Marijuana use among youth poses significant risks to brain development and mental health. Regular marijuana use is associated with cognitive decline across all domains even after years of abstinence. It can also increase the likelihood of developing psychiatric disorders like depression and psychosis. Prenatal marijuana exposure has been linked to lower birth weight, abnormal development and long term cognitive impairments in offspring. Overall, the evidence shows that marijuana jeopardizes the healthy development of youth.
Jose Miguel De Angula of MAP International discusses the prevalence of child sexual abuse, the severe mental and physical effects of the abuse, prevention programs, and how MAP International is working with abused children.
This document provides biographical information about a neurofeedback practitioner and researcher. It outlines his educational background which includes a medical degree from Rutgers in 1999 and residencies/fellowships in psychiatry. He is board certified in QEEG and neurofeedback. His areas of research and publications include epilepsy, autism, and neurofeedback. He has worked for various government and private organizations. He operates several websites related to neurofeedback training and retreats. The document emphasizes brainwave training and neurofeedback as methods for improving brain function and mental health conditions.
Understanding Opioid Dependence: a significant harm of long-term opioid therapyMark Sullivan
In this presentation, I argue that prescription opioid policy is often framed as a balance of the right to pain relief vs the risk of addiction. But our brains have evolved to make both physical and social injury painful, with our endogenous opioid system modulating both forms of pain to promote both forms of survival. Long-term exogenous opioid medications disrupt this system and thereby impair human social and emotional function.
The document discusses various genetic studies of schizophrenia, including family, twin, and adoption studies. Family studies found an increased risk of schizophrenia in relatives of schizophrenic probands, suggesting a genetic basis. Twin studies estimated the heritability of schizophrenia to be around 80%, while adoption studies found an increased risk of schizophrenia in children adopted away from schizophrenic biological mothers. Overall, these various study designs provide strong evidence for a genetic contribution to schizophrenia.
This document summarizes the stories of Charlotte Figi and Jayden David, two children with severe epilepsy whose symptoms were greatly reduced through treatment with CBD oil extracted from marijuana. Both children suffered frequent, prolonged seizures and found no relief from conventional medications. Desperate to help their suffering children, their families turned to CBD oil as a last resort treatment. Remarkably, CBD oil nearly eliminated the children's seizures and allowed them to regain abilities they had lost. The document argues this shows CBD can be an effective treatment and should be researched further.
Ad webinar diet and exercise to prevent cognitive declinewef
The document provides information about a webinar on Alzheimer's disease and dementia prevention. It discusses proper webinar etiquette, introduces the panelists and moderator, and outlines topics including the most common forms of dementia, risk factors, protective strategies like physical activity and nutrition, latest research findings, and tips for healthy brain aging.
Success in neurofeedback therapy is affected by many factors. This PowerPoint was used as a background discussion of factors that positively and negatively affect neurofeedback training.
Jose Miguel De Angula of MAP International discusses the prevalence of child sexual abuse, the severe mental and physical effects of the abuse, prevention programs, and how MAP International is working with abused children.
This document provides biographical information about a neurofeedback practitioner and researcher. It outlines his educational background which includes a medical degree from Rutgers in 1999 and residencies/fellowships in psychiatry. He is board certified in QEEG and neurofeedback. His areas of research and publications include epilepsy, autism, and neurofeedback. He has worked for various government and private organizations. He operates several websites related to neurofeedback training and retreats. The document emphasizes brainwave training and neurofeedback as methods for improving brain function and mental health conditions.
Understanding Opioid Dependence: a significant harm of long-term opioid therapyMark Sullivan
In this presentation, I argue that prescription opioid policy is often framed as a balance of the right to pain relief vs the risk of addiction. But our brains have evolved to make both physical and social injury painful, with our endogenous opioid system modulating both forms of pain to promote both forms of survival. Long-term exogenous opioid medications disrupt this system and thereby impair human social and emotional function.
The document discusses various genetic studies of schizophrenia, including family, twin, and adoption studies. Family studies found an increased risk of schizophrenia in relatives of schizophrenic probands, suggesting a genetic basis. Twin studies estimated the heritability of schizophrenia to be around 80%, while adoption studies found an increased risk of schizophrenia in children adopted away from schizophrenic biological mothers. Overall, these various study designs provide strong evidence for a genetic contribution to schizophrenia.
This document summarizes the stories of Charlotte Figi and Jayden David, two children with severe epilepsy whose symptoms were greatly reduced through treatment with CBD oil extracted from marijuana. Both children suffered frequent, prolonged seizures and found no relief from conventional medications. Desperate to help their suffering children, their families turned to CBD oil as a last resort treatment. Remarkably, CBD oil nearly eliminated the children's seizures and allowed them to regain abilities they had lost. The document argues this shows CBD can be an effective treatment and should be researched further.
Ad webinar diet and exercise to prevent cognitive declinewef
The document provides information about a webinar on Alzheimer's disease and dementia prevention. It discusses proper webinar etiquette, introduces the panelists and moderator, and outlines topics including the most common forms of dementia, risk factors, protective strategies like physical activity and nutrition, latest research findings, and tips for healthy brain aging.
Success in neurofeedback therapy is affected by many factors. This PowerPoint was used as a background discussion of factors that positively and negatively affect neurofeedback training.
This elderly patient presents with insomnia and worsening depression since her husband passed away 10 months ago. She is currently taking sertraline but her sleep and mood have continued to decline. A thorough evaluation including questions about sleep patterns, depression screening, and input from family would help assess the situation. Treatment options may include cognitive behavioral therapy and low dose melatonin to address insomnia, with close monitoring of the patient's mood and safety.
Understanding the Fundamentals of Brain Health and Chronic Diseases Safdar...S'eclairer
Safdar I. Chaudhary, MD
Medical Director S’eclairer; Clinical Assistant Professor, Chatham
University; Board Certified in Adult Psychiatry by American Board of
Psychiatry and Neurology
Xyzmusts to know about internet addiction (1)Milen Ramos
This document discusses internet addiction and provides an overview of the topic. It begins by outlining how internet addiction came to be studied as a disorder and some of the key players in the field. It then discusses attempts to diagnose internet addiction using psychological tests and molecular tools like examining Delta FosB expression. The dangers of internet addiction are examined by looking at case studies and the biological mechanisms involved like dopamine dysregulation. The document ends by proposing future directions for research, including examining the epigenetic factors related to increased vulnerability to internet addiction.
Holding Hands With The Hopeless Edps Project Finalcmadison
This was initially completed as a project in one of my courses. However, understanding substance abuse as a disease and not a moral issue or lack of willpower is vitaly important to continue to make advancements in treatments and reimbursement issues, which are a huge threat.
