According to an article in USA today, the new product is called Sativex and has already been approved for use in Canada and in eight European countries for different types of use, such as relief for Multiple Sclerosis pain.

Getting the FDA approval would prove to be a big milestone toward the nation’s uneasy relationship with the drug. Sixteen states and the District of Columbia have already allowed residents to legally use the drug with a doctor’s recommendation. However, the DEA believes it is a dangerous drug which can be addictive.

If there is future availability of the prescription drug that may lead to increased pressure on our federal government to reevaluate their position and encourage other pharmaceutical companies to follow GW Pharma’s lead. A pharmacology professor with Virginia Commonwealth University believes there is disconnect between public demands, state demands and what this market actually provides. Possession of marijuana is still illegal in the UK but nearly ten years ago, the founder of GW Pharma, Dr. Geoffrey Guy was allowed permission to develop and grow it for prescription drug use.

Recently a study was conducted that explored the impact of using marijuana and alcohol together (Harrington, Baird et al. 2012). The researchers sought to investigate whether specific clusters of individuals using the substances together existed and the spectrum of consequences that are associated with these behaviors.

To gather data, the researchers utilized information gathered during a randomized controlled trial related to brief intervention at an emergency room in a trauma department.

The researchers examined data from 427 participants who had agreed to sign up for a study focused on consequences of the use of alcohol and marijuana and had also indicated that they had used the substances within the past month. The researchers gathered information from the participants about their frequency of use for both substances during the past month.

Using a cluster analysis, the research team identified sub-groups of users of both marijuana and alcohol according to their frequency of use. There were also several additional inventories completed by the participants:

• Marijuana Problem Scale
• Alcohol Use Disorders Inventory Test
• Noteworthy Index of Problems
• Injury Behavior Scale
• High Risk Behavior Scale

The researchers used the separate measures to compute a single score for each individual enrolled in the study. Analysis of Variance and Tukey tests were used to compare the participants grouped in clusters and determine whether there were differences in behavioral and psychosocial factors.

The researchers’ analysis showed that there were four specific clusters of participants identified based on the frequency of marijuana and alcohol use.

The authors of the study note that there are limitations to the results of the study, such as the use of self-reported data can result in some bias. In addition, while the study measured frequency of use for the two substances, there was no inclusion of a measure to determine quantity of use.

The analysis of the clusters showed that for individuals who use alcohol daily, there were more alcohol-related problems when compared with those who used it weekly, despite the level of marijuana use. For marijuana, the pattern was not as apparent and there were more variations among the clusters of users.

The study’s findings may be very helpful for those who plan education and intervention for marijuana and alcohol users. Those who use both of the substances on a daily basis may require intervention because of the high number of consequences associated with the substances.

Researchers at the University of South Wales’ National Cannabis Prevention and Information Centre hope that a cannabis mouth spray that is used to help multiple sclerosis (MS) patients could also help individuals recover from a marijuana addiction.

A Balancing Act in Sativex

Director of the study, Jan Copeland, says that the combination of ingredients in Sativex, the mouth spray, could likely help marijuana users break free from their abuse. The mouth spray contains tetrahydrocannabinol (THC) and cannabidiol (CBD)-two main cannabinoids from the cannabis plant that could help fight the intensity of a craving for marijuana.

CBD is referred to by Professor Copeland as the "good" cannabinoid, while THC is the cannabinoid associated with getting users stoned. The two balance each other. In Sativex, CBD can lower the effects of THC so that an individual’s receptor systems protect the body from getting stoned.

Using the cannabis mouth spray rather than using marijuana is safer for the body in two ways. The lungs stay healthier with the spray, and most of the better CBD has been removed from the cannabis that is smoked.

Sativex for MS Users

Sativex is legal in the UK, Canada, New Zealand, and Spain to help treat spasticity in individuals with multiple sclerosis. Britain’s GW Pharmaceuticals developed the drug that was legalized for MS users in 2010.

