. Among Indigenous prisoners, significant independent correlates of alcohol dependence included income below the poverty line and daily cannabis use before incarceration. Daily heroin use and history of injecting drug use were protective. Among non-Indigenous prisoners, significant independent correlates included history of mental illness or self harm, and daily tobacco or cannabis use before incarceration. Older age and daily heroin use before incarceration were protective. Conclusions and Implications: The prevalence of risky alcohol use and dependence is high in Australian prisoner populations, particularly among Indigenous prisoners. Risk factors for alcohol dependence differ according to Indigenous status, indicating that separate, culturally appropriate interventions to reduce alcohol-related harm for Indigenous prisoners may be required.

Copyright 2012, Wiley-Blackwell

Kopak AM; Proctor SL; Hoffmann NG. An assessment of the compatibility of DSM-IV and proposed DSM-5 criteria in the diagnosis of cannabis use disorders. Substance Use & Misuse 47(12): 1328-1338, 2012. (34 refs.)

The current study used an automated version of the Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV) to assess DSM-IV (fourth edition of the Diagnostic and Statistical Manual of Mental Disorders) and two sets of proposed DSM-5 (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders) cannabis use disorder criteria among adult prison inmates in the Minnesota Department of Corrections state prison system from 2000 to 2003. Initially proposed DSM-5 criteria had only two diagnostic designations (moderate and severe). A subsequent revision added a mild designation and required a greater number of positive findings for the severe diagnosis. The sample was composed of 7,672 (89.6% male) inmates. Inmates with no DSM-IV diagnoses and most who currently received a cannabis dependence diagnosis according to the DSM-IV guidelines will fit into corresponding DSM-5 categories (i.e., no diagnosis and severe cannabis use disorder, respectively). Some diagnostic criteria, in addition to those proposed for the DSM-5, emerged as cardinal indicators of moderate cannabis use disorder. The study's limitations are noted.

Copyright 2012, Informa Healthcare

Le Merrer J; Befort K; Gardon O; Filliol D; Darcq E; Dembele D et al. Protracted abstinence from distinct drugs of abuse shows regulation of a common gene network. Addiction Biology 17(1): 1-12, 2012. (98 refs.)

Addiction is a chronic brain disorder. Prolonged abstinence from drugs of abuse involves dysphoria, high stress responsiveness and craving. The neurobiology of drug abstinence, however, is poorly understood. We previously identified a unique set of hundred mu-opioid receptor-dependent genes in the extended amygdala, a key site for hedonic and stress processing in the brain. Here we examined these candidate genes either immediately after chronic morphine, nicotine, delta-9-tetrahydrocannabinol or alcohol, or following 4 weeks of abstinence. Regulation patterns strongly differed among chronic groups. In contrast, gene regulations strikingly converged in the abstinent groups and revealed unforeseen common adaptations within a novel huntingtin-centered molecular network previously unreported in addiction research. This study demonstrates that, regardless the drug, a specific set of transcriptional regulations develops in the abstinent brain, which possibly contributes to the negative affect characterizing protracted abstinence. This transcriptional signature may represent a hallmark of drug abstinence and a unitary adaptive molecular mechanism in substance abuse disorders.

Copyright 2012, Wiley-Blackwell

Leeson VC; Harrison I; Ron MA; Barnes TRE; Joyce EM. The effect of cannabis use and cognitive reserve on age at onset and psychosis outcomes in first-episode schizophrenia. Schizophrenia Bulletin 38(4): 873-880, 2012. (40 refs.)

Objective: Cannabis use is associated with a younger age at onset of psychosis, an indicator of poor prognosis, but better cognitive function, a positive prognostic indicator. We aimed to clarify the role of age at onset and cognition on outcomes in cannabis users with first-episode schizophrenia as well as the effect of cannabis dose and cessation of use. Methods: Ninety-nine patients without alcohol or substance abuse other than cannabis were divided into lifetime users and never-users of cannabis and compared on measures of premorbid function, cognition, and clinical outcome. Results: Cannabis users demonstrated better cognition at psychosis onset, which was explained by higher premorbid IQ. They also showed better social function and neither measure changed over the subsequent 15 months. Cannabis users had an earlier age at onset of psychosis, and there was a strong linear relationship between age at first cannabis use and age at onset of both prodromal and psychotic symptoms. Cannabis use spontaneously declined over time with 3-quarters of users giving up altogether. Later age at first cannabis use predicted earlier cessation of use and this in turn was linked to fewer positive psychotic symptoms and days in hospital during the first 2 years. Conclusions: Cannabis use brings forward the onset of psychosis in people who otherwise have good prognostic features indicating that an early age at onset can be due to a toxic action of cannabis rather than an intrinsically more severe illness. Many patients abstain over time, but in those who persist, psychosis is more difficult to treat.

Copyright 2012, Oxford University Press

Legleye S; Kraus L; Piontek D; Phan O; Jouanne C. Validation of the Cannabis Abuse Screening Test in a sample of cannabis inpatients. European Addiction Research 18(4): 193-200, 2012. (39 refs.)

The present study aims at validating the Cannabis Abuse Screening Test (CAST) in a clinical sample of adolescent and young adult cannabis users seeking treatment. Applying a classical test theory approach using DSM-IV diagnoses as gold standard, two versions of the CAST questionnaire are compared. The sample consisted of 140 subjects aged 15-26 years (mean 18.9) recruited from two cannabis treatment centers. Gold standard diagnoses were assessed using the Adolescent Diagnostic Interview-Light. Internal structure and consistency of the CAST were assessed by principal component analysis and Cronbach's alpha. Optimal thresholds were defined using receiver operating characteristic analysis. Both the binary and the full test version revealed unidimensional structures with moderate to satisfactory internal consistency (alpha = 0.66 and 0.73). Screening properties were unsatisfactory when the CAST was compared against cannabis dependence. With regard to cannabis use disorders, both test versions yielded comparable and good sensitivity and specificity at cut-off 3 (binary: 92.2%, 66.7%) and 6 (full: 93.0%, 66.7%). Overall, the full CAST may be used for screening cannabis use disorders in clinical settings. Further research may use validation methods that do without gold standard.

Copyright 2012, Karger

Lisdahl KM; Price JS. Increased marijuana use and gender predict poorer cognitive functioning in adolescents and emerging adults. Journal of the International Neuropsychological Society 18(4): 678-688, 2012. (90 refs.)

This study sought to characterize neuropsychological functioning in MJ-using adolescents and emerging adults (ages 18-26) and to investigate whether gender moderated these effects. Data were collected from 59 teens and emerging adults including MJ users (n = 23, 56% female) and controls = 35, 50% female) aged 18-26 (M = 21 years). Exclusionary criteria included independent Axis 1 disorders (besides SUD), and medical and neurologic disorders. After controlling for reading ability, gender, subclinical depressive symptoms, body mass index, and alcohol and other drug use, increased MJ use was associated with slower psychomotor speed/sequencing ability (p < .01), less efficient sustained attention (p < .05), and increased cognitive inhibition errors (p < .03). Gender significantly moderated the effects of MJ on psychomotor speed/sequencing ability (p < .003) in that males had a more robust negative relationship. The current study demonstrated that MJ exposure was associated with poorer psychomotor speed, sustained attention and cognitive inhibition in a dose-dependent manner in young adults, findings that are consistent with other samples of adolescent MJ users. Male MJ users demonstrated greater cognitive slowing than females. Future studies need to examine the neural substrates underlying with these cognitive deficits and whether cognitive rehabilitation or exercise interventions may serve as a viable treatments of cognitive deficits in emerging adult MJ users.

Copyright 2012, Cambridge University Press

McChargue DE; Klanecky AK; Anderson J. Alcohol use problems mediate the relation between cannabis use frequency and college functioning among students mandated to an alcohol diversion program. Journal of College Student Development 53(4): 611-615, 2012. (15 refs.)

The present study examined the degree to which alcohol use problems explained the relationship between cannabis use frequency and college functioning. Undergraduates (N = 546) mandated to an alcohol diversion program at a Midwestern United States university completed screening questionnaires between October 2003 and April 2006 Sobel's (1982) test of mediation showed that problematic drinking fully mediated cannabis use frequency's relationship to (a) lower grades and (b) greater legal problems. Findings underscore the notion that cannabis use's association with college functioning may depend on the severity of alcohol use problems.

Copyright 2012, Johns Hopkins University Press

McGuinness TM; Newell D. Risky recreation: Synthetic cannabinoids have dangerous effects. Journal of Psychosocial Nursing and Mental Health Services 50(8): 16-18, 2012. (12 refs.)

Use of synthetic marijuana (also known as spice, K2, aroma, and eclipse) is often viewed by young people as harmless recreation. Until recently, the substance was freely available in U.S. convenience stores and head shops, and it is still available via the Internet. Emerging evidence shows a wide range of responses to the drug, including paranoia, aggressive behavior, anxiety, and short-term memory deficits. Synthetic cannabinoids are not currently detectable via standard toxicology tests. Recognition and management of synthetic cannabinoid use are discussed.

Copyright 2012, Slack

Miech R; Koester S. Trends in U.S., past-year marijuana use from 1985 to 2009: An age-period-cohort analysis. Drug and Alcohol Dependence 124(3): 259-267, 2012. (23 refs.)

Background: We present a formal age-period-cohort analysis to examine if the recent increase in past-year marijuana use among the young is specific to the younger generation or if, instead, it is part of a general increase present across cohorts of all ages. This is the first age-period-cohort analysis of past-year marijuana use that includes adult trends from 2001 to 09. Methods: Data come from the National Survey on Drug Use and Health, a series of annual, nationally representative, cross-sectional surveys of the U.S. civilian, non-institutionalized population. The analysis focuses on the 25 year time span from 1985 to 2009 and uses the recently developed 'intrinsic estimator' algorithm to estimate independent effects of age, period, and cohort. Results: The recent increase in past-year marijuana use is not unique to the youngest birth cohorts. An independent, positive influence of cohort membership on past-year marijuana use, net of historical period and age effects, is smaller for today's youngest cohorts than it was for the cohorts that came immediately before, and, in fact, is at its lowest level in three decades. The recent increase in marijuana use among the young is more consistent with a historical period effect that has acted across all cohorts. Period and cohort trends differ substantially for Hispanics. Conclusions: The major forces that drive trends in past-year marijuana use are moving away from cohort-specific factors and toward broad-based influences that affect cohorts of all ages. Strategic public health and policy efforts aimed at addressing the recent increase in past-year marijuana use should do the same.

