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Drugs FAQ part 2

The bulk of this document has been extracted from the book "THE CRUEL HOAX" by ELAINE WALTERS - Permission granted

Answer 1:

How long does a person have to be using marijuana before any effects occur? There is a whole range of time and behavioural factors associated with the use of marijuana. Sometimes personality changes occur within weeks or months of initial involvement. Other people sustain their normal lifestyles for many years and the compromising of potential skills and personality is so gradual that marijuana is not seen to be associated with these changes. There are also many people who appear to be unaffected, even after many years of continuous use.

Answer 2:

What about people who have smoked marijuana all their lives and do not appear to be affected? There are many middle-aged users who have been smoking marijuana for years and do not exhibit any of the signs or symptoms associated with its use. However, in many cases, people in this age group have settled into lives limited by their use of the drug, and the presenting symptoms are likely to be difficulties associated with thinking and failure to make commitments. One thing is clear, the younger a person starts using marijuana, the more serious the consequences, and as long as this contemporary obsession with drugs keeps gathering momentum the greater the risk of younger people becoming involved.

Answer 3:

What are the psychological effects of marijuana? Since 1970 there have been well over 600 scientific papers on the harmful psychological, psychiatric and social aspects of chronic marijuana use. Since then marijuana-impaired personalities have been clearly defined by many psychiatrists. In the early seventies two psychiatrists from the University of Pennsylvania, Dr. Harold Kolonsky and Dr. William Moore, published a lengthy report detailing specific cannabis-related problems. This is a summary of their findings:

"During the past six years, we have seen a clinical entity different from the routine syndromes usually found in adolescents and young adults. Long and careful diagnostic evaluation convinced us that this entity is a toxic reaction in the central nervous system due to regular use of marijuana and hashish. Contrary to what is frequently reported, we have found the effect not merely that of a mild intoxicant which causes a mild exaggeration of usual adolescent behaviour, but a specific and separate clinical syndrome unlike any other variation of the abnormal manifestations of adolescents. We feel there should be no confusion, because regardless of the underlying psychological difficulty, mental changes - hallmarked by disturbed awareness of the self, apathy, confusion, and poor reality testing - will occur in an individual who smokes marijuana on a regular basis whether he is a normal adolescent, an adolescent in conflict, or a severely neurotic individual."(23)

Dr. Doris H. Milman, professor of pediatrics at the State University of New York, substantiates Kolonsky and Moore's point of view:

"The psychological effects of cannabis have been known since antiquity. The most obvious of these effects is, of course, the cannabis-induced psychotic reaction, with delusional symptoms, disorientation, hallucinations, paranoia, and feeling of depersonalisation and derealisation. The psychosis may present acutely or insidiously, may be transient and wholly reversible, or it may be prolonged and chronic. When chronic, it is clinically indistinguishable from chronic psychosis of the schizophrenic or paranoid type.

The most prominent cognitive effects are impaired recent memory and retrieval, attentional deficits, difficulties in central processing, altered time perception, visual distortions, and hallucinations. Among emotional effects are mood fluctuations including euphoria, dysphoria, listlessness, apathy, and depression. Other emotional responses include drowsiness, indolence, withdrawal, anxiety and apprehension. Hallucinations, paranoid delusions, and feelings of depersonalisation and derealisation are not uncommon, and are seen in acute intoxicated states as well as in acute or chronic psychoses.(24)

According to Dr. Donald Ian Macdonald a paediatrician and former President of the Florida Paediatric Society:

"The use of psychoactive chemicals by children and adolescents leads to a clear-cut and easily recognizable syndrome of behavioral and emotional change. Regardless of the motive for experimenting with mind-altering drugs, once children begin to use drugs for producing good feelings at a time of stress, they are in trouble. As they become chemically dependent, as millions of our youngsters have, their disease progresses in a remarkably predictable downward path."(25)

Dr. Harold Voth who has studied the psychopathology of marijuana since 1972 has this to say:

"Based on the observations I have made on the effects of marijuana, it is my opinion that this substance is harmful, especially to the young. I believe marijuana does lead to maladjustment and that it reinforces rebellious, negativistic behavior and lowers the individual's motivation for effective social adaptation. Furthermore, I am completely convinced that marijuana affects psychological processes and personality across a wide spectrum of behaviors and functions. My interest in the effects of marijuana began approximately 10 years ago because of its apparent effects on both inpatient and outpatient psychiatric populations. Without any question in my own mind, patients use the substance to facilitate their repressive trends, that is, to assist them in their escape from the responsibilities and stresses of life and to calm their anxieties. Periodic conversations with my psychiatrist colleagues provide support for my observations with only a few exceptions. Some of these exceptions may be related to the fact that some of these psychiatrists use themselves. One psychiatrist of national prominence who disclaims any harmful effects of marijuana has stated publicly that he smokes the substance several times weekly. For the most part, however, colleagues agree that marijuana is harmful." (26)

Dr. John Meeks, psychiatrist and medical director of the Psychiatric Institute of Montgomery County, Maryland, made the following comments:

"...it is striking that most marijuana users - as long as they are actively using the drug - tend to view themselves as undamaged by the chemicals in cannabis. They are often joined in the denial by their parents, teachers, and other adults. Obvious evidences of irritability, altered consciousness, volatile moods, paranoid hostility, and impaired social, educational, and economic functioning are dismissed or minimised as 'adolescent rebellion' or cultural protest. This is a transformation of reality that makes simple alchemy a snap by comparison."(27)