Final coaching on coping with internet addiction counsellor s tool (1)Milen Ramos
This document discusses counseling on coping with internet addiction. It begins by defining internet addiction disorder and comparing behavioral vs physiological addictions. It then discusses various researchers and scales used to study internet addiction, including the Chen Internet Addiction Scale. The document explores attempting to diagnose internet addiction using psychological tests and biomolecular tools like the protein Delta FosB. It outlines potential dangers of internet addiction seen in cases of collapsed gamers and outlines brain changes caused by addiction like dopamine downregulation.
The Teenage Brain, Drinking & Risky Behavior Cysaguest56d903
Slides from presentation delivered 10/2/09 at the CT Youth Services Association Annual Conference in Southington, CT. Contact the presenter, Christopher Brown, at 203-685-7691 or brown.christopher@ymail.com You can make arrangements to have this presentation delivered in your community.
This document discusses several topics related to psychopharmacology in children and adolescents. It notes that there has been a large increase in the prescription of psychiatric medications for children in recent decades. It outlines some of the ethical issues and debates surrounding the diagnosis and treatment of mental health conditions in children, including concerns about overdiagnosis and the influence of parents and legal/business factors. The document also provides information on several classes of psychiatric medications commonly prescribed to children, including antidepressants, stimulants for ADHD, atypical antipsychotics, and mood stabilizers for bipolar disorder. It discusses the mechanisms of action, efficacy evidence, side effects and special considerations for use of these medications in developing populations.
This document provides an overview of pharmacotherapy options for anxiety disorders. It discusses the prevalence and types of anxiety disorders according to DSM-5 criteria. Common medications for disorders like generalized anxiety disorder and social anxiety disorder are SSRIs, which are first-line treatment options. Alternative options include SNRIs, benzodiazepines, anticonvulsants, and buspirone. The document reviews clinical trial data on medications and discusses treatment algorithms. It also covers investigational compounds that have shown promise or failed in development for anxiety disorders.
This is a presentation done on 4/6/11 for the Grand Rounds at Wayne State university by Pallav Pareek M.D.
This presentation talks about the concept of prdrome as it is(if?) applicable to schizophrenia, and if schizophrenia is becoming more of a preventable illness as science progresses. If so what are the various ways and means in which we can accomplish this prevention.
Amidst so much controversy on the issue , whether there is a prodrome for this illness or not, here I have tried to present the recent advances in this field and the recent scientific literature in this regard.
This PowerPoint Presentation reviews common mental health disorders and highlights evidence-based strategies for supervising justice-involved individuals with mental health diagnoses. It will be presented at the 2019 State of Maryland Behavioral Health Symposium by Aaron Wonneman and Ginger Miller.
The document discusses several anatomical and physiological peculiarities of the nervous system in children. It notes that the brain mass is a higher percentage of body mass in newborns compared to adults, and certain areas develop more quickly than others. Neurons in newborns have less surface area covered by synapses and shorter axons compared to older children and adults. The formation of the nervous system is most important in early childhood, and negative influences in the first 18 months can cause future disturbances.
The document discusses anatomical peculiarities of the nervous system in children. It notes that the brain mass of a newborn is 10% of body mass, and development is uneven across brain areas. For newborns, the brain is shorter and wider. Myelination begins after birth and intensifies from ages 1-2. The structure of neurons matures with age, developing nuclei, axons, and dendrites. The functioning of the nervous system also matures with age.
The document discusses reasons for drug use and abuse. It provides 10 reasons why drug use is more serious today than in the past, including more potent drugs, younger experimentation, and greater availability of information. It also lists basic reasons people take drugs like pleasure-seeking, peer pressure, and relieving pain. The document examines definitions of addiction, models of addiction, risk factors, and biological explanations for drug abuse.
This document summarizes key concepts about treating individuals who have experienced trauma. It discusses how trauma can affect people's emotions, behavior, and ability to self-regulate. Trauma treatment should aim to avoid re-traumatization and help traumatized individuals maintain calm states and build skills to prevent intense emotional responses. The document also explains how trauma physically impacts brain development and can cause changes in brain structures. Effective treatment needs to address both emotional dysregulation and environments that cannot contain strong emotions.
The document discusses the anatomical and physiological peculiarities of the nervous system in children. It describes how the nervous system develops rapidly in early childhood, especially in the first 3 years of life. Key aspects covered include the structure of the brain and neurons, myelination processes, and how the nervous system functions differently in children compared to adults. The development of the central nervous system is influenced by both genetic and environmental factors.
This document discusses the link between marijuana use and mental illness. It outlines several studies that have found regular marijuana use increases the risk of developing psychotic illnesses like schizophrenia, especially for those with a family history or who start using in adolescence. The document also discusses the experiences in Colorado since legalizing marijuana, including an increase in marijuana-related emergency room visits and traffic deaths involving marijuana. The authors argue for a "smart approach" to marijuana policy that decreases access and availability, especially to youth, through prevention programs and increased treatment options rather than an "all or nothing" legalization vs prohibition debate.
Alice P. Mead gave a presentation on the history of medical marijuana and the potential for developing marijuana-based medicines. She summarized that while crude marijuana extracts were used medically in the past, modern synthetic medicines replaced them. Identification of cannabinoids like THC in the 1960s renewed scientific interest. GW Pharmaceuticals is developing standardized pharmaceutical cannabinoid medicines and conducting international clinical trials through the FDA process to establish safety and efficacy. Developing marijuana as a modern medicine requires meeting standards for composition, dosage, and delivery unlike herbal "medical marijuana".
This elderly patient presents with insomnia and worsening depression since her husband passed away 10 months ago. She is currently taking sertraline but her sleep and mood have continued to decline. A thorough evaluation including questions about sleep patterns, depression screening, and input from family would help assess the situation. Treatment options may include cognitive behavioral therapy and low dose melatonin to address insomnia, with close monitoring of the patient's mood and safety.
Understanding the Fundamentals of Brain Health and Chronic Diseases Safdar...S'eclairer
Safdar I. Chaudhary, MD
Medical Director S’eclairer; Clinical Assistant Professor, Chatham
University; Board Certified in Adult Psychiatry by American Board of
Psychiatry and Neurology
Xyzmusts to know about internet addiction (1)Milen Ramos
This document discusses internet addiction and provides an overview of the topic. It begins by outlining how internet addiction came to be studied as a disorder and some of the key players in the field. It then discusses attempts to diagnose internet addiction using psychological tests and molecular tools like examining Delta FosB expression. The dangers of internet addiction are examined by looking at case studies and the biological mechanisms involved like dopamine dysregulation. The document ends by proposing future directions for research, including examining the epigenetic factors related to increased vulnerability to internet addiction.