Copyright 2012, Elsevier Science

Mihalca AM; Gherasim LR; Chendran LA. Research Note: Adolescents' perception of psychosis risk following cannabis consumption. Substance Use & Misuse 47(4): 396-402, 2012. (25 refs.)

Cannabis consumption during adolescence has been associated with the onset of psychosis. In 2010, we examined adolescents' perception of this association. Adolescents (N = 583) from four Romanian urban high schools filled in psychosis proneness scales according to the risk they assigned to hypothetical adolescents described in vignettes. Target adolescent's frequency and age of first consumption were manipulated. Analysis of variance indicated a main effect of target's consumption frequency, but no effect of age of first consumption on psychosis risk perception. Participants' own consumption status acted as moderator. Results highlight the discrepancy between clinical research results and adolescents' perception of psychosis risk. The study's limitations are noted.

Copyright 2012, Informa Healthcare

Moeller K. Estimating drug policy expenditures: Direct costs of policing cannabis in Copenhagen 2000-2009. Drugs: Education, Prevention and Policy 19(5): 379-386, 2012. (47 refs.)

Aim: To establish estimates for the direct costs of policing cannabis in Copenhagen. Methods: Policing is disaggregated into the two tactical components of retail-level policing and crackdowns. Costs for retail-level policing are estimated using a micro-costing and gross-costing approach. Crackdowns are estimated on the basis of data contained in memorandum. Findings: Retail-level policing is found to require between 0.1 and 2.2% in low-intensity years and 0.25 and 5.7% in high-intensity years. Crackdowns are found to cost upwards of 10% of available annual resources. These estimates illustrate the variations in policing cannabis from year-to-year, depending on enforcement intensity and choice of tactical components between retail-level and crackdowns. Conclusions: Estimating drug policy expenditures is an exploratory endeavour in Denmark. The scopes of the presented estimates are found to be congruent with international estimates to the extent that conditions are comparable.

Copyright 2012, Informa Healthcare

Moreno M; Estevez AF; Zaldivar F; Montes JMG; Gutierrez-Ferre VE; Esteban L et al. Impulsivity differences in recreational cannabis users and binge drinkers in a university population. Drug and Alcohol Dependence 124(3): 355-362, 2012. (99 refs.)

Background: Recreational cannabis use and alcohol binge drinking are the most common drug consumption patterns in young adults. Impulsivity and several psychopathological signs are increased in chronic drug users, but the implications of recreational use are still poorly understood. Methods: We evaluated impulsivity, sensation-seeking traits, impulsive decision-making, inhibitory control and possible symptoms of depression, anxiety and psychosis in three groups of young university adults: recreational cannabis users (N = 20), alcohol binge drinkers (N=22) and non-drug users (N=26). Results: The cannabis and binge drinking groups had increased scores for impulsivity and sensation-seeking traits. Both groups also exhibited increased impulsive decision-making on the two-choice task and the Iowa Gambling task; however, only the cannabis group was significantly different from the non-drug group regarding inhibitory control (Go/No-Go and Stop tasks). The cannabis and binge drinking groups did not show differences in the psychopathological symptoms evaluated. Conclusions: Our observations of this population of non-dependent drug users are consistent with the increased impulsivity traits and behaviors that have been described previously in chronic drug abusers. In this study, compared to no drug use, the recreational use of cannabis was associated with a major dysfunction of the different facets of impulsive behaviors. However, alcohol binge drinking was related only to impulsive decision-making. These results suggest that impulsivity traits and behaviors are present not only in chronic drug abusers but also in recreational drug users. Future work should continue to investigate the long-term effects of these common consumption patterns on various impulsive behaviors and psychopathological symptoms.

Copyright 2012, Elsevier Science

Moss HB; Chen CM; Yi HY. Measures of substance consumption among substance users, DSM-IV abusers, and those with DSM-IV dependence disorders in a nationally representative sample. Journal of Studies on Alcohol and Drugs 73(5): 820-828, 2012. (24 refs.)

Objective: Neither the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), nor the DSM-IV uses measures of substance consumption as part of the diagnostic criteria for substance use disorders. Therefore, this report examined the extent to which frequency and/or quantity of consumption across a broad spectrum of substances are associated with DSM-IV diagnoses of specific substance use disorders and whether there are informative hierarchical levels of consumption among users, abusers, and those who are substance dependent in the U.S. general population. Method: The analyses focused on consumption data from respondents of the 2001-2002 National Epidemiologic Survey of Alcohol and Related Disorders. Multinomial logistic regression was used to predict DSM-IV diagnoses of dependence or abuse based on the continuous consumption measures. Results: Among individuals who used substances, the substances with the greatest liability for dependence were nicotine first and cocaine second. For nearly all substances investigated, users without specific substance use disorders demonstrated lower levels of quantity and frequency of consumption relative to those with DSM-IV abuse and dependence disorders. Dose-response curves for the log odds of abuse and dependence suggested unidimensionality of abuse and dependence for frequency of alcohol drinking; frequency of cannabis use; frequency of opioid use; frequency of hallucinogen use; and, to a lesser extent, frequency of amphetamine use. However, the dose-response curves for the quantity of alcohol consumed demonstrated differential patterns for abuse and dependence such that alcohol dependence has a distinctly greater "quantity of use" relationship than that found among alcohol-abusing individuals. Conclusions: These results confirm the findings of others concerning the unidimensionality of abuse and dependence diagnoses when consumption variables alone are examined and suggest that consumption measures may be useful metrics gauging severity.

Copyright 2012, Alcohol Research Documentation

Newton NC; Havard A; Teesson M. The association between moral disengagement, psychological distress, resistive self-regulatory efficacy and alcohol and cannabis use among adolescents in Sydney, Australia. Addiction Research & Theory 20(3): 261-269, 2012. (82 refs.)

Objective: The current study aimed to: (i) examine the estimated proportion of young Australian's using alcohol and cannabis, and (ii) investigate a number of individual risk factors associated with use. Method: A total of 1022 students aged between 12 and 15 years (86% male) were recruited from ten independent schools in Sydney, Australia. All participants completed a questionnaire measuring demographics, levels of moral disengagement, psychological distress, self-regulatory efficacy to resist peer pressure to engage in transgressive behaviour, and alcohol and cannabis use. Results: Approximately 85% of participants reported having ever tried alcohol in their life, 31% reported having ever had a full serve of alcohol in their life, 9% reported binge drinking in the past 3 months, and 4% reported having ever tried cannabis in their life. Logistic regression analyses revealed higher moral disengagement and lower resistive self-regulatory efficacy were independent predictors of ever having a full serve of alcohol, binge drinking in the past 3 months and ever trying cannabis. Psychological distress was not associated with alcohol or cannabis use. Conclusions: A better understanding of the factors associated with early alcohol and cannabis use may help identify groups who have difficulties controlling use and aid the development of targeted prevention strategies for reducing use and related harms.

Copyright 2012, Informa Healthcare

Nutt D. Drugs without the Hot Air. Cambridge, England: UIT Cambridge, 2012

The central theme of this book is that all drugs are harmful, from tobacco to heroin; that not all drugs harm equally; that we have to measure all the different harms of a drug. Only then can individuals make informed decisions regarding a choice of lifestyle, and only then can policymakers an take a rational approach to legislation on alcohol, cocaine, heroin, tobacco etc. It's also necessary to consider the potential therapeutic and other benefits of some drugs that are currently illegal. Trials have shown that ecstasy could be effective in treating PTSD (post-traumatic stress disorder), LSD might have a role in treating addiction, and heroin is the most effective painkiller we know of, but it's not allowed to be used even for extreme pain in cases of terminal illness. There are 17 chapters, following a brief introduction, attention turns to ecstasy as an example of potential harm, potential benefits, and how the harms compare to other activities. Chapter 3 discusses different approaches to measuring harm. Chapter 4 explores the question of why people take drugs, what constitutes a "drug" and major drug classes. Chapter 5 deals with cannabis. Chapter 6 focuses upon alcohol, with the question, were it discovered today, would it be legal? The influence of the beverage industry is discussed as well as the question of whether it is possible to reduce the harm associated with alcohol. Chapter 7 considers designer drugs, with mephedrone as an example. Chapter 8 deals with the nature of addiction, including the brain mechanisms associated with addiction, the phenomena or tolerance and craving, diagnosis, the construct of the "addictive personality", and protective factors. Chapter 9 considers the question of whether addiction can be cured. It also discusses both psychological treatments and pharmacological substitutes as well as pharmacological treatments. Chapter 10 considers issues related to cocaine, the basis for different forms and different routes of administration and the associated implications. Chapter 11 addresses tobacco and smoking including an examination of the tobacco industry; Chapter 12 deals with prescription drugs, including the role of the pharmaceutical industry. Chapter 13 focuses upon performance-enhancing drugs, not only in respect to power and muscle, but also cognitive enhancers to improve mental performance. Chapter 14 turns to the psychodelics. Chapter 15 turns to policy, re-examining the "war on drugs" and whether the ostensible aims have been achieved: i.e. supply reduction, demand reduction, and harm minimization. Chapter 16 looks to the future and the role of drugs in terms of genetic sequencing, treatment, learning and unlearning and brain research. The final chapter addresses a pertinent question for parents: What should I tell my kids about drugs?" The chapter is organized around suggested guidelines: Alcohol and tobacco are drugs; all drugs can potentially cause harm; tell your kids about drugs from an early age; never inject; don't use solvents; don't take drugs and drink at the same time; a criminal record could ruin your career; find good sources of advice; if you take drugs, be clear why; if you get into trouble with drugs, get help quickly; and if you use drugs, don't let them interfere with school.

Copyright 2012, Project Cork

Oakley A. The strange case of the two Wootton Reports: What can we learn about the evidence-policy relationship? Evidence & Policy 8(3): 267-283, 2012. (78 refs.)

The contrasting careers of two government-sponsored commissions of inquiry in the late 1960s are the focus of this paper, which examines what can be learnt from them about the impact, or lack of impact, of such bodies on policy making. The Wootton Report on cannabis, published in 1968, had its recommendations rejected by the government that had sponsored it. The Wootton Report on alternatives to prison, published in 1970, resulted in speedy changes to the law, which had the effect of introducing the penalty of community service in Britain for the first time. The paper looks at the short-and long-term impact of the two reports, and at factors that may have accounted for the different receptions they received from politicians and policy makers.

Copyright 2012, Policy Press

Ogden R; Montgomery C. High time. Psychologist 25(8): 590-592, 2012. (21 refs.)

