Legal cannabis laws impact teen use

June 27, 2017

Science Daily/The Geisel School of Medicine at Dartmouth

A new study by researchers at Dartmouth has found that adolescents living in medical marijuana states with a plethora of dispensaries are more likely to have tried new methods of cannabis use, such as edibles and vaping, at a younger age than those living in states with fewer dispensaries. The study will appear in the August issue of Drug and Alcohol Dependence.

"This study was driven by two motivations -- the need to understand if and how the shifting legal landscape of cannabis may affect kids, and the potential utility of social media as an epidemiological sampling method," says Jacob Borodovsky, a PhD candidate at The Dartmouth Institute for Health Policy and Clinical Practice and the Center for Technology and Behavioral Health, and the lead author of the study. "If it is true that certain components of legalization change the way young people use cannabis, then we need to devote more resources to understanding the important consequences (good or bad) of the specific provisions included in the diverse cannabis laws that are emerging across the country."

Borodovsky and colleagues examined associations between provisions of legal cannabis laws (such as allowing dispensaries, home cultivation, etc.) and cannabis consumption patterns among youth using online surveys distributed through Facebook, which proved to be a reliable method for generating geographically diverse samples of specific subgroups of cannabis-using youth.

"Our data suggest a relationship between the degree of regulatory oversight of legal cannabis and kids' propensity for trying new ways of using cannabis," Borodovsky says. "I think we need to start having a broader national conversation about how best to design the production and distribution regulations for legal cannabis to mitigate potential public health harms."

As cannabis legalization rapidly evolves, in both medical and recreational usage, understanding the laws' effect on young people is crucial because this group is particularly vulnerable to the adverse effects of marijuana and possesses an inherent elevated risk of developing a cannabis disorder.

"Using social media to disseminate web surveys is a useful epidemiological research method. It allows us to quickly collect geographically diverse data on cannabis-related questions that aren't asked in the traditional federally-sponsored drug use surveys," Borodovsky says. "My hope is that we can use these and other types of results to create rational legal cannabis laws that are based on data rather than anecdotes."

https://www.sciencedaily.com/releases/2017/06/170627105316.htm

Marijuana use among college students on rise following Oregon legalization

June 14, 2017

Science Daily/Oregon State University

College students attending an Oregon university are using more marijuana now that the drug is legal for recreational use, but the increase is largely among students who also report recent heavy use of alcohol, a new study has found.

Oregon State University researchers compared marijuana usage among college students before and after legalization and found that usage increased at several colleges and universities across the nation but it increased more at the Oregon university. None of the universities were identified in the study.

"It does appear that legalization is having an effect on usage, but there is some nuance to the findings that warrant further investigation," said the study's lead author, David Kerr, an associate professor in the School of Psychological Science in OSU's College of Liberal Arts.

"We found that overall, at schools in different parts of the country, there's been an increase in marijuana use among college students, so we can't attribute that increase to legalization alone."

The results were published today in the journal Addiction. Co-authors are Harold Bae and Sandi Phibbs of OSU's College of Public Health and Human Sciences and Adam Kern of the University of Michigan.

The study is believed to be the first to examine marijuana usage patterns following legalization of recreational marijuana in Oregon and the first to examine the effects of any state's legalization on college students. Voters in Oregon approved legalization in 2014 and the law took effect in 2015.

Oregon's legalization of marijuana is part of a larger trend among U.S. states, but little research has been done so far to understand the impact. In their study, Kerr and his colleagues set out to begin addressing some of those questions.

"It's an important current issue and even the most basic effects have not been studied yet, especially in Oregon," he said. "There are a lot of open questions about how legalization might affect new users, existing users and use of other substances."

Researchers used information collected in the Healthy Minds Study, a national survey of college students' mental health and well-being -- including substance use -- conducted by the University of Michigan. The study is designed to give colleges and universities information to help them understand the needs of their student populations.

As part of the survey, participants are asked about marijuana and cigarette use in the previous 30 days, as well as frequency of heavy alcohol use within the previous two weeks.

Using data from a large public university in Oregon and six other four-year universities around the country where recreational marijuana is not legal, researchers compared rates of marijuana use before and after the drug was legalized in Oregon. They also examined frequency of heavy alcohol use and cigarette use at those points.

The researchers found that the overall rates of marijuana use rose across the seven schools. Rates of binge drinking -- where a person consumes four to five or more drinks in a period of about two hours -- stayed the same and cigarette use declined in that period.

"It's likely that the rise in marijuana use across the country is tied in part to liberalization of attitudes about the drug as more states legalize it, for recreational or medical purposes or both," Kerr said. "So legalization both reflects changing attitudes and may influence them even outside of states where the drug is legal."

Researchers also found that marijuana use rates were generally higher, overall, among male students; those living in Greek or off-campus housing; those not identifying as heterosexual; and those attending smaller, private institutions.

One area where legalization had a marked impact was among college students who indicated recent binge drinking; students at the Oregon university who reported binge drinking were 73 percent more likely to also report marijuana use compared to similar peers at schools in states where marijuana remains illegal.

"We think this tells us more about the people who binge drink than about the effects of alcohol itself," Kerr said. "Those who binge drink may be more open to marijuana use if it is easy to access, whereas those who avoid alcohol for cultural or lifestyle reasons might avoid marijuana regardless of its legal status."

The researchers also found that Oregon students under age 21 -- the minimum legal age for purchasing and using marijuana -- showed higher rates of marijuana use than those over 21.

"This was a big surprise to us, because legalization of use is actually having an impact on illegal use," said Bae, the study's primary statistician.

These initial findings about marijuana use among college students help form a picture of how legalization may be affecting people, Kerr said, but more study is needed before researchers can quantify the harms or net benefits of legalization for young people.

"Americans are conducting a big experiment with marijuana," Kerr said. "We need science to tell us what the results of it are."

https://www.sciencedaily.com/releases/2017/06/170614160510.htm

Mixing booze, pot is a serious threat to traffic safety

Drivers testing positive for alcohol and marijuana are five times more likely to be responsible for causing fatal two-vehicle crashes than sober drivers involved in the same crashes

June 12, 2017

Science Daily/Columbia University's Mailman School of Public Health

Use of marijuana in combination with alcohol by drivers is especially dangerous, according to a latest study conducted at Columbia University's Mailman School of Public Health. Drivers who used alcohol, marijuana, or both were significantly more likely to be responsible for causing fatal two-vehicle crashes compared to drivers who were involved in the same crashes but used neither of the substances. The findings are published in the journal, Annals of Epidemiology.

"The risk of crash initiation from concurrent use of alcohol and marijuana among drivers increases by more than fivefold when compared with drivers who used neither of the substances," said Guohua Li, MD, DrPH, professor of Epidemiology at the Mailman School of Public Health. The study also indicates that when used in isolation, alcohol and marijuana increase crash culpability by 437 percent and 62 percent, respectively.

The researchers analyzed data for 14,742 fatal two-vehicle crashes between 1993 and 2014 recorded in the Fatality Analysis Reporting System, a database containing information on crashes that resulted in at least one fatality within 30 days and that occurred on U.S. public roads. Included in the study were 14,742 drivers who were responsible for causing the fatal crashes and 14,742 non-culpable drivers who were involved in the same crashes. Crashes involving single vehicles, more than two vehicles, commercial trucks, and two-vehicle crashes in which both drivers were responsible were excluded from the analysis.

Drivers who were responsible for the crashes were significantly more likely than non-culpable drivers to test positive for alcohol (28 percent vs. 10 percent), marijuana (10 percent vs. 6 percent), and both alcohol and marijuana (4 percent vs. 1 percent). Drivers who tested positive for alcohol, marijuana, or both were more likely than those who tested negative to be male, aged 25 to 44 years, and to have had a positive crash and violation history within the previous three years.

The three most common driving errors that led to these fatal crashes were failure to keep in proper lane (43 percent), failure to yield right of way (22 percent), and speeding (21 percent).

Since the mid-1990s, the prevalence of marijuana detected in fatally injured drivers has increased markedly. During the same time period, 28 states and the District of Columbia have enacted legislation to decriminalize marijuana for medical use, including eight states that have further decriminalized possession of small amounts for adult recreational use. Although toxicological testing data indicate a continuing increase in marijuana use among drivers, a positive test does not necessarily infer marijuana-induced impairment.

"While alcohol-impaired driving remains a leading cause of traffic fatalities in the United States, driving under the influence of marijuana and other drugs has become more prevalent in the past two decades," said Dr. Li, who is also the founding director of Columbia University's Center for Injury Epidemiology and Prevention. "Countermeasures targeting both drunk driving and drugged driving are needed to improve traffic safety."

https://www.sciencedaily.com/releases/2017/06/170612135506.htm

Why pot-smoking declines, but doesn't end, with parenthood

June 1, 2017

Science Daily/University of Washington

Adults who smoke marijuana often cut back after becoming parents -- but they don't necessarily quit.

The influence of a significant other and positive attitudes toward the drug overall, in addition to the onset of parenthood, also are factors in whether someone uses marijuana.

It's a changing landscape for marijuana use, as laws ease and cultural acceptance grows -- in Washington state and elsewhere around the country. Against that backdrop, the study by the University of Washington's Social Development Research Group (SDRG) aims to present information about marijuana use among parents and nonparents alike.

"When it comes to adults, we don't know long-term consequences of moderate marijuana use in the legal context, so that we cannot say that we absolutely must intervene," explained Marina Epstein, a UW research scientist and lead author of the study. "However, when it comes to parents, their use is strongly related to their children's marijuana use, and that is a significant problem, since adolescent marijuana use can be harmful. Our study wanted to prepare us to build effective interventions for all adults if it becomes an issue."

The study, published online May 19 in Prevention Science, surveyed 808 adults (parents and nonparents), a group the SDRG first identified as fifth-graders at Seattle elementary schools in the 1980s as part of a long-term research project. For the marijuana study, participants were interviewed at specific intervals over a 12-year period, ending when most participants were 39 years old. That survey concluded in 2014 -- two years after marijuana was legalized in Washington. A parent-only subset of 383 people was surveyed at separate times, ending in 2011, just before the statewide vote that gave rise to pot shops.