Holding Hands With The Hopeless Edps Project Finalcmadison
This was initially completed as a project in one of my courses. However, understanding substance abuse as a disease and not a moral issue or lack of willpower is vitaly important to continue to make advancements in treatments and reimbursement issues, which are a huge threat.
Final coaching on coping with internet addiction counsellor s tool (1)Milen Ramos
This document discusses counseling on coping with internet addiction. It begins by defining internet addiction disorder and comparing behavioral vs physiological addictions. It then discusses various researchers and scales used to study internet addiction, including the Chen Internet Addiction Scale. The document explores attempting to diagnose internet addiction using psychological tests and biomolecular tools like the protein Delta FosB. It outlines potential dangers of internet addiction seen in cases of collapsed gamers and outlines brain changes caused by addiction like dopamine downregulation.
The Teenage Brain, Drinking & Risky Behavior Cysaguest56d903
Slides from presentation delivered 10/2/09 at the CT Youth Services Association Annual Conference in Southington, CT. Contact the presenter, Christopher Brown, at 203-685-7691 or brown.christopher@ymail.com You can make arrangements to have this presentation delivered in your community.
This document discusses several topics related to psychopharmacology in children and adolescents. It notes that there has been a large increase in the prescription of psychiatric medications for children in recent decades. It outlines some of the ethical issues and debates surrounding the diagnosis and treatment of mental health conditions in children, including concerns about overdiagnosis and the influence of parents and legal/business factors. The document also provides information on several classes of psychiatric medications commonly prescribed to children, including antidepressants, stimulants for ADHD, atypical antipsychotics, and mood stabilizers for bipolar disorder. It discusses the mechanisms of action, efficacy evidence, side effects and special considerations for use of these medications in developing populations.
This document provides an overview of pharmacotherapy options for anxiety disorders. It discusses the prevalence and types of anxiety disorders according to DSM-5 criteria. Common medications for disorders like generalized anxiety disorder and social anxiety disorder are SSRIs, which are first-line treatment options. Alternative options include SNRIs, benzodiazepines, anticonvulsants, and buspirone. The document reviews clinical trial data on medications and discusses treatment algorithms. It also covers investigational compounds that have shown promise or failed in development for anxiety disorders.
This is a presentation done on 4/6/11 for the Grand Rounds at Wayne State university by Pallav Pareek M.D.
This presentation talks about the concept of prdrome as it is(if?) applicable to schizophrenia, and if schizophrenia is becoming more of a preventable illness as science progresses. If so what are the various ways and means in which we can accomplish this prevention.
Amidst so much controversy on the issue , whether there is a prodrome for this illness or not, here I have tried to present the recent advances in this field and the recent scientific literature in this regard.
This PowerPoint Presentation reviews common mental health disorders and highlights evidence-based strategies for supervising justice-involved individuals with mental health diagnoses. It will be presented at the 2019 State of Maryland Behavioral Health Symposium by Aaron Wonneman and Ginger Miller.
The document discusses several anatomical and physiological peculiarities of the nervous system in children. It notes that the brain mass is a higher percentage of body mass in newborns compared to adults, and certain areas develop more quickly than others. Neurons in newborns have less surface area covered by synapses and shorter axons compared to older children and adults. The formation of the nervous system is most important in early childhood, and negative influences in the first 18 months can cause future disturbances.
The document discusses anatomical peculiarities of the nervous system in children. It notes that the brain mass of a newborn is 10% of body mass, and development is uneven across brain areas. For newborns, the brain is shorter and wider. Myelination begins after birth and intensifies from ages 1-2. The structure of neurons matures with age, developing nuclei, axons, and dendrites. The functioning of the nervous system also matures with age.
The document discusses reasons for drug use and abuse. It provides 10 reasons why drug use is more serious today than in the past, including more potent drugs, younger experimentation, and greater availability of information. It also lists basic reasons people take drugs like pleasure-seeking, peer pressure, and relieving pain. The document examines definitions of addiction, models of addiction, risk factors, and biological explanations for drug abuse.
This document summarizes key concepts about treating individuals who have experienced trauma. It discusses how trauma can affect people's emotions, behavior, and ability to self-regulate. Trauma treatment should aim to avoid re-traumatization and help traumatized individuals maintain calm states and build skills to prevent intense emotional responses. The document also explains how trauma physically impacts brain development and can cause changes in brain structures. Effective treatment needs to address both emotional dysregulation and environments that cannot contain strong emotions.
The document discusses the anatomical and physiological peculiarities of the nervous system in children. It describes how the nervous system develops rapidly in early childhood, especially in the first 3 years of life. Key aspects covered include the structure of the brain and neurons, myelination processes, and how the nervous system functions differently in children compared to adults. The development of the central nervous system is influenced by both genetic and environmental factors.
This document discusses the link between marijuana use and mental illness. It outlines several studies that have found regular marijuana use increases the risk of developing psychotic illnesses like schizophrenia, especially for those with a family history or who start using in adolescence. The document also discusses the experiences in Colorado since legalizing marijuana, including an increase in marijuana-related emergency room visits and traffic deaths involving marijuana. The authors argue for a "smart approach" to marijuana policy that decreases access and availability, especially to youth, through prevention programs and increased treatment options rather than an "all or nothing" legalization vs prohibition debate.
Alice P. Mead gave a presentation on the history of medical marijuana and the potential for developing marijuana-based medicines. She summarized that while crude marijuana extracts were used medically in the past, modern synthetic medicines replaced them. Identification of cannabinoids like THC in the 1960s renewed scientific interest. GW Pharmaceuticals is developing standardized pharmaceutical cannabinoid medicines and conducting international clinical trials through the FDA process to establish safety and efficacy. Developing marijuana as a modern medicine requires meeting standards for composition, dosage, and delivery unlike herbal "medical marijuana".
This document provides information on electronic cigarettes (e-cigarettes). It describes how e-cigarettes work by heating liquid nicotine into an aerosol, and that they are available in various flavors and refillable or disposable models. The document summarizes research showing e-cigarettes may be a gateway to traditional cigarettes for youth and that their vapor contains toxic chemicals. It also outlines marketing tactics used to promote e-cigarettes that mirror traditional tobacco and concerns they could re-normalize smoking.