Time rarely feels like it is passing at a constant rate; instead it expands and contracts from one activity to the next. Never is this more true than when under the influence of drugs or alcohol. Drugs such as cocaine, methamphetamine and alcohol appear to make time speed up, whereas haloperidol and marijuana appear to slow time down. Drugs alter perceived time by affecting the speed of our internal clock and the amount of attention that we pay to time. Whilst such time-altering effects are generally perceived as pleasant and harmless, there is some evidence to suggest that the effects may be long-lasting.

Copyright 2012, British Psychological Society

Okamoto SK; Helm S; Kulis S; Delp JA; Dinson AL. Drug resistance strategies of rural Hawaiian youth as a function of drug offerers and substances: A community stakeholder analysis. Journal of Health Care for the Poor and Underserved 23(3): 1239-1252, 2012. (24 refs.)

This study examined the variations in drug resistance strategies endorsed by community members for rural Native Hawaiian youth in drug-related problem situations. Community stakeholders completed a Web-based survey focused on drug-related problem scenarios and their matched set of responses developed by middle/intermediate school youth in prior research. Mean differences were examined based on drug offerers described in the scenarios (i.e., peers/friends, cousins, and parents) and the substances offered in the scenarios (i.e., marijuana and alcohol). Compared with other strategies, Refuse had the highest mean scores within two offerer subgroups (peers/friends and cousins) and within both substances (alcohol and marijuana). Leave had the highest mean score within scenarios describing drug offers from parents. The endorsement of different resistance strategies varied based on drug offerers and substances offered in the selected scenarios. This study suggests that resistance skills in prevention should be tailored to youths' social context in rural Hawai'i.

Copyright 2012, Johns Hopkins University Press

Palamar JJ; Kiang MV; Halkitis PN. Predictors of stigmatization towards use of various illicit drugs among emerging adults. Journal of Psychoactive Drugs 44(3): 243-251, 2012. (42 refs.)

The stigma associated with illegal drug use is nearly universal, but each drug is associated with its own specific level of stigma. This study examined level of stigmatization towards users of various illegal drugs and determined what variables explain such attitudes. A sample of emerging adults (age 18 to 25) was surveyed throughout New York City (N = 1021) and lifetime use, level of exposure to users, and level of stigmatization was assessed regarding use of marijuana, powder cocaine, Ecstasy, and nonmedical use of opioids and amphetamine. Bivariate and multivariate analyses were conducted to examine predictors of stigmatization towards each drug. Results suggest that non-illegal drug users reported high levels of stigmatization towards users of all drugs, but lifetime marijuana users reported significantly lower levels of stigmatization towards users of all harder drugs. This may suggest that once an individual enters the realm of illegal drug use, stigmatization towards use of harder drugs decreases, potentially leaving individuals at risk for use of more dangerous substances. Since stigma and social disapproval may be protective factors against illegal drug use, policy experts need to consider the potential flaws associated with classifying marijuana with harder, more dangerous drugs.

Copyright 2012, Haight-Ashbury Publishing

Palmer RHC; Button TM; Rhee SH; Corley RP; Young SE; Stallings MC et al. Genetic etiology of the common liability to drug dependence: Evidence of common and specific mechanisms for DSM-IV dependence symptoms. Drug and Alcohol Dependence 123(Supplement 1): S24-S32, 2012. (56 refs.)

Background: We investigated the etiological nature of comorbid alcohol, tobacco, and cannabis DSM-IV dependence symptoms in late adolescence and young adulthood while accounting for gender differences in the magnitude of genetic and environmental influences. Methods: Univariate and multivariate twin modeling was used to determine the heritability of each substance and the etiology of multiple drug problems in a sample of 2484 registrants of the Center for Antisocial Drug Dependence who provided data at the second wave of an ongoing longitudinal study. We report on mean and prevalence levels of whole-life DSM-IV dependence symptoms that were assessed with the Composite International Diagnostic Interview-Substance Abuse Module. Biometrical analyses were limited to age-adjusted DSM-IV dependence symptom counts from a subset of twins that reported using alcohol, tobacco, or cannabis in their lifetime. Results: Male and female alcohol, tobacco, and cannabis DSM-IV symptoms are indicators of a heritable unidimensional latent continuous trait. Additive genetic factors explain more than 60% of the common liability to drug dependence. A larger proportion of the variation in each substance is attributable to substance-specific genetic and environmental factors. Conclusions: These data suggest that both common and substance-specific genetic and environmental factors contribute to individual differences in the levels of DSM-IV alcohol, tobacco, and cannabis dependence symptoms.

Copyright 2012, Elsevier Science

Pasch KE; Latimer LA; Cance JD; Moe SG; Lytle LA. Longitudinal bi-directional relationships between sleep and youth substance use. Journal of Youth and Adolescence 41(9): 1184-1196, 2012. (57 refs.)

Despite the known deficits in sleep that occur during adolescence and the high prevalence of substance use behaviors among this group, relatively little research has explored how sleep and substance use may be causally related. The purpose of this study was to explore the longitudinal bi-directional relationships between sleep duration, sleep patterns and youth substance use behaviors. Participants included 704 mostly white (86.4 %) youth, 51 % female, with a baseline mean age of 14.7 years. Self-reported substance use behaviors included past month alcohol, cigarette, and marijuana use. Sleep measures included sleep duration on weekends and weekdays, total sleep, weekend oversleep, and weekend sleep delay. Cross-lagged structural equation models, accounting for clustering at the school level, were run to determine the longitudinal association between sleep and substance use adjusting for socio-demographic characteristics, pubertal status, body mass index z-score, and depressive symptoms. Cigarette use and weekend sleep were bi-directionally related as were marijuana use and total sleep. No other bi-directional associations were identified. However, alcohol use predicted shorter weekend oversleep and marijuana use predicted increased weekend sleep and weekend oversleep. Sleep patterns and duration also predicted adolescents' cigarette, alcohol, and marijuana use. Sleep, both patterns and duration, and substance use among youth are intertwined. Future research is needed to explore these bi-directional relationships, as well as other important contextual factors that may moderate these associations.

Copyright 2012, Springer

Patrick ME; O'Malley PM; Johnston LD; Terry-McElrath YM; Schulenberg JE. HIV/AIDS risk behaviors and substance use by young adults in the United States. Prevention Science 13(5): 532-538, 2012. (33 refs.)

The current research assessed the extent to which substance use behaviors (i.e., heavy episodic drinking, marijuana use, and use of illicit drugs other than marijuana) were associated with behaviors that confer risk for HIV infection (i.e., sex with multiple partners, inconsistent condom use, and injection drug use) in a nationally representative sample of young adults. Generalized estimating equations (GEEs) examined patterns in the data from U.S. young adults (N = 7, 595), ages 21 to 30, who participated in the Monitoring the Future (MTF) panel study between 2004 and 2009. Fifty-two percent of the participants were female and 70% were White. Time-varying effects indicated that more frequent heavy episodic drinking, marijuana use, and other illicit drug use were associated with a greater number of sex partners. Frequency of marijuana and other illicit drug use was associated with less frequent condom use, and marijuana use was associated with use of injection drugs. Younger individuals (i.e., 21-24 years old versus 25-30 years old) had fewer sexual partners, more frequent condom use, and a stronger association between heavy episodic drinking and number of sexual partners than did older individuals. These effects did not vary across gender. Findings highlight the covariation of substance use with HIV-related risk factors among recent cohorts of young adults in the U. S. and the particularly strong link between heavy episodic drinking and number of sexual partners among individuals aged 21 to 24. Prevention programs should acknowledge the co-occurring risks of substance use and HIV risk behaviors, especially among young adults in their early twenties.

Copyright 2012, Springer

Patrick ME; Wightman P; Schoeni RF; Schulenberg JE. Socioeconomic status and substance use among young adults: A comparison across constructs and drugs. Journal of Studies on Alcohol and Drugs 73(5): 772-782, 2012. (35 refs.)

Objective: Little consensus exists regarding the relationship between socioeconomic status (SES) and substance use. This study examined the associations of three indicators of family SES during childhood-income, wealth, and parental education-with smoking, alcohol use, and marijuana use during young adulthood. Method: Data were obtained from the national Panel Study of Income Dynamics, a survey of U.S. families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood data drawn from a national sample of young adults, 18-23 years old. Data from the young adults (N = 1,203; 66.1% White; 51.5% female) on their current use of alcohol, cigarettes, and marijuana were used as outcome variables in logistic regressions. Socioeconomic background was calculated from parental reports of education, wealth, and income during the respondent's childhood (birth through age 17 years). Results: Smoking in young adulthood was associated with lower childhood family SES, although the association was explained by demographic and social role covariates. Alcohol use and marijuana use in young adulthood were associated with higher childhood family SES, even after controlling for covariates. Conclusions: Findings based on three indicators of family background SES-income, wealth, and parental education-converged in describing unique patterns for smoking and for alcohol and marijuana use among young adults, although functional relationships across SES measures varied. Young adults with the highest family background SES were most prone to alcohol and marijuana use.

Copyright 2012, Alcohol Research Documentation

Pechtel P; Woodman A; Lyons-Ruth K. Early maternal withdrawal and nonverbal childhood IQ as precursors for substance use disorder in young adulthood: Results of a 20-year prospective study. International Journal of Cognitive Therapy 5(3): 316-329, 2012. (60 refs.)

The relation between early mother-infant interaction and later socio-emotional development has been well established. The present study addresses the more recent interest in the impact of maternal caregiving on cognitive development and their role in decision-making in young adulthood. Using data from a prospective longitudinal study on attachment, prediction from early mother-infant interactions at age 18 months and from verbal and nonverbal cognitive skill at age 5 were examined as predictors of a substance use disorder (abuse/dependence) in young adulthood (age 20) on the Structured Clinical Interview for DSM-IV (SCID). Results reveal that the mother's withdrawal from interaction with the infant at age 18 months, coded using the AMBIANCE coding system (Atypical Maternal Behavior Instrument for Assessment and Classification), was associated with the child's lower nonverbal cognitive scores but not verbal cognitive scores at age 5. In addition, maternal withdrawal at 18 months predicted a clinical diagnosis of substance use disorder (alcohol/cannabis) at age 20. Finally, nonverbal reasoning at age 5 mediated the relationship between early maternal withdrawal and substance use disorder (alcohol/cannabis) in young adulthood. Findings indicate the need for further work examining how early maternal withdrawal affects nonverbal cognitive development by school entry, and how these nonverbal deficits further contribute to maladaptive coping strategies such as substance use by young adulthood.