According to Dr. Sidney Cohen, who conducted one of the largest adult studies ever done on marijuana users:

"The demotivating potential of potent preparation of cannabis has received renewed attention because of the vast increase in the use of marijuana by young people in many parts of the world where it had never been a part of the dominant life-style. "(28)

In 1968 the term "amotivational syndrome", in connection with sustained marijuana use, was employed independently by a number of health professionals. One of these was Dr. David Smith, who stated that:

"Certain younger individuals who regularly use marijuana also develop what I have called the amotivational syndrome in that they lose the desire to work or compete."(29)

Doctors McGlothlin and West, also experienced in the field of drug abuse, describe the syndrome as follows:

"Clinical observations indicate that regular marijuana use may contribute to the development of more passive, inward turning, amotivational personality characteristics. For numerous middle class students, the progressive change from conforming, achievement-oriented behavior to a state of relaxed and careless drifting has followed their use of significant amounts of marijuana." (30)

The clinical observations which describe the various forms of marijuana dysfunctioning are remarkably consistent. Nevertheless, it is important to point out that not all health professionals agree with all these definitive conclusions. However, the areas of concern usually relate to emphasis and perspective rather than disagreement about the various diagnoses. For example, there is general agreement about the condition referred to as the "amotivational syndrome". (a loss of interest in normal activities and responsibilities). But the difference is that some health professionals believe adolescents develop this syndrome as a direct result of using marijuana, whilst others believe the condition only occurs in those with a predisposition to adolescent depression.

Answer 4:

How can it be proven that personality changes are the result and not the cause of using marijuana? The human brain performs a number of complex inter-related tasks. It has to absorb information, evaluate it, place it in context with previous information and anticipate the consequences. On this basis the brain then decides what action to take. This process requires metabolic energy and effective communication between nerve cells. The cannabinoids inhibit these activities. Consequently the behaviour and responses of many users are adversely affected and they often display personality traits such as poor social judgement, poor attention span, poor concentration, confusion, anxiety, depression, apathy, passivity and often slow and slurred speech.(31)

Since the effects of marijuana are primarily manifested in personality and behavioural changes, 'observations' by parents, teachers and family doctors are essential for valid assessments. In addition, because ethical and legal constraints limit controlled studies to healthy male volunteers being administered a 2% THC dosage in these experiments, it is even more important to accumulate case histories and clinical evaluation of damage incurred by adolescents and young adults (especially females) who smoke marijuana with a much higher THC content. As far as street drugs are concerned the accumulation of case histories is a valuable and valid form of research.

Answer 5:

Is short-term memory loss a serious problem? Short-term memory loss has serious implications for students because the accumulation of knowledge is diminished at a time where previous learning is essential for the understanding of future lessons. Not only is the past forgotten, but the comprehension of the present and future becomes increasingly impaired. Such chronic interference with the complications of the foundation for future decisions causes retardation or stunting of the potential which might otherwise have been achieved.

The most recent research demonstrating short-term memory loss was completed in 1989 by Dr. Richard Schwartz of Georgetown University. He reported the results of an exceptionally well controlled study of persistent short-term memory impairment in a group of primarily white, American, middle class adolescents. Their median age was 16, and they had at least eight years of education. Their performance was compared with that of a group of controls matched for age and I.Q. Schwartz began his study after he noticed that marijuana-dependent adolescents who had just entered a rehabilitation program experienced difficulties in recalling newly learned rules as well as remembering conversations and exchanges in their group therapy sessions. These adolescents reported that such memory deficits persisted for at least 3 to 4 weeks after their last use of marijuana.

When initially tested, the marijuana-dependent group compared unfavourably on short term memory tests with the control group. After six weeks of supervised abstention from intoxicants, they still presented short term memory deficits.

"Marijuana mangles memory," says Schwartz, and "memory loss poses one of the main problems with kids who smoke pot. They think they are losing their minds for good! Marijuana use hits hardest those teenagers who do poorly in school. For them, remedial teaching without concurrent abstention from marijuana is ineffective. While the brightest might compensate for a while, the average hardly get by, and the low I.Q. groups are devastated by it."

The problem of impaired memory and learning has been reported in many other studies.

Answer 6:

How does marijuana affect learning? There are certain skills needed to acquire knowledge and the first of these is memory. This is necessary in order to compare new experiences with past information. Other important requirements are sensory and cognitive integrity - in other words, a prepared mind, one that is capable of evaluating and integrating what is learned. Having learned a skill, whether social, emotional or intellectual, practice is then essential in order to store what has been learned in long term memory. Another essential aspect of acquiring knowledge is motivation (the desire to know). Unless this is present, intellectual and emotional immaturity is perpetuated. Finally and importantly, there must be the reward or reinforcing component of acquiring knowledge.

If marijuana is used in the formative years it replaces the reward system. If knowledge is acquired, getting 'stoned' takes precedence over practice so that verbal information and behavioral skills are lost before they become part of the permanent repertoire of knowledge and behaviour. Often there is a loss of ambition and initiative (the 'amotivational syndrome'). Because sensory changes occur when using marijuana, new learning is distorted and cognition can swing from reverie or fantasy to paranoid delusions and magical thinking. The inability to form new memories is well established as an integral part of marijuana use. (32)

Answer 7:

Is brain impairment caused by marijuana reversible? Most people do not sustain permanent brain impairment from using marijuana. However, as the use of marijuana escalates in Western societies, reports of adolescents and young adults suffering varying degrees of impairment are also increasing. Evidence indicates that certain factors cause people to be more susceptible to developing 'drug burnout', or chronic young adult psychiatric syndrome. It is medically classified as Post Drug Impairment Syndrome, (PDIS)..