This document discusses the risks of energy drinks, especially when mixed with alcohol. It notes that energy drinks contain large doses of caffeine and other stimulants that can cause short-term effects like increased heart rate and blood pressure. When mixed with alcohol, the stimulant effects of energy drinks can mask intoxication, leading people to drink more than they realize. This can be dangerous as the depressant effects of alcohol will still occur later on. The document lists some common ingredients in energy drinks and their purported benefits and risks. It expresses concern about marketing tactics that target youth and how energy drinks may introduce them to alcohol.
The Affordable Care Act outlines various preventive health services that must be covered under insurance plans, including screening services for adults, women, children, and seniors. Key provisions require coverage of services like mammograms and colonoscopies with no out-of-pocket costs. The law also expands coverage of tobacco cessation programs and annual wellness visits for Medicare recipients.
The document summarizes key provisions of the Affordable Care Act (ACA) and how it aims to improve access to affordable health care. It discusses how the law expands coverage to millions of uninsured Americans through Medicaid expansion and health insurance exchanges. It also outlines important consumer protections now required of health plans, such as prohibiting denial of coverage due to pre-existing conditions. The document also highlights how the ACA strengthens Medicare and aims to reduce health care costs.
The Silver State Health Insurance Exchange (SSHIX) is Nevada's state-based health insurance exchange created by SB 440. The SSHIX will facilitate the purchase of qualified health plans for individuals and small businesses, provide consumer assistance, and reduce the number of uninsured in Nevada. It has advisory committees that make recommendations on issues like plan certification, risk adjustment, and consumer outreach. The SSHIX is led by an executive director and governed by a 10-member board.
The document outlines preventive services covered by the Affordable Care Act for adults, women including pregnant women, children, and seniors over 65 years old. It provides lists of specific screening and counseling services covered in each category with no co-pay, such as annual physicals, cancer screenings, immunizations, HIV and STI testing.
Sandra Koch, MD discusses the impact of health care reform on the uninsured. The Affordable Care Act is estimated to reduce the number of uninsured women ages 19-64 from 20% to 8% when fully implemented. However, health care costs and access to providers will still be challenges as millions gain coverage. Electronic health records and data sharing aim to improve care coordination and lower costs but introducing technology brings privacy concerns. Overall the reforms seek to make health insurance and costs more transparent while shifting payment models to value health outcomes over procedures.
This document discusses pain management and opioid addiction. It begins with introductions and disclosures from the presenter, Dr. Mel Pohl. The objectives are then outlined as reviewing addiction as a brain disease, describing chronic pain, and discussing pain treatment in the context of opioid addiction. Key facts about chronic pain and definitions of pain and addiction are provided. The neurobiology of addiction and how it is similar to other diseases is examined through PET scan images. Issues with using opioids to treat chronic pain like side effects, tolerance, and hyperalgesia are covered. The emergence of the opioid epidemic in the US is shown through various graphs and charts. Non-opioid and non-medication treatment options at Las Vegas Recovery Center are
- Marijuana legalization advocates have effectively organized and messaged their position, securing support and passing ballot initiatives in some states.
- Opponents of legalization need to learn from their tactics and emphasize potential risks of legalization to public health and safety, especially for youth.
- While current drug policies could be reformed to reduce incarceration, legalizing marijuana could normalize and increase use, especially among kids, with negative health outcomes and unknown economic and social costs.
- Moving forward, opponents should focus on the specifics of legalization proposals rather than generalizations, build new partnerships, and position themselves as favoring sensible reform rather than appearing inflexible.
The document discusses the potential risks of legalizing marijuana for children and adolescents, citing research showing negative health impacts of marijuana use on developing brains and the tactics used by the tobacco industry to market and sell products to youth. It proposes contingency planning now to regulate a potential legal marijuana industry similarly to alcohol and tobacco, learning from past mistakes, in order to prevent targeting of underage users and protect public health.
This document provides an overview of prescription drug abuse in the United States. It discusses how the U.S. consumes a disproportionate amount of opioids and other prescription drugs globally. The document traces the historical factors that have contributed to the development of America's drug culture, from the Civil War era to modern pharmaceutical marketing practices. It also shares current statistics on prescription drug abuse rates and risks in Nevada. The presentation concludes by outlining the activities of Nevada's Controlled Substance Prescription Abuse Prevention Task Force and its prescription monitoring program.
This document discusses the history of opiate commercialization and addiction. It begins with the British East India Company trading opium to China in the 17th-18th centuries, leading to widespread addiction. In the 1990s, Purdue Pharma aggressively marketed OxyContin, leading to its overprescription and misuse. Today, 30-40% of prescribed opiates are misused. The document outlines strategies to educate prescribers on appropriate opiate prescribing through training, monitoring programs, and care agreements with patients.
This document summarizes a presentation given by Jeff Kallal of the DEA on prescription drug abuse and diversion. It discusses how prescription drug abuse has led to a national crisis and opioid epidemic, with many users transitioning to heroin due to lower costs. It outlines trends seen across various states and provides data on prescription drug-related deaths in Nevada and Clark County specifically. The presentation covers commonly abused prescription opioids and depressants, as well as methods of diversion such as doctor shopping, pharmacy theft, and internet sales.
This document provides information about synthetic drugs like "bath salts" and "spice" that contain cathinones and cannabinoids. It summarizes the chemicals found in these drugs, their scheduling as illegal substances in Nevada, common brand names and methods of ingestion. The document also describes some of the drugs' physiological and psychological effects. It discusses law enforcement challenges in investigating these drugs and provides strategies for criminal case development and preventing distribution.
Officer Eddie Dutchover of the Moapa Tribal Police Department provided information on law enforcement response to drug trafficking organizations. Interdiction teams work across agencies to gather intelligence and identify traffickers beyond typical traffic stops. They seize illicit currency and drugs moving north, south, east, and west. Hidden vehicle compartments are increasingly used to transport money out of Mexico, with about $35-40 billion returned yearly. Proper searches include inspection of areas like firewalls, exhaust systems, gas tanks, and spare tires, where drugs and money have been found. Emerging trends on I-15 include one-way rentals, avoidance of I-40, short-term vehicle registrations, and use of high-end
Synthetic cathinones ("bath salts") and cannabinoids ("spice") pose emerging public health threats. They produce effects similar to illegal drugs like cocaine and marijuana but are marketed as "bath salts", "plant food", or "incense" to avoid regulation. While little was known about them initially, reports show they can cause agitation, hallucinations, and even death. Most states have now controlled or criminalized them in response.