Women and people of color made up approximately half the big study pool; of the parent subsample, about 60 percent were women, and an equivalent percentage were people of color.

The increasing availability of marijuana, along with shifting societal opinions about it, lends a timeliness to the findings and provides potential for further study, Epstein said. What factors affect behavior, especially among parents? Past studies have linked parenthood with decreased marijuana use; what makes this one different is the examination of other influences, too, and how those might inform intervention strategies.

More than half of Americans now support legalizing marijuana, according to a 2015 Pew Research Center report, and data from 2014 indicate a majority of Americans view alcohol as more damaging to a person's health than pot.

Meanwhile, concerns about the health effects of marijuana tend to focus on children and teens -- years when the brain is still developing. The Centers for Disease Control and Prevention and the National Institute on Drug Abuse stress the potential for long-term cognitive impairment, problems with attention and coordination and other risk-taking behaviors due to heavy marijuana use. For those reasons, medical professionals recommend that parents avoid using marijuana -- or drinking heavily -- around kids to prevent modeling the behavior.

The UW research found that, in general, a greater percentage of nonparents reported using marijuana in the past year than parents. At age 27, for example, 40 percent of nonparents said they had smoked pot, compared to about 25 percent of parents. By participants' early 30s, their marijuana use had declined, but a gap between the two groups remained: Slightly more than 16 percent of parents said they smoked pot in the past year, while 31 percent of nonparents reported the same.

But the study also showed that participants who started using marijuana as young adults were much more likely to continue to use into their mid- to late 30s, even after they became parents. Having a partner who used marijuana also increased the likelihood of participants' continued use. Those trends were true of both parents and nonparents, demonstrating the impact of attitudes and the behavior of others, Epstein said.

"This shows that we need to treat substance use as a family unit. It isn't enough that one person quits; intervention means working with both partners," she said. "We also need to tackle people's positive attitudes toward marijuana if we want to reduce use."

And while the health risks to adults are being debated, the focus on children can be a driver for prevention campaigns, Epstein said.

https://www.sciencedaily.com/releases/2017/06/170601124057.htm

Cannabidiol reduces seizures in children with severe epilepsy

May 26, 2017

Science Daily/Ann & Robert H. Lurie Children's Hospital of Chicago

Children with Dravet syndrome, a severe form of epilepsy, had fewer seizures after taking a daily oral solution of the cannabis compound called cannabidiol, which does not have the psychoactive properties of marijuana, results from a double-blind, placebo-controlled trial reveal.

Results from a double-blind, placebo-controlled trial published in The New England Journal of Medicine revealed that children with Dravet syndrome, a severe form of epilepsy, had fewer seizures after taking a daily oral solution of the cannabis compound called cannabidiol, which does not have the psychoactive properties of marijuana. Over a 14-week treatment with cannabidiol, convulsive seizures dropped from a monthly average of 12.4 to 5.9. In comparison, seizures in the placebo group decreased from a monthly average of 14.9 to 14.1. During the study, seizures stopped completely in 5 percent of patients taking cannabidiol.

"Seizures in Dravet syndrome are extremely difficult to control and they can be deadly," says study co-author Linda Laux, MD, from Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago. "Our results are encouraging, especially considering that we don't have any antiepileptic drugs approved for Dravet syndrome in the U.S."

The study included 120 children and young adults with Dravet syndrome and drug-resistant seizures. They were randomly assigned to receive either cannabidiol or a placebo, in addition to standard antiepileptic treatment.

Adverse events were reported in 93 percent of the patients taking cannabidiol, compared to 75 percent of the patients in the placebo group. The most common side effects were drowsiness, diarrhea and decreased appetite.

"We will need more data to determine the long-term efficacy and safety of cannabidiol for Dravet syndrome," says Laux, who is the Medical Director of the Comprehensive Epilepsy Center at Lurie Children's and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

https://www.sciencedaily.com/releases/2017/05/170526085003.htm

ER visits related to marijuana use at a Colorado hospital quadruple after legalization

More than half of teens' marijuana-related visits also involved psychiatric evaluations

May 4, 2017

Science Daily/American Academy of Pediatrics

Visits by teens to a Colorado children's hospital emergency department and its satellite urgent care centers increased rapidly after legalization of marijuana for commercialized medical and recreational use, according to new research being presented at the 2017 Pediatric Academic Societies Meeting in San Francisco.

The study abstract, "Impact of Marijuana Legalization in Colorado on Adolescent Emergency Visits" on Monday, May 8 at the Moscone West Convention Center in San Francisco.

Colorado legalized the commercialization of medical marijuana in 2010 and recreational marijuana use in 2014. For the study, researchers reviewed the hospital system's emergency department and urgent care records for 13- to 21-year-olds seen between January 2005 and June 2015. They found that the annual number of visits with a cannabis related diagnostic code or positive for marijuana from a urine drug screen more than quadrupled during the decade, from 146 in 2005 to 639 in 2014.

Adolescents with symptoms of mental illness accounted for a large proportion (66 percent) of the 3,443 marijuana-related visits during the study period, said lead author George Sam Wang, MD, FAAP, with psychiatry consultations increasing from 65 to 442. More than half also had positive urine drug screen tests for other drugs. Ethanol, amphetamines, benzodiazepines, opiates and cocaine were the most commonly detected.

Dr. Wang, an assistant professor of pediatrics at the University of Colorado Anschutz Medical Campus, said national data on teen marijuana use suggest rates remained roughly the same (about 7 percent) in 2015 as they'd been for a decade prior, with many concluding no significant impact from legalization. Based on the findings of his study, however, he said he suspects these national surveys do not entirely reflect the effect legalization may be having on teen usage.

"The state-level effect of marijuana legalization on adolescent use has only begun to be evaluated," he said. "As our results suggest, targeted marijuana education and prevention strategies are necessary to reduce the significant public health impact of the drug can have on adolescent populations, particularly on mental health."

Dr. Wang will present the abstract, "Impact of Marijuana Legalization in Colorado on Adolescent Emergency Department (ED) Visits," from 8 a.m. to 10 a.m. Numbers in this news release reflect updated information provided by the researchers.

https://www.sciencedaily.com/releases/2017/05/170504083114.htm

Cannabis use in people with epilepsy revealed: Australian survey

People with epilepsy resort to cannabis products when anti-epileptic drug side-effects are intolerable, epilepsy uncontrolled

March 9, 2017

Science Daily/University of Sydney

The first Australian nationwide survey on the experiences and opinions of medicinal cannabis use in people with epilepsy has revealed that 14 per cent of people with epilepsy have used cannabis products as a way to manage seizures.

The study showed that of those with a history of cannabis product use, 90 per cent of adults and 71 per cent of parents of children with epilepsy reported success in managing seizures after commencing using cannabis products.

Published in Epilepsy & Behaviour, the Epilepsy Action Australia study, in partnership with The Lambert Initiative at the University of Sydney, surveyed 976 respondents to examine cannabis use in people with epilepsy, reasons for use, and any perceived benefits self-reported by consumers (or their carers).

The survey revealed:

* 15 per cent of adults with epilepsy and 13 per cent of parents/guardians of children with epilepsy were currently using, or had previously used, cannabis products to treat epilepsy.

* Across all respondents, the main reasons for trying cannabis products were to manage treatment-resistant epilepsy and to obtain a more favourable side-effect profile compared to standard antiepileptic drugs.

* The number of past antiepileptic drugs was a significant predictor of medicinal cannabis use in both adults and children with epilepsy.

"This survey provides insight into the use of cannabis products for epilepsy, in particular some of the likely factors influencing use, as well as novel insights into the experiences of and attitudes towards medicinal cannabis in people with epilepsy in the Australian community," said lead author Anastasia Suraev from The Lambert Initiative.

"Despite the limitations of a retrospective online survey, we cannot ignore that a significant proportion of adults and children with epilepsy are using cannabis-based products in Australia, and many are self-reporting considerable benefits to their condition.

"More systematic clinical studies are urgently needed to help us better understand the role of cannabinoids in epilepsy," she said.

Co-author of the paper Carol Ireland, CEO of Epilepsy Action Australia, who was recently appointed to the Australian Government's new Australian Advisory Council on the Medicinal Use of Cannabis, said: "Cannabis products are often what people turn to when they have been unable to control their epilepsy with conventional medication."

"This highlights a growing need to educate consumers and health professionals on the use of cannabis by people with epilepsy, and to provide safe and timely access to cannabinoid medicine in order to lessen people's reliance on illicit black-market products" she said.

https://www.sciencedaily.com/releases/2017/03/170309120525.htm

How can marijuana policy protect the adolescent brain?

February 8, 2017

Science Daily/SAGE

As more states begin to legalize the use of marijuana, more young people may start to believe that it's safe to experiment with the drug. However, those under 25 are more vulnerable to the effects of drugs than are older adults. New legislation on legal marijuana use should include consideration of age limits and other guidelines for safe use, according to the authors of an article published in Policy Insights from the Behavioral and Brain Sciences, a Federation of Associations in Behavioral & Brain Sciences (FABBS) journal published in partnership with SAGE Publishing.

"As states consider legislation for marijuana use, it is imperative to determine safe guidelines regarding its impact on the brain, particularly during critical periods of neurodevelopment," commented study authors Staci A. Gruber and Kelly A. Sagar of McLean Hospital and Harvard Medical School. "Although 'just say no' did not work as a successful prevention policy, 'just not yet' may be a more effective and informed message to promote, especially among our nation's youth."

Examining research on recreational marijuana's impact on the brain, Gruber and Sagar recommend that laws legalizing marijuana outline restrictions on:

·     Age: Some parts of the brain, such as those dealing with planning and problem-solving, continue to develop until the mid-20s. In addition, those who start using marijuana during adolescence are more likely to have problems with memory and to use marijuana at high levels in the future. Policymakers should take into account the risks that marijuana poses to adolescents when considering age restrictions and advertisements for these products should not target youth.

·     Frequency and magnitude of use: Those who use marijuana frequently and/or in high doses are more likely to have worse problems with cognition and memory than those who don't. To prevent users from abusing marijuana, policymakers should determine safe guidelines for use.