In the United States, 16 states and the District of Columbia allow the growth and sale of medicinal marijuana. But those in the U.S. who suffer from MS do not have the choice to use Sativex yet. According to GW Pharmaceuticals, the FDA has not approved the use of Sativex in the United States.

According to Professor Copeland, side effects reported for Sativex include the following:

• Sleeplessness
• Anger
• Difficulty functioning

Neurology consultant and cannabinoid expert, John Zajicek, at Derriford Hospital in Plymouth states that the side effects can usually be managed by adjusting the dosage of Sativex for the need of the patient.

Sativex for Marijuana Users

Professor Copeland says that her research team at the university has been given permission to use Sativex with individuals in their study. In a controlled environment, the team plans to administer the mouth spray in low doses every six hours.

John Zajicek believes that using Sativex to treat patients with an addiction to marijuana is a "milestone" in cannabinoid research. He believes its addition to the field will yield future benefits in the world of recovery.

The researchers’ findings are shown in a recent journal review showing that in eight of nine studies done drivers were at twice the risk for vehicle crashes. These are significant findings since national debate is heating up over the issue of legalizing marijuana. A recent Gallup poll shows that half of adult Americans favor the legalization of marijuana and that number is up from just 36 percent in 2006.

Statistics show that marijuana was the most commonly found substance those drivers in vehicle accidents tested positive for when testing for non-alcoholic drugs. Analysis showed that of the 28 percent killed in vehicular accidents, over 11 percent of the general population of drivers tested positive for drugs other than alcohol and marijuana was most common.

Professor Guohua Li at Columbia University says that if these facts are further confirmed by more research, this will have major impact on driving safety and the public policy that surrounds it. Furthermore, it would play a key role when it comes to policy making and the use of medical marijuana, says Li.

This is quite a large problem and if more states like California allow the medical use of marijuana, it could grow even bigger. In 2009 the National Survey on Drug Use and Health estimated that over 10 million people ages 12 and up have driven while under the influence of illegal drugs.

With growing access to medical marijuana, experts are more seriously assessing the repercussions of legalization. Here are some of the leading arguments on both sides of the debate.

Advocates Tout the Benefits of Legalization

From personal freedom to economic rewards, advocates of legalization site a list of benefits of decriminalization, including:

• Marijuana’s potential medical benefits for people suffering from cancer and other illnesses
• Legalization would take away marijuana’s black market value, thereby lowering the price and potentially reducing crimes committed to fund a marijuana addiction
• Marijuana would become a source of tax revenue for the government
• Drug dealers would lose business, potentially reducing crime
• Government agencies could regulate the quality and safety of marijuana and issue warning labels, reducing the risk and costs of overdose
• Lower economic costs of treating addiction rather than putting addicts in jail
• Law enforcement could use their resources to focus on more serious crimes

Research supports some of the arguments for legalization. An emergency medicine physician with Rhode Island Hospital recently assessed whether legalizing marijuana in the state would increase drug use among the most vulnerable population: teens. Based on an analysis of 32,570 teens, the research team found that legalization didn’t have a significant impact on adolescent marijuana use.

A look at decriminalization efforts in other countries offers further support for the legalization of marijuana. In 2001, Portugal became the first European country to legalize marijuana and other drugs. Anyone found in possession of small amounts of drugs are sent to substance abuse treatment rather than jail.

While many citizens worried that legalizing marijuana and other drugs would exacerbate the country’s rampant drug problem, a report by the Cato Institute found that illegal drug use among teens declined, deaths related to heroin and similar drugs were cut by more than half, and the rate of new HIV infections decreased. Meanwhile, the number of people seeking substance abuse treatment more than doubled. Years after decriminalizing drug use, Portugal boasts one of the lowest rates of marijuana use in the E.U.

These statistics have led some experts to question whether the United States’ hard-line drug policy and harsh penalties on drug possession have served us well, particularly given that America has some of the highest rates of marijuana use in the world.

Legal Marijuana Takes a Toll

While legalization may work in other countries, experts question whether more lenient drug policies would benefit communities in the U.S.