Evidence suggests that certain factors may render a person vulnerable to PDIS e.g.:

Commencing at a young age e.g. 15 years.

Heavy consumption.

Using marijuana with at least one other illegal drug e.g. mushrooms, amphetamines, PCP, LSD or designer drugs.

Using drugs for a number of years e.g. 3 years or more.

PDIS is believed to be a form of chronic brain syndrome, i.e. a permanent imbalance of the chemical equilibrium of the brain. Symptoms of PDIS include the inability to maintain patterns of consistency, inability to withstand stress, slowed speech, slowed response to time, superficial interest, instability and unwillingness to carry out former responsibilities. Such people do not perceive the world as most normal people do, they feel alienated from society and blame others for their problems. They usually have a bland or dull personality and have frequent temper tantrums. PDIS may vary in intensity from person to person and not all people will exhibit all signs and symtoms.

Unfortunately there is neither predictable nor effective treatment for PDIS. Most will treat these people along traditional psychiatric lines and often such treatment is not effective. According to Dr. Forest S. Tennant:

"The best hope for future PDIS treatment lies in research. With better identification of the precise neurochemical defects in PDIS, it may be possible to select medication that will be specific for the individual. Observations to date indicate that PDIS may involve different patterns of neurochemical impairment so that medication will probably have to be specific, based on differences as diagnosed by laboratory tests." (33)

Answer 8:

How does cannabis affect various organs in the body? The cells of every organ in the body are affected to some degree by the accumulation of cannabinoids in cell membranes. These include:

Brain - Female and Male reproductive systems - Immune system - Lungs - Heart

Most of us probably assume that scientific research is beyond our comprehension and therefore the whole issue should be left in the hands of the experts. On the contrary, it is important for everyone to familiarise themselves with every aspect of street drugs and this includes the results of scientific research. Remember, important components of research are our own observations, common sense and intuition. It is also important to evaluate 'future projections' or 'probability'. For example, at an international scientific conference in Helsinki in 1975, it was established that marijuana probably had long-term damaging effects on the brain, learning and behaviour, the immune system, reproductive function and foetal development. However, before such damage could be scientifically documented time was needed to carry out long-term studies of marijuana users. Many clinical scientific studies now support the original impressions of the 1975 Helsinki Symposium.

The time lapse between laboratory and clinical experimentation and eventual scientific documentation can be many years, and although experience and common sense dictate that such proof will eventually be established, special interest groups take advantage of this situation to confuse lay people with statements which infer that until the side-effects of marijuana are scientifically established, there is in fact no real evidence of harm associated with the use of marijuana.

The following are just brief summaries of important milestones in marijuana research:

Dr. Julius Axelrod - Nobel prize winner 1973 - initiated a significant experiment to establish how long psychoactive drugs remained in the body, the amounts which get to the brain, and how the body disposes of them. He documented the fact that THC, the major psychoactive substance in marijuana, was transformed into metabolic products in the liver, also that cannabinoids are stored in the fatty tissues, in particular, the brain and gonads.(34)

Answer 9:

Brain

Anecdotal reports from medieval Islam (1396), India (1878-1972), Egypt (1843-1925) Brazil (1955), Bahamas (1970) and Jamaica (1976), all indicated an association between marijuana and mental disturbances ranging from distorted perception to hallucinations and dementia (schizophrenia). (35)

Dr. Robert Heath in a 1973 paper reported on the psychological symptoms in his patients for many years, the amotivational syndrome, abnormal irritability and hostility, abrupt mood swings, short term memory loss and in some patients depression and paranoia. Dr. Heath initiated studies on Rhesus monkeys (the limbic areas of the brains of human and monkey are similar). This was to study the brain cells and assess if any permanent structural changes occurred. He concluded that:

"The findings indicate that exposure to delta-9-THC at doses commensurate with those used by human marijuana smokers can produce permanent alterations in brain function and structure of monkeys."(36,37)

Dr. Doris H. Milman published a report in 1982 on a study of adolescents:

"The patients and their parents were particularly frightened by flashbacks and the occurrence of delusions. These states evoked unbearable anxiety, fear and agitation, requiring sedation with chlorpromazine. Flashbacks lasted up to four months after stopping the drug. Other researchers have found that marijuana can induce LSD, mescaline or PCP flashbacks in patients who have taken these drugs. The total of eleven instances out of twenty-four of schizophrenia and borderline schizophrenic personality was extremely high in relation to the absence of these categories in the pre-drug state. Personality traits and features also included a new finding of paranoia in addition to an increased incidence of depressive features."(38)

After years of neurological research of the effects of marijuana on adolescents, an extract from Dr. Robert C. Gilkeson's publication "Marijuana Myths and Misconceptions" gives a simple explanation of how cannabinoids react on brain cells:

"The most important, the most specialised, the most complex, and the most fragile cells in the body are the cells of the human brain, the neurones. These cells make huge numbers of connections or synapses.

These connections transmit and associate information arising from outside and inside the body. Internal messages relate the needs of the cells in the body. External messages tell us everything going on in the 'outside world'. The brain 'reads' these messages, analyzes them, then plans and initiates the correct movements, the glandular secretions, and the other functions to meet those needs.

To pass accurate messages, sodium, potassium, calcium, chloride, and the complex messenger chemicals called neurotransmitters must all cross the cell membrane channels in the correct amounts, very rapidly.

