AMERICAN MEDICAL ASSOCIATION OPPOSES MARIJUANA LEGALISATION; SUPPORTS HEALTH-FIRST APPROACH TO MARUIJUANA USE
Largest medical group in the US explicitly rejects calls to become “neutral” on legalization; supports full funding of the Office of National Drug Control Policy; calls for proper study of Colorado and Washington policies. It joins the American Psychiatric Association, who issued a statement last week outlining the public health harms of marijuana.
NATIONAL HARBOR, MD-The delegates at the 2013 Interim Meeting of the American Medical Association (AMA) House of Delegates, in National Harbor, Maryland, today voted to pass a resolution on marijuana, “Council of Science & Public Health Report 2 in Reference Committee K,” explicitly opposing marijuana legalization — fending off a challenge to “neutralize” their position. The report changes H-95.998 AMA Policy Statement on Cannabis to read in part that: “Our AMA believes that (1) cannabis is a dangerous drug and as such is a public health concern; (2) sale of cannabis should not be legalized.”
“The AMA today reiterated the widely held scientific view that marijuana is dangerous and should not be legalized,” commented Dr. Stuart Gitlow, Chair-Elect of the AMA Council on Science and Health and SAM Board Member. “We can only hope that the public will listen to science — not ‘Big Marijuana’ interests who stand to gain millions of dollars from increased addiction rates.”
Additionally, the report called for several provisions consistent with Project SAM’s marijuana pillars, including efforts to “discourage cannabis use, especially by persons vulnerable to the drug’s effects and in high-risk situations…support the determination of the consequences of long-term cannabis use through concentrated research, especially among youth and adolescents… support the modification of state and federal laws to emphasize public health based strategies to address and reduce cannabis use.”
“The American Medical Association took a bold step today, and they should be commended,” commented former Congressman Patrick J. Kennedy, SAM’s co-founder. “By explicitly rejecting calls to neutralize their anti-legalization position, they are sending a loud and powerful message to state and local decision makers, the Federal government, and the general public that to be on the side of science is to oppose efforts to expand marijuana use and addiction.”
Furthermore, several other elements in the report are consistent with SAM’s pillars, including calls to support: “the availability of and reduc[tion] (of) the cost of treatment programs for substance use disorders…a coordinated approach to adolescent drug education…community-based prevention programs for youth at risk to fund the Office of National Drug Control Policy… greater protection against discrimination in the employment and provision of services to drug abusers.” The report sums up much of these policy initiatives as a public health approach to marijuana use, which SAM wholeheartedly supports.
The AMA report follows an American Psychiatric Association position paper released last week, which concluded: “There is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. In contrast, current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development.”
http://learnaboutsam.com/american-medical-association-opposes-marijuana-legalization-supports-health-first-approach-to-marijuana-use/
American Psychiatric Association Position on \’Medical Marijuana\’
– There is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. In contrast, current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development.
– Further research on the use of cannabis-derived substances as medicine should be encouraged and facilitated by the federal government. The adverse effects of marijuana, including, but not limited to, the likelihood of addiction, must be simultaneously studied.
– Policy and practice surrounding cannabis-derived substances should not be altered until sufficient clinical evidence supports such changes.
– If scientific evidence supports the use of cannabis-derived substances to treat specific conditions, the medication should be subject to the approval process of the FDA.
Regarding state initiatives to authorize the use of marijuana for medical purposes:
– Medical treatment should be evidence-based and determined by professional standards of care; it should not be authorized by ballot initiatives.
– No medication approved by the FDA is smoked. Marijuana that is dispensed under a state-authorized program is not a specific product with controlled dosages. The buyer has no way of knowing the strength or purity of the product, as cannabis lacks the quality control of FDA-approved medicines.
– Prescribers and patients should be aware that the dosage administered by smoking is related to the depth and duration of the inhalation, and therefore difficult to standardize. The content and potency of various cannabinoids contained in marijuana can also vary, making dose standardization a challenging task.
– Physicians who recommend use of smoked marijuana for “medical” purposes should be fully aware of the risks and liabilities inherent in doing so. Item 2013A2 4.B Assembly November 8-10, 2013 Attachment #1
AUTHORS: Tauheed Zaman, M.D.; Richard N. Rosenthal, M.D.; John A. Renner, Jr., M.D.; Herbert D. Kleber, M.D.; Robert Milin, M.D.
