Medical Marijuana Laws and Adolescent Marijuana Use in the USA from 1991 to 2014 The Lancet This article may translate as, “…regional cultural factors are a greater determinant of adolescent cannabis use than the legal environment.” The authors’ findings, consistent with previous evidence, suggest that passage of state medical marijuana laws does not increase adolescent use of marijuana. However, overall, adolescent use is higher in states that ever passed such a law than in other states. State-level risk factors other than medical marijuana laws could contribute to both marijuana use and the passage of medical marijuana laws, and such factors warrant investigation.
Editor’s Comments William Haning, MD, FASAM, DFAPA Please note that of the six peer-reviewed articles (9 total of all types), 4 focus on cannabinoids. Another from the lay press reports on cannabis laws and policy. This in part reflects the topic prevalence among new research, and possibly the level of interest in the reading community. – W. Haning
FROM JOURNAL OF ADDICTION MEDICINE
Knowledge, Attitudes, and Practice of Electronic Cigarette Use Among Pregnant Women Journal of Addiction Medicine (free ASAM member resource) The findings in this article reflect a persistent failure, as much in the scientific community as among the lay public, to focus on the risk of nicotine’s inherent toxicity, among the most lethal of plant-derived poisons. Misconceptions about e-cigarettes are common among pregnant women, potentially motivating use that may pose risks to both maternal and child health. Screening and education regarding e-cigarettes should be included in prenatal care. Future research in this area is necessary, including research examining pregnancy outcomes among women who use e-cigarettes.
Increase in Reported Adverse Health Effects Related to Synthetic Cannabinoid Use — United States, January–May 2015 CDC Morbidity and Mortality Weekly Report On April 6, 2015, CDC received notification of an increase in telephone calls to U.S. poison centers related to synthetic cannabinoid use. Monthly calls to all poison centers are tracked by the National Poison Data System, which reported that adverse health effects or concerns about possible adverse health effects related to synthetic cannabinoid use increased 330% from 349 in January 2015 to 1,501 in April 2015. Synthetic cannabinoids include various psychoactive chemicals or a mixture of such chemicals that are sprayed onto plant material, which is then often smoked or ingested to achieve a “high.” These products are sold under a variety of names (e.g., synthetic marijuana, spice, K2, black mamba, and crazy clown) and can be sold in retail outlets as herbal products. An equally stunning datum is the 11.3% of
callers whose query was associated with a major adverse effect –– “life-threatening, or substantial residual disability or disfigurement.” Limitations on the data submission format do not permit specification of the type of injury or illness in the MMWR; however, separate case reports would suggest arrhythmia or seizure as the most likely associated morbidity.
Parity Implementation Coalition & Kennedy Forum Release Parity Resource Guide Parity Implementation Coalition Members of the Parity Implementation Coalition join with the Kennedy Forum in releasing the 2nd edition of the Parity Resource Guide, entitled “Simplifying the Appeals Process: Strategies for Winning Disputes with Your Health Plan.” This new free resource targeted towards consumers, providers and advocates can be downloaded at http://www.parityispersonal.org and http://www.thekennedyforum.org.
VA/DoD Clinical Practice Guideline for the Management of Chronic Multisymptom Illness VA/DoD Lengthy but well worth reading for its conclusions, this practice guideline by the VA and DoD uses an increasingly popular methodology to give practical recommendations in the management of the CMI cluster (Chronic Fatigue Syndrome, fibromyalgia, etc.). These are of particular interest to addictionologists and pain management specialists, as many entail specific and firm imprecations against certain classes of medications and laboratory studies; and strong support for
non-pharmacological therapeutic modalities, including physical exercise and CBT. The recommendations for the management of chronic multisymptom illness (CMI) are organized into 6 modules (including diagnosis/evaluation, management strategies, and 3 therapeutic intervention modules) with 1 algorithm. See the original guideline document for the algorithm and evidence tables associated with selected recommendations, including level and quality of evidence, strength of recommendation, and supporting evidence citations.
Telling True from False: Cannabis Users Show Increased Susceptibility to False Memories Molecular Psychiatry In an article that is likely to prove important in the forensic setting, fMRI-assessed memory center activation was studied in 16 cannabis users and 14 controls. Cannabis users, including those now abstinent, demonstrated increased susceptibility to false memories. Previous studies on the neurocognitive impact of cannabis use have found working and declarative memory deficits that tend to normalize with abstinence. An unexplored aspect of cognitive function in chronic cannabis users is the ability to distinguish between veridical and illusory memories, a crucial aspect of reality monitoring that relies on adequate memory function and cognitive control.
Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol Clinical Chemistry An inference of this study of the interactive pharmacokinetics of alcohol and THC is that concurrent consumption of ethanol and THC yields higher blood THC levels than with consumption of THC alone. The significantly higher blood THC and 11-OH-THC Cmax values with alcohol possibly explain increased performance impairment observed from cannabis-alcohol combinations. Chosen driving-related THC cutoffs should be considered carefully to best reflect performance impairment windows. These results should aid forensic interpretation and inform the debate on drugged driving legislation.
AMA Passes Model State Law on Access to Addiction Medications American Medical Association The American Medical Association has passed a model state law which calls for increased access to pharmacologic and behavioral therapies for opioid addiction and recommends states prohibit insurers from placing limitations on these critical treatments. It would also require the state Medicaid program to cover the same medications and services.
Senate Committee Approves Protections for State Medical Marijuana Programs The Huffington Post The Senate Appropriations Committee approved a provision Thursday that would protect medical marijuana operations from federal crackdown in states where the substance is legal. The committee passed the measure, by a vote of 22-8, as an amendment to the Commerce, Justice and Science appropriations bill for fiscal year 2016. The amendment blocks the Department of Justice, which includes the Drug Enforcement Administration, from using appropriated funds to interfere with medical marijuana programs in the states that have legalized the drug for medical purposes.
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