The most recent National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), suggests that legalization of marijuana may lead to increased drug abuse. Between 2008 and 2010, fewer Americans were using meth and cocaine yet the overall rate of illicit drug abuse increased. SAMHSA warned that medical marijuana may be a prime factor in this increase.

In 2007, 14.4 million Americans were current users of marijuana. By 2010, that number rose to 17.4 million. Figures were even more alarming for young adults aged 18 to 25, whose marijuana use increased from 19.6 percent in 2008 to 21.5 percent in 2010. Although a couple percentage points may not sound substantial, that correlated to millions more teens abusing marijuana each year.

“Emerging research reveals potential links between state laws permitting access to smoked medical marijuana and higher rates of marijuana use,” said Gil Kerlikowske, Director of National Drug Control Policy. “In light of what we know regarding the serious harm of illegal drug use, I urge every family – but particularly those in states targeted by pro-drug political campaigns – to redouble their efforts to shield young people from serious harm by educating them about the real health and safety consequences caused by illegal drug use.”

Experts point to legalized gambling, nicotine use and alcohol consumption as examples of what happens when a dangerous substance or behavior is legalized. In all three cases, legalization has not resulted in less gambling, smoking or drinking, and has likely exacerbated the problem.

In response to arguments that marijuana is not as dangerous or habit-forming as other drugs, experts note that marijuana consistently ranks among the leading causes of addiction. In addition, more people enter drug rehab for marijuana addiction than for any other illegal drug. Long-term effects of marijuana abuse may include paranoia, depression, anxiety, memory loss and respiratory problems.

Additional threats posed by legalizing marijuana include:

• Increases in drug-impaired driving (marijuana is a significant factor in car accidents, injuries and deaths)
• Higher health care costs for marijuana users, secondhand smokers and children neglected by addicted parents
• Because legalization sends a message that drug use is acceptable, more children and teens may try marijuana (and studies have shown that marijuana is often a gateway to using harder drugs like heroin, meth and cocaine) and more parents will face an uphill battle in teaching children otherwise

Growing Perception of Marijuana as a Harmless Substance

Social acceptance of marijuana use undermines prevention efforts and harms the nation’s youth and their families, say some experts. Today’s marijuana is more potent than it was years ago, and it is showing up in formats that suggest people are not taking the drug’s dangers seriously.

Some communities report that candy shaped like marijuana, appropriately named “Pothead Ring Pots” or “’Pothead Lollipops,” is being sold in stores. They fear that these products, though not illegal drugs themselves, are glorifying drug use and sending a message that marijuana abuse isn’t a serious threat.

Marijuana is also showing up in synthetic forms, such as Spice or K2, making it more difficult to regulate. These drugs are being sold legally in convenience stores and on the Internet and aren’t detectable by standard drug tests. Teens, who believe the drugs must be safe to be sold legally, are the primary consumers, often with devastating consequences. The effects of synthetic marijuana include delusions, paranoia, panic attacks, cardiac problems and long-term psychosis.

Synthetic marijuana is slowly garnering the attention of the Drug Enforcement Administration, which has banned some of the chemicals found in synthetic marijuana. But these products have proven difficult to regulate since they are constantly being manufactured with new chemical formulations and under different brand names.

Help for Marijuana Addiction

Although there is tremendous disagreement on how to achieve it, an important goal of all concerned parties is to minimize marijuana abuse and its negative impact on families, communities and the nation. Whether or not legalization ever takes hold in the U.S., the fact remains that more than 23 million people need substance abuse treatment, yet only 2.6 million receive it. Treatment for marijuana addiction saves lives and reunifies families, and can stop the cycle of addiction before it harms future generations.

A new study published in the journal Addiction Biology indicates that the initial euphoric feeling provided by cannabis may be replaced by depressive symptoms in the majority of the population. The study was conducted by Roy Otten of the Behavioral Science Institute of Radboud University Nijmegen.

For those who have a gene variant that makes them sensitive to depression, the use of cannabis can lead to an increased risk of developing symptoms of depression. The gene variant is found in approximately two-thirds of people.