\”You can study, study, study it, but it\’s THC (Delta-9-tetrahydrocannabinol) – that is the active ingredient,\” Franson said. \”And there are certain things that happen to everyone who takes THC.\”
These, she said, are a feeling of pleasure or high, motor instability, decreased reaction time, attention deficit and increased heart rate.
\”People think it mellows them out, but it causes an average increase in heart rate of 16 beats per minute,\” Franson said. \”That\’s why people who take high doses they are unaccustomed to can experience significant anxiety or paranoia.\”
Other THC effects commonly experienced are increased appetite, decreased nausea, decreased motivation and decreased pain perception.
Additional typical effects are bloodshot eyes, decreased pressure inside the eye (it\’s used to treat glaucoma), heightened sensory perception (intense colors and sounds), distorted sense of time and sometimes a dry mouth.
\”The cannabinoid receptor system is one of the biggest systems. Your brain is chock-full of them,\” said Dr. Christian Hopfer, an associate professor of psychiatry at University of Colorado Hospital\’s Center for Dependency, Addiction and Recovery.
\”You need (the body\’s natural cannabinoids), and it has an effect when you\’re messing with those receptors,\” Hopfer said.
THC mimics the body\’s cannabinoids. Both interact with the same receptors. When THC binds to the receptor, it interferes with normal brain function, such as dopamine regulation.
Dopamine is part of the body\’s natural reward system and a key molecule in many brain functions, such as attentiveness, motivation, learning, memorization and motor control. THC increases dopamine in the short term, but ultimately interferes with the body\’s own reward circuit.
With chronic cannabis consumption, the body decreases the number of receptors for its cannabinoids. Researchers have found that this results in reduced blood flow – and glucose and oxygen – to the brain. This could manifest as attention-deficit, memory loss and other impaired mental abilities.
\”There is evidence you don\’t recover all your mental capacity when you quit using,\” said Hopfer, who treats marijuana and other addictions. \”It\’s a very insidious addiction. It\’s very hard to treat. Its effects are subtle, gradual and less dramatic. And it\’s been trivialized.\”
http://www.denverpost.com/news/ci_24627637/pot-hundreds-names-one-key-ingredient-and-far
“Permissibility, availability and accessibility all increase consumption.” Dalgarno Institute
The pro-drug lobby has been relentlessly pushing the liberalization of drug use for about 25 years. Whilst the vast majority of people stay clear of illicit drugs, the push for Cannabis use has been aided and abetted by first medical marijuana (a Trojan Horse if ever there was one) and the ‘giving up’ on demand reduction strategies — especially aggressive and fully government supported education against cannabis. Cannabis use was in decline up until the ‘medical marijuana con’ got traction, this trend has reversed because a growing and completely false perception that ‘dope’ is relatively harmless.
The following is just a snapshot of the impact of this ‘it’s harmless really’ ideology has had on our communities.
Some USA Data
According to NSDUH survey data, the number of people reporting current (past month) marijuana use increased 21 percent from 2007 to 2011. In each of those years, the number of people reporting marijuana abuse was greater than for all other drugs combined.
- DAWN (Drug Abuse Warning Network — SAMHSA) data show there was a 59 percent increase in marijuana-related emergency department visits between 2006 (290,565) and 2010 (461,028). Marijuana was second only to cocaine for illicit drug-related emergency department visits in 2010.
- According to Monitoring the Future (MTF) data, between 2008 and 2012 there was a steady decline in the percentage of 8th, 10th, and 12th graders who view trying marijuana once or twice, smoking marijuana occasionally, or smoking marijuana regularly as high-risk behavior. The most pronounced decline in viewing marijuana use as risky behavior occurred among 10th graders.
- Marijuana-related treatment admissions increased 14 percent between 2006 (310,155) and 2010 (353,271), according to TEDS data.
In 2012, marijuana availability appeared to be increasing throughout the United States, most likely because of increased domestic cannabis cultivation and sustained high levels of production in Mexico. Additionally, marijuana potency is increasing. According to the Potency Monitoring Project, the average percentage of tetrahydrocannabinol (THC), the constituent that gives marijuana its potency, increased 37 percent from 2007 (8.7 percent) to 2011 (11.9 percent).