Copyright 2012, Guilford Publications

Pedersen ER; Grow J; Duncan S; Neighbors C; Larimer ME. Concurrent validity of an online version of the Timeline Followback Assessment. Psychology of Addictive Behaviors 26(3): 672-677, 2012. (46 refs.)

The Timeline Followback (TLFB) interview has been used extensively in the assessment of alcohol and other substance use. While this methodology has been validated in multiple formats for multiple behaviors, to date no systematic comparisons have been conducted between the traditional interview format and online versions. The present research employed a randomized within-subjects design to compare interview versus online-based TLFB assessments of alcohol and marijuana use among 102 college students. Participants were randomly assigned to receive either the online version first or the in-person interview format first. Participants subsequently completed the second format within 3 days. While we expected few overall differences between formats, we hypothesized that differences might emerge to the extent that participants are more comfortable and willing to answer honestly in an online format, which provides a degree of anonymity. Results were consistent with expectations in suggesting relatively few differences between the online version and the in-person version. Participants did report feeling more comfortable in completing the online version. Moreover, greater discomfort during the in-person assessment was associated with reporting more past-month marijuana use on the online assessment, but reported discomfort did not moderate differences between formats in reported alcohol consumption.

Copyright 2012, American Psychological Association

Pedersen K; Waal H; Kringlen E. Patients with nonaffective psychosis are at increased risk for heroin use disorders. European Addiction Research 18(3): 124-129, 2012. (21 refs.)

Background/Aim: It is well-established knowledge that persons with nonaffective psychotic disorders often have problematic use of alcohol, cannabis and stimulants, but heroin use is usually not included. Our aim was to investigate the prevalence of heroin use disorders in patients with nonaffective psychosis. Methods: As the combination of heroin use and nonaffective psychosis is infrequent, epidemiological studies have to include large populations. The present study is a case count study using information from all psychiatric and social services in Oslo. Prevalence was calculated for four possible scenarios of minimum and maximum case counts and prevalences of nonaffective psychosis. Odds ratios were calculated for the resulting prevalences compared to the minimum and maximum prevalence of heroin use disorder in the general population. Results: We found between 39 and 56 subjects with nonaffective psychoses and comorbid heroin use disorder. The number of individuals with nonaffective psychosis was estimated to be between 692 and 1, 730. This corresponds to a prevalence of heroin use disorder of between 2.3 and 8.1%. The odds ratio compared to the general population will range from 1.83 with a prevalence of heroin use disorder in the general population of 1.2% to 9.43 with a prevalence of 0.9%. Conclusion: Individuals with non-affective psychosis are at increased risk of heroin use.

Copyright 2012, Karger

Rojek S; Klys M; Strona M; Maciow M; Kula K. "Legal highs"-Toxicity in the clinical and medico-legal aspect as exemplified by suicide with bk-MBDB administration. Forensic Science International 222(1-3): E1-E6, 2012. (32 refs.)

The easily available "legal highs", which are products containing psychoactive substances, such as cathinones, piperazines and synthetic cannabinoids, are abused by adolescents in Poland and in the world as alternatives to classic drugs, such as amphetamines or marijuana. The majority of these potentially dangerous substances are still legal and they are associated with a risk of severe poisoning or even death, and provide new challenges in clinical and forensic toxicological practice. Investigations in the field of "designer drugs" may be well illustrated by the case of a suicide of a 21-year old male who ingested a specified dose of a preparation called "Amphi-bi-a" that contains bk-MBDB, chemically 2-methylamino-1-(3,4-methylenedioxyphenyl) butan-1-one, which belongs to the cathinone group, as a synthetic euphoric empathogen and psychoactive stimulant that is chemically similar to MDMA. It is one of more common components of "legal highs" examined in Poland and other countries. The documentation of the case includes a clinical assessment of the patient's health status performed during his almost 4-h hospitalization before death, autopsy and histological examinations supported by toxicological findings revealing bk-MBDB at extremely high concentrations (at 20 mg/l in the blood and 33 mg/kg in the liver); hence, this body of evidence contributes to knowledge in the field of "designer drugs". Inventions of designers of new psychoactive xenobiotics, which are much in demand, especially in view of the dynamic Internet marketing, which drums up narcobusiness, must be balanced by a national strategy developed by medical, legal and educational circles in the modern civilized world in order to prevent the spreading of the phenomenon.

Copyright 2012, Elsevier Science

Russoniello K. The devil (and drugs) in the details: Portugal's focus on public health as a model for decriminalization of drugs in Mexico. Yale Journal of Health Policy, Law, and Ethics 12(Summer): 373-431, 2012. (323 legal refs.)

Summary: ... In 2001, Portugal decriminalized possession of all drugs for personal consumption and has since reported positive results in combating drug addiction, related health problems, and drug trafficking. ... Next, Part II will examine Mexican drug legislation before decriminalization and the violence, public health problems, and other social consequences associated with drug use and trafficking. ... This Part will address the different approaches to decriminalization in Portugal and Mexico and will ultimately argue that Mexico could achieve decreased rates of drug use and drug-related disease, a reduction in prison populations, and an increase in resources for enforcement against large-scale drug trafficking if Mexico were to adopt a model similar to the one in Portugal. ... Second, it encouraged the creation of specific harm reduction programs that directly targeted the health-related dangers of drug use, such as shelters for homeless drug users and needle exchanges all over the country. ... This separation is likely to encourage users to seek treatment voluntarily; reduce the burden of drug use cases on the courts; decrease corruption, extortion, and human rights abuses; and refocus law enforcement efforts on large-scale drug trafficking. ... An advantage of the Portuguese system is that experts in the field of drug addiction, and not judges with limited knowledge in this field, determine whether a drug possession offense has occurred and whether the offender is addicted. ... Assuming that arrest power for drug possession offenses has been removed, police officers will not be able to target users and addicts who possess amounts below the maximum - removing or limiting their ability to threaten offenders with incarceration if they fail to produce a bribe. ... Additionally, changes to the Mexican law could still increase penalties for traffickers, reinforcing the objective of identifying and dismantling drug-trafficking organizations while providing more resources for drug users. ... In order to fully effectuate its strategy, Portugal increased overall funding for drug policy implementation, increased the number of public treatment and harm reduction facilities, and established CDTs in every region of the country

Copyright 2012, Yale Journal of Health Policy, Law, and Ethics

Sandberg S. Is cannabis use normalized, celebrated or neutralized? Analysing talk as action. Addiction Research & Theory 20(5): 372-381, 2012. (48 refs.)

In qualitative interviews with 100 cannabis users in Norway, three discursive repertoires were particularly frequent. The first emphasized how users were 'normal' with statements, such as 'everyone smokes cannabis' or 'cannabis users are not different from others'. The second discursive repertoire emphasized the fascinating difference of both users and the drug. Many cannabis users, stated that cannabis was used by 'free-thinking, open people' and triggered creativity. The third discursive repertoire was different techniques of risk denial, arguing that cannabis 'is just a plant' or that cannabis use did not have any harmful consequences. These three discursive repertoires are the empirical foundations for three conflicting theoretical traditions in studies of illegal drugs. Cannabis has been described as 'normalized', interpreted in a subcultural framework, or researchers have emphasized how illegal drug use is neutralized by users. The interdiscursivity of Norwegian cannabis users challenge all three theoretical frameworks and can only be understood by analysing talk as action. This article argues that all three discursive repertoires can be understood as responses to stigmatization. The conclusion is that the theoretical framework of 'normalization' is not the best way to to understand cannabis use in Norway and possibly elsewhere.

Copyright 2012, Informa Healthcare

Schreiner AM; Dunn ME. Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: A meta-analysis. Experimental And Clinical Psychopharmacology 20(5): 420-429, 2012. (65 refs.)

Cannabis is the most widely used illicit drug in the U.S., and the number of illicit and licit users is rising. Lasting neurocognitive changes or deficits as a result of use are frequently noted despite a lack of clarity in the scientific literature. In an effort to resolve inconsistencies in the evidence of lasting residual effects of cannabis use, we conducted two meta-analyses. First, we updated a previous meta-analysis on broad nonacute cognitive effects of cannabis use through inclusion of newer studies. In a second meta-analysis, we focused on evidence for lasting residual effects by including only studies that tested users after at least 25 days of abstinence. In the first meta-analysis, 33 studies met inclusion criteria. Results indicated a small negative effect for global neurocognitive performance as well for most cognitive domains assessed. Unfortunately, methodological limitations of these studies prevented the exclusion of withdrawal symptoms as an explanation for observed effects. In the second meta-analysis, 13 of the original 33 studies met inclusion criteria. Results indicated no significant effect of cannabis use on global neurocognitive performance or any effect on the eight assessed domains. Overall, these meta-analyses demonstrate that any negative residual effects on neurocognitive performance attributable to either cannabis residue or withdrawal symptoms are limited to the first 25 days of abstinence. Furthermore, there was no evidence for enduring negative effects of cannabis use.

Copyright 2012, American Psychological Society

Schuster RM; Crane NA; Mermelstein R; Gonzalez R. The influence of inhibitory control and episodic memory on the risky sexual behavior of young adult cannabis users. Journal of the International Neuropsychological Society 18(5): 827-833, 2012. (31 refs.)

Cannabis use is associated with risky sexual behavior (RSB) and sex-related negative health consequences. This investigation examined the role of inhibitory control and episodic memory in predicting RSB and sex-related negative consequences among current cannabis users. Findings indicated that the relationships among cannabis, neurocognition, and sexual-risk varied according to the dimension of neurocognition and the parameter of RSB in question. Specifically, more risk-taking was associated with more RSB. Furthermore, amount of recent cannabis use was associated with more RSB and sex-related negative consequences, but only among those with worse performances on a measure of decision-making and of risk-taking. Contrary to hypotheses, worse episodic memory also significantly predicted higher overall sexual-risk and decreased safe-sex practices. Results indicate that worse neurocognitive performance in the areas of risk-taking, decision-making, and episodic memory may influence the degree to which cannabis users engage in RSB and experience negative health consequences as a result.

Copyright 2012, Cambridge University Press

Scott LA; Roxburgh A; Bruno R; Matthews A; Burns L. The impact of comorbid cannabis and methamphetamine use on mental health among regular ecstasy users. Addictive Behaviors 37(9): 1058-1062, 2012. (33 refs.)