The centre of the brain coordinating the interaction of the other brain centres and controlling the amount of brain energy is called the Reticular Activating System (RAS). Since it makes the most connections and is always in operation, it is the most saturated and affected of all the centres. This centre controls our alertness and our level of consciousness. When the energy of the RAS is decreased, the efficiency of the entire conscious brain is lowered.

This activating system turns on and increases, or turns off and decreases, the chemical messages between areas of the brain that regulate the very level and complexity of human thought and behaviour. It regulates the intensity of messages between the centres for memory, the centre for feelings, and the centre for analyzing all the messages from inside and outside the body. This information in turn triggers necessary motor behaviour or glandular activity."

Prof. Ulf Rydberg, at an international conference in 1989, in association with Drs. Andreasson, Allebeck and Engstrom, presented an important epidemiological study based on a fifteen year follow up of Swedish conscripts. The results indicated that the use of marijuana was not only responsible for triggering an underlying psychosis in "predisposed patients", but the relative risk of developing schizophrenia among high consumers of marijuana (use on more than fifty occasions) was six times greater than in non-users.(39)

According to Dr. Juan Negrete, who presented a paper at the 1992 Paris symposium, there appears to be agreement on the following findings: cannabis use is associated with an increased risk of developing schizophrenia; it precipitates a more sudden and earlier onset of the illness; cannabis use enhances the "positive" symptoms of schizophrenia (excessive dopaminergic activity, greater hallucinatory and delusional activity); cannabis exacerbates the "negative" symptoms of schizophrenia (lethargy, autism, anhedonia, social withdrawal). According to Dr. Negrete these symptoms might result from cholinergic hyperactivity, and the effects of cannabis on the symptoms of schizophrenia may be related to THC with central dopaminergic and cholinergic neurotransmissions. Dr. Juan C. Negrete futher stated that "in some individuals, those observations imply the disease may have remained limited to a 'subclinical' derangement, with only minor behavioural manifestations, were it not for the enhancing action of the cannaboids".(40)

Answer 10:

FEMALE REPRODUCTIVE SYSTEM

A study by Dr. Joan Bauman and Dr. Robert Kolodny in 1977 on human female reproduction indicated that a significant number of the women had abnormal menstrual cycles compared to non-users. The study also indicated that the subjects had significantly lower prolactin levels and that there were "statistically and consistently higher testosterone levels in the marijuana groups". (41)

Separate studies by Professor Harris Rosenkrantz and Professor Ethal Sassentrath in 1979 demonstrated that marijuana was toxic to foetal development in laboratory animals including Rhesus monkeys. (42,43,44,45)

The committee on public health of the Ontario Medical Association 1983 issued the following statement:

"Cannabinoids from marijuana cross the placenta and become a potential teratogen. To date no strong trend to a single defect has arisen, but subtle developmental defects are being observed now, especially of the central nervous system, along with evidence of decreased size and weight of infants at term". (46)

At an international symposium at the Paris National Academy of Medicine in 1990, a paper presented by Profs. S.J. Parker and B.S. Zuckerman reviewed the literature relevant to the effects on foetal growth of maternal marijuana use during pregnancy. They also presented findings from an epidemiologic study conducted in Boston. The result of the study suggested foetal growth was impaired as a result of foetal hypoxia (a decrease in blood oxygenation).(47) Prof. Parker expressed concern that this may be associated with later adverse health and developmental outcomes for children.

In the discussion following Prof. Parker's presentation, Prof. H. Tuchmann-Duplessis referred to the results of a study by Robinson (1989) where it indicated that maternal marijuana use during pregnancy could result in a 11-fold increased risk that the child will develop acute non-lymphocytic leukemia (ANLL). Summarising the effects of cannabis on reproduction, Prof. H. Tuchmann-Duplessis stated that: "The noxious effects of cannabis on reproduction, which are well demonstrated, clearly indicate that cannabis should be considered as a dangerous compound for humans".(48)

Marijuana exposure thus joins environmental risk factors such as ionizing radiation, pesticide solvents and petroleum products in triggering ANLL in children. The marijuana-exposed patients developed the disease at an earlier age and displayed greater cellular abnormalities. (49)

Answer 11:

MALE REPRODUCTIVE SYSTEM

In 1975 Dr. Wylie Hembree conducted a controlled study of sixteen healthy young male marijuana smokers which demonstrated a decrease in sperm motility and a decrease in sperm count. (50)

In 1982 Dr. Susan Dalterio summarised her findings of reproductive studies of mice in the following categories:

1. Both psychoactive and non-psychoactive components of marijuana affect male reproductive functions in mice.

2. In both adult and immature male mice, exposure to THC or CBN decreased levels of the male sex hormone testosterone, as well as pituitary hormones, which stimulate the testes.

3. These changes in hormone levels are accompanied by decreased adult sexual activity in male mice.

4. Maternal exposure to THC and CBN results in long-term alterations in body regulations, pituitary-testicular functions, and sexual behaviour in their male offspring.