Taken from: USA National Drug Threat Assessment 2013 summary
http://www.justice.gov/dea/resource-center/DIR-017-13%20NDTA%20Summary%20final.pdf
Some UK findings
We evaluate the impact of a policing experiment that depenalized the possession of small quantities of cannabis in the London borough of Lambeth, on hospital admissions related to illicit drug use. To do so, we exploit administrative records on individual hospital admissions classified by ICD-10 diagnosis codes. These records allow the construction of a quarterly panel data set by London borough running from 1997 to 2009 to estimate the short and long run impacts of the depenalization policy unilaterally introduced in Lambeth between 2001 and 2002.
We find the depenalization of cannabis had significant longer term impacts on hospital admissions related to the use of hard drugs, raising hospital admission rates for men by between 40 and 100% of their pre-policy baseline levels. Among Lambeth residents, the impacts are concentrated among men in younger age cohorts, and among those with no prior history of hospitalization related to illicit drug or alcohol use. The dynamic impacts across cohorts vary in profile with some cohorts experiencing hospitalization rates remaining above pre-intervention levels six years after the depenalization policy is introduced.
We find evidence of smaller but significant positive spill-over effects in hospitalization rates related to hard drug use among residents in boroughs neighbouring Lambeth, and these are again concentrated among younger cohorts without prior histories of hospitalizations related to illicit drug or alcohol use. We combine these estimated impacts on hospitalization rates with estimates on how the policy impacted the severity of hospital admissions to provide a lower bound estimate of the public health cost of the depenalization policy.
… Our results suggest policing strategies have significant, nuanced and lasting impacts on public health. In particular our results provide a note of caution to moves to adopt more liberal approaches to the regulation of illicit drug markets, as typically embodied in policies such as the depenalization of cannabis. While such policies may well have numerous benefits such as preventing many young people from being criminalized (around 70% of drug-related criminal offences relate to cannabis possession in London over the study period), allowing the police to reallocate their effort towards other crime types and indeed reduce total crime overall [Adda et al., 2011], there remain potentially offsetting costs related to public health that also need to be factored into any cost benefit analysis of such approaches.
Policing Cannabis and Drug Related Hospital Admissions: Evidence from Administrative Records; Elaine Kelly & Imran Rasul, October 2012
As with many of the new synthetic drugs of abuse, there is limited research and/or information available on long-term effects. Most of the information is gathered by users or those in contact with users. Below you will find a short summary of what can be gleaned on this insidious cocktail known in Russian as ….Krokodil.
What is Krokodil?
Medical name: Desomorphine. Desomorphine is an opioid (a synthetic narcotic that has opiate-like activities but is not derived from opium) first patented in 1932 by the United States. It’s a derivative of morphine that has sedative and analgesic effects and is 8-10 times more potent than morphine. It is a classified as a Schedule I substance under the federal Controlled Substances Act. Schedule I means:
- The drug or other substance has a high potential for abuse.
- The drug or other substance has no currently accepted medical use in treatment in the United States.
- There is a lack of accepted safety for use of the drug or other substance under medical supervision.
Street Names: Krokodil, Walking Dead, Crocodile, Krok and Zombie Drug.
The name Krokodil comes from the word crocodile and was named as such because of the greenish and scale-like skin condition that occurs as a result of injecting the drug. At $6 to $8 a syringe, it’s roughly three times cheaper than the price of heroin.
Manufacture of this Novel Psychoactive Substance:
Krokodil is produced using over-the-counter codeine-based pills and mixing them with gasoline, paint thinner, hydrochloric acid and red phosphorous (scrapped from the tips of matches). The ingredients are boiled, distilled, mixed and what remains is a caramel colored liquid that can be injected.
Prevalence of use began in 2007 in Siberia and spread throughout the Russia. In 2011 the Russian Federal Drug Control Services confiscated approximately 65 million doses of Krokodil.