Objective: Residual effects of ecstasy use induce neurotransmitter changes that make it biologically plausible that extended use of the drug may induce psychological distress. However, there has been only mixed support for this in the literature. The presence of polysubstance use is a confounding factor. The aim of this study was to investigate whether regular cannabis and/or regular methamphetamine use confers additional risk of poor mental health and high levels of psychological distress, beyond regular ecstasy use alone. Method: Three years of data from a yearly, cross-sectional, quantitative survey of Australian regular ecstasy users was examined. Participants were divided into four groups according to whether they regularly (at least monthly) used ecstasy only (n = 936), ecstasy and weekly cannabis (n = 697), ecstasy and weekly methamphetamine (n = 108) or ecstasy, weekly cannabis and weekly methamphetamine (n = 180). Self-reported mental health problems and Kessler Psychological Distress Scale (K10) were examined. Results: Approximately one-fifth of participants self-reported at least one mental health problem, most commonly depression and anxiety. The addition of regular cannabis and/or methamphetamine use substantially increases the likelihood of self-reported mental health problems, particularly with regard to paranoia, over regular ecstasy use alone. Regular cannabis use remained significantly associated with self reported mental health problems even when other differences between groups were accounted for. Regular cannabis and methamphetamine use was also associated with earlier initiation to ecstasy use. Conclusions: These findings suggest that patterns of drug use can help identify at risk groups that could benefit from targeted approaches in education and interventions. Given that early initiation to substance use was more common in those with regular cannabis and methamphetamine use and given that this group had a higher likelihood of mental health problems, work around delaying onset of initiation should continue to be a priority.

Copyright 2012, Elsevier Science

Shechtman M. Joint authority? The case for state-based marijuana regulation. Tennessee Journal of Law & Policy 8(Winter): 45-97, 2012. (197 legal refs.)

Over the past several decades the United States government has cast an intimidating shadow over the states in the drug policy arena. Congress inaugurated the "War on Drugs" in 1970 through the Controlled Substances Act, banning the possession, consumption, and distribution of a host of narcotic substances, including marijuana. The past decade, however, brought a revolution in the form of state-based marijuana regulation. Ranging from decriminalization to medical licensing, more than a dozen states have enacted laws contradicting the blunt legalist strictures of the CSA. ... Relying on the tenets of public choice theory and jurisdictional competition for law, this article addresses a range of regulatory frameworks for marijuana regulation, concluding that decentralization in favor of the states provides the most efficient and pragmatic mechanism for marijuana policy. ...With state experimentation comes the possibility for competition between states in the enactment of innovative marijuana regulatory schemes and legalization policies. ... This drug regime also confuses the citizenry and retail merchants as to how the federal government will react to marijuana use, possession, and distribution. ... Though federal legislators may lose the political soapbox federal regulation so conveniently provides, repeal of the CSA (as it relates to marijuana) will lead to the same benefits we saw following enactment of the Twenty-First Amendment: reduced corruption and organized crime, job creation, and invigorated addiction support programs. ... The "Competitive Alternative" also cogently points to the problems inherent in the federal framing of the drug issue to the American public The federal propaganda machine and its "War on Drugs" distorts the issues surrounding marijuana legislation and pits reform groups against politicians responding to the federal anti-drug stance. ...Beyond the alcohol regulatory analogy, the past generations of over-enforcement; billions of dollars of federal taxpayer money; seeming absence of a "Race to the Bottom" or substantial negative externalities; exceedingly high violent crime rates associated with illicit drugs; and unclear federal enforcement policy lead to the conclusion that decentralization is the best regulatory stance for marijuana laws. ... The United States system of federalism is premised on extensive state autonomy, leading to experimentation and innovation in policymaking, concurrent with the citizenry's ability to choose the laws they want applied by locating in a jurisdiction with the bundle of laws they find most appealing..

Copyright 2012, University of Tennessee School of Law

Smeerdijk M; Keet R; Dekker N; van Raaij B; Krikke M; Koeter M et al. Motivational interviewing and interaction skills training for parents to change cannabis use in young adults with recent-onset schizophrenia: A randomized controlled trial. Psychological Medicine 42(8): 1627-1636, 2012. (38 refs.)

Background. Cannabis use by people with schizophrenia has been found to be associated with family distress and poor clinical outcomes. Interventions to reduce drug use in this patient group have had limited efficacy. This study evaluated the effectiveness of a novel intervention for parents of young adults with recent-onset schizophrenia consisting of family-based motivational interviewing and interaction skills (Family Motivational Intervention, FMI) in comparison with routine family support (RFS). Method. In a trial with 75 patients who used cannabis and received treatment for recent-onset schizophrenia, 97 parents were randomly assigned to either FMI (n=53) or RFS (n=44). Assessments were conducted at baseline and 3 months after completion of the family intervention by an investigator who remained blind throughout the study about the assignment of the parents. Results. At follow-up, patients' frequency and quantity of cannabis use was significantly more reduced in FMI than in RFS (p<0.05 and p<0.04 respectively). Patients' craving for cannabis was also significantly reduced in FMI whereas there was a small increase in RFS (p=0.01). There was no difference between FMI and RFS with regard to patients' other substance use and general level of functioning. Both groups showed significant improvements in parental distress and sense of burden. Conclusions. Training parents in motivational interviewing and interaction skills is feasible and effective in reducing cannabis use among young adults with recent-onset schizophrenia. However, FMI was not more effective than RFS in increasing patients' general level of functioning and in reducing parents' stress and sense of burden.

Copyright 2012, Cambridge University Press

Ste-Marie PA; Fitzcharles MA; Gamsa A; Ware MA; Shir Y. Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia. Arthritis Care and Research 64(8): 1202-1208, 2012. (38 refs.)

Objective. Patients with chronic pain, including fibromyalgia (FM), may seek treatments outside of mainstream medicine. Medicinal cannabinoids are popularly advocated for pain relief but with limited evidence for efficacy in FM. The extent of use of cannabinoids in FM is unknown. Methods. We have documented the self-reported prevalence of cannabinoid use in 457 patients with the diagnosis of FM and referred to a tertiary care pain center. We validated the diagnosis of FM and examined the associations of cannabinoid use in these patients. Results. Cannabinoids were being used by 13% of all patients, of whom 80% used herbal cannabis (marijuana), 24% used prescription cannabinoids, and 3% used both herbal cannabis and prescription cannabinoids. One-third of all men used cannabinoids. Current unstable mental illness (36% versus 23%; P = 0.002), opioid drug-seeking behavior (17% versus 4%; P = 0.002), and male sex (26% versus 7%; P = 0.0002) were all associated with herbal cannabis use. There was a trend for cannabinoid users to be unemployed and receiving disability payments. The diagnosis of FM was validated in 302 patients, with 155 assigned another primary diagnosis. When the FM group was analyzed separately, significant associations were lost, but trends remained. Conclusion. Cannabinoids were used by 13% of patients referred with a diagnosis of FM. The association of herbal cannabis use with negative psychosocial parameters raises questions regarding the motive for this self-medication practice. Although cannabinoids may offer some therapeutic effect, caution regarding any recommendation should be exercised pending clarification of general health and psychosocial problems, especially for those self-medicating.

Copyright 2012, Wiley-Blackwell

Substance Abuse and Mental Health Services, Center for Behavioral Health Statistics and Quality. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-44. Rockville MD: Substance Abuse and Mental Health Administration, 2012. (58 refs.)

This report presents the first information from the 2011 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. Approximately 67,500 persons are interviewed in NSDUH each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level. Information is summarized in 58 figures, 64 tables. The Report opens with a summary of the highlights and central findings of the Survey. This is followed by 8 chapters with deal with the following topics: Chapter 1, a summary of survey and methodology; Chapter 2. Illicit drug use by population groups and demographic characteristics, sources of illicit and prescription drug use; Chapter 3. alcohol use, by age, gender, geogrpahy, and other demographic characteristics, and separately considers underage drinking; Chapter 4. addresses tobacco use in a similar fashion; Chapter 5. the initiation of substance use, both licit and illicit drugs; Chapter 6 addresses youth prevention efforts, including discussion of the perceptions of risks, availability, and approval/disapproval of peers and family; the role of religiosity and religious involvement, and exposure to prevention efforts; Chapter 7 focuses upon substance dependence, abuse, and treatment, and beyond demographic characteristics also presents information on treatment entry, need for treatment, and for both illicit and licit drugs; Chapter 8 focuses upon trends in marijuana, prescription drug, heroin, and other substance use by youth and young adults and it compares the data from the Survey to other survey results.

Public Domain

Tarter RE; Kirisci L; Mezzich A; Ridenour T; Fishbein D; Horner M et al. Does the "gateway" sequence increase prediction of cannabis use disorder development beyond deviant socialization? Implications for prevention practice and policy. Drug and Alcohol Dependence 123(Supplement 1): S72-S78, 2012. (64 refs.)

Background: This study was conducted to test whether non-normative socialization mediates the association between transmissible risk measured in childhood and cannabis use disorder manifested by young adulthood, and whether the sequence of drug use initiation ("gateway", i.e., consuming legal drugs before cannabis, or the reverse) increases accuracy of prediction of cannabis use disorder. Methods: Sons of fathers with or without substance use disorders (SUDS) related to illicit drugs were tracked from 10-12 to 22 years of age to model the association between transmissible risk for SUD, socialization (peer deviance), order of drug use initiation ("gateway" or reverse sequence), and development of cannabis use disorder. Path analysis was used to evaluate relationships among the variables. Results: Non-normative socialization mediates the association between transmissible risk measured during childhood and cannabis use disorder manifest by young adulthood. The sequence of drug use initiation did not contribute additional explanatory information to the model. Conclusions: The order of drug use initiation does not play a substantial role in the etiology of cannabis use disorder.

Copyright 2012, Elsevier Science

Tashkin DP; Simmons MS; Tseng CH. Impact of changes in regular use of marijuana and/or tobacco on chronic bronchitis. Journal of Chronic Obstructive Pulmonary Disease 9(4): 367-374, 2012. (24 refs.)

We sought to evaluate possible changes in the prevalence of chronic bronchitis in relation to continuing or changing smoking status for marijuana and/or tobacco. For this purpose we followed 299 participants in a longitudinal cohort study of the impact of heavy habitual use of marijuana alone or with tobacco on respiratory symptoms over a mean of 9.8 years during which subjects underwent repeated administration of a detailed drug use and respiratory questionnaire at intervals of >= 1 yr. Using logistic regression, we calculated odds ratios to assess the relationship between chronic bronchitic symptoms and smoking status for marijuana and tobacco at the first visit (current smoking versus never smoking) and at the last follow-up visit (continuing smoking versus, separately, never smoking and former smoking). We found that continuing smokers of either marijuana or tobacco had a significantly increased likelihood of having chronic bronchitis at follow-up compared to both never smokers and former smokers. On the other hand, former smokers of either substance were no more likely to have chronic respiratory symptoms at follow-up than never smokers. These findings demonstrate the benefit of marijuana smoking cessation in resolving pre-existing symptoms of chronic bronchitis.