5. Ingestion of these cannabinoids by pregnant female mice can result in decreased testosterone levels in their male foetuses. (52)

In 1980 Dr. Marietta Issidorides conducted a study on males with an average age of 40, who were daily smokers of 'hash' for at least ten years. Her observations revealed a significant decrease in sperm count and motility and many sperm were deformed, the chromatin diffused or dispersed and a decrease in essential arginine-rich proteins. (52)

Answer 12:

IMMUNE SYSTEM

Dr. Gabriel Nahas and colleagues, after numerous studies, came to the general conclusion in 1974 that marijuana depressed the immune systems of humans and probably rendered the subjects more vulnerable to infection. At the time the following statement was issued: "Over periods of prolonged usage of marijuana the (resulting) slow cellular erosion might well become clinically apparent if a serious disease should develop". (53)

In 1979 Dr. Al Munson and associates, in a laboratory study on 2000 mice injected with the Herpes simplex type 2, found that all mice which were given THC contracted the virus and the more THC they received the more deaths occurred. (54)

Dr. Arthur Zimmerman, published papers in the 1983 edition of Pharmacology, demonstrating in both the test tube and in mice that THC resulted in marked suppression of the immune system. (55)

Professor Guy Cabral, documented a study in 1989, demonstrating that THC impairs the competence of the macrophage to destroy virus-infected and tumour cells. In patients with an immune system compromised by prolonged marijuana use, the macrophages may still attract and incorporate the bacteria, but, instead of killing them, carry them around the body. In addition, Cabral's group demonstrated that marijuana decreased the capacity of the body to resist genital herpes infection, and that even casual smoking of one or more joints will cause more virus to be produced at the site of infection, which becomes more severe, with more rapid onset and longer duration. These observations, first documented by Cabral on experimental animals, were subsequently reported on marijuana smokers, who developed severe herpetic lesions of the genitalia and which had a high rate of recurrence. (56)

In recent years Paul J. Donald from the Department of Ololaryngology, Head and Neck Surgery, University of California, documented a study of twenty cases of advanced head and neck cancer in young patients. Dr Donald established the following points:

1. The average age at which patients present with squamous cell carcinoma of the upper aerodigestive (sic) tract is 64. Tumors of this type are exceedingly unusual in anyone under the age of 40. The mean age of patients in this study were 24.2.

2. Abundant evidence is available from numerous research efforts indicating marijuana as a possible carcinogen and thereby as a cause of upper aerodigestive tract malignancy in the young.

3. Marijuana has an abundance of primary irritants and carcinogens. Delta-9-tetrahydrocannabinol has been found to cause chemical aberrations in DNA and RNA, resulting in alterations in chromosomes. It has also been found to cause alterations in T-cell functions. In his summary Dr. Donald made the following statement: "Disquieting information concerning the effects of marijuana smoke on cellular genetics and the immune system raises the level of suspicion, suggesting the implication of this drug in the genesis of cancer. Certainly the incidence of marijuana smoking in this series of twenty patients with head and neck squamous cell carcinoma intensifies the suspicion".(57)

Answer 13:

LUNGS

Dr. Robert Petersen presented a comparative study in 1979 of the inhalation pattern of cigarette and cannabis smokers found that the latter inhale more deeply and hold the smoke longer than cigarette smokers. They also smoke the butt or 'roach' (using a roach holder) where there is a greater concentration of THC. Therefore despite the fact that cigarette smokers usually smoke more cigarettes per day, the results of this study showed that the amounts of ammonia, hydrogen cyanide, acrolein, acetonitrile, benzene and toluene and the volatile carcinogenic compounds are not significantly different between the two types of smoke. (58)

COMPARATIVE ANALYSIS OF MAINSTREAM SMOKE FROM MARIJUANA AND TOBACCO REFERENCE CIGARETTE.

(Average weight: 1.11mg; Length: 85mm)

Measurements	Marijuana	Tobacco
Gas Phase
Carbon monoxide, vol.%	3.99	4.58
Carbon dioxide, vol.%	8.27	9.38
Ammonia, mg	228	199
Cyanic acid, mg	532	498
Cyanogen, mg	19	20
Isoprene, mg	83	310
Acetaldehyde, mg	1,200	980
Acetone, mg	443	578
Acrolein, mg	92	85
Acetonitrile, mg	132	123
Benzene, mg	76	67
Toluene, mg	112	108
Vinyl Chloride, ng*	5.4	12.4
Dimethylnitrosamine, ng*	75	84
Methtylethylnitrosamine, ng*	27	30
Particulate Phase
Total Particulate Matter, dry, mg	22.7	39
Phenol, mg	76.8	138.5
o-Cresol, mg	17.9	24
m-and p-Cresol, mg	54.4	65
Dimethylphenol, mg	6.8	14.4
Catechol, mg	188	328
Cannabidiol, mg	190	-
Delta-9-tetrahydrocannabinol, mg	820	-
Cannabinol, mg	400	-
Nicotine, mg	-	2,850
n-Nitrosonornicotine, ng*	-	2,850
Naphthalene, mg	3	1.2
1-Methylnaphthalene, mg	6.1	3.65
2-Methylnaphthalene, mg	3.6	1.4
Benz(a)anthracene, ng*	75	43
Benzo(a)pyrene, ng*	31	21.1

*indicates known carcinogens.

From Marijuana and Health, National Academy of Sciences, Institute of Medicine Report, Washington, D.C. 1982

Dr. Donald P. Tashkin did research in 1976 to determine subclinical pulmonary effects of marijuana smoking. Sophisticated lung-function tests were given to subjects in a study of young males. They averaged five joints a day over a period of 47-59 days. Results found that all had "significant lung function impairment in several areas. These impairments were similar to those found by other researchers studying people who had smoked tobacco moderately to heavily for many years." When these subjects stopped smoking for four weeks, lung function improved significantly. (59,60)

In 1980 Dr. Forest S. Tennant published a remarkable study which involved lung biopsies of U.S. soldiers stationed in Germany in the early 70s, which demonstrated the damage to lungs not only in those who combined cigarettes and hashish but also in those who smoked hashish only. Symptoms included chronic bronchitis, emphysema and a precancerous condition, squamous metaplasia. The average age of subjects was 21 years. (61)

Answer 14:

HEART

Marijuana affects the heart and blood pressure. The elevation in blood pressure is dose-related but it is variable and less marked than the rapid heart rate. Blood pressure usually returns to baseline values within ninety minutes. Marijuana is known to decrease the force with which the heart can pump the blood, and it decreases the amount of blood that can be pumped with each stroke. It also decreases the capacity of the heart. The effect of the drug on the functions of the heart is apparent in humans within ten minutes of smoking and usually lasts from one to two hours.