The document discusses the dangers of prescription drug and over-the-counter drug abuse among teens, noting that it can be as addictive and deadly as using illegal street drugs. It provides statistics showing that thousands of teens abuse prescription drugs daily, and that prescription drug abuse has become a new tier of substance experimentation for teens. The document outlines how teens obtain these drugs and which types are most commonly abused. It identifies factors driving teen medicine abuse and discusses how abuse has been normalized in teen culture. The document urges parents to take action by educating themselves and their children about the risks.
This document discusses the risks of underage drinking and provides tips for parents. It notes that alcohol use is normalized for kids through extensive advertising. Underage drinking can lead to unsafe sex, injuries, deaths from car crashes and other causes. Developing teen brains are especially vulnerable to alcohol's harms. Kids who begin drinking before age 15 are more likely to have problems later. The document encourages parents to clearly communicate their rules against underage drinking and model responsible behavior if they choose to drink. It provides hosting tips to help prevent underage drinking at parties.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
How to Setup Default Value for a Field in Odoo 17Celine George
In Odoo, we can set a default value for a field during the creation of a record for a model. We have many methods in odoo for setting a default value to the field.
CapTechTalks Webinar Slides June 2024 Donovan Wright.pptxCapitolTechU
Slides from a Capitol Technology University webinar held June 20, 2024. The webinar featured Dr. Donovan Wright, presenting on the Department of Defense Digital Transformation.
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إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
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THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
A Free 200-Page eBook ~ Brain and Mind Exercise.pptxOH TEIK BIN
(A Free eBook comprising 3 Sets of Presentation of a selection of Puzzles, Brain Teasers and Thinking Problems to exercise both the mind and the Right and Left Brain. To help keep the mind and brain fit and healthy. Good for both the young and old alike.
Answers are given for all the puzzles and problems.)
With Metta,
Bro. Oh Teik Bin 🙏🤓🤔🥰
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
1. Marijuana Jeopardizing Youth
Eric A. Voth, M.D., F.A.C.P-Eric A. Voth, M.D., F.A.C.P-
ChairmanChairman
The Institute onThe Institute on
Global Drug PolicyGlobal Drug Policy
7. CESAR FAX
U n i v e r s i t y o f M a r y l a n d , C o l l e g e P a r k
A Weekly FAX from the Center for Substance Abuse Research
January 18, 2010
Vol. 19, Issue 2
U.S. High School Seniors’ Perception of Harm from Regular Marijuana Use Decreasing
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30%
40%
50%
60%
70%
80%
Perceived Risk of Harm
from Regular Use
Used in Past Month
Percentage of U.S. Twelfth Grade Students Reporting Past Month
Marijuana Use and Perceived Risk of Harm from Regular Marijuana Use, 1975-2009
SOURCE: Adapted by CESAR from University of Michigan, “Teen Marijuana Use Tilts Up, While Some
Drugs Decline in Use,” Press Release, 12/14/09. Available online at
http://www.monitoringthefuture.org/data/09data.html#2009data-drugs.
8.
9.
10. Marijuana
Impurity-488 substances, 66 cannabinoidsImpurity-488 substances, 66 cannabinoids
Resembles tobacco in constituents.Resembles tobacco in constituents.
High THC concentrations 2-30%High THC concentrations 2-30%
1/2 life 5-7 days1/2 life 5-7 days
13. Cognitive Changes
AttentionAttention
ConcentrationConcentration
Decision-makingDecision-making
InhibitionInhibition
ImpulsivityImpulsivity
Working memoryWorking memory
Verbal fluencyVerbal fluency
Concept formation and planningConcept formation and planning
J Addict Med 2011;5:1-8J Addict Med 2011;5:1-8
14. Memory
Difficulty sorting information andDifficulty sorting information and
inhibition of memory even after ainhibition of memory even after a
mean two year abstinence.mean two year abstinence.
SOLOWIJ- LIFE SCIENCESSOLOWIJ- LIFE SCIENCES
1995;5:2119-261995;5:2119-26
15. Structural Damage to Brain
59 users 33 controls59 users 33 controls
Ave age 33, Ave use 15 yrs, started 16.7 yoAve age 33, Ave use 15 yrs, started 16.7 yo
Ave joints /mo=147Ave joints /mo=147
Ave life joints 25922Ave life joints 25922
Demonstrated axonal connectivityDemonstrated axonal connectivity
impairment in hippocampus, splenium ofimpairment in hippocampus, splenium of
corpus callosum, commissural fiberscorpus callosum, commissural fibers
Brain 2012:135;2245-2255Brain 2012:135;2245-2255
16. Neuropsychological Decline
1037 individuals1037 individuals
Pot use at 18,21,26,32,38 y/oPot use at 18,21,26,32,38 y/o
Neuropsych testing at 13 before pot and 38Neuropsych testing at 13 before pot and 38
Broad Neuropsychological decline acrossBroad Neuropsychological decline across
all domains even controlling for educationall domains even controlling for education
Greatest decline was adolescent andGreatest decline was adolescent and
persistent use.persistent use.
Proc Natl Acad Sci U S A. 2012 Aug 27Proc Natl Acad Sci U S A. 2012 Aug 27
17. From the horse’s mouth
““I used to smoke this stuff regulerly I quit because II used to smoke this stuff regulerly I quit because I
needed to pass a test to get a job. The reason I am writingneeded to pass a test to get a job. The reason I am writing
is because I never had any of thougs side effects you talkis because I never had any of thougs side effects you talk
about don’t get me wrong its not for every body. But youabout don’t get me wrong its not for every body. But you
don’t need to say untrue things about it coordinationdon’t need to say untrue things about it coordination
imparment that’s bs it allows you to focus better on singleimparment that’s bs it allows you to focus better on single
things its perfect for kids like I was that cant concetrate onthings its perfect for kids like I was that cant concetrate on
ting well you don’t have to reply to this email I am justting well you don’t have to reply to this email I am just
bored and looking at stuff on the net and emailing peoplebored and looking at stuff on the net and emailing people
and going on and on cause I cant sleep well you have aand going on and on cause I cant sleep well you have a
nice day.nice day.
19. Driving Effects
Combining EtOH and Marijuana in FirstCombining EtOH and Marijuana in First
Study Reduced Driving SkillsStudy Reduced Driving Skills
.07 + 100ug = Plain EtOH of 0.09.07 + 100ug = Plain EtOH of 0.09
.07 + 200 ug = Plain EtOH of .14 g/dl.07 + 200 ug = Plain EtOH of .14 g/dl
NHTSA Notes Annals of Emergency MedicineNHTSA Notes Annals of Emergency Medicine
2000;35:3992000;35:399
23. Marijuana and depression
1920 subjects1920 subjects
15 year follow up15 year follow up
Likelyhood of major depression 4 timesLikelyhood of major depression 4 times
greater among users.greater among users.