Copyright 2012, Informa Healthcare

Teesson M; Hall W; Proudfoot H; Degenhardt L. Addictions. London: Psychology Press, 2012

This volume provides an overview of addictions. It is organized into nine chapters. It begins with a discussion of the nature of addiction, followed by a discussion of risk factors and demographics as it addresses who becomes addiction. Chapter 3 addresses the health consequences of alcohol and other drug use/dependence. Chapter 4 sets forth the theories of addiction in respect to etiology and maintenace. The next five chapters examines different drug classes: alcohol, nicotine, cannabis, opiates and the psychostimulants (cocaine, amphetamines, ecstasy.) The concluding summary chapter also considers central research questions and policy issues

Copyright 2012, Oxford University Press

Teesson M; Newton NC; Barrett EL. Australian school-based prevention programs for alcohol and other drugs: A systematic review. (review). Drug and Alcohol Review 31(6): 731-736, 2012. (42 refs.)

Issues. To reduce the occurrence and costs related to substance use and associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for alcohol and other drugs. Approach. Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and other drug use in schools. Key Findings. Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in alcohol, cannabis and tobacco use at follow up. Conclusion. Existing school-based prevention programs have shown to be efficacious in the Australian context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective.

Copyright 2012, Wiley-Blackwell

Tofighi B; Lee JD. Internet highs: Seizures after consumption of synthetic cannabinoids purchased online. Journal of Addiction Medicine 6(3): 240-241, 2012. (18 refs.)

Background: Since 2004, a new wave of synthetic cannabinoids (SCs) known as "Spice drugs" has come under scrutiny because of their suspected link to neurological and psychiatric sequelae. These "herbal incense" or "potpourri blends" have gained popularity as a result of being more potent than natural cannabinoids, are not detected with current screening tests, and are easily modified by manufacturers to bypass legal restrictions. Unfortunately, cases of withdrawal phenomena, nausea, hypertension, and psychosis are now being reported in the medical literature. In addition, after reports in lay media of seizures and coma attributed to the consumption of the drug, anecdotal reports have emerged of similar findings in the medical literature. Case Description: We report on a 48-year-old man who, after consuming the herbal blend, lost consciousness and suffered several episodes of seizures. Despite a complicated ICU stay, the patient recovered well with no subsequent neurological sequelae. Conclusions: The authors interpreted the history and findings consistent with the consumption of a large amount of synthetic cannabinoids leading to new-onset seizures and coma. However, at the time of admission, the lack of routine laboratory testing and treatment options delayed the diagnosis and delivery of appropriate therapy.

Copyright 2012, Lippincott, Williams & Wilkins

Tsumura Y; Aoki R; Tokieda Y; Akutsu M; Kawase Y; Kataoka T et al. A survey of the potency of Japanese illicit cannabis in fiscal year 2010. Forensic Science International 221(1-3): 77-83, 2012. (20 refs.)

In recent years, increased 'cannabis potency', or Delta(9)-tetrahydrocannabinol (THC) content in cannabis products, has been reported in many countries. A survey of Japanese illicit cannabis was conducted from April 2010 to March 2011. In Japan, all cannabis evidence is transferred to the Minister of Health, Labour and Welfare after criminal trials. The evidence was observed at Narcotics Control Department offices in major 11 cities. The total number of cannabis samples observed was 9072, of which 6376 were marijuana. The marijuana seizures were further classified, and it was found that in terms of the number of samples, 65.2% of them were seedless buds, and by weight 73.0% of them were seedless buds. Seedless buds were supposed to be 'sinsemilla', a potent class of marijuana. THC, cannabinol (CBN) and cannabidiol (CBD) in marijuana seizures exceeding 1 g were quantified. The number of samples analyzed was 1115. Many of them were shown to contain CBN, an oxidative product from THC. This was a sign of long-term storage of the cannabis and of the degradation of THC. Relatively fresh cannabis, defined by a CBN/THC ratio of less than or equal to 0.1, was chosen for analysis. Fresh seedless buds (335 samples) contained an average of 11.2% and a maximum of 22.6% THC. These values are comparable to those of 'high potency cannabis' as defined in previous studies. Thus, this study shows that highly potent cannabis products are distributed in Japan as in other countries.

Copyright 2012, Elsevier Science

United Nations Office on Drugs and Crime (UNODC). World Drug Report, 2012. Vienna: United Nations, 2012. (163 refs.)

About 230 million people, or 5 per cent of the world's adult population, are estimated to have used an illicit drug at least once in 2010. Problem drug users number about 27 million, which is 0.6 per cent of the world adult population. Throughout the world, illicit drug use appears to be generally stable, though it continues to be rising in several developing countries. Heroin, cocaine and other drugs kill around 0.2 million people each year. Global opium production amounted to 7,000 tons in 2011. That is more than a fifth less than the peak of 2007 but an increase from the low level of 2010, the year in which a plant disease destroyed almost half of the opium harvest in Afghanistan, which continues to be the world's biggest producer. The total area under coca bush cultivation in the world fell by 18 per cent between 2007 and 2010 and by 33 per cent since 2000. Efforts to reduce cultivation and production of the main plant-based problem drugs have, however, been offset by rising levels of synthetic drug production, including significant increases in the production and consumption of psychoactive substances that are not under international control. The report has two major parts. Section I provides recent statistics and trend analysius of illicit drug markets. This includes the extent of illicit drug use and health consequences, the opiate, cocaine and cannabis markets, and illicit markets for amphetamine-type stimulants. Section II characterizes the contemporary drug problem in terms of the the fundamental characteristics of illict drug production and use, the shifts in the problems of drug use over time, and the factors which shape the evolution of drug use problems.

Copyright 2012, United Nations

Van Dam NT; Bedi G; Earleywine M. Characteristics of clinically anxious versus non-anxious regular, heavy marijuana users. Addictive Behaviors 37(11): 1217-1223, 2012. (50 refs.)

Both the key mechanism of action for marijuana (the endocannabinoid system) and the symptoms associated with marijuana withdrawal suggest an important link to anxiety. Despite this link, there is a dearth of research on the characteristics of heavy marijuana users with clinical-level anxiety compared to those with heavy marijuana use alone. Over 10, 000 participants (friends or affiliates of the National Organization for the Reform of Marijuana Laws) provided data via online survey. After careful, conservative screening, anxiety, other psychopathology, other drug use, and marijuana-related problems were examined in 2567 heavy marijuana users. Subsequently. 275 heavy users with clinical-level anxiety were compared to demographically-equivalent non-anxious heavy users on psychopathology, drug use, and cannabis-related problems. Among several psychological variables (including anxiety, depression, schizotypy, and impulsivity), anxiety was most strongly predictive of amount of marijuana used and marijuana-related problems. Group comparison (n = 550 total) revealed that clinically anxious heavy users exhibited more use, more non-anxiety psychopathological symptoms, and a greater number and severity of marijuana-related problems than their non-anxious peers. The findings reveal that anxiety shows an important relation to marijuana use and related problems among regular, heavy users. Further examinations of common and unique factors predisposing individuals for anxiety and marijuana abuse appear warranted.

Copyright 2012, Elsevier Science

van Gastel WA; Wigman JTW; Monshouwer K; Kahn RS; van Os J; Boks MPM et al. Cannabis use and subclinical positive psychotic experiences in early adolescence: Findings from a Dutch survey. Addiction 107(2): 381-387, 2012. (45 refs.)

Aims: To investigate the association between early cannabis use and subclinical psychotic experiences, distinguishing between five levels of use: never used, discontinued use (life-time users who did not use in the preceding year), experimental use, regular use and heavy use. Design Cross-sectional observational study. Setting Dutch Health Behaviour in School-aged Children (HBSC) study, 2005 wave. Participants: A total of 4552 secondary school children aged 12-16 years. Measurements: Cannabis use, Community Assessment of Psychic Experiences (CAPE) positive scale, confounding factors: age, gender, family affluence, household composition, social support, alcohol use, cigarette smoking, ethnicity and urbanicity. Findings: The association between cannabis use and subclinical positive symptoms was confirmed, and remained significant after extensive adjustment for potential confounders. Associations were found for all user groups, with strongest associations for the discontinued use group (beta = 0.061, P = 0.000) and for the heavy use group (beta = 0.065, P = 0.000). Conclusions: There is an enduring association between cannabis use at an early age and subclinical positive psychotic experiences, even after abstaining from cannabis for at least 1 year.

Copyright 2012, Society for the Study of Addiction to Alcohol and Other Drugs

Van Havere T; Lammertyn J; Vanderplasschen W; Bellis M; Rosiers J; Broekaert E. Illicit drug use in the Flemish nightlife scene between 2003 and 2009. European Addiction Research 18(4): 153-160, 2012. (35 refs.)

Aims: Given the importance of party people as innovators and early adaptors in the diffusion of substance use, and given the lack of longitudinal scope in studies of the nightlife scene, we explored changes in illicit drug use among young people participating in the nightlife scene in Flanders. Methods: A survey among party people selected at dance events, rock festivals and clubs was held in the summer of 2003 and repeated in 2005, 2007 and 2009. In total, 2, 812 respondents filled in a questionnaire on the use of cannabis, ecstasy, cocaine, amphetamines, GHB and ketamine. Results: The results of the multiple logistic regression analyses show that in the group of frequent pub visitors, the predicting probability of cannabis use increased over time, while the gap in drug use between dance music lovers and non-lovers of dance music narrowed. For cocaine use during the last year, an increase was found related to the housing situation (alone or with parents) of respondents. While the odds of using ecstasy decreased over the years, the odds of using GHB increased. Conclusion: We can conclude that monitoring emerging trends, which can be quickly observed in the nightlife scene, provides meaningful information for anticipating possible trends.

Copyright 2012, Karger

van Ours JC; Williams J. The effects of cannabis use on physical and mental health. Journal of Health Economics 31(4): 564-577, 2012. (33 refs.)

This paper investigates whether cannabis use affects physical and mental health. To do so, information on prime aged individuals living in Amsterdam in 1994 is used. Dutch data offer a clear advantage in estimating the health impacts of cannabis use because the legal status of cannabis in the Netherlands ensures that estimates are free from confounding with the physical and psychological effects of engaging in a criminal activity. Accounting for selection into cannabis use and shared frailties in mental and physical health, the results suggest that cannabis use reduces the mental wellbeing of men and women and the physical wellbeing of men. Although statistically significant, the magnitude of the effect of using cannabis on mental and physical health is found to be small.