·     Potency: Some varieties of marijuana plants and related products, including concentrates such as oils and wax, have high levels of tetrahydrocannabinol (THC), the chemical responsible for most of marijuana's ability to get users high. Other varieties and products contain greater concentrations of non-psychoactive cannabinoids including cannabidiol (CBD), which does not get users high and is well known for its role in treating conditions such as pediatric epilepsy, anxiety, and pain. Instead of treating all types of marijuana as the same, policymakers should consider limits on THC potency for young consumers as well as minimums for potentially beneficial cannabinoids, such as CBD, for medical use.

While recreational marijuana use during vulnerable periods of neurodevelopment has been linked to adverse effects, marijuana and its constituents also appear to hold great therapeutic potential. Currently, "policy has outpaced science, and eased restrictions allowing citizens to use marijuana, in some cases without the benefit of appropriate research," continued Gruber and Sagar. "Additional investigation is warranted and necessary to help guide informed policy decisions. Consumers have a right and a clear need to understand what their chosen marijuana products contain and what to expect."

https://www.sciencedaily.com/releases/2017/02/170208094219.htm

Teen use of any illicit drug other than marijuana at new low, same true for alcohol

December 13, 2016

Science Daily/University of Michigan

Teenagers' use of drugs, alcohol and tobacco declined significantly in 2016 at rates that are at their lowest since the 1990s, a new national study showed.

But University of Michigan researchers cautioned that while these developments are "trending in the right direction," marijuana use still remains high for 12th-graders.

The results derive from the annual Monitoring the Future study, now in its 42nd year. About 45,000 students in some 380 public and private secondary schools have been surveyed each year in this national study, designed and conducted by research scientists at U-M's Institute for Social Research and funded by the National Institute on Drug Abuse. Students in grades 8, 10 and 12 are surveyed.

Overall, the proportion of secondary school students in the country who used any illicit drug in the prior year fell significantly between 2015 and 2016. The decline in narcotic drugs is of particular importance, the researchers say. This year's improvements were particularly concentrated among 8th- and 10th-graders.

Considerably fewer teens reported using any illicit drug other than marijuana in the prior 12 months -- 5 percent, 10 percent and 14 percent in grades 8, 10 and 12, respectively -- than at any time since 1991. These rates reflect a decline of about one percentage point in each grade in 2016, but a much larger decline over the longer term.

In fact, the overall percentage of teens using any of the illicit drugs other than marijuana has been in a gradual, long-term decline since the last half of the 1990s, when their peak rates reached 13 percent, 18 percent and 21 percent, respectively.

Marijuana, the most widely used of the illicit drugs, dropped sharply in 2016 in use among 8th-graders to 9.4 percent, or about one in every 11 indicating any use in the prior 12 months. Use also declined among 10th-graders as well, though not by a statistically significant amount, to 24 percent or about one in every four 10th-graders.

The annual prevalence of marijuana use (referring to the percentage using any marijuana in the prior 12 months) has been declining gradually among 8th-graders since 2010, and more sharply among 10th-graders since 2013. Among 12th-graders, however, the prevalence of marijuana use is higher (36 percent) and has held steady since 2011. These periods of declining use (or in the case of 12th-graders, stabilization) followed several years of increasing use by each of these age groups.

Daily or near-daily use of marijuana -- defined as use on 20 or more occasions in the previous 30 days -- also declined this year among the younger teens (significantly so in 8th grade to 0.7 percent and to 2.5 percent among 10th-graders). However, there was no change among 12th-graders in daily use, which remains quite high at 6 percent or roughly one in every 17 12th-graders -- about where it has been since 2010.

Prescription amphetamines and other stimulants used without medical direction have constituted the second-most widely used class of illicit drugs used by teens. Their use has fallen considerably, however. In 2016, 3.5 percent, 6.1 percent and 6.7 percent of 8th-, 10th- and 12th-graders, respectively, say they have used any in the prior 12 months -- down from recent peak levels of 9 percent, 12 percent and 11 percent, respectively, reached during the last half of the 1990s.

Prescription narcotic drugs have presented a serious problem for the country in recent years, with increasing numbers of overdose deaths and emergencies resulting from their use. Fortunately, the use of these drugs outside of medical supervision has been in decline, at least among high school seniors -- the only ones for whom narcotics use is reported. In 2004, a high proportion of 12th-graders -- 9.5 percent, or nearly one in 10 -- indicated using a prescription narcotic in the prior 12 months, but today that percentage is down by half to 4.8 percent.

"That's still a lot of young people using these dangerous drugs without medical supervision, but the trending is in the right direction," said Lloyd Johnston, the study's principal investigator. "Fewer are risking overdosing as teenagers, and hopefully more will remain abstainers as they pass into their twenties, thereby reducing the number who become casualties in those high-risk years."

Users of narcotic drugs without medical supervision were asked where they get the drugs they use. About four in every 10 of the past-year users indicated that they got them "from a prescription I had."

"That suggests that physicians and dentists may want to consider reducing the number of doses they routinely prescribe when giving these drugs to their patients, and in particular to teenagers," Johnston said.

Heroin is another narcotic drug of obvious importance. There is no evidence in the study that the use of heroin has risen as the use of prescription narcotics has fallen -- at least not in this population of adolescents still in school, who represent over 90 percent of their respective age groups.

In fact, heroin use among secondary school students also has declined substantially since recent peak levels reached in the late 1990s. Among 8th-graders, the annual prevalence of heroin use declined from 1.6 percent in 1996 to 0.3 percent in 2016. And among 12th-graders, the decline was from 1.5 percent in 2000 to 0.3 percent in 2016.

"So, among secondary school students, at least, there is no evidence of heroin coming to substitute for prescription narcotic drugs -- a dynamic that apparently has occurred in other populations," Johnston said. "Certainly there will be individual cases where that happens, but overall the use of heroin and prescription narcotics both have declined appreciably and largely in parallel among secondary school students."

The ecstasy epidemic, which peaked at about 2001, was a substantial one for teens and young adults, Johnston said. Ecstasy is a form of MDMA (methylenedioxy-methamphetamine) as is the much newer form on the scene, "Molly."

"The use of MDMA has generally been declining among teens since about 2010 or 2011, and it continued to decrease significantly in 2016 in all three grades even with the inclusion of Molly in the question in more recent years," Johnston said.

MDMA's annual prevalence now stands at about 1 percent, 2 percent and 3 percent in grades 8, 10 and 12, respectively.

Synthetic marijuana (often sold over the counter as "K-2" or "Spice") continued its rapid decline in use among teens since its use was first measured in 2011. Among 12th-graders, for example, annual prevalence has fallen by more than two-thirds, from 11.4 percent in 2011 to 3.5 percent in 2016. Twelfth-graders have been showing an increased appreciation of the dangers associated with these drugs. It also seems likely that fewer students have access to these synthetic drugs, as many states and communities have outlawed their sale by retail outlets.

Bath salts constitute another class of synthetic drugs sold over the counter. Their annual prevalence has remained quite low -- at 1.3 percent or less in all grades -- since they were first included in the study in 2012. One of the very few statistically significant increases in use of a drug this year was for 8th-graders' use of bath salts (which are synthetic stimulants), but their annual prevalence is still only 0.9 percent with no evidence of a progressive increase.

A number of other illicit drugs have shown declining use, as well. Among them are cocaine, crack, sedatives and inhalants (the declining prevalence rates for these drugs may be seen in the tables and figures associated with this release.)

Alcohol

The use of alcohol by adolescents is even more prevalent than the use of marijuana, but it, too, is trending downward in 2016, continuing a longer-term decline. For all three grades, both annual and monthly prevalence of alcohol use are at historic lows over the life of the study. Both measures continued to decline in all three grades in 2016.

Of even greater importance, measures of heavy alcohol use are also down considerably, including self-reports of having been drunk in the previous 30 days and of binge drinking in the prior two weeks (defined as having five or more drinks in a row on at least one occasion).

Binge drinking has fallen by half or more at each grade level since peak rates were reached at the end of the 1990s. Today, the proportions who binge drink are 3 percent, 10 percent and 16 percent in grades 8, 10 and 12, respectively.

"Since 2005, 12th-graders have also been asked about what we call 'extreme binge drinking,' defined as having 10 or more drinks in a row or even 15 or more, on at least one occasion in the prior two weeks," Johnston said. "Fortunately, the prevalence of this particularly dangerous behavior has been declining as well."

In 2016, 4.4 percent of 12th-graders reported drinking at the level of 10 or more drinks in a row, down by about two-thirds from 13 percent in 2006.

Rates of daily drinking among teens has also fallen considerably over the same intervals. Flavored alcoholic beverages and alcoholic beverages containing caffeine have both declined appreciably in use since each was first measured -- again, particularly among the younger teens, where significant declines in annual prevalence continued into 2016.

Tobacco

Declines in cigarette smoking and certain other forms of tobacco use also occurred among teens in 2016, continuing an important and now long-term trend in the use of cigarettes.

https://www.sciencedaily.com/releases/2016/12/161213074519.htm

Beware: Children can passively 'smoke' marijuana, too

First study to successfully detect traces of marijuana chemicals in children's bodies

December 7, 2016

Science Daily/Springer

Relaxing with a joint around children is not very wise. Not only do youngsters inhale harmful secondary smoke in the process, but the psychoactive chemicals in the drug are taken up by their bodies as well. This warning comes from Karen Wilson of the Icahn School of Medicine at Mount Sinai and the American Academy of Pediatrics Julius B. Richmond Center of Excellence in the US. She led the first study showing that it is possible to pick up traces of THC, the primary psychoactive chemical in marijuana, in the urine of children exposed to secondary marijuana smoke. The findings are published in Springer Nature's journal Pediatric Research.

The two primary active components in marijuana are the psychoactive chemical delta9-tetrahydrocannabinol (THC), and the nonpsychoactive cannabidiol (CBD). Previous analytical methods were mostly developed to measure biomarkers of marijuana in users themselves. In this study, a new and more sensitive analytic method was developed and used by the US Centers for Disease Control and Prevention (CDC) to quantify the trace biomarkers resulting from secondhand marijuana smoke exposure.