The link between cigarette smoking and coronary heart disease is now well established, and because many compounds in tobacco and marijuana are virtually identical, it is reasonable to assume the impact on the heart must be similar. However, very little research has been done in this area and therefore no studies have been scientifically documented. There have been some studies on the effect of marijuana and people with compromised heart function, which demonstrate that marijuana should never be used by anyone with coronary heart disease or angina pectoris. It is worth noting, however, that many people have subclinical heart disease.(62)

These examples only present an impression of the way scientific research has progressed and developed over the years. The complete collection of published scientific papers are summarised in "Marijuana: An Annotated Bibliography". (63)

Hopefully some of this data will give parents a fighting chance when their children present them with some of the so called proven facts. The 'facts' which are so cleverly presented in pro-drug magazines and the popular press are often hypothetical or the outcome of shoddy work.

Answer 15:

How does a person cope with everyday matters if they are using marijuana? Because marijuana and other psychoactive drugs are 'mind-altering' (another term is 'cerebral dysfunctioning' - well known with alcohol), they therefore alter behaviour. The degree of change depends on the individual. Some changes are basic and others temporary. Paradoxically, because adolescents are in the actual process of forming adult personalities, drugs which interfere with the process impede their chances of ever making mature decisions about various situations and activities including the use of drugs.

Students who use marijuana are usually unable to concentrate and lack incentive for study. As a result they become disruptive and frustrate the efforts of the teacher to teach effectively or of other students to learn. Family life can be seriously disturbed as parents try to fathom the reason for the difficult behaviour of a child. Often parents believe that drug users only come from deprived and dysfunctional families and because they are conscientious and caring do not consider drug use as a possibility. Childhood friendships are neglected as young drug users merge with other young people who want a similar lifestyle. In families where parents have other priorities and neglect the welfare of their children, then drug taking may quickly become a substitute for care and love. However, drug use is an all-pervasive problem which is found in even the most stable and caring families.

Answer 16:

What are the effects of marijuana in combination with alcohol and other drugs? Although there are undoubtedly individual differences in response to drugs in combination, and the effect may vary depending on the dosages of the drugs involved, research demonstrates that simultaneous use of both alcohol and marijuana appears to be at least additive. Used together they cause greater deficits than a corresponding amount of either drug used alone. There is also the risk that an individual, especially an adolescent, may overdose on alcohol or other drugs because the 'vomiting reflex', a natural protective mechanism, is suppressed by the effects of THC.

Binge drinking appears to be inextricably linked to the present drug epidemic. The fashion of getting drunk, high or stoned has become a significant part of the scene. It is not unusual for people to experiment with various reactions produced from different drug combinations and this results in the effects being even more unpredicable.

It is not uncommon for users of marijuana to have amphetamines as a 'pick-me-up' to counteract against feelings of constant tiredness, lack of motivation, apathy and listlessness. We have a very serious amphetamine problem in Australia and it is often suggested that people use amphetamines if there is a shortage of marijuana. However, since these drugs produce a completely different form of intoxication this contention is doubtful.

Answer 17:

How does marijuana compare with cigarettes? It took sixty years of research, but it has now been scientifically documented that cigarettes aggravate many existing health problems, as well as harming the healthy person. All comparative studies between tobacco and marijuana show that both types of smoke possess many of the same compounds, a difference being that tobacco contains nicotine and marijuana contains cannabinoids. Benzopyrenes, well-known cancer-causing agents which are produced in the burning process, are 70% more abundant in marijuana smoke than in smoke from high tar cigarettes. In addition marijuana contains 400% more particulates than tobacco.(64) It is well established that the health consequences of marijuana are more serious than tobacco. No study suggests that tobacco is responsible for impairment of memory, personality, driving ability and the physiology of reproduction.

Preliminary studies have not been done on passive smoking and its relationship to marijuana. However, because it is generally accepted that there is an association between cigarette smoking and passive inhalation by non-users, it is assumed that people are similarly affected by marijuana smoke.

Answer 18:

Do marijuana users progress to other drugs? One aspect of the drug culture which is continually distorted by experts is whether marijuana is the precursor to other prohibited drugs. While for many people this is not the case, there have been some interesting U.S.A. surveys which clearly indicate that most heroin and cocaine addicts started their drug dependency with marijuana use. The most acclaimed is the National High School Senior Survey. It was commenced in 1975 at the peak of marijuana use by 16-18 year old students. It was conducted by researchers from the University of Michigan and included every State except Alaska and Hawaii. This survey demonstrated that in the years when approximately half of a typical senior class used marijuana to some degree, approximately 50% of that group used one or more other illegal drugs. But far more importantly, of the other half of students who did not use marijuana, virtually none were regular users of any other illegal drug. (65)

In a detailed dose-related progression study in the 1980 National High School Senior Survey the results were as follows:

Marijuana progressing to Cocaine:
non-users	0.04%
annual consumption 10-19 times	11.7%
annual consumption 20-39 times	20.2%
annual consumption 40 or more times	52.9%

To date, cocaine is not a significant problem among our young people in Australia. However, it would be interesting to survey the relationships between marijuana and amphetamines which, like cocaine, are also a central nervous stimulant and easily obtainable in most Australian states.