Effects of Krokodil:
- So called ‘High’ lasts from 30 minutes to approximately 1.5 hours and is reported by addicts/users to be similar, but more powerful, than the effects of heroin
- Causes flesh to rot from the inside out
- Skin becomes scaly; blood vessels burst causing the surrounding tissue to die
- Results in gangrene and amputations
- Exposed bone
- Kidney and liver damage
- Rotting teeth
- Blood poisoning
- Brain damage
- Death; average lifespan of users is 2-3 years, 3 year expectancy after first use
Withdrawal symptoms:
- Could last as long as 30 days
- Painful due to the blood vessel destruction and tissue damage
Articles and Resources:
- The Curse of the Crocodile: Russia\’s Deadly Designer Drug Time World 2011
- Krokodil: The drug that eats junkies (Independent, UK June 2011)
www.krokdildrug.com - Krokodil, the Drug That Eats Your Flesh: 5 Fast Facts You Need to Know [WARNING: GRAPHIC] (September 2013)
- DEA Now Monitoring Krokodil, a Deadly Morphine Derivative (Fox News 2011)
- http://www.youtube.com/watch?v=ZfkXH8wXqQI
The Myth of Drug Legalisation.
by Dr Ian OLIVER.
Increasingly the assertion is made that International drug control policies have failed and that the best solution would be to legalise drugs so that they would be controlled and distributed safely through Government authorised outlets thus denying the trade to criminal traffickers. Regrettably, these assertions are often made by self-appointed groups with grand sounding titles which have their own reasons for supporting legalisation. Frequently high profile people claim that legalisation is the best way of addressing a major social problem without cogent supporting evidence. The data used and distributed is inaccurate but presented to impress people who believe that it must be true because it is published by such impressive sounding organisations and respected ‘celebrities’. The flawed argument is that all prohibition monies have been wasted and would be better spent for the general benefit of the community; it is claimed that taxation on legally supplied drugs could be used to offset any associated problems arising from drug use.
The truth is that all drugs are potentially dangerous including prescription and over the counter medicines unless taken under medical guidance and supervision. International organised crime has capitalised on drug trafficking to the point where the money generated often exceeds the GDP of many countries. Traffickers spread false information aimed at convincing gullible people that drugs are safe “recreational” and fun; it has to be remembered that it is the demand for drugs that has made illicit trafficking so profitable. Accurate information has been submerged by an abundance of deliberately false statements about all drug users being treated as criminals and that drug control is an abuse of human rights which should allow all people freedom of choice.
Elementary research will reveal that the problem with uncontrolled drugs just one hundred years ago was vast and there were many people addicted to hard drugs marketed in various forms and widely used and abused. The International drug control system was born out of a real humanitarian crisis, a catastrophe that happened only because of a lack of global norms and standards. The UN Conventions were developed because it was universally agreed that control was necessary to protect the health and welfare of mankind and most countries became signatories to agreements that are reviewed and approved every decade. The main Convention of 1961 is very flexible in its approach and far from being all about arrests and imprisonment it emphasises the need that drugs should be used only for legitimate medical and research purposes; it stresses health and requires that all drug users are treated with respect and not marginalised or discriminated against. The Conventions encourage evidence based therapy for those who become dependent as well as education, rehabilitation and social re-integration. Criminality also has to be addressed.
There is another important UN Convention on the Rights of the Child, 1989 designed to protect children from the illicit use of narcotic drugs and psychotropic substances and to prevent the use of children in illicit production and trafficking. This is important as the human brain does not stop developing until well into the twenties and substances like cannabis are proven to damage the brain permanently.
The purpose of any effective drug policy should be to lessen the harm that illegal drugs do to society. Lowering or eliminating current legal and social restrictions that limit the availability and acceptance of drug use would have the opposite effect. Any Government policy must be motivated by the consideration that it must first do no harm. There is an obligation to protect citizens and the compassionate and sensible method must be to do everything possible to reduce dependency and misuse, not to encourage or facilitate it. Criminals will not stop their crimes, change course and become honest tax-paying citizens if drugs were legalised. Although there may be freedom of choice to use dangerous substances there can be no freedom from the consequences. International drug control is working; fewer than 6% of people globally use drugs regularly and legalisation is not the answer.