Copyright 2012, Elsevier Science BV

Vandrey R; Dunn KE; Fry JA; Girling ER. A survey study to characterize use of Spice products (synthetic cannabinoids). Drug and Alcohol Dependence 120(1-3): 238-241, 2012. (17 refs.)

Background: Synthetic cannabinoids are a rapidly emerging class of abused drugs. Synthetic cannabinoids are typically sold as "herbal blends" or "incense," commonly referred to as Spice products. No controlled human experiments have been conducted on the effects of Spice products or the synthetic cannabinoids they often contain. Methods: An internet-based survey study was conducted with adults reporting at least one lifetime use of a Spice product. Results: Respondents were primarily male, Caucasian and >= 12 years of education. Use of other psychoactive drugs was common, though 21% identified Spice products as their preferred drug. Spice products were most frequently obtained from retail vendors and smoked, though other forms of ingestion were endorsed. Mean age of first use was 26 and mean frequency of use in the past year was 67 days (range 0-365). Primary reasons for use were curiosity, positive drug effect, relaxation, and to get high without having a positive drug test. Acute subjective effects were similar to known effects of cannabis, and a subset of users met DSM criteria for abuse and dependence on Spice products. Conclusions: Participants exhibited a diverse profile of use patterns as is typical for other drugs of abuse. There was evidence that users continued to seek and use these drugs after being banned by local authorities. This study should be interpreted with caution due to methodological limitations. Controlled laboratory research is needed to further examine the behavioral pharmacology of individual synthetic cannabinoids found in Spice products.

Copyright 2012, Elsevier Science

Verweij KJH; Zietsch BP; Liu JZ; Medland SE; Lynskey MT; Madden PAF et al. No association of candidate genes with cannabis use in a large sample of Australian twin families. Addiction Biology 17(3): 687-690, 2012. (8 refs.)

While there is solid evidence that cannabis use is heritable, attempts to identify genetic influences at the molecular level have yielded mixed results. Here, a large twin family sample (n = 7452) was used to test for association between 10 previously reported candidate genes and lifetime frequency of cannabis use using a gene-based association test. None of the candidate genes reached even nominal significance (P < 0.05). The lack of replication may point to our limited understanding of the neurobiology of cannabis involvement and also to potential publication bias and false-positive findings in previous studies.

Copyright 2012, Wiley-Blackwell

Vivas AB; Estevez AF; Moreno M; Panagis G; Flores P. Use of cannabis enhances attentional inhibition. Human Psychopharmacology: Clinical and Experimental 27(5): 464-469, 2012. (38 refs.)

Objective Orienting attention to an irrelevant location hampers the response to subsequent targets presented at that location in relation to novel, not previously attended, locations. This inhibitory effect has been named inhibition of return. We conducted an experiment to study the temporal course of inhibition of return in users of cannabis. Method Twenty-five cannabis users who self-reported a regular frequency of cannabis use in joints per month, and 26 drug-free controls participated in the study. We employed a typical inhibition of return task with a single cue and manipulated the time interval between the onset of the cue and the target (150, 350, 550, 1500, and 2550?ms). Participants were asked to detect the onset of the target regardless of its location. Results The group of cannabis users showed a significantly greater overall inhibition relative to the group of nonusers. Furthermore, inhibition of return appeared earlier (at the 350?ms cuetarget interval) in the user group. Conclusions This is the first study to show that attentional inhibition is enhanced in cannabis users. More research is needed to determine whether greater inhibition represents an advantage or disadvantage for visual search performance of cannabis users.

Copyright 2012, Wiley-Blackwell

Vogl L; Newton N; Teessson M; Swift W; Karageroge A; Deans C et al. Climate Schools: Universal Computer-based Programs to Prevent and Alcohol and Other Drug Use in Adolescence. NDARC Technical Report No. 321. Sydney, Australia: National Drug and Alcohol Research Centre, 2012

Background: Early initiation to drug use is associated with a range of negative consequences including substance use disorders, co-morbid mental health problems, juvenile offending, impaired educational performance and early school drop-out, resulting in negative impacts on both current functioning and future life options. Preventing drug use and misuse in young Australians is essential and the school setting is the ideal location for delivering such prevention programs. Although school-based prevention programs do exist, the efficacy of such programs is contentious. Given that school-based drug prevention is the primary means by which drug prevention education is delivered to adolescents, it is essential to focus on increasing program efficacy. Previous research has shown that two factors compromise the efficacy of the school-based prevention programs: (1) the focus on abstinence-based outcomes and (2) implementation failure. The aim of the current research was to develop an innovative new platform for the delivery of drug prevention education which would potentially overcome such concerns. This new platform of delivery is known as CLIMATE Schools. These prevention programs drug are designed to remedy the identified problems. There is a growing body of evidence suggesting that harm-minimisation programs for drug use could potentially be more effective than abstinence-based programs as they provide greater scope for preventive information and skills, whilst appropriate for all young people irrespective of levels of use. The CLIMATE Schools programs have also been developed in collaboration with teachers, students and relevant health and legal professionals to ensure they address different problematic issues (e.g., program complexity, teacher workload, teacher training and program adaptation). The computer delivery guarantees that the complete content is consistently delivered to each student overcoming the majority of the obstacles to effective program implementation. The classroom activities included include role plays, small group discussions, decision making and problem solving activities and skill rehearsal, all of which have been identified as important. the first program to test the model focused upon alcohol. The evaluation found it to be effective in increasing alcohol-related knowledge of facts and in decreasing the positive social expectations which students believed alcohol may afford. For females, the program was effective in decreasing average alcohol consumption, alcohol-related harms and the frequency of drinking to excess (> 4 standard drinks; 10g ethanol). For males, the behavioural effects were not significant. The CLIMATE Schools: Alcohol Module has been found to increase alcohol related knowledge up to six month following the intervention, and reducing average consumption of alcohol immediately after the intervention. Two subsequent modules are described, focusing upon the two most commonly used drugs - cannabis and psychostimulants. Booster sessions were also developed. The evaluation revealed that in comparison with usual drug education programs, students in the intervention group showed significantly greater improvements in alcohol and cannabis knowledge at the end of the course and the six month follow-up. In addition, the intervention group showed a reduction in average weekly alcohol consumption and frequency of cannabis use at the six month follow-up. No differences between groups were found on alcohol expectancies, cannabis attitudes, or alcohol and cannabis harms. The Psychostimulant and Cannabis Module also used cannabis significantly less frequently than students who received drug education as usual. There were no changes in meth/amphetamine use or harms resulting from cannabis or psychostimulant use in general. The low prevalence of use is the most likely reason for why the CLIMATE intervention did not impact on drug-related harms. Finally, the CLIMATE intervention was effective in decreasing students' intention to use meth/amphetamine and ecstasy in the future. Both students and faculty had a positive response to the model.

Copyright 2012, National Drug and Alcohol Research Centre (Australia)

Vrieze SI; Hicks BM; Iacono WG; McGue M. Decline in genetic influence on the co-occurrence of alcohol, marijuana, and nicotine dependence symptoms from age 14 to 29. American Journal of Psychiatry 169(10): 1073-1081, 2012. (36 refs.)

Objective: Cross-sectional studies have demonstrated high rates of comorbidity among substance use disorders. However, few studies have examined the developmental course of incident comorbidity and how it changes from adolescence to adulthood. The authors examine patterns of comorbidity among substance use disorders to gain insight into the effect of shared versus specific etiological influences on measures of substance abuse and dependence. Method: The authors evaluated the pattern of correlations among nicotine, alcohol, and marijuana abuse and dependence symptom counts as well as their underlying genetic and environmental influences in a community-representative twin sample (N=3,762). Symptoms were assessed at ages 11, 14, 17, 20, 24, and 29 years. A single common factor was used to model the correlations among symptom counts at each age. The authors examined age-related changes in the influence of this general factor by testing for differences in the mean factor loading across time. Results: Mean levels of abuse or dependence symptoms increased throughout adolescence, pea ked a round age 20, and declined from age 24 to age 29. The influence of the general factor was highest at ages 14 and 17, but decreased from age 17 to age 24. Genetic influences of the general factor declined considerably with age alongside an increase in nonshared environmental influences. Conclusions: Adolescent substance abuse or dependence is largely a function of shared etiology. As young people age, their symptoms are increasingly influenced by substance-specific etiological factors. Heritability analyses revealed that the generalized risk is primarily influenced by genetic factors in adolescence, but nonshared environmental influences increase in importance as substance dependence becomes more specialized in adulthood.

Copyright 2012, American Psychiatric Publishing

Wang F; Gelernter J; Kranzler HR; Zhang HP. Identification of POMC exonic variants associated with substance dependence and body mass index. PLoS ONE 7(10): e45300, 2012. (42 refs.)

Background: Risk of substance dependence (SD) and obesity has been linked to the function of melanocortin peptides encoded by the proopiomelanocortin gene (POMC). Methods and Results: POMC exons were Sanger sequenced in 280 African Americans (AAs) and 308 European Americans (EAs). Among them, 311 (167 AAs and 114 EAs) were affected with substance (alcohol, cocaine, opioid and/or marijuana) dependence and 277 (113 AAs and 164 EAs) were screened controls. We identified 23 variants, including two common polymorphisms (rs10654394 and rs1042571) and 21 rare variants; 12 of which were novel. We used logistic regression to analyze the association between the two common variants and SD or body mass index (BMI), with sex, age, and ancestry proportion as covariates. The common variant rs1042571 in the 3'UTR was significantly associated with BMI in EAs (Overweight: P-adj = 0.005; Obese: P-adj = 0.018; Overweight+Obese: P-adj = 0.002) but not in AAs. The common variant, rs10654394, was not associated with BMI and neither common variant was associated with SD in either population. To evaluate the association between the rare variants and SD or BMI, we collapsed rare variants and tested their prevalence using Fisher's exact test. In AAs, rare variants were nominally associated with SD overall and with specific SD traits (SD: P-FET,(1df) = 0.026; alcohol dependence: P-FET,P-1df = 0.027; cocaine dependence: P-FET,P-1df = 0.007; marijuana dependence: P-FET,(1df) = 0.050) (the P-value from cocaine dependence analysis survived Bonferroni correction). There was no such effect in EAs. Although the frequency of the rare variants did not differ significantly between the normal-weight group and the overweight or obese group in either population, certain rare exonic variants occurred only in overweight or obese subjects without SD. Conclusion: These findings suggest that POMC exonic variants may influence risk for both SD and elevated BMI, in a population-specific manner. However, common and rare variants in this gene may exert different effects on these two phenotypes.