Am J. Psychiatry
2001;158:2033-2037
25. Marijuana and Psychosis
40454045 psychosis-freepsychosis-free and 59 individualsand 59 individuals
exhibiting psychosis at baseline assessment.exhibiting psychosis at baseline assessment.
Marijuana predictedMarijuana predicted 2.762.76 times greatertimes greater
likelihood oflikelihood of any psychotic symptomsany psychotic symptoms,,
predictedpredicted 24.1724.17 times higher incidence oftimes higher incidence of
severe psychotic symptomssevere psychotic symptoms, and predicted, and predicted
12 times higher need for clinical assessment12 times higher need for clinical assessment
and care for psychotic symptoms.and care for psychotic symptoms.
American Journal of EpidemiologyAmerican Journal of Epidemiology
2002;156:319-272002;156:319-27
26. Persistence of Psychosis
Risk of psychosis -no prior psychosis whoRisk of psychosis -no prior psychosis who
used pot, 1.9 times greater that non-users inused pot, 1.9 times greater that non-users in
ave 3.5 years.ave 3.5 years.
Continued pot use risk of future psychosisContinued pot use risk of future psychosis
was 31% vs 20% in those who did not usewas 31% vs 20% in those who did not use
out to approx 8.5 years.out to approx 8.5 years.
BMJ 2011;342: d738BMJ 2011;342: d738
27. Marijuana and Bipolar Illness
166 first-episode bipolar I disorder patients.166 first-episode bipolar I disorder patients.
Cannabis and alcohol associated with theCannabis and alcohol associated with the
first episode of maniafirst episode of mania
Bipolar Disorder 2008;10:738-741Bipolar Disorder 2008;10:738-741
28. Marijuana and Behavior
Marijuana had a greater effect on degree ofMarijuana had a greater effect on degree of
violent behavior in non-delinquentviolent behavior in non-delinquent
individuals than in delinquent individuals.individuals than in delinquent individuals.
This effect is even more prominent than theThis effect is even more prominent than the
effect of cocaine, amphetamine, oreffect of cocaine, amphetamine, or
tranquilizer/sedative use.tranquilizer/sedative use.
Friedman AS, J Addict Dis. 2003;22:63-78Friedman AS, J Addict Dis. 2003;22:63-78
30. Gateway Effect
Risk spans entire course of adolescent
development.
Young people exposed to other users are at
higher risk for early initiation.
Clear family standards and proactive
family management are important in
delaying alcohol and marijuana use.
Kosterman R, Hawkins JD, Guo J, Catalano RF, Abbott RD.
. American Journal of Public Health 2000;90:360-366.
31. Gateway effects
Risk of other drug use with weekly
marijuana vs nonusers:
14-15 y/o 66.7%
17-18y/o 28.5%
20-21y/o 12.2%
24-25y/o 3.9%
Fergusson DM, et al.
Addiction 2006;101:556-569
32. Marijuana Dependence
Most patients claimed serious problems withMost patients claimed serious problems with
cannabis, and 78.6% met criteria for cannabiscannabis, and 78.6% met criteria for cannabis
dependence.dependence.
Two thirds reported withdrawal. Cannabis is aTwo thirds reported withdrawal. Cannabis is a
reinforcer. produces both dependence andreinforcer. produces both dependence and
withdrawal and reinforces cannabis use.withdrawal and reinforces cannabis use.
Regular cannabis use rapid as tobaccoRegular cannabis use rapid as tobacco
progression, and more rapid than alcoholprogression, and more rapid than alcohol
CrowleyDrug and Alcohol Dependence 1998;50:27-37CrowleyDrug and Alcohol Dependence 1998;50:27-37
33. Marijuana Dependence
20% used before age 16 (20% used before age 16 (New Zealand)New Zealand)
21.7% demonstrated dependence by age 2121.7% demonstrated dependence by age 21
If 5 positive experiences with pot, 28 xIf 5 positive experiences with pot, 28 x
increase risk of dependence.increase risk of dependence.
Fergusson DM, Horwood LJ, Lynskey MT, Madden PAF.
Early reactions to cannabis predict later dependence.
Arch Gen Psychiatry 2003;60:1033-1039
35. Effect on Conception
Women smoking> 90 times in their lifetimeWomen smoking> 90 times in their lifetime
had 27% fewer oocytes retrieved (P=.03)had 27% fewer oocytes retrieved (P=.03)
and 1 fewer embryo transferred (P!.05).and 1 fewer embryo transferred (P!.05).
Women smoking marijuana >10 times inWomen smoking marijuana >10 times in
lifetime infants 17% (P=.01) smallerlifetime infants 17% (P=.01) smaller
Women smoking marijuana 1 year beforeWomen smoking marijuana 1 year before
IVF/ GIFT had25% fewer oocytes retrievedIVF/ GIFT had25% fewer oocytes retrieved
(P=.03)(P=.03)
Am J Ob-Gyn (2006) 194, 369–76Am J Ob-Gyn (2006) 194, 369–76..
36. Effect on Conception (cont)
If men smoked marijuana 11 to 90 times inIf men smoked marijuana 11 to 90 times in
their lifetime, there was a 15% decrease intheir lifetime, there was a 15% decrease in
infant birth weight (P = .03)infant birth weight (P = .03)
more than 90 times, there was a 23%more than 90 times, there was a 23%
decrease (P=.01).decrease (P=.01).
Women and men who smoked in the past 15Women and men who smoked in the past 15
years, had 12%(P=.04) and 16% (P=.03)years, had 12%(P=.04) and 16% (P=.03)
smaller infants, respectively.smaller infants, respectively.
37. Pre-Term Birth
3234 births from healthy women3234 births from healthy women
Use of marijuana (particularly pre-Use of marijuana (particularly pre-
pregnancy) is a strong environment risk forpregnancy) is a strong environment risk for
pre-term birth.pre-term birth.
Dekker GA, Lee SY, North RA, McCowan LM, Simpson NAB, et al.Dekker GA, Lee SY, North RA, McCowan LM, Simpson NAB, et al.
(2012PLoS ONE 7(7): e39154. doi:10.1371/journal.pone.0039154)(2012PLoS ONE 7(7): e39154. doi:10.1371/journal.pone.0039154)
39. Fetal/Infant Effects
Prenatal exposure to marijuana is associated withPrenatal exposure to marijuana is associated with
reduction in birth weight, length, and headreduction in birth weight, length, and head
circumference even when tobacco use factoredcircumference even when tobacco use factored
out.out.