The method was used to analyze the urine samples of 43 babies between the ages of one month and two years who were hospitalized with bronchiolitis in Colorado in the US between 2013 and 2015. Their parents also completed a survey about their marijuana smoking habits. The urine samples were analyzed for traces of marijuana metabolites (measured as levels of COOH-THC) and also for cotinine, a biomarker that indicates exposure to tobacco smoke.

COOH-THC was detectable in 16 percent of the samples, at concentrations between 0.04 and 1.5 nanograms per milliliter of urine. Higher concentrations were found in the urine of non-white children compared with white children.

"While documenting the presence of metabolites of THC in children does not imply causation of disease, it does suggest that, like tobacco smoke, marijuana smoke is inhaled by children in the presence of adults who are using it," says Wilson.

In 56 percent of children with detectable COOH-THC levels, more than 2.0 nanograms of cotinine per milliliter of urine were also measured. This indicates that children exposed to marijuana smoke are also more likely to be exposed to tobacco smoke, which increases their risk for cognitive deficits and respiratory ailments.

According to Wilson, more research is needed to investigate if secondhand marijuana smoke exposure is also a health risk. She believes that further high-sensitivity testing will give researchers the opportunity to do so more effectively, and that funds and human resources should be prioritized for such investigations.

"This research will help inform appropriate educational materials and outreach to parents and caregivers who use both marijuana and tobacco in the presence of their children," she says.

Wilson also supports the inclusion of a parent report screening question for institutions in areas where marijuana is legal, so that those who report household marijuana smoking can be counseled on how to reduce potentially harmful secondhand smoke exposure of their children.

https://www.sciencedaily.com/releases/2016/12/161207124123.htm

Marijuana use remains on the rise among US college students, but narcotic drug use declines

September 8, 2016

Science Daily/University of Michigan

College student marijuana use continues its nearly decade-long increase, according to the most recent national Monitoring the Future study.

In 2015, 38 percent of college students said they had used marijuana in the prior 12 months, up from 30 percent in 2006.

Daily or near-daily use of marijuana (having used 20 or more times in the prior 30 days) also has increased in recent years for college students, rising from 3.5 percent in 2007 to 5.9 percent in 2014 -- the highest level of daily use measured in the last 34 years.

However, in 2015 their daily use fell back some to 4.6 percent, or one in every 22 college students. A decline in the degree of risk of harm associated with using marijuana may account for much of the increase in use. Since 2003, proportions of 19-to-22-year-olds seeing regular use of marijuana as dangerous to the user has fallen sharply -- from 58 percent in 2003 to 33 percent by 2015.

"This increase in use and decrease in perceived risk of harm regarding marijuana use should be taken seriously by college administrators, parents and students themselves. We know through other research that frequent marijuana use can adversely affect academic performance and college completion," said John Schulenberg, one of the study's lead researchers and research professor at the University of Michigan's Institute for Social Research.

In contrast to the story for marijuana use, other types of drug use are declining among college students. Nonmedical use of prescription narcotic drugs has been declining among college students since reaching a high in 2006 of 8.8 percent annual prevalence (that is, any use in the prior 12 months). By 2015, 3.3 percent of college students reported using any narcotic drug in the past 12 months without medical supervision -- a drop of about six-tenths.

"It appears that college students, at least, are hearing and heeding the warnings about the very considerable dangers of using narcotic drugs," said Lloyd Johnston, the study's principal investigator and ISR distinguished senior research scientist and research professor.

Use of heroin, another narcotic drug, has been low among college students for many years. The highest annual prevalence recorded since 1980 was in 1998 at 0.6 percent, but the rate has been at or under 0.3 percent since 2005 and was down to 0.1 percent in 2015.

Use of amphetamines has started to decline among college students. From 2008 through 2012, the percentage of college students who reported using an amphetamine without medical supervision in the prior 12 months rose from 5.7 percent to 11.1 percent, likely due to more students using them to improve their academic performance. But, by the time of the latest survey in 2015, that had fallen slightly to 9.7 percent.

"It appears that the increase in nonmedical use of prescription stimulant drugs may have passed its peak, though about one in 10 college students still report using them in the prior 12 months," Johnston said.

The use of MDMA (ecstasy and more recently "Molly") had made a bit of a comeback among college students between 2007 and 2012, but has been in decline since then. Annual prevalence in 2015 was 4.2 percent.

Certain drugs have declined in popularity quite rapidly among the nation's college students. For example, past-year use of synthetic marijuana, which is usually sold over the counter under such brand names as "K-2" and "Spice," dropped from 8.5 percent when first measured in 2011 to just 1.5 percent in 2015 -- a decline of about 80 percent. Salvia has fallen from 5.8 percent when its use was first measured in 2009 to just 0.4 percent in 2015 -- a decrease of more than 90 percent.

Some other drugs never gained much of a foothold on American college campuses. Past-year use of so-called "bath salts," a form of synthetic stimulants usually sold over the counter, has never exceeded 0.3 percent among college students since first being measured in 2012, and stands at 0.1 percent in 2015.

Past-year use of inhalants has been below 2 percent since 2005. The so-called "club drugs," Rohypnol and GHB, never really caught on, and have had negligible rates of use among college students.

Annual nonprescribed use of tranquilizers (4.3 percent) and sedatives (2.3 percent) has changed little in recent years, although these annual prevalence rates in 2015 are below those observed in the college population in the early 2000s.

In general, college males are more likely than college females to use nearly all of the illicit drugs. Sedatives are the primary exception; and there the genders are very close in their annual prevalence rates.

Cigarettes and Alcohol

Cigarette smoking continues to decline gradually among college students, but the cumulative drop over the past 16 years has been dramatic. A peak rate of any smoking in the prior 30 days was reached in 1999 at 31 percent.

By 2015, the rate had fallen by nearly two-thirds to 11 percent, a record low. Daily smoking declined even more, from 19.3 percent in 1999 to 4.2 percent in 2015 -- a drop of nearly four-fifths and also a record low since 1980.

"The study shows that large declines in smoking rates have been occurring among secondary school students, as well," Johnston said. "So much of the improvement among college students actually began when they were still in high school."

Their high school classmates not in college have dramatically higher rates of smoking. In 2015, 23 percent of them indicated past-month smoking, compared to 11 percent among the college students.

Heavy smoking is even more concentrated among those not in college, with their half-pack-or-more-per-day smoking rate at 9.1 percent versus 1.4 percent among college students.

"Cigarette smoking has become increasingly concentrated among the less educated," Johnston said.

Through 1993, college females had higher rates of smoking than college males; but since 1994, the opposite is true.

Electronic vaporizers, which include e-cigarettes, were used in the month prior to the survey by 14 percent of college males and 6 percent of college females.

Alcohol clearly remains the drug of choice among college students, with 79 percent indicating that they used in the past 12 months and 63 percent in the past 30 days.

Indeed, 62 percent said they were drunk at least once in the past 12 months and 38 percent in the past 30 days. So drinking and drunkenness remain quite commonplace on the nation's college campuses, even though there has been some modest falloff in these rates since the early 1980s.

Binge drinking -- defined as having five or more drinks on at least one occasion in the past two weeks -- was reported by 40 percent of all college students in 2015 (close to the 38 percent who reported being drunk in the last month).

While the rate of binge drinking has gradually declined among college males over the past 30 years, there has been very little change in the rate among college females, resulting in some closing of the gap between genders (though males have consistently had a higher rate of binge drinking).

"Of even greater concern than binge drinking is what we have called 'extreme binge drinking,' defined as having 10 or more drinks -- or even 15 or more drinks -- on at least one occasion in the prior two weeks," Johnston said.

Over the years 2011 to 2015 combined, about one in nine college students reported having 10 or more drinks in a row on at least one occasion in the prior two weeks, while one in 25 reported having 15 or more drinks in a row at least once in the same interval.

"Drinking at these levels can result in alcohol poisoning, serious accidents, and a host of unwise and dangerous behaviors," Johnston said. "So this remains a serious problem to be addressed."

The Monitoring the Future study is now in its 42nd year. Starting in 1980, the study has included nationally representative samples of full-time college students who are one to four years beyond high school. The annual samples of college students have ranged between 1,000 and 1,500 per year.

MTF is an investigator-initiated research undertaking, conceived and conducted by a team of research professors (listed as authors below) at the University of Michigan's Institute for Social Research. It is funded under a series of peer-reviewed, competitive research grants from the National Institute on Drug Abuse, one of the National Institutes of Health.

MTF also conducts an annual national survey of high school seniors, from which a random, nationally representative subsample is drawn for follow-up by mail in future years. Of these follow-up respondents, those who are one to four years beyond high school and who report being in a two-year or four-year college full-time in March comprise the college student sample each year. They are not drawn from particular colleges or universities, which helps to make the sample more representative of the wide range of two- and four-year institutions of higher education in the country.

The findings presented here are drawn from Chapters 8 and 9 in this newly published monograph: Johnston, L.D., O'Malley, P.M, Bachman, J.G., Schulenberg, J.E. & Miech, R. A. (2016). Monitoring the Future national survey results on drug use, 1975-2015: Volume 2, College students and adults ages 19-55. Ann Arbor: Institute for Social Research, The University of Michigan, 427 pp. Available at myumi.ch/65jNB.

https://www.sciencedaily.com/releases/2016/09/160908083815.htm

Legalization of marijuana in Washington had no effect on teens' access to drug

Study to be presented at Pediatric Academic Societies 2016 Meeting shows no change in proportion of adolescents who find it 'easy' to access marijuana after its recreational use was legalized for adults

April 30, 2016

Science Daily/American Academy of Pediatrics

Despite concerns that legalizing marijuana use for adults would make it easier for adolescents to get ahold of it, a new study in Washington State shows that teens find it no easier now than before the law was passed in 2012.

An abstract of the study, "Adolescents' Ease of Access to Marijuana Before and After Legalization of Marijuana in Washington State," will be presented at the Pediatric Academic Societies 2016 Meeting in Baltimore on Sunday, May 1. Researchers compared 2010 and 2014 data from the Washington State Healthy Youth Survey. Each year's survey included questions about ease of access to marijuana, alcohol, cigarettes and other illicit drugs.