A study called "Stages in Adolescent Involvement in Drug Use" by Doctor Denise Kandel of Columbia University and New York State Psychiatric Institute, reported similar findings and stressed another interesting epidemiological aspect. The study, done in the early seventies, demonstrated the progression from legal to illegal drugs, and the follow up survey in the eighties, when respondents were in their early twenties, confirmed the results. (66)

The three most important findings of this study were firstly that whereas 27% of high school students who smoked cigarettes and drank alcohol progressed to marijuana during a school year, only 2% of those who had not used these legal drugs did so. Secondly, whereas 26% of marijuana users became involved with other prohibited psychotropic drugs, only 1% of non-drug users and 4% of alcohol and cigarette users did so. This same pattern was evident in the four years in high school and in the first year out of school. The third interesting finding was that illegal drug users, when deciding to give up drug taking, regressed to a lower category of illegal drugs or to alcohol and cigarettes. This study demonstrated that the progression from marijuana to other prohibited drugs was one in every four cases in a six month trial period in a large group of adolescents fourteen to eighteen years old.

Another interesting survey, which supports the results of the previous two, was initiated by research sociologists John O'Donnell and Richard Clayton. According to Dr. Clayton, the 2,510 men chosen for the survey were registered with the 'Selective Service System', and therefore was a true representation of the nineteen million American males born between 1944 and 1954. The aim of this survey was to determine the relationships between marijuana use and the progression to heroin and cocaine. The result: 73% of men who had used marijuana at least 1,000 times progressed to cocaine and 33% to heroin. Of the 1,126 non-users of marijuana, 1 person had used heroin and 1 cocaine. Although there is no pharmacological link between using marijuana and progressing to the use of other drugs, these surveys and other studies clearly indicate the progression of drug use. For this reason, marijuana has been described as a 'gateway' drug.(67)

Answer 19:

Surely if marijuana is used in moderation there can be no real harm? 'Moderate use' (an imprecise and unscientific term) implies that a certain amount of mind alteration is acceptable. It must be remembered that even prescribed psychoactive drugs can be dangerous for adolescents. Because young people lack coping skills they are extremely susceptible once they cross the threshold with their first use. This is why it is important to challenge the notion that experimentation with street drugs is a normal part of growing up. Once young people begin to use drugs for producing good feelings in times of stress, a problem is already established - the problem of reinforcement and habit formation.

Nevertheless, despite the best advice and information, some people will always be attracted to using mind-altering drugs. In every aspect of living, in various cultures and societies, there are always some people who do not fit into expected patterns of behaviour. In western societies, this is seen in a variety of unacceptable ways, e.g. truancy and rebellious behaviour in school. Some people do not want to join in social or sporting activities and for various reasons want to retreat from the challenges of life. When they start using marijuana it serves to reinforce their withdrawal and make it more pleasant. Although the drug use was not the original reason for their dropping out, it still presents a serious problem, because it retards the re-emergence of the maturation process and contributes to the perpetuation of their inappropriate behaviour.

Answer 20:

Has there been much research into the effects of marijuana? There are over 10,000 documented studies about marijuana. These include research in the laboratory, official statistics, surveys and clinical observations. Most of the research relating to illegal drugs and in particular marijuana was conducted in the U.S.A. in the 1970s and 1980s.

A crucial factor about the research in those days is that the drug, i.e. sativa, usually contained small amounts of THC. Today, sinsemilla and other more intoxicating mixtures such as a hybrid called 'skunk' are especially cultivated and processed for the drug market. Many researchers believe that this fact invalidates many earlier studies-which indicate that marijuana is harmless. Over the past few years some of the long term epidemiological studies have been concluded. As a result, the detrimental effects of marijuana on the foetus, brain and immune system have now been scientifically documented.(68)

Answer 21:

Is scientific research more important than anecdotal and clinical observation? Research is a combination of intuition, common sense and subjective evaluation, combined with scientific and medical data. An accumulation of cases, sharing the same features, is the first line of research and often determines planned studies that may be retrospective or prospective. Anecdotal material and personal observations have lost much of their status in the field of research, but for identifying the effects of drug abuse they are essential.

For example, the great antisepsis movement in the mid-nineteenth century began to bring infectious diseases such as typhoid and cholera under control long before the germs which caused these diseases had been discovered. The movement was based on observations, e.g. that drinking polluted water was associated with the disease (a form of anecdotal evidence). If the provision of clean water had been delayed until the discovery of bacteria, preventable deaths, numbered in the thousands, would have continued to occur for many years. (69)

The accepted format for modern scientific drug research usually involves five stages. Firstly, it is necessary to study the compound in its historical perspective; next, the chemistry and metabolism of the compound - the way it is absorbed, broken down or eliminated by the body. This is followed by research on small animals, usually rodents and guinea pigs. The advantage of using mice is that several generations can be examined over a short period of time. Extensive and repeated animal studies are required, sometimes involving larger animals such as monkeys, before researchers are satisfied that the compound may be given to man. Research on Rhesus monkeys has proved invaluable in detecting the alteration of cell structure caused by cannabinoids.