Clinical Chemisty 2010;56:1442-1450Clinical Chemisty 2010;56:1442-1450
40. Fetal Effects: 14 y/o
524 subjects524 subjects
Confounding variables controlledConfounding variables controlled
Greatest effect first Trimester >1joint /dayGreatest effect first Trimester >1joint /day
Fetal exposure= 14 y/o Wechsler compositeFetal exposure= 14 y/o Wechsler composite
Poor Intelligence age 6Poor Intelligence age 6
Attention and Depression age 10Attention and Depression age 10
Neurotoxicology and TeratologyNeurotoxicology and Teratology
Goldschmidt and DayGoldschmidt and Day
34 (2012) 161–16734 (2012) 161–167
42. Respiratory Effects
Cannabis associated with dose-relatedCannabis associated with dose-related
impairment of large airways resulting inimpairment of large airways resulting in
obstruction, wheezing, mucous, andobstruction, wheezing, mucous, and
hyperinflation.hyperinflation.
Dose equivalence 1: 2.5-5 vs tobaccoDose equivalence 1: 2.5-5 vs tobacco
Thorax 2007;0: 1-7Thorax 2007;0: 1-7
43. Lung Damage
Marijuana smoking leads to bullous lungMarijuana smoking leads to bullous lung
disease in normal CXR and lung functiondisease in normal CXR and lung function
20 years earlier than seen with tobacco20 years earlier than seen with tobacco
Respirology 2008;13:122-127Respirology 2008;13:122-127
44. Marijuana and Lung Cancer
The risk of lung cancer increased 8% (95%The risk of lung cancer increased 8% (95%
confidence interval (CI) 2–15) for eachconfidence interval (CI) 2–15) for each
joint-yr of cannabis smoking, 7% (95% CIjoint-yr of cannabis smoking, 7% (95% CI
5–9) for each pack-yr of cigarette smoking,5–9) for each pack-yr of cigarette smoking,
The highest tertile of cannabis use wasThe highest tertile of cannabis use was
associated with an increased risk of lungassociated with an increased risk of lung
cancer relative risk 5.7 (95% CI 1.5–21.6)),cancer relative risk 5.7 (95% CI 1.5–21.6)),
Eur Respir J 2008; 31: 280–286Eur Respir J 2008; 31: 280–286
47. Medical Excuse Marijuana
No compelling evidence that there
is a significant group of untreated
or inadequately treated patients.
Pro-marijuana lobby getting its
“nose under the tent”
48. Marijuana Policy Project
"This is the next step in the evolution of medical
marijuana as a political issue," "We have informed
elected officials about the widespread public
support for the issue, we have lobbied members
of Congress and their staffs directly, and we
have activated our grassroots. Now it is time to
provide financial support to those who are willing
to support medical marijuana.”
Steve Fox
Marijuana Policy Project (MPP) Washington, D.C.
49. Important points to remember
Safe, effective reliable medicines are bestSafe, effective reliable medicines are best
for patients, and they are availablefor patients, and they are available
Marijuana is impure, unreliable, full ofMarijuana is impure, unreliable, full of
contaminants, high side effect rate.contaminants, high side effect rate.
Defense to possession bypasses FDA andDefense to possession bypasses FDA and
jeopardizes consumer protectionjeopardizes consumer protection
Medical excuse marijuana createsMedical excuse marijuana creates
“medicine by popular vote.”“medicine by popular vote.”
50. Proposed Medicinal Uses of
Marijuana
Nausea of ChemotherapyNausea of Chemotherapy
GlaucomaGlaucoma
Appetite StimulationAppetite Stimulation
Multiple SclerosisMultiple Sclerosis
Pain/ MigrainePain/ Migraine
Misc- Cramps, Sleep, DepressionMisc- Cramps, Sleep, Depression
51. Who is Actually Using
Medical Excuse Marijuana?
Under 34 -- 45.4%Under 34 -- 45.4%
Under 54 (most pain age older) 84%Under 54 (most pain age older) 84%
For Pain 82%For Pain 82%
For Anxiety 37%For Anxiety 37%
For Depression 26%For Depression 26%
For Nausea 27%For Nausea 27%
For Appetite 37.7%For Appetite 37.7%
Journal of psychoactive drugsJournal of psychoactive drugs
2011;43:128-1352011;43:128-135
52. Colorado Medical Excuse Pot
Sept 2011 127,444 usersSept 2011 127,444 users
94% pain94% pain
Ave Age 40Ave Age 40
Denver has 400 dispensaries (375 StarbucksDenver has 400 dispensaries (375 Starbucks
state-wide)state-wide)
Denver Dispensary crime up 69% with 75%Denver Dispensary crime up 69% with 75%
increase in burglaries.increase in burglaries. Denver Police June 4, 2012Denver Police June 4, 2012
54. Pain
Healthy volunteers doses 0,2,4,8% THCHealthy volunteers doses 0,2,4,8% THC
Decrease of pain medium dosesDecrease of pain medium doses
Increase of pain higher dosesIncrease of pain higher doses
?Specific substance responsible??Specific substance responsible?