There was virtually no change in the proportion of teens who reported it was "easy" to access marijuana in 2010 (55 percent), compared to 2014 (54 percent) after the new law was enacted, according to the study. This seemingly good news was tempered by additional findings suggesting that current public health efforts around drug abuse prevention may be less effective for marijuana than for other substances teens now perceive as more difficult to obtain. Significantly more adolescents said it was "hard" to access alcohol in 2014 (47 percent, compared with 43 percent in 2010), cigarettes (53 percent in 2014; 42 percent in 2010), and other illegal drugs such as cocaine, LSD, and amphetamines (82 percent in 2014; 75 percent in 2010).

"It is both surprising and reassuring that teens didn't perceive that marijuana was easier to access after it was legalized for recreational use by adults," said senior investigator Andrew Adesman, MD, FAAP, chief of developmental and behavioral pediatrics at the Cohen Children's Medical Center of New York. "It was interesting and somewhat concerning, though, that while teens responded that it was harder to access cigarettes, alcohol, and psychoactive drugs abuse in 2014 compared to 4 years earlier, they didn't report increased difficulty in obtaining marijuana during that same time period," he said.

Principal investigator Natalie Colaneri said she hopes the findings will prompt increased efforts to reduce teens' access to marijuana in Washington and other states now considering the legalization of adult recreational marijuana use. "Given the detrimental health effects associated with adolescent marijuana use, it is important that states that choose to legalize marijuana take steps to minimize use by teens. States should specifically implement measures that make it more difficult for teens to access marijuana in the first place," she said.

https://www.sciencedaily.com/releases/2016/04/160430100249.htm

Using medical marijuana to stop seizures in kids

February 8, 2016

Science Daily/Texas A&M University

Desperate for relief, parents are taking unusual steps to help children plagued with seizures. The relief, however, comes in a most unlikely form: marijuana.

As many as 30 percent of people with epilepsy -- or about one million Americans -- still have seizures while on Food and Drug Administration (FDA)-approved treatments. It's left many who suffer from uncontrollable seizures -- or their parents, as many of them are children -- turning to medical marijuana and its derivatives in an attempt to take back control of a disease with no cure.

A seizure is an abnormal electrical storm in the brain that causes sudden alteration in consciousness, sensation and behavior that can manifest from an eye flicker to full-body convulsions. People with medication-resistant (also called intractable) epilepsy suffer from consequences of recurrent seizures, which could damage the brain and adversely impact their quality of life. This is commonly observed in children with certain types of devastating pediatric epilepsy, such as Lennox-Gastaut, Doose and Dravet syndromes.

Stories about desperate parents seeking anything to relieve their children's seizures abound, but how much scientific evidence is there for cannabis' effectiveness?

D. Samba Reddy, Ph.D., R.Ph., professor in the Department of Neuroscience and Experimental Therapeutics at the Texas A&M Health Science Center College of Medicine, studies novel therapies for epilepsy. He recently published an article, with co-author Victoria Golub, in the Journal of Pharmacology and Experimental Therapeutics about the current state of research into medical marijuana for treating epilepsy.

"There was a lot of media attention about how medical marijuana is good for epilepsy," said Reddy, who is a fellow of both the American Association of Pharmaceutical Scientists (AAPS) and the American Association for the Advancement of Science (AAAS). "We became interested in finding out whether there was scientific evidence in the literature to support the claims of these people who have seen great benefits."

There are at least 85 active components of the plant colloquially known as marijuana, but two major ones of have been the focus of study: delta 9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the psychoactive component of the plant, while CBD doesn't cause any sort of a "high" and isn't thought to be addictive. Preliminary studies -- largely in animal models -- have shown CBD might have some anti-seizure potential.

Derivatives of marijuana high in CBD (but with negligible amount of THC) might offer some benefit for intractable epilepsy. CBD-enriched products, like Epidiolex and Realm Oil, exist, but their efficacy hasn't been proven and they exist in a sort of legal grey area. Homemade compounds exist, but since they don't go through rigorous best practice manufacturing procedures and haven't been approved by the FDA, it can be difficult for consumers to know exactly what they're getting.

Although THC is known to share the actions of anandamide (from the Indian Sanskrit word "anand" for bliss or happiness), a naturally occurring compound in the brain, the exact mode of anti-seizure action of CBD is unclear. "It is critical to know how CBD controls seizures, so pharmaceutical companies can design novel synthetic compounds for epilepsy that could surpass the hurdles of mixed CBD extracts," said Reddy, who directs an epilepsy research lab at Texas A&M. These compounds might provide the benefits without some of the risks -- or the legal issues -- associated with the marijuana plant.

A standard manufacturing process and clinical trials might help answer some of these questions, but conducting one isn't easy, and there are currently only 19 clinical trials going on to test the use of cannabinoids for epilepsy. For one thing, cannabis is still listed as a Schedule I substance by the federal government, meaning gaining permission to use it in research on human participants is extremely difficult.

Still, change is occurring at the state level. Recreational marijuana use is legal for adults in four states (Alaska, Colorado, Oregon and Washington) and in 23 states and Washington, DC, medical marijuana is allowed. Texas, in a law passed during the last legislative session in 2015, legalized low-THC cannabis oils for people with intractable epilepsy while still prohibiting medical marijuana more broadly.

A new study at the University of Colorado Anschutz Medical Campus is enrolling Dravet epilepsy patients who have tried Charlotte's Web, a specific strain of medical marijuana that is low in THC and high in CBD. The researchers will compare the genetics of those who have seen seizure activity decreased dramatically (at least 50 percent) in response to the drug versus those who did not. Although this research could yield useful information about how CBD and genetic factors interact in a Dravet population, it is not the gold standard of scientific drug trials: the randomized, placebo-controlled, double-blinded clinical trial in which patients were randomly assigned to either CBD or a placebo.

As for experts like Reddy, who is a Texas board-certified pharmacist, most are taking a cautious wait-and-see approach.

The American Epilepsy Society (AES) has released a statement on the use of medical marijuana in the treatment of epilepsy stating that due to the lack of data, no conclusion can be drawn at present.

The Epilepsy Foundation doesn't specifically discourage cannabis use, but urges anyone exploring treatment for epilepsy to work with their treating physician to make the best decisions for their own care and to follow applicable laws.

"Despite all of the controversy about medical marijuana as a potential therapy for epilepsy," Reddy said, "most people agree that what we need is greater rigorous scientific study into cannabinoids to prove or disprove their safety and efficacy."

https://www.sciencedaily.com/releases/2016/02/160208140604.htm

Cannabis-based drug reduces seizures in children with treatment-resistant epilepsy

First study to examine the safety, efficacy of cannabidiol for children

January 5, 2016

Science Daily/University of California - San Francisco

Children and young adults with severe forms of epilepsy that does not respond to standard antiepileptic drugs have fewer seizures when treated with purified cannabinoid, according to a multi-center study led by researchers from UCSF Benioff Children's Hospital San Francisco.

"Better treatment for children with uncontrolled seizures is desperately needed," said Maria Roberta Cilio, MD, PhD, senior author and director of research at the UCSF Pediatric Epilepsy Center. "It's important to get seizure control at any age, but in children, uncontrolled seizures may impact brain and neurocognitive development, which can have an extraordinary effect on quality of life and contribute to progressive cognitive impairment."

The researchers evaluated 162 children and young adults across 11 independent epilepsy centers in the U.S. All of the children were treated with Epidiolex, a purified cannabinoid that comes in a liquid form containing no tetrahydrocannabinol (THC), the psychotropic component in cannabis, over a 12-week period. The results showed a median 36.5 percent reduction in monthly motor seizures, with a median monthly frequency of motor seizures falling from 30 motor seizures a month to 15.8 over the course of the 12 week trial.

The study was published in the December 23, 2015 issue of The Lancet Neurology.

The patients in the trial were all between the ages of one and 30 with intractable epilepsies shown to be resistant to many if not all of the antiepileptic treatments, including drugs and a ketogenic diet. This includes children with Dravet syndrome, a rare genetic disorder that manifests in early childhood with frequent, disabling seizures often occurring daily and numbering into the hundreds, as well as profound cognitive and social deficits.

"This trial is pioneering a new treatment for children with the most severe epilepsies, for whom nothing else works," said Cilio. "This is just the first step. This open label study found that CBD both reduces the frequency of seizures and has an adequate safety profile in children and young adults. Randomized controlled trials are the next step to characterize the true efficacy and safety profile of this promising compound."

UCSF Benioff Children's Hospital San Francisco was the first site to ever administer Epidiolex in a child with epilepsy. In April 2013, the drug was given to a patient after obtaining a special approval from the U.S. Food and Drug Administration's Investigational New Drug (IND) program, and results from that initial experience provided the framework for the current study, according to the researchers. A second patient was then enrolled at UCSF in July 2013, and in January 2014 UCSF and other centers started to enroll patients under an expanded access IND.

Produced by the biopharmaceutical company GW Pharmaceuticals, Epidiolex is considered a schedule 1 substance, meaning it has a high potential for abuse, and is closely monitored and restricted by the FDA. GW Pharmaceuticals supplied the cannabidiol for the study, but had no role in the study design, data analysis, data interpretation, writing of the study, or publication submission. The study was also funded by the Epilepsy Therapy Project of the Epilepsy Foundation, and Finding A Cure for Epilepsy and Seizures (FACES).

https://www.sciencedaily.com/releases/2016/01/160105223552.htm

Drug use trends remain stable or decline among teens

2015 survey shows long term decline in illicit drug use, prescription opioid abuse, cigarette and alcohol use among the nation's youth

December 16, 2015

Science Daily/NIH/National Institute on Drug Abuse

The 2015 Monitoring the Future survey (MTF) shows decreasing use of a number of substances, including cigarettes, alcohol, prescription opioid pain relievers, and synthetic cannabinoids ("synthetic marijuana"). Other drug use remains stable, including marijuana, with continued high rates of daily use reported among 12th graders, and ongoing declines in perception of its harms.