The researchers report that cannabis use is very popular in the Netherlands, with almost 30 percent of 16-year-olds reporting that they have tried the drug at least once. About 12 percent say that they have used it in the last 30 days. The drug can have a negative impact on academic achievement, but it also can result in symptoms of schizophrenia and psychosis.

While the use of cannabis was suspected to be connected with depressive symptoms, Otten’s work is the first to establish conclusive evidence. Otten believes that the consideration of genetic vulnerability is the key to understanding the connection between cannabis and depressive symptoms.

Otten’s team conducted a long-term examination over five years. During this time, information was collected from 428 families and each family’s two adolescent children. The children were asked to complete questionnaires examining topics including behavior and symptoms of depression. The participants were also tested for the gene variant responsible for causing increased vulnerability to depression.

The researchers found that for those adolescents genetically predisposed to depression, cannabis use resulted in depressive symptoms. Even after accounting for various other factors, such as smoking, alcohol consumption and various background information like socio-economic status, the pattern was still consistent.

Otten says that though some might assume that the connection was due to adolescents with depressive symptoms using marijuana to self-medicate, the pattern of behavior was the reverse. Many reported an initial euphoric feeling, only to be replaced with depressive symptoms.

The findings are important as marijuana is considered by some to be a safe alternative to other types of pain treatments. This study, however, shows that for the majority of the population, cannabis use may result in additional difficulty after the initial response to the drug.

Now a set of case studies has shown that there may also be a connection between synthetic cannabis and psychosis. While its use is largely as a street drug, the effects sought are similar to those occurring in natural cannabis. Synthetic cannabis is created by coating plant material with a combination of chemicals designed to mimic the effects of natural cannabis. The compounds are not, regulated, approved or examined by the FDA.

When a person is admitted to the hospital for a problem related to synthetic cannabis, the nature of the drug can create challenges in treatment. Because there are many variations of synthetic cannabis compounds available on the street, emergency department staff may not know the specific chemicals that are causing the patient’s reaction. On the street, synthetic cannabis is commonly known as “Spice,” “K2,” “Blaze,” and “Red X Dawn.”

Researchers at the Naval Medical Center in San Diego examined the outcomes of ten patients hospitalized for psychosis related to the use of synthetic cannabis. The ten patients ranged in age from 21 to 25 and all experienced symptoms of psychosis after using synthetic cannabis. Some of the patients experienced ongoing psychotic symptoms. The symptoms included auditory and visual hallucinations, paranoid delusions, odd or flat affect, thought blocking, disorganized speech, thoughts of suicide, insomnia, slowed reaction times, agitation and anxiety.

The length of time that the psychotic episode lasts varied widely between the ten patients. The symptoms generally were resolved between five and eight days after hospitalization for most of the patients, but some of the cases involved psychotic symptoms that lasted for three months or more.

The study provides the first evidence that shows a connection between psychosis and synthetic cannabis, similar to results found for natural cannabis and psychotic episodes. Further research is needed to determine which chemicals cause different types of psychotic experiences in users of unregulated synthetic cannabis.

The research by the Naval Medical Center was presented on May 14 at the American Psychiatric Association’s Annual Meeting in Honolulu.

Marijuana’s effects are made possible by natural receptors in the brain called cannabinoid receptors. Recently, a team led by Steven Laviolette at The University of Western Ontario has identified an important brain pathway that plays an important role in how the effects of marijuana are processed in the brain to affect emotional information.

The research is included in The Journal of Neuroscience and may offer clues to the possible link between marijuana use and the appearance of symptoms of schizophrenia. The study, conducted at the Schulich School of Medicine and Dentistry, showed that the area of the brain called the amygdala contains cannabinoid receptors that when activated can have a strong influence on how the brain processes the significance of emotional information and memory processes.

The cannabinoids are also involved in the activity patterns of neurons in the area of the brain called the prefrontal cortex, controlling how the brain processes emotional information, both the significance of the emotion and the strength of memories connected with the emotions.

