Marijuana discussed

Psychosocial and environmental factors play a major role in the development and recovery from opioid dependence however, a detailed discussion is beyond the scope of this chapter. In general, the use of such drugs as marijuana and alcohol precedes the use of opioids (Clayton and Voss 1981 Kandel and Faust 1975). Although one cannot predict definitively which users will proceed to opioid use, those who do generally have low self-esteem, disrupted families, and/or difficult relationships with their parents. The increased availability of opioids in inner cities of major urban centers contributes to initiation of use and relapse. It is particularly difficult to avoid use and relapse in areas with high unemployment, poor school systems, and high crime rates, because living in such an area may contribute to the very affects opioid use temporarily reheves. 

Many drugsbromides, morphine, cocaine, hashish, marijuana, mescaline, scopolamine, di-isopropyl fluorophosphate, ACTH, pervitin, sodium amytal, lysergic acid, reserpine and chlorpromazine are known to have marked effects on the mental processes of the individuals who receive them. These effects are varied and cannot be discussed here. Suffice it to say that some drugs produce symptoms which resemble those observed in mental disease others work in the opposite direction. There can be no doubt that enzyme systems are... 

There was an unmistakable discomfort shared by the gentlemen from Washington. After a bit of discussion 1 volunteered the statement, "Of course, with three chiral centers, there will be eight distinct optical isomers possible, all of different pharmacology, and some may not resemble marijuana at all in action." The meeting broke up shortly thereafter. A lot of things just couldn t be talked about. 

Little is known about the pharmacology of DMHP and DMHP acetate, but the reference compound, THC, has been extensively described both in humans and in animals. Many reviews and symposia have discussed marijuana and the cannabinoids.6>10>l9 26,39 National Insti-... 

This book will focus on forensic pharmacology and drugs of abuse. Drugs of abuse, such as cocaine, heroin, marijuana, PCP, benzodiazepines, and methamphetamine, are often involved in criminal and civil matters concerning personal injury, motor vehicle accidents, drug overdose, and murder, and thus, are discussed to illustrate forensic pharmacology issues and investigations. 

In recent years federal authorities have pressured doctors not even to discuss medical marijuana as an option for their patients. They sought to revoke an offending doctor s license to prescribe federally controlled narcotics. Such an action would make it virmally impossible for many doctors to practice medicine in their specialty. However, in October 2002, a federal appeals court in San Erancisco ruled that such a sanction violates the constimtional right of doctors and patients to discuss health matters freely. About a year later the Supreme Court let the decision stand. The decision does not affect the illegality of actually prescribing medical marijuana, however. 

This ruling suggests that the necessity defense is unlikely to be permitted in federal court, even when bolstered by a local community s or even state s decision to support medical marijuana use. However, substantive constitutional challenges to federal drug regulations may be more successful. See the case of Raich v. Ashcroft, discussed later. In that case the question is whether the constitutional power of Congress to regulate interstate commerce properly extends to local, noncommercial medical use of marijuana. 

October 14 The U.S. Supreme Court lets stand an appeals court decision that doctors and patients have a constitutional right to discuss all health-related matters, including medical marijuana. Federal authorities had sought to revoke prescription licenses for physicians who discussed the matter. 

Abel, Ernest L. Marihuana The First Tvelve Thousand Years. New York Plenum Press, 1980. This readable narrative explores one of humankind s oldest drugs and its use in primitive rituals, later abuse, and its characterization as a drug of abuse. There is also discussion of marijuana s portrayal in the arts and attitudes toward the drug in different cultures. 

Mack, Alison, and Janet Joy. Marijuana as Medicine The Science Beyond the Controversy. Washington, D.C. National Academy Press, 2001. Recent findings from a National Institute of Medicine study are explained in lay terms, assessing the value of marijuana for treating various illnesses and types of pain. The book also discusses possible negative effects. Alternative forms of marijuana (such as Marinol) are also considered, and the current legal situation is explained. 

Randall, Blanchard, IV. Medical Use of Marijuana Policy and Regulatory Issues. Washington, D.C. Congressional Research Service, 2002. Describes the development of the medical marijuana issue and summarizes and analyzes policy issues. Government regulatory decisions, congressional proposals, and state ballot initiatives are also discussed. 

THE BRAIN S OWN MARIJUANA-LIKE NEUROTRANSMITTER The very high potency and structure of the cannabinoids contained within the marijuana plant enable them to cross the blood—brain barrier and bind to a receptor for the brain s very own endogenous cannabinoid neurotransmitter system. If this were not true, then the marijuana plant would be popular only for its use in making rope, paper, and cloth. The two currently identified neurotransmitters compounds (and there are probably more) in this system are anandamide, from the Sanskrit word amnia () meaning bliss, and 2-AG (2-arachidonoyl-glycerol). Unlike the other neurotransmitters that I ve discussed, these two endocannabinoids are not stored in synaptic vesicles. 