Anesthesiology. 2007;107:785-96Anesthesiology. 2007;107:785-96
55. THC as Opioid Adjunct
THC alone ineffective for the most partTHC alone ineffective for the most part
Literature is contradictory. SomeLiterature is contradictory. Some
demonstrated higher morphine dosesdemonstrated higher morphine doses
May be useful as an adjunct to opiodsMay be useful as an adjunct to opiods
International Review of Psychiatry,International Review of Psychiatry,
April 2009; 21(2): 143–151April 2009; 21(2): 143–151
56. Palliative Care
Studies largely marginalStudies largely marginal
Mostly involve oral or SativexMostly involve oral or Sativex
Not indicated as sole agentNot indicated as sole agent
May be some add-on benefitMay be some add-on benefit
International Journal of Palliative NursingInternational Journal of Palliative Nursing
2010, Vol 16, No 102010, Vol 16, No 10
57. Sativex as add-on for pain
Advanced cancer patients on opioid painAdvanced cancer patients on opioid pain
medsmeds
Low, medium, high dose treatementsLow, medium, high dose treatements
Add on to the opioid medicationAdd on to the opioid medication
Low and medium dose had benefit, not highLow and medium dose had benefit, not high
dosedose
Adverse events dose related and high doseAdverse events dose related and high dose
was unfavorablewas unfavorable
58. Pain in HIV
Trial in HIV-associated neuropathyTrial in HIV-associated neuropathy
No comparison to other medicines norNo comparison to other medicines nor
MarinolMarinol
Benefit in reducing the neuropathic painBenefit in reducing the neuropathic pain
comparable to existing medicationscomparable to existing medications
Difficult to discern “high” vs. medicalDifficult to discern “high” vs. medical
effecteffect
Abrahms Neurology 2007;68 515-521Abrahms Neurology 2007;68 515-521
60. HIV Cognitive Impairment
HIV patients vs controlsHIV patients vs controls
Significantly more depression and anxietySignificantly more depression and anxiety
in marijuana using groupin marijuana using group
More alcohol use if used marijuanaMore alcohol use if used marijuana
Memory impaired even after factoring outMemory impaired even after factoring out
depression, anxiety, and alcoholdepression, anxiety, and alcohol
The Journal of Neuropsychiatry andThe Journal of Neuropsychiatry and
Clinical Neurosciences 2004; 16:330–335Clinical Neurosciences 2004; 16:330–335
61. Pain Summary
Summary of literature on pain/ quality ofSummary of literature on pain/ quality of
studies generally marginalstudies generally marginal
Mostly discussing oral or syntheticMostly discussing oral or synthetic
cannabinoidscannabinoids
May be useful as an adjunct particularly forMay be useful as an adjunct particularly for
neuropathic painneuropathic pain
As solo agent, high doses needed and moreAs solo agent, high doses needed and more
side effectsside effects
Current Opinion in Anaesthesiology 2005, 18:424–427Current Opinion in Anaesthesiology 2005, 18:424–427
62. Cannabinoids in MS
meta-analysis
All studied were non-smokedAll studied were non-smoked
Cannabinoids difficult to work withCannabinoids difficult to work with
Adverse effects not related to doseAdverse effects not related to dose
Little benefit for spasticity-poss as add-onLittle benefit for spasticity-poss as add-on
Evidence on tremor weakEvidence on tremor weak
Evidence on pain moderateEvidence on pain moderate
Problems with psychoactivityProblems with psychoactivity
CNS Drugs 2011:25 ZajicekCNS Drugs 2011:25 Zajicek
63. MS- Cognitive Effects
MS patients using smoked or ingested potMS patients using smoked or ingested pot
Impaired processing speed, memory,Impaired processing speed, memory,
executive function, spatial perceptionexecutive function, spatial perception
Twice as likely as nonusers to beTwice as likely as nonusers to be
classified as globally cognitivelyclassified as globally cognitively
impaired.impaired.
Neurology 2011;76:1153-1160Neurology 2011;76:1153-1160
64. As Paul Harvey would say--
““And now for the rest of the story.”And now for the rest of the story.”
65. Marijuana and Fatal Crashes
California 2008
Five years following medical excuseFive years following medical excuse
marijuana dispensaries 1240 fatal crashesmarijuana dispensaries 1240 fatal crashes
compared to 631 for the five years priorcompared to 631 for the five years prior
8.3% of fatal single vehicle crashes8.3% of fatal single vehicle crashes
5.5% fatal passenger crashes5.5% fatal passenger crashes
Use rate estimated at 16-20%Use rate estimated at 16-20%
Rivals alcohol as top cause of fatalitiesRivals alcohol as top cause of fatalities
Crancer and CrancerCrancer and Crancer
Involvement of marijuana inInvolvement of marijuana in
California Fatal Vehicle CrashesCalifornia Fatal Vehicle Crashes
66. Marijuana treatment episodes
National increaseNational increase
1992 92,5001992 92,500
2008 322,0002008 322,000
California increaseCalifornia increase
1992 73001992 7300
2008 350002008 35000
RAND 2010RAND 2010
Altered State?Altered State?
Assessing How Marijuana LegalizationAssessing How Marijuana Legalization
in California Could Influencein California Could Influence
Marijuana ConsumptionMarijuana Consumption
67. Scientific Status of Medical
Excuse Marijuana
Cannabinoids may be useful and worthCannabinoids may be useful and worth
studyingstudying
Smoking is problematicSmoking is problematic
Legislative processes bypass the FDA andLegislative processes bypass the FDA and
jeopardize the publicjeopardize the public
69. IOM Recommendations
Rec 5-The goal of clinical trials ofRec 5-The goal of clinical trials of
smoked marijuana wouldsmoked marijuana would not be tonot be to
develop marijuana as a licensed drugdevelop marijuana as a licensed drug
Rec 6-Rec 6- must meet the followingmust meet the following
conditions:conditions: failure of all approvedfailure of all approved
medicationsmedications to provide relief has beento provide relief has been
documenteddocumented
70. Practical Issues/Regulation
Has user exhausted all other acceptedHas user exhausted all other accepted
medical interventions?medical interventions?
Is the proposed patient a drug abuser?Is the proposed patient a drug abuser?
Does law allow for drug screening to assureDoes law allow for drug screening to assure
no use of illegal drugs?no use of illegal drugs?
Will patient have medical oversite andWill patient have medical oversite and
monitoring of status and adverse Eventsmonitoring of status and adverse Events
Legal liability and responsibility?Legal liability and responsibility?
71. Practical Issues/ Regulation
What marijuana will be allowed, whatWhat marijuana will be allowed, what
strengths, and who pays for it?strengths, and who pays for it?
Who produces the marijuana?Who produces the marijuana?
Is marijuana purity assured?Is marijuana purity assured?
Is the caregiver licensed and in goodIs the caregiver licensed and in good
standing with regulatory agencies?standing with regulatory agencies?
Does the caregiver demonstrate formalDoes the caregiver demonstrate formal
training or experience in addiction and intraining or experience in addiction and in
the administration of dangerous drugs?the administration of dangerous drugs?
72. Practical Social Issues
Employment drug testsEmployment drug tests
Health insurance medication ridersHealth insurance medication riders
DUI statutes/ accidentsDUI statutes/ accidents
Student/adult athleticsStudent/adult athletics
Side effectsSide effects
Work productivityWork productivity
73. Important points to remember
Safe, effective reliable medicines are bestSafe, effective reliable medicines are best
for patients, and they are availablefor patients, and they are available
Marijuana is impure, unreliable, full ofMarijuana is impure, unreliable, full of
contaminants, high side effect rate.contaminants, high side effect rate.
Defense to possession bypasses FDA andDefense to possession bypasses FDA and
jeopardizes consumer protectionjeopardizes consumer protection
Medical excuse marijuana createsMedical excuse marijuana creates
“medicine by popular vote.”“medicine by popular vote.”