The findings are significant because they provide additional clues to the recent research that shows a connection between marijuana use and the development of schizophrenia. While researchers have known that there are abnormalities in the same regions of the brain in schizophrenia patients, this is the first study to show that the same areas are affected by marijuana use, explains Laviolette, who is an associate professor in the Department of Anatomy and Cell Biology.

The findings of this study also identify a brain pathway useful for explaining other effects of marijuana that were known to be associated, but there was no understanding of the causality of the connections between marijuana and psychotic episodes. Individuals who participate in heavy marijuana use have been shown to have a higher risk of psychotic episodes later in life.

The research is also significant because its findings may help in developing a pharmacological solution for combating the effects of early marijuana use on the brain’s functions. Treating the cannabinoid receptors so that emotions are perceived and processed properly may help individuals avoid serious psychotic problems.
 

Laviolette and colleagues at the Schulich School of Medicine & Dentistry found that activating cannibinoid receptors directly in the amygdale region of the brain can significantly influence how the brain processes emotional information and memory. The activation also drastically increased the activity patterns of neurons in the prefrontal cortex of the brain, controlling how the brain perceives emotional significance of sensory information and the strength of the associated memories.

Laviolette, an associate professor in the Department of Anatomy and Cell Biology, said that these findings are very important given the recent evidence that suggests that smoking marijuana in adolescence can increase the risk of developing schizophrenia later in life. He added that it is already known that there are abnormalities in the amygdale and the prefrontal cortex of patients with schizophrenia, and now it is known that these brain areas are important in the effects of marijuana and other cannabinoid drugs on processing emotions.

The findings also uncover a new brain pathway through which cannabinoid drugs can alter the processing of emotional information, which can lead to psychotic side effects associated with heavy marijuana use (such as paranoia). The researchers believe that these findings could lead to the development of medication that could block or modify this pathway, thereby helping to control psychotic episodes. It could also be used to help people suffering from Post-Traumatic Stress Disorder who have trouble controlling their highly emotional memories.

Source: Science Daily, How Marijuana Affects the Way the Brain Processes Emotional Information, April 5, 2011

In a press release, the DEA explained that the five chemicals are now registered as Schedule I substances under the Controlled Substances Act (CSA), the most severe categorization under the CSA reserved for substances considered to have a high potential for abuse, no known medical use, and lack of safety for use. The new scheduling authority makes the possession, sale, or distribution of the chemicals or products containing these chemicals illegal in the U.S. The DEA’s ban will remain in place for at least one year, with the possibility of a 6-month extension as it continues to examine the chemicals’ hazardous potential to the public, and whether they should become permanently controlled.

The new ban is the DEA’s latest response to a growing number of safety reports involving the “legal” faux marijuana chemicals from numerous poison control centers, hospitals, and law enforcement agencies across the country in recent years. Prior to today’s federal issue, 16 states had already issued state bans on the chemicals and products containing the chemicals due to the rise in medical emergencies related to the consumption of these chemicals.

Most of the emergencies have involved teens and young adults who mistakenly believed the “fake pot” products to be safe since they have been legal and readily available at such locations as head shops, convenient stores, and Internet retail sites. Products like “K2” and “Spice,”—sold under the guise of “herbal incense” and widely accepted as synthetic alternatives to marijuana—have become increasingly popular among young people in the past few years.

Intended to mimic the effects of THC, the active ingredient in marijuana, these synthetic cannabinoids (which have never been tested by the FDA or any federal agency) are combined with plant materials and then marketed as smokeable herbal products. According to the DEA, reports of medical emergencies involving the synthetic chemicals have caused such side effects as anxiety attacks, extremely elevated heart rates, increased blood pressure, convulsions, vomiting, and disorientation.

Although temporary, the DEA asserts that the new ban is the result of rising concerns among parents, law enforcement, and medical professionals, which the administration intends to take seriously. After its year-long investigation, the DEA will announce its decision regarding the safety of the chemicals and their potential for accessibility.

Source: Medical News Today, DEA Ban: Faux Marijuana "Imminent Threat To Public Safety," March 1, 2011