INTRODUCTION AND REVIEW

1
UP IN SMOKE MARIJUANA TODAY

• INTRODUCTION AND REVIEW
• Current challenge
• 1) Information
• 2) Education

2
(No Transcript)
3

• DRUGS OF REWARD AND THE BRAIN
• Neuropharmacology of Marijuana
• 1) Dopamine agonist
• dopamine with stimulant effect
  (speed)
• 2) Opiate agonist
• affinity MU receptor site (narcotic)
•   3) Interaction with opioid receptors
  in the CNS

4

• New York Daily News March 10, 2003
•  
• AN OPEN LETTER TO PARENTS
•  
• HERES WHAT THE EXPERTS SAY ABOUT MARIJUANA AND
  TEENS.
•  
• Marijuana is not a benign drug. Use impairs
  learning and judgment, and may lead to the
  development of mental health problems.
• - American Medical Association
• Smoking marijuana can injure or destroy lung
  tissue. In fact, marijuana smoke contains 50 to
  70 percent more of some cancer causing chemicals
  than does tobacco smoke.
• - American Lung Association
•  
• Teens who are high on marijuana are less able to
  make safe, smart decisions about sex including
  saying no. Teens who have used marijuana are four
  times more likely to have been pregnant or gotten
  someone pregnant than teens who havent.
• - National Campaign to Prevent Teen Pregnancy
• Marijuana can impair perception and reaction
  time, putting young drivers, their passengers and
  others on the road in danger. Teens, the highest
  risk driving population, should avoid anything
  that might impair their ability to operate a
  vehicle safely.
• - American Automobile Association
•  
• Marijuana use may trigger panic attacks,
  paranoia, and even psychoses, especially if you
  are suffering from anxiety, depression or having
  thinking problems.

5

• ASAM BOARD ADOPTS NEW POLICY STATEMENTS ON
  MARIJUANA, OPIOIDS, PAIN AND PATIENT SCREENING
  
• G. Douglas Talbott, MD July 1997
•  
• At its approval, these statements become the
  official policy of the Society. April meeting,
  the ASAM Board of Directors approved four Public
  Policy Statements at the recommendation of the
• Public Policy committee, chaired by Sheila Blume,
  MD. With the boards
•  
• The Public Policy Statement on Marijuana, first
  adopted in 1987, was revised by the Public Policy
  Committee to respond to issues recently raised in
  public ballots on the use of marijuana in
• medical care, as well as by the responses of
  federal and state law enforcement agencies to
  those ballot initiatives.
•  
• The Public Policy Statement on the Rights and
  Responsibilities of Physicians in the use of
  Opioids for the Treatment of Pain was adopted to
  elucidate issues that have emerged in recent
  years in
• relation to the management of acute and chronic
  pain, for whom physicians specializing in
  addiction medicine increasingly are asked to
  provide expert consultation. A related statement
  on
• Definitions Related to the Use of Opioids in Pain
  Treatment clarifies concepts such as dependence
  and preoccupation as they relate to pain patients
  managed on opioids.
•  
• The Public Policy Statement on Screening for
  Addiction in Primary Care Settings responds to
  issues raised by the growing focus on use of
  primary caregivers to provide a majority of
  patient care.
•  
• The full text of the policy statement on
  marijuana follows.
• Public Policy Statement on Marijuana
•  

6
MARIJUANADelta 9 T.H.C. 1964(fat soluble)

1. Psyche
2.   Brain
3.   Lungs
4.   Reproduction
5.   Genes and Chromosomes
6.   Immune System
7.   Tolerance
8.   Addiction

7
PSYCHE

•  
• A) confusion - attention span
  inability to concentrate
•  
• B) emotional disorders
• 1) aggression irritability impulsivity
• 2) panic possible
• 3) paranoid ideation overt
• 4) depression isolation suicide
  psychosis
• 5) grandiosity special insights
•  
• C) short term memory impairment time and
  space concept
•  
• D) persistent organic brain syndrome
• 1) impairment of orientation
• 2) memory impairment
• 3) intellectual impairment
•  
• E) amotivational syndrome
• massive and chronic
  passivity

8
BRAIN

• A) limbic system EEG receptor site
• 1) permanent dose and time related
• 2) electron microscope evidence
•  
• B) brain weight decrease (rats)
•  
• C) protein synthesis (rats)
•  
• D) brain atrophy (humans CT scan)
• 
  Air ECP

9
RESPIRATORY TREE

•  
• A) lungs
• 1) cancer risk increased
• 2) COPD
•  
• B) sinusitis
•  
• ALL findings substantially increased over
  tobacco

10
REPRODUCTION

• A) female process
• 1) menstrual cycle effect
  ovulation sterility
•  
• B) fetal development
• 1) teratogenic effects
• 2) embryocidal effect
• a) resorption
• b) abortion
• 3) fetal syndrome weight
  development hydrocephalus
•  
• C) male process
• 1) testosterone - sperm count -
  sterility
• impotence
  gynecomastia
• 2) sperm motility
• 3) abnormal sperm morphology

11
GENES ANDCHROMOSOMES

• A) breakage somatic cells sperm
  cells
•  
• B) sperm cells
• 1) DNA RNA synthesis 50
•  
• C) chromosome reduction (lymph
  cells) 5 - 30
•  
• D) long term, multigeneration,
  birth defects in mice

12
IMMUNE SYSTEM

• A) lymphocytes (T-Lym)
• 1) division (41)
• 2) abnormal DNA
• 3) cancer potential
•   B) granulacytes
• 1) infection

13
TOLERANCE

•  
•   A) marked increase and cumulative (fat
  soluble)
• pathway to harder drugs

14
THERAPEUTICS

• A) bronchial asthma
•   B) glaucoma
•   C) antiemetic cancer patients