Copyright 2012, Public Library of Science

Wang Z; Solloway T; Tchernev JM; Barker B. Dynamic motivational processing of antimarijuana messages: Coactivation begets attention. Human Communication Research 38(4): 485-509, 2012. (52 refs.)

In the theoretical framework of dynamic motivational activation, this study reveals the dynamics of antimarijuana public service announcement (PSA) processing, especially the processing of co-occurring positive and negative content. It specifies the important role of endogenous feedback dynamics of the information processing system and teases them apart from exogenous message effects. As suggested by real-time psychophysiological responses (heart rate, skin conductance level, and facial electromyography), the copresence of positive and negative content is most attention eliciting and is not moderated by individuals' marijuana experience. Marijuana experience, however, increases attention to arousing content in the PSAs, increases smiling responses to positive content, and escalates arousal to the PSAs in general. Implications for designing and evaluating PSAs and health campaigns are discussed.

Copyright 2012, Wiley-Blackwell

White J; Batty GD. Intelligence across childhood in relation to illegal drug use in adulthood: 1970 British Cohort Study. Journal of Epidemiology and Community Health 66(9): 767-774, 2012. (41 refs.)

Background: Recent reports have linked high childhood IQ scores with excess alcohol intake and alcohol dependency in adult life, but the relationship with illegal drug use in later life is relatively unknown. Methods: The authors used data from a large population-based birth cohort (1970 British Cohort Study) with measures of lifetime cannabis and cocaine use, parental social class and psychological distress at 16 years; cannabis, cocaine, amphetamine, ecstasy and polydrug use (more than three drugs) in the past 12 months; and social class, educational attainment and gross monthly income at 30 years. All members of the cohort with IQ scores at 5 or 10 years were eligible to be included in the analyses. Results: Of the 11 603 (at 5 years) and 11 397 (at 10 years) cohort members eligible, 7904 (68.1%) and 7946 (69.7%) were included in the analyses. IQ scores at 5 years were positively associated with cannabis (OR ((bottom vs top tertile)) = 2.25, 95% CI 1.71 to 2.97) and cocaine use (OR 2.35, 95% CI 1.41 to 3.92) in women and with amphetamines (OR 1.46, 95% CI 1.03 to 2.06), ecstasy (OR 1.65, 95% CI 1.15 to 2.36) and polydrug use (OR 1.57, 95% CI 1.09 to 2.26) in men at 30 years. IQ scores at 10 years were positively associated with cannabis, cocaine (only at 30 years), ecstasy, amphetamine and polydrug use. Associations were stronger in women than in men and were independent from psychological distress in adolescence and life-course socioeconomic position. Conclusion: High childhood IQ may increase the risk of illegal drug use in adolescence and adulthood.

Copyright 2012, BMJ Publishing Group

White J; Mortensen LH; Batty GD. Cognitive ability in early adulthood as a predictor of habitual drug use during later military service and civilian life: The Vietnam Experience Study. Drug and Alcohol Dependence 125(1-2): 164-168, 2012. (32 refs.)

Background: Recent reports have linked cognitive ability (IQ) with alcohol dependency, but the relationship with illegal drug use is not well understood. Methods: Participants were 14,362 male US Vietnam veterans with IQ test results at entry into military service in 1965-1971 (mean age 22.58) who participated in a telephone interview in 1985-1986. A structured diagnostic telephone interview was used to ascertain habitual drug use during military service (for once a week, >= 3 months) and in civilian life (in the past 12 months, >= once a week), combat exposure, and post-traumatic stress disorder according to established Diagnostic and Statistical Manual of Mental disorders criteria (version III). Results: In unadjusted analysis, men with high IQ scores were less likely to be habitual users of cannabis (OR = 0.89, 95% CI = 0.86, 0.93), cocaine (OR = 0.69, 95% CI = 0.61, 0.78), heroin (OR = 0.80, 95% CI = 0.73, 0.88), amphetamines (OR = 0.90, 95% CI = 0.83, 0.98), barbiturates (OR = 0.79, 95% CI = 0.72, 0.86) and LSD (OR = 0.91, 95% CI = 0.82, 0.99) during military service and civilian life. These associations were markedly attenuated after adjustment for socioeconomic status in early and later civilian life. Conclusion: In this cohort, socioeconomic position might lie on the pathway linking earlier IQ and later habitual drug use but might also act as a surrogate for IQ. This suggests interventions to prevent drug use could attempt to improve early life IQ and opportunities for employment.

Copyright 2012, Elsevier Science

White JW; Gale CR; Batty GD. Intelligence quotient in childhood and the risk of illegal drug use in middle-age: the 1958 National Child Development Survey. Annals of Epidemiology 22(9): 654-657, 2012. (26 refs.)

Purpose: High childhood IQ test scores have been associated with increased alcohol dependency and use in adult life, but the relationship between childhood IQ and illegal drug use in later life is unclear. Methods: Participants were 6713 members of the 1958 National Child Development Survey whose IQ was assessed at 11 years and had their lifetime illegal drug use measured at 42 years of age. Results: In analyses adjusted for a range of covariates, a 1 SD (15-point) increase in IQ scores was associated with an increased risk of illegal drug use in women: ever using cannabis (odds ratio [OR] 1.30; 95% confidence interval [95% CI], 1.16-1.45), cocaine (OR, 1.66; 95% CI, 1.21-2.27), amphetamines (OR, 1.50; 95% CI, 1.22-1.83), amyl nitrate (OR, 1.79; 95% CI, 1.30-2.46) and "magic mushrooms" (OR, 1.52; 95% CI, 1.18-1.98). Associations were of lower magnitude in men. Conclusions: In this cohort, high childhood IQ was related to illegal drug use in adulthood.

Copyright 2012, Elsevier Science

Whitesell NR; Kaufman CE; Keane EM; Crow CB; Shangreau C; Mitchell CM. Patterns of substance use initiation among young adolescents in a Northern Plains American Indian Tribe. American Journal of Drug and Alcohol Abuse 38(5): 383-388, 2012. (30 refs.)

Background: Substantial evidence documents problematic substance use in Northern Plains American Indian communities. Studies suggest that disparities can be traced to disproportionate rates of early substance use, but most evidence comes from the retrospective reports of adults or older adolescents. Objective: To use a prospective longitudinal design to examine substance use initiation patterns as they emerge among young American Indian adolescents. Methods: Four waves of data were collected across three consecutive school years from middle school students on a Northern Plains reservation (N = 450). Discrete-time survival analyses were used to estimate risks of initiation of cigarettes, alcohol, and marijuana from age 10 to 13. Results: Risk for cigarette initiation was relatively high at age 10 and stable until age 13. Marijuana risk was low at age 10 but increased sharply by age 12. Alcohol initiation lagged, not surpassing risk for cigarette initiation until age 13 and remaining below risk for marijuana initiation throughout middle school. Hazards for girls trended higher than those for boys across all substances, but differences did not reach significance. Conclusion: Initiation patterns among these American Indian adolescents differed from patterns reported in other US groups, particularly with respect to deviation from the sequence characterized the initiation of marijuana before alcohol that is predicted by the gateway theory. Scientific Significance: Findings suggest that prevention efforts with youth in this community should begin early with a primary focus on marijuana use. They also suggest the importance of examining sequences of substance initiation among youth in other American Indian communities.

Copyright 2012, Informa Healthcare

Zeiger JS; Haberstick BC; Corley RP; Ehringer MA; Crowley TJ; Hewitt JK et al. Subjective effects for alcohol, tobacco, and marijuana association with cross-drug outcomes. Drug and Alcohol Dependence 123(Supplement 1): S52-S58, 2012. (52 refs.)

Methods: The cross-drug relationship of subjective experiences between alcohol, tobacco, and marijuana and problem drug use behaviors were examined. Data were drawn from 3853 individuals between the ages of 11 and 30 years of age participating in the Colorado Center on Antisocial Drug Dependence [CADD]. Subjective experiences were assessed using a 13-item questionnaire that included positive and negative responses for alcohol, tobacco, and marijuana. Lifetime abuse and dependence on these three drugs was assessed using the Composite International Diagnostic Interview, Substance Abuse Module [CIDI-SAM]. Results: Positive and negative subjective experience scales were similar for alcohol, tobacco, and marijuana, although the hierarchical ordering of items differed by drug. Subjective experience scales for each of the three drugs examined correlated significantly, with the strongest relationship being for alcohol and marijuana experiences. Significant associations were identified between how a person experienced a drug and abuse and dependence status for the same or different drug. Conclusion: Cross-drug relationships provide evidence for a common liability or sensitivity towards responding in a similar manner to drugs of abuse within and across different pharmacological classes.

Copyright 2012, Elsevier Science

Zhang HP; Wang F; Kranzler HR; Anton RF; Gelernter J. Variation in regulator of G-protein signaling 17 gene (RGS17) is associated with multiple substance dependence diagnoses. Behavioral and Brain Functions 8: article 23, 2012. (45 refs.)

Background: RGS17 and RGS20 encode two members of the regulator of G-protein signaling RGS-Rz subfamily. Variation in these genes may alter their transcription and thereby influence the function of G protein-coupled receptors, including opioid receptors, and modify risk for substance dependence. Methods: The association of 13 RGS17 and eight RGS20 tag single nucleotide polymorphisms (SNPs) was examined with four substance dependence diagnoses (alcohol (AD), cocaine (CD), opioid (OD) or marijuana (MjD)] in 1,905 African Americans (AAs: 1,562 cases and 343 controls) and 1,332 European Americans (EAs: 981 cases and 351 controls). Analyses were performed using both chi(2) tests and logistic regression analyses that covaried sex, age, and ancestry proportion. Correlation of genotypes and mRNA expression levels was assessed by linear regression analyses. Results: Seven RGS17 SNPs showed a significant association with at least one of the four dependence traits after a permutation-based correction for multiple testing (0.003 <= P-empirical <= 0.037). The G allele of SNP rs596359, in the RGS17 promoter region, was associated with AD, CD, OD, or MjD in both populations (0.005 <= P-empirical <= 0.019). This allele was also associated with significantly lower mRNA expression levels of RGS17 in YRI subjects (P = 0.002) and non-significantly lower mRNA expression levels of RGS17 in CEU subjects (P = 0.185). No RGS20 SNPs were associated with any of the four dependence traits in either population. Conclusions: This study demonstrated that variation in RGS17 was associated with risk for substance dependence diagnoses in both AA and EA populations.

Copyright 2012, Biomed Central