Aspirin is not the only popular choice for the relief of minor aches and pains. Another is acetaminophen, primarily known by its trade name, Tylenol. Its pain-relief mechanism has not been fully determined, but recent evidence indicates that acetaminophen increases the brain s production of the endogenous marijuana-like neurotransmitter anandamide discussed earlier. Anandamide can, in fact, reduce the experience of pain. Patients who suffering from the pain associated with multiple sclerosis, for example, have found that a combination of marijuana and acetaminophen or aspirin provides significant relief of their symptoms. Thus, the future of pain treatment may involve a... 

Before discussing the short-term and long-term physical effects of marijuana, we need to say a word about dose. Any substance, whether a drug or even water, can benefit or harm a person, depending on its quantity and potency. High doses of a substance can produce very different effects from those of low doses. Water is necessary for human life, but drink extreme... 

Chronic effects are frequent, habitual, and long-term. Investigators are also very interested in the chronic health effects of marijuana and THC and their influence on the lives of teenagers. The scientific literature discusses health effects of marijuana on bodily systems. 

Teenagers cite numerous motivations for their use of marijuana, and researchers have generated an equal number of hypotheses to explain what may lie behind its use. To better understand the teenage thought and decision-making processes regarding drug use, much discussion has focused on two important predictive factors personality type and peer and parental influences. 

Summary Leading authorities on drugs discuss the use, abuse, and the effects of marijuana, alcohol, LSD, heroin, cocaine, PCP, and other drugs and the alternatives to drug use. 

In addition to narcotics and marijuana, the nonmedical use of anabolic steroids became increasingly popular during the 1980s. This was particularly true for athletes seeking to increase skeletal muscle mass and performance, as discussed previously. The Omnibus Anti-Substance Abuse Act of 1988 made the unlawful distribution of anabolic steroids across state lines a felony under federal law, punishable by 1 to 3 years in prison and a fine of up to 250,000. State laws governing the possession and distribution of anabolic drugs vary, but a conviction in most states carries a stiff fine and imprisonment. 

As discussed above, marijuana contains four constituents (viz,I-IV) similar in structure and chemical properties whereas the metabolites are more polar and in the case of V and VI, more acidic than I. Thus it seemed plausible that I-IV could be separated from V and VI in plasma based upon pH adjustment and solvent extraction properties. Compounds I-IV were found to be extractable at ambient pH of 7.4 using petroleum ether whereas V and VI could be extracted at pH 4.1 using 99 1, benzene isopropanol. Once the initial plasma separation was effected a chromatographic separation was feasible using normal phase conditions for I-IV and reverse phase conditions for V and VI. Each technique is detailed in the following sections. 

Dr. David Smith — now a "medical advisor" for the National Organization for the Reform of Marijuana Laws (NORML), an entity we shall discuss in Part V ... 

Later that year, the outgoing Ford Administration eased the previous federal stand against decriminalization, encouraging discussion of this issue for the first time in a policy statement from the Strategy Council on Drug Abuse. Ford s chief advisor on drugs, Robert DuPont, stated that marijuana was less harmful than alcohol or tobacco and urged decriminalization of limited home production. 

With the "Isomerizer, the process is much easier. More than 200,000 Isomerizers are said to have been sold with the expectation that the device will increase potency of weak marijuana up to six times. After five or sue years on the market, however, the isomerizing process hasn t really become popular. The main reasons appear to be because it s still too much trouble and most people don t enjoy the taste of the "Iso-hash or oil which result since there is generally a lingering odor from bicarbonate of soda that is used to neutralize the sulfuric acid. Some complain that Iso-hash doesn t get them all that high. Robert Connell Clarke s Marijuana Botany provides a fuller discussion. 

To sum up this discussion, it seems appropriate to quote again the panel from the National Academy of Sciences investigating marijuana users in the 1980s there is as yet "no conclusive evidence that marijuana causes permanent, long-term health damage in humans, is addictive, leads to use of harder drugs, affects the brain structure or causes birth defects. Fora fully detailed... 

A booklet titled Using Marijuana in the Reduction of Nausea Associated with Chemotherapy discusses the timing of grass use with specific anticancer drugs and even supplies recipes and instructions (for advanced cases) for preparing suppositories. Priced at 2.50, it is shipped within twenty-four hours from Murray Publishing Co., 2312 Third Ave., Seattle, WA 98121, (206) 682-3560. The author, Dr. Roger A. Roffman, has just published the fullest account of recent uses of Marijuana as Medicine, and would like to hear from those who want to share their experience. He can be contacted at Box 5651, University Station, Seattle, WA 98105, (206) 543-5968. 

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