On marijuana legalization and Mental illness
A possible future legalization of cannabis (marijuana) would lead to wide commercial access of cannabis and an increase in the cannabis-using population, as found in other countries. As reported in many studies, increased cannabis use leads to a later increase in psychoses, especially schizophrenia. T.H. Moore and colleagues in the Lancet, 2007, concluded that there was “sufficient evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life”. For example, cannabis use in the UK increased four-fold between 1970 and 2002, and increased 18-fold in the under-18s. They estimated that new cases of schizophrenia would increase by 29% in men between 1990 and 2010. In fact, it was later found that the annual new cases of schizophrenia and psychoses increased from 49 per 100,000 in 1996 up to 77 per 100,000 in 1999, an increase of 58% over three years. In the canton of Zurich, Switzerland, cannabis use in 15-16-year old boys went up from 15% in 1990 to 50% in 2002. This was followed by a doubling in hospital first admissions for psychosis and schizophrenia in those aged 15 to 24. A major study by Zammit and colleagues in 2008 found that 1.1% of 1,648 Swedish men conscripts for military service who had ever used cannabis prior to 1970 subsequently developed schizophrenia, two-fold higher than those who never used cannabis. This went up to six-fold higher in those who ever used cannabis 50 times or more.
In general, studies found that psychosis occurs 2 to 8 years after a significant amount of cannabis use, and that the risk of psychosis is higher when cannabis use starts at an earlier age. An Australian study of 83 reports found that cannabis users had an age of onset of psychosis that was 2.7 years younger than non-users. Alcohol use was not associated with an earlier age of psychosis onset. In The Netherlands men cannabis users had a first psychotic episode 7 years younger than non-users.
Any future increases in cannabis-associated new cases of schizophrenia would add to the current high rate in Canada and the USA. M.-J. Dealberto at Queen’s University in Ontario found that the rate of new cases of schizophrenia in Canada is about 26 per 100,000 per year, considerably higher than the countries outside Canada which average about 12 new cases per 100,000 per year. (Quebec is even higher at 40.)
In addition, such an increase in new schizophrenia cases would need to be matched by significant increases in psychiatric hospital budgets and in community-based housing and welfare. For example, Ontario’s two major psychiatric centers (Ontario Shores Centre for Mental Health Sciences in Whitby, and the Centre for Addiction and Mental Health in Toronto) have a combined annual budget of about 400 million dollars, with approximately half assigned for schizophrenia. Across Canada, such budgets would need major increases. Considering that Ontario, for example, receives about 1,100 million dollars each year for tobacco taxes, a cannabis tax might cover the increased needs of the psychiatric hospitals and the community housing.
While the majority of cannabis users would not develop schizophrenia, the wider use of cannabis would lead not only to more hospitalizations of the new cases of schizophrenia, but also to an increased confrontation of psychotically disturbed young men with police.
Although there are valid medical uses for cannabis in cases of resistant epilepsy, and various painful chronic illnesses, wider use of cannabis may also be associated with drowsy driving and car accidents.
Almost all aspects of cannabis use and the related laws are contentious. Whatever laws are adopted by government may have to be a compromise between medical need and a reduced burden to all citizens.
******************
The author discovered the human brain’s dopamine receptor for psychosis and all antipsychotic drugs. [email protected] Oct. 17, 2013.
\”A big role is played by the Vietnamese drug barons who, according to DrugScope, control two-thirds of Britain\’s cannabis trade. They use nail salons as brothels and places to launder money raised from the sale of cannabis grown on suburban UK farms. Farms run by slaves.\”
http://www.huffingtonpost.com/monique-villa/they-walk-among-us—30-m_b_4120458.html
Blog Comment – Slavery is alive and well, in fact, doing better than ever before. It was the moral \’West\’ that fought hard to drive down slavery. Now it appears it is the insatiable demands of the immoral or (for the \’P.C Thugs\’ reading this) \’amoral West\’ that now drives the predicates of this new slave market – Drugs, sex and fashion. Invariably illicit drugs are enmeshed in at least two of these arenas and drugs particularly are used to control and manipulate the most vulnerable.
The hedonistic and utterly self indulgent demands for \’rights\’ to use illicit drugs in such countries as the USA, UK and Australia, are some of the greatest drivers for social injustice on the planet – Legalising drugs will only release another market to overlay the current illegal one. A key component of the answer to this heinous issue, is for the careless and egocentric substances users to actually give more of a damn about their \’fellow human beings\’ than for their own drug use! Ah, yes, but that\’s right, it\’s hard to make that \’justice call\’ when you\’re too busy trying to get \’high\’, yet again!
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The drug has been linked to strokes in young people but it is not known why. Photograph: Frank Miller/ Irish Times