The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, and is funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. The survey has been conducted by researchers at the University of Michigan at Ann Arbor since 1975.

For the first time, daily marijuana use exceeds daily tobacco cigarette use among 12th graders. Daily marijuana use for this group remained relatively stable at 6 percent, compared to 5.5 percent reporting daily cigarette smoking (down from 6.7 percent in 2014).

"We are heartened to see that most illicit drug use is not increasing, non-medical use of prescription opioids is decreasing, and there is improvement in alcohol and cigarette use rates," said Nora D. Volkow, M.D., director of NIDA. "However, continued areas of concern are the high rate of daily marijuana smoking seen among high school students, because of marijuana's potential deleterious effects on the developing brains of teenagers, and the high rates of overall tobacco products and nicotine containing e-cigarettes usage."

"This year's Monitoring the Future data continue the promising trends from last year with declining rates of adolescent substance use, and support the value of evidence-based prevention, treatment, and recovery," said National Drug Control Policy Director Michael Botticelli. "Efforts to prevent drug use from ever starting are particularly important as we work to reduce the rising number of drug overdoses across the country. I encourage parents, teachers, coaches, and mentors to have a conversation with the young people in their lives about making the healthy decisions that will keep them on a path toward a successful future."

"We are very encouraged by the continued decline in underage drinking illustrated in these data," said George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism. "However, the percent of underage individuals drinking still remains unacceptably high. For example, approximately 40 percent of 12th graders have reported being drunk in the past year and binge drinking remains a significant problem."

Other highlights from the 2015 survey:

Drugs

·     Use of many illicit drugs has trended down. Among high school seniors, 23.6 percent report using an illicit drug in the past month, with 7.6 percent reporting they used an illicit drug other than marijuana.

·     Perception of marijuana use as risky continues to decline, with 31.9 percent of seniors saying regular use could be harmful, compared to 36.1 percent last year.

·     Past year use of synthetic cannabinoids ("synthetic marijuana") is at 5.2 percent for 12th graders, down significantly from 11.4 in 2011, the first year it was measured in the survey.

·     Past year use of heroin, typically very low among teens, is at an all-time low at 0.3 percent for eighth graders, and 0.5 for 10th and 12th graders.

·     Use of MDMA (also known as Ecstasy or Molly), inhalants, and LSD are generally stable or down. In 2015, 3.6 percent of seniors reported past year use of MDMA, compared to 5 percent in 2014.

·     Non-medical use of the prescription amphetamine Adderall, typically given for ADHD, remains high at 7.5 percent among 12th graders.

·     Use of prescription opioids continues its downward trend, with 4.4 percent of high school seniors reporting non-medical use of Vicodin (hydrocodone and acetaminophen), down from a peak of 10.5 percent in 2003.

·     Most teens abusing prescription opioids report getting them from friends or family members. However, one-third report getting them from their own prescriptions, underscoring the need to monitor teens taking opioids and evaluate prescribing practices.

Tobacco

·     Cigarette smoking rates have greatly declined among teens in recent years. For example, among 10th graders, there has been a 54.9 percent drop in daily smoking in just five years, reported at just 3 percent this year compared to 6.6 percent five years ago.

·     However, rates of use of other tobacco products, while not significantly changed from 2014, remain high with 12th graders, reporting rates of past year use of hookah and small cigars of 19.8 percent and 15.9 percent, respectively.

·     More than 75 percent of high school seniors view smoking a pack or more a day as harmful, compared to 51.3 percent in 1975, first year of the survey.

·     As e-cigarettes are currently unregulated, there is limited data on what chemicals teens are actually smoking. However, when asked what they inhaled the last time they used an e-cigarette, only about 20 percent said they were using nicotine. Most say they inhaled flavoring alone and many admitted they were unsure what they inhaled. In fact, about 13 percent of eighth graders who use e-cigarettes said they did not know what was in the device they used. Furthermore, some products labeled nicotine-free may actually contain nicotine.

·     Roughly twice as many boys as girls report using e-cigarettes (21.5 percent to 10.9 percent).

Alcohol

·     Alcohol use continues its gradual downward trend among teens, with significant changes seen in the past five years in nearly all measures.

·     Binge drinking (described as having five or more drinks in a row within the past two weeks) is 17.2 percent among seniors, down from 19.4 percent last year and down from peak rates in 1998 at 31.5 percent.

·     37.7 percent of 12th graders say they have been drunk in the past year, compared to 41.4 percent in 2014 and 53.2 percent in 2001, when rates were highest for that group.

·     High school seniors see a distinction in potential harmfulness between one or two drinks nearly every day (21.5 percent) versus four to five drinks nearly every day (59.1 percent).

Overall, 44,892 students from 382 public and private schools participated in this year's MTF survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th graders nationwide. Eighth and 10th graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. Questions are also asked about daily cigarette and marijuana use. NIDA has provided funding for the survey since its inception by a team of investigators at the University of Michigan at Ann Arbor, led by Drs. Lloyd Johnston and Richard Miech. MTF is funded under grant number DA001411. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at http://www.drugabuse.gov/drugpages/MTF.html.

https://www.sciencedaily.com/releases/2015/12/151216115801.htm

Pharmaceutical CBD (cannabidiol) shows promise for children with severe epilepsy

Significant seizure reduction in studies using CBD in combination with AEDs

December 7, 2015

Science Daily/American Epilepsy Society

Around the globe there is high interest in the use of cannabidiol (CBD), a type of cannabinoid, for the treatment of people with epilepsy, especially children who have treatment-resistant forms of the disorder such as Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome (DS). Three studies presented at the American Epilepsy Society's 69th Annual Meeting in Philadelphia highlight emerging efficacy and safety data of Epidiolex, a pharmaceutical liquid formulation of cannabidiol, which is currently undergoing U.S. Food and Drug Administration (FDA) authorized Phase 3 pivotal clinical trials in the United States and across the globe by GW Pharmaceuticals. A fourth study highlights possible interactions of CBD with existing anti-epileptic drugs (AEDs) in animal models of seizures.

The largest CBD study presented efficacy and safety data on GW Pharmaceutical's investigational medicine, Epidiolex (cannabidiol) from open-label Expanded Access programs at 16 sites. The study (abstract 3.034) involves 261 people, predominantly children, who have severe epilepsy that had not responded adequately to other treatments. The average age of the participants was 11. Over the course of 12 weeks, the study participants were given Epidiolex in gradually increasing doses. In all cases, Epidiolex was added to current AED treatment regimes. On average, patients were taking approximately three other AEDs. Participants and their families/caregivers recorded the number of seizures prior to taking CBD and during the 12 weeks of treatment. Clinicians also tested hematologic, liver and kidney function as well as AED levels before treatment and then at four, eight and 12 weeks during the study.

After three months of treatment, the frequency of all seizures was reduced by a median of 45 percent in all participants. Almost half (47%) of the participants in the study experienced a 50 percent or greater reduction in seizures and nine percent of patients were seizure-free. Among specific patient populations, DS patients had a 62 percent reduction in seizures and 13 percent were seizure-free. Patients with LGS experienced a 71 percent reduction in atonic seizures.

Adverse events occurred in more than 10 percent of participants with the most common being somnolence, diarrhea and fatigue and led to discontinuation in 4 percent of patients. Thirty-four percent of participants reported serious adverse events of which 5 percent were considered treatment related including altered liver enzymes (n=4), status epilepticus (n=4), diarrhea (n=4) and others. Twelve percent withdrew from the study for lack of efficacy.

"We are pleased to report these promising data on significant numbers of children," said lead author Orrin Devinsky, M.D., of New York University Langone Medical Center's Comprehensive Epilepsy Center. "These data reinforce and support the safety and efficacy we have shared in previous studies. Most importantly it is providing hope to the children and their families who have been living with debilitating seizures."

However, Devinsky cautions that "these results are from an uncontrolled study. Further study is needed before results can be confirmed. Randomized controlled studies are now underway to help us better understand the effectiveness of the drug. We very much look forward to the results from these studies during 2016," he said.

A related study (abstract 2.296) authored by Michael Oldham, M.D., MPH, formerly at the University of California San Francisco (UCSF) and currently at the University of Louisville, explored the long-term efficacy of Epidiolex. This study followed a subset of the first population (n=25) at UCSF Benioff Children's Hospital San Francisco, with an average age of 9, for one year. The patients took CBD in addition to their regular AED regimen. After 12 months, treatment with CBD resulted in a 50 percent reduction in seizures for 10 participants (40%). One participant with DS remained seizure-free. Twelve of the participants discontinued CBD because the treatment did not work for them. One participant suffered a marked increase in seizure frequency due to CBD.

"The CBD as an add-on therapy reduced seizures by half for a third of the patients in the first 12 weeks of the study," Oldham said. "This substantial improvement was maintained by 40 percent of participants for the entire 12-month period showing strong promise that CBD can be effective in controlling seizures."

A third preclinical study (abstract 3.397) explored the anticonvulsant and tolerability profile of CBD in animal models. Using the Anticonvulsant Screening Program (ASP), the researchers used four well-established acute seizure models and found that CBD exerted significant anticonvulsant effects and was well-tolerated in rodents. This study, provided as a free service by the National Institute of Neurological Disorders and Stroke ASP, was conducted at the University of Utah.

A fourth study, led by Misty D. Smith, Ph.D. at the University of Utah (abstract 1.215), explores how CBD interacts with five different AEDs in animal models of seizure. The study helps determine the effects of CBD in combination with common AEDs, including carbamazepine, valproate, levetiracetam, clobazam and lacosamide. The interactions between these drugs could be additive, meaning the drugs work well together; synergistic, meaning the drugs enhance each other's effects; or antagonistic, which occurs when the combination of drugs seems to reduce overall effectiveness.

Smith used isobolographic analysis of three fixed dose ratio combinations of CBD with each AED in order to rapidly assess the effectiveness of each combination against limbic seizure activity. The study found a significant synergistic interaction of CBD with levetiracetam and significant antagonistic interactions with some of the fixed dose-ratio combinations of CBD with clobazam and CBD with carbamazepine.