If no adverse effects are observed up to this stage, then human subjects may be given the drug under supervision, subject to strict ethical principles. Such people are closely monitored. Finally, the new drug is carefully observed for many years by Food and Drug Administration and World Health Organisation authorities, including guidelines regulating manufacture, purity and quality control.

Answer 22:

Has anyone ever died as a result of using marijuana? The question of death from drug use is closely linked to the pharmacology of the particular drug and the user's level of tolerance to it. Tolerance is also related to the user's own body chemistry and the length of time and level of concentration of the substance and the frequency of use.

Take the case of heroin (diacetylmorphine). Overdose occurs when users exceed their level of tolerance. Because heroin is a depressant drug, the body's vital functions, especially the lung functions, are depressed to the point where breathing ceases and death ensues. In the case of cocaine, which is a stimulant drug, overdose is associated with gross over-stimulation of bodily functions, especially of heartbeat, which can result in heart attack, heart failure or stroke.

The pharmacology of marijuana includes some stimulant and hallucinogenic properties' but it is primarily a depressant drug. Because it is fat-soluble and is gradually stored in the body in larger and larger quantities, marijuana acts more slowly. So we do not see the dramatic shut-down or acceleration of body functions that we see in the case of heroin or cocaine. There has never been a death directly attributed to marijuana through overdose. However, studies are indicating marijuana may be a contributing factor, and like nicotine and alcohol, risk of death or disability may be attributed to its use - that is attributable harm.

For example, Dr Joran Rajs, Department of Forensic Medicine, Korolinska Institute, Stockholm, Dr. Anna Flugelstad, Department of Psychiatry, St. Goran's Hospital, Stockholm and Dr. John Jonsson from the National Laboratory of Forensic Chemistry, Linkoping, Sweden, worked together to examine the question of cannabis-associated deaths. The aim of their study was to document the results of twenty-four medico-legal autopsies which revealed the use of cannabinoids. In eight cases cannabis was the only drug used. In ten cases it was a combination of cannabis and alcohol. In five cases alcohol, medication and cannabinoids were all used and, in one case, a combination of medication and cannabinoids. The researchers made the following points:

1. "It appeared that manners of death among the cannabis users were unexpectedly violent compared to the ways of death among other drug addicts. The proportion of suicides, ten out of twenty-four, was particularly high. This finding was remarkable, since cannabis use is not generally associated with violence."

2. "The literature contains several descriptions of delusional states, paranoid symptoms and personality disturbances in cannabis users. These abnormal mental states are of comparatively short duration, usually lasting for just a few hours. Even first-time users may be affected."

3. "In case studies of cannabis psychosis it is not uncommon to see descriptions of violent and destructive outbursts, suicide attempts and assults on other persons, often with major violence."

4. "Use of cannabis may have a stronger association to violent crimes than has been previously acknowledged. One possible explanation could be the confusional states or cannabis psychosis in users giving rise to rapid fluctuations in mood, panic attacks and paranoid elusions."(70)

Summarizing their findings, Drs Rajs, Flugelstadt and Jonsson stated the following: "It is seen that suicides among cannabis users were more frequent than in all the three control groups taken together....Another notable difference between cannabis-user suicides and controls was homicidal actions preceding suicide among cannabis users. In one case, a cannabis user suspected that one of his four children had been subject to incestuous behavior by a family member. This prompted him to kill his wife, all his children and himself. A Swedish epidemiological study by Dr. Sven Andreasson et al. gives added weight to the previous study when it was found that the incidence of suicide amongst heavy users (50 times or more) was 5.4 times greater than in the non-using control group.(71)

In addition, we need to consider that marijuana has in excess of 70% more cancer-causing tars than tobacco. We have not collected the data on how many lung problems, asthma, lung cancer, emphysema and chronic bronchitis in Australia can be associated with marijuana use. However research by Dr D.P. Tashkin has clearly shown serious lung impairment in frequent marijuana mokers.(72)

Another consideration is the relationship between fatal road accidents and the use of marijuana, particularly marijuana used in combination with alcohol.(73)

Answer 23:

Why is there such conflict among experts regarding marijuana research? Controversy relating to research is a common and appropriate academic activity and, as in most other areas of conflicting opinion, emotions can run exceedingly high. As an example of extreme points of view the debate surrounding tobacco was very interesting. In the 1950s much of the research linking cigarette smoke and cancer was statistical. Twenty-four investigations in nine countries surveyed groups of populations, noted their smoking habits and in subsequent years ascertained the cause of death. In Britain, Dr. Richard Doll and Professor Austin Bradford Hill made an extensive study of 40,000 British doctors. In America Dr. Daniel Horn and Dr. Cuyler Hammond surveyed 187,000 American smokers and non-smokers. All these studies concluded that there was an association between the risk of lung cancer and the number of cigarettes smoked.

However, in the late 1950s some prominant medical scientists were sceptical of the link between lung cancer and cigarette smoke. Dr. Ian McDonald, one of California's foremost cancer specialists, stated before a U.S. Congressional Committee that not only did he believe that cigarette smoking bore no relationship to lung cancer, but suggested:

"A pack of cigarettes a day will keep lung cancer away."

Similarly today, statements are made such as:

"Marijuana causes much less trouble than aspirin."(74)

"Prohibition of cannabis is based on unscientific, systematic and fraudulent exaggeration of the drug's toxicity."(75)

"Although marijuana is certainly not a perfectly harmless drug, no drug is. It is our considered view, based on laboratory and clinical literature, that it is indeed less dangerous than alcohol." (76)

No doubt there will continue to be dissent about marijuana among physicians and scientists similar to those who still dispute the dangers associated with cigarettes.