"By identifying the synergistic, additive or antagonistic interactions between CBD and other ASDs, we are gaining a better understanding of the nature of these interactions. This will help optimize therapeutic safety and efficacy for CBD going forward," said Smith.

https://www.sciencedaily.com/releases/2015/12/151207145856.htm

Daily marijuana use among U.S. college students highest since 1980

September 1, 2015

Science Daily/University of Michigan

Daily marijuana use among the nation's college students is on the rise, surpassing daily cigarette smoking for the first time in 2014.

A series of national surveys of U.S. college students, as part of the University of Michigan's Monitoring the Future study, shows that marijuana use has been growing slowly on the nation's campuses since 2006.

Daily or near-daily marijuana use was reported by 5.9 percent of college students in 2014 -- the highest rate since 1980, the first year that complete college data were available in the study. This rate of use is up from 3.5 percent in 2007. In other words, one in every 17 college students is smoking marijuana on a daily or near-daily basis, defined as use on 20 or more occasions in the prior 30 days.

Other measures of marijuana use have also shown an increase: The percent using marijuana once or more in the prior 30 days rose from 17 percent in 2006 to 21 percent in 2014. Use in the prior 12 months rose from 30 percent in 2006 to 34 percent in 2014. Both of these measures leveled in 2014.

"It's clear that for the past seven or eight years there has been an increase in marijuana use among the nation's college students," said Lloyd Johnston, the principal investigator of the study. "And this largely parallels an increase we have been seeing among high school seniors."

Much of this increase may be due to the fact that marijuana use at any level has come to be seen as dangerous by fewer adolescents and young adults. For example, while 55 percent of all 19-to-22-year-old high school graduates saw regular marijuana use as dangerous in 2006, only 35 percent saw it as dangerous by 2014.

The study also found that the proportion of college students using any illicit drug, including marijuana, in the prior 12 months rose from 34 percent in 2006 to 41 percent in 2013 before falling off some to 39 percent in 2014. That seven-year increase was driven primarily by the increase in marijuana use, though marijuana was not the only drug on the rise.

The proportion of college students using any illicit drug other than marijuana in the prior 12 months increased from 15 percent in 2008 -- the recent low point -- to 21 percent in 2014, including a continuing increase in 2014. The increase appears attributable mostly to college students' increased use of amphetamines (without a doctor's orders) and use of ecstasy.

These and other results about drug use come from Monitoring the Future, an annual survey that has been reporting on U.S. college students' substance use of all kinds for 35 years. The study began in 1980 and is conducted by the U-M Institute for Social Research with funding from the National Institute on Drug Abuse, one of the National Institutes of Health.

College students' nonmedical use of amphetamines in the prior 12 months nearly doubled between 2008 (when 5.7 percent said they used) and 2012 (when 11.1 percent used), before leveling at 10.1 percent in 2014.

"It seems likely that this increase in amphetamine use on the college campus resulted from more students using these drugs to try to improve their studies and test performance," Johnston said.

Their age-peer high school graduates not in college had higher-reported amphetamine use for many years (1983-2008), but after 2010, college students have had the higher rate of use.

"Fortunately, their use of these drugs appears to have leveled among college students, at least," he said.

Ecstasy (MDMA, sometimes called Molly), had somewhat of a comeback in use among college students from 2007 through 2012, with past 12-month use more than doubling from 2.2 percent in 2007 to 5.8 percent in 2012, before leveling. Previously, ecstasy had fallen from favor among college students. By 2004, it had fallen to quite low levels and then remained at low levels through 2007.

Past-year use of cocaine showed a statistically significant increase from 2.7 percent in 2013 to 4.4 percent in 2014.

"We are being cautious in interpreting this one-year increase, which we do not see among high school students; but we do see some increase in cocaine use in other young adult age bands, so there may in fact be an increase in cocaine use beginning to occur," Johnston said. "There is some more welcome news for parents as they send their children off to college this fall. Perhaps the most important is that five out of every 10 college students have not used any illicit drug in the past year, and more than three quarters have not used any in the prior month."

In addition, the use of synthetic marijuana (also called K-2 or spice) has been dropping sharply since its use was first measured in 2011. At that time, 7.4 percent of college students indicated having used synthetic marijuana in the prior 12 months; by 2014 the rate had fallen to just 0.9 percent, including a significant decline in use in 2014. One reason for the decline in synthetic drug use is that an increasing number of young people see it as dangerous.

Likewise, college students' use of salvia -- a hallucinogenic plant which became popular in recent years -- fell from an annual prevalence of 5.8 percent in 2009 to just 1.1 percent in 2014.

The nonmedical use of narcotic drugs -- which has accounted for an increasing number of deaths in recent years according to official statistics -- actually has been declining among college students, falling from 8.8 percent reporting past-year use in 2006 down to 4.8 percent by 2014. This is a particularly welcome improvement from a public health point of view, note the investigators.

There is no evidence of a shift over from narcotic drugs to heroin use in this population. Use of heroin has been very low among college students over the past five years or so -- lower than it was in the late 1990s and early 2000s.

The non-medical use of tranquilizers by college students has fallen by nearly half since 2003, when 6.9 percent reported past-year use, to 2014, when 3.5 percent did.

The use of LSD and other hallucinogenic drugs, once popular in this age group, remains at low levels of use on campus, with past-year usage rates at 2.2 percent and 3.2 percent, respectively. And use of the so-called club drugs (Ketamine, GHB, Rohypnol) remains very low. Further, the use of so-called bath salts (synthetic stimulants often sold over the counter) never caught on among college students, who have a negligible rate of use.

In sum, quite a number of drugs have been fading in popularity on U.S. college campuses in recent years, and a similar pattern is found among youth who do not attend college. Two of the newer drugs, synthetic marijuana and salvia, have shown steep declines in use. Other drugs are showing more gradual declines, including narcotic drugs other than heroin, sedatives and tranquilizers -- all used nonmedically -- as well as inhalants and hallucinogens.

On the other hand, past-year and past-month marijuana use increased from 2006 through 2013 before leveling; and daily marijuana use continues to grow, reaching the highest level seen in the past 35 years in 2014 (5.9 percent). Amphetamine use grew fairly sharply on campus between 2008 and 2012, and it then stabilized at high levels not seen since the mid-1980s.

Ecstasy use has made somewhat of a rebound since the recent low observed among college students in 2007. Cocaine use among college students is well below the 1980s and 1990s rates, but the significant increase in 2014 among college students suggests a need to watch this drug carefully in the future.

ALCOHOL AND TOBACCO

Use of a number of licit drugs is also covered in the MTF surveys, including alcoholic beverages and various tobacco products.

While 63 percent of college students in 2014 said that they have had an alcoholic beverage at least once in the prior 30 days, that figure is down a bit from 67 percent in 2000 and down considerably from 82 percent in 1981. The proportion of the nation's college students saying they have been drunk in the past 30 days was 43 percent in 2014, down some from 48 percent in 2006.

Occasions of heavy or binge drinking -- here defined as having five or more drinks in a row on at least one occasion in the prior two weeks -- have consistently had a higher prevalence among college students than among their fellow high school classmates who are not in college.

Still, between 1980 and 2014, college students' rates of such drinking declined 9 percentage points from 44 percent to 35 percent, while their noncollege peers declined 12 percentage points from 41 percent to 29 percent, and high school seniors' rates declined 22 percentage points from 41 percent to 19 percent.

Of particular concern is the extent of extreme binge drinking in college, first defined as having 10 or more drinks in a row at least once in the prior two weeks, and then defined as having 15 or more drinks in a row in that same time interval. Based on the combined years 2005-2014, the estimates for these two behaviors among college students are 13 percent and 5 percent, respectively.

"Despite the modest improvements in drinking alcohol at college, there are still a sizable number of students who consume alcohol at particularly dangerous levels," Johnston said.

Cigarette smoking continued to decline among the nation's college students in 2014, when 13 percent said they had smoked one or more cigarettes in the prior 30 days, down from 14 percent in 2013 and from the recent high of 31 percent in 1999 -- a decline of more than half. As for daily smoking, only 5 percent indicated smoking at that level, compared with 19 percent in 1999 -- a drop of nearly three fourths in the number of college students smoking daily.

"These declines in smoking at college are largely the result of fewer of these students smoking when they were still in high school," Johnston said. "Nevertheless, it is particularly good news that their smoking rates have fallen so substantially."

Unfortunately, the appreciable declines in cigarette smoking have been accompanied by some increases in the use of other forms of tobacco or nicotine. Smoking tobacco using a hookah (a type of water pipe) in the prior 12 months rose substantially among college students, from 26 percent in 2013 to 33 percent in 2014.

In 2014, the use of e-cigarettes in the past 30 days stood at 9.7 percent, while use of flavored little cigars stood at 9.8 percent, of regular little cigars at 8.6 percent and of large cigars at 8.4 percent. The study will continue tracking the extent to which these alternate forms of tobacco use are changing in popularity, not only among college students, but also among their age peers not in college and among secondary school students.

The full report is available online at: http://monitoringthefuture.org/pubs/monographs/mtf-vol2_2014.pdf

https://www.sciencedaily.com/releases/2015/09/150901095321.htm

Getting high in senior year: Researchers examine whether reasons for smoking pot are associated

June 29, 2015

Science Daily/New York University

Marijuana is the most prevalent drug in the U.S. Approximately 70% of the 2.8 million individuals who initiated use of illicit drugs in 2013 reported that marijuana was their first drug. Despite extensive research examining potential links between marijuana use and other drug use, the literature is currently lacking data regarding which illicit marijuana users are most likely to engage in use of other illicit drugs.

A new study, published in the American Journal of Drug and Alcohol Abuse by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR), examines how reasons for illicit marijuana use relates to the use of other drugs individually, rather than grouping them into a single "illicit drug" group.

"Aside from marijuana, a wide range of illicit drugs are prevalent, each having different use patterns, and different effects and dangers associated with use," said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Our research helped to identify subtypes of illicit marijuana users who use other drugs, as this may be able to inform prevention efforts."

The cross-sectional study, "Reasons for Recent Marijuana Use in Relation to Use of Other Illicit Drugs among High School Seniors in the United States," draws data from Monitoring the Future (MTF), a nationwide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 high school seniors are assessed annually.

Analyses focused on data collected from high school seniors (12th graders), in 12 cohorts (2000-2011; weighted N=6,481), who reported use of marijuana in the last 12 months. The analysis examined self-reported use of eight other illicit drugs: powder cocaine, crack, heroin, LSD, other psychedelics, and nonmedical use of amphetamine/stimulants, tranquilizers/benzodiazepines, and narcotics (other than heroin).

The researchers found that using marijuana to alleviate boredom was associated with increased risk for reporting use of powder cocaine or hallucinogens other than LSD. Nearly a fifth (19.8%) of the sample reported using marijuana for insight or understanding and this reason was also positively related to use of hallucinogens other than LSD. And, 11% reported using marijuana to increase the effects of other drugs; this was a consistent correlate of reporting use of each drug examined in this analysis, even when controlling for sociodemographic and substance use variables.

"Interestingly, we found that using marijuana 'to experiment' decreased risk of reporting use of each of the eight drugs examined before adjusting for other variables," said Palamar. "The marijuana users in this sample who used to experiment were consistently at low risk for use of nonmedical use of prescription narcotics."

Palamar warns that this does not mean that experimenting with marijuana within itself is protective against other drug use. Rather -- among recent marijuana users, those who say they're merely just trying it are often at low risk for moving on to other drugs.

Researchers also found that infrequent use in the last year was generally not a risk factor for use of other illicit drugs.

"It seems that only a subset of illicit marijuana users is at risk for use of other illicit drugs," notes Palamar. "Most teens who use marijuana don't progress to use of other drugs and we believe this is evidenced in part by the fact that nearly two-thirds of these marijuana-using teens did not report use of any of the other illicit drugs we examined."

This study highlights different associations between reasons for marijuana use and use of other specific illicit drugs. These results can help inform preventive and education efforts in identifying and targeting specific risk factors in illicit marijuana users with aims to prevent the use of other drugs.

"Programs and education efforts, for example, can benefit from knowing that marijuana users who use because they are bored are more likely to use certain other drugs," said Palamar. "It may be feasible for prevention programs to address ways of coping with factors such as boredom in order to decrease risk."

Palamar notes that research is needed to determine whether legalization and regulation in states such as Colorado further remove marijuana from "street" markets which may contain sources of not just marijuana, but other illicit drugs.

https://www.sciencedaily.com/releases/2015/06/150629092638.htm

Adolescents, drugs and dancing

May 18, 2015

Science Daily/New York University

In recent years, the popularity of "electronic dance music" (EDM) and dance festivals has increased substantially throughout the US and worldwide.

Even though data from national samples suggests drug use among adolescents in the general US population has been declining, targeted samples have shown nightclub attendees tend to report high rates of drug use, above that of the general population. In spite of increasing deaths among dance festival attendees in recent years, no nationally representative studies have examined potential associations between nightlife attendance and drug use.

In order to inform prevention and harm reduction (for those who reject abstinence), data has been needed from nationally representative samples to determine the extent to which nightlife (or "rave") attendees may in fact more likely to use various drugs.

A new study, published in Drug and Alcohol Dependence by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR), is the first to examine the sociodemographic correlates of rave attendance and relationships between rave attendance and recent (12-month) use of various drugs in a representative US sample of high school seniors.

The study, "Illicit Drug Use among Rave Attendees in a Nationally Representative Sample of US High School Seniors," used data from Monitoring the Future (MTF), a nationwide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 high school seniors are assessed annually. This study utilized MTF responses from 2011 to 2013, examining data from a total of 7,373 students who, in addition to reporting their sociodemographic data, alcohol and drug use, were asked how often they attended "raves."

Researchers compared rates of recent use of various drugs according to whether or not any rave attendance was reported. They also examined differences by more frequent use (defined as use six or more times a year), and they also examined differences in use by level of rave attendance.

"One out of five students reported ever attending a rave, and 7.7% reported attending at least monthly," said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Females and highly religious students were less likely to attend raves, while students residing in cities, students with higher income and those who go out for fun multiple times per week were more likely to attend."

Most notably, the study found that use of illicit drugs other than marijuana was about 20% higher among rave attendees compared to non-attendees. Moreover, rave attendees were more likely to report more frequent use for each of the 18 drugs assessed.

"Use of each illicit drug other than marijuana was at least twice as prevalent among rave attendees, and the common "club drugs" ketamine and GHB were both almost six-times more prevalent among attendees," said Palamar. "Higher frequency of rave attendance was consistently associated with higher odds for reporting recent use of each of the drugs assessed, especially use of the party drugs LSD, ketamine, GHB and methamphetamine."

A major limitation of this national data Palamar and his team analyzed was that the students who were asked about rave attendance were not asked about use of ecstasy (MDMA, commonly referred to as "Molly"). In addition, he cautioned that the survey questions they examined did not define "rave" for the students so it is unknown whether all respondents considered dance festivals or nightclub parties "raves."

"Our research findings shouldn't be used to label or stigmatize the latest generation of nightlife and festival attendees. While rates of use are in fact higher in this population we need to keep in mind that two-thirds of rave attendees reported that they did not use drugs other than marijuana," notes Palamar.

Accordingly, the study's findings should inform prevention and much needed harm reduction efforts around rave attendees.

"The summer festival season is about to begin," said Palamar. "I commend the recent efforts of festival promoters to ensure safety of attendees--for example, serving free water and having medical staff present to help patrons in need. However, I do worry that increased presence of law enforcement may lead to riskier drug taking practices among those who reject abstinence. We urge patrons to look out for one another to ensure everyone's safety."

Palamar and the other authors of this study advocate for the availability of drug testing services at or outside of raves and realistic education initiatives, such as social media campaigns, to prevent use and adverse outcomes, which would likely reduce poisonings in the new cohort of partiers.

https://www.sciencedaily.com/releases/2015/05/150518135016.htm

Medical marijuana for children with developmental and behavioral disorders?

February 5, 2015

Science Daily/Wolters Kluwer Health: Lippincott Williams and Wilkins

As medical marijuana becomes increasingly accepted, there is growing interest in its use for children and adolescents with developmental and behavioral problems such as autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD), according to a review in the February Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics.

That's despite a lack of studies showing any clinical benefit of cannabis for young patients with these disorders -- whereas evidence strongly suggests harmful effects of regular marijuana use in the developing brain. Scott Hadland, MD, MPH, John R. Knight, MD, and Sion Kim Harris, PhD of Boston Children's Hospital write, "Given the current scarcity of data, cannabis cannot be safely recommended for the treatment of developmental or behavioral disorders at this time."

"Children with severe ASD cannot communicate verbally and may relate to the world through loud, repetitive shrieking and hand-flapping that is very disruptive to their families and all those around them," comments Dr Knight, the study's senior author. "So my heart goes out to families who are searching for something, anything to help their child," he continues. "But in using medicinal marijuana they may be trading away their child's future for short-term symptom control."

Known Harmful Effects of Marijuana in Children and Teens...

The review was prompted by rapid changes in US marijuana policy, with marijuana being permitted for medical use in many jurisdictions and legalized in others. "Amidst this political change, patients and families are increasingly asking whether cannabis and its derivatives may have therapeutic utility for a number of conditions, including developmental and behavioral disorders in children and adolescents," according to Dr Knight and colleagues.

They review the important pharmacological properties of cannabis and related compounds, along with data on marijuana use in the population. Adolescents with developmental and behavioral disorders -- especially ADHD -- may be predisposed to early and heavier substance use. Meanwhile, a growing body of evidence links cannabis to "long-term and potentially irreversible physical, neurocognitive, psychiatric, and psychosocial adverse outcomes."

Over time, regular cannabis use by adolescents has been linked to persistent declines in intelligence quotient and increased risk of addiction, major depression, anxiety disorders, and psychotic thinking. The adolescent brain may be uniquely susceptible to the harmful effects of marijuana, reflecting the role of the cannabinoid receptors in normal neurodevelopment. Brain abnormalities in adults who are heavy marijuana users may have their origin in neurodevelopmental changes starting in adolescence.

...With Little Data on Benefits in Developmental or Behavioral Disorders

While cannabis has been proposed to have a broad range of clinical benefits in adults, "At this time, good evidence is almost entirely lacking for its application in pediatric developmental and behavioral conditions," Dr Knight and coauthors write.

"The scant research that we have on adolescent use is alarming enough," says Leonard Rappaport MD, MS, Chief of the Division of Developmental Medicine at Boston Children's Hospital and past president of the Society for Developmental and Behavioral Pediatrics. "But we are really moving into entirely new territory when we consider giving cannabis to children as that has not even been done in neurotypical children, let alone those with developmental or behavioral problems."

And yet, a number of online groups are advocating the use of "medical marijuana" for children with autism, ADHD, and other developmental and behavioral conditions. These groups often cite evidence from animal research, or from a small number of clinical reports, to claim beneficial effects of cannabis in children. Those beneficial effects are likely from cannabidiols, which also benefit children with uncommon forms of epilepsy and have limited euphoric effects; rather than tetrahydrocannabinol (THC), with its strong euphoric and neurotoxic effects.

This movement, coupled with the increased willingness of physicians to prescribe cannabis, "may result in issuing of medical marijuana permits for developmental or behavioral diagnoses for which no data on efficacy, safety, or tolerability exist," the researchers write. They note that if and when studies of cannabis for developmental and behavioral conditions are performed, they will likely use extracts formulations of known dosage -- rather than plant forms of medical marijuana, which vary widely in strength and effects. Dr Knight adds, "We need more research on cannabidiols, and development of products that are high in cannabidiols and low in THC."

Dr Knight and coauthors hope their article will draw attention to the potential harmful effects of marijuana in young people -- as well as lack of evidence on its effects in those with developmental or behavioral disorders. They conclude, "As marijuana policy evolves and as the drug becomes more readily available, it is important that practicing clinicians recognize the long-term health and neuropsychiatric consequences of regular use."

https://www.sciencedaily.com/releases/2015/02/150205122733.htm