The Drug Problem, Confusing and Will We Ever Get a Handle on the Drug Problem?

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This weekend while traveling I had a chance to spend some time people watching in New York City and especially Penn Station. The homeless and those strung out on drugs and especially in freezing temperatures. We have a huge problem that has spilled out into our juveniles, our children, our friends and relatives.

A number of articles have popped up recently, which makes me very pessimistic as to whether we will ever solve the drug problem in this country. And let me be very clear, there is a huge problem. States are falling in line fast allowing marijuana to be sold without worry about the law, even though the Federal laws keep it against the law. The latest article shows that smoking marijuana dose cause harm down the line. Take a look at this recent article.

Christopher Ingraham, from the Washington Post wrote that “new research published today in the journal JAMA Internal Medicine confirms what many of us have suspected for some time: If you smoke a lot of weed — like a lot of it — it can potentially do permanent damage to your short-term memory.

Professor Reto Auer of the University of Lausanne led a team of researchers who examined data on the marijuana habits of nearly 3,400 Americans over a 25-year period. At the end of the study period, the subjects took a battery of tests designed to assess cognitive abilities — memory, focus, ability to make quick decisions, etc.

The study found that people who smoked marijuana on a daily basis for a long period of time — five years or more — had poorer verbal memory in middle age than people who didn’t smoke, or who smoked less. This association remained even after researchers controlled for a variety of other factors known to affect cognitive performance, including age, education, use of other substances and depression.

Auer and his team measured lifetime marijuana exposure in a fantastic new unit of measurement they call “marijuana-years.” Essentially, if you smoke pot every day for a year, that equals one marijuana-year of use. Ditto if you smoke every other day for two years, or once a week for seven years.

As of Feb. 26, 2015 marijuana was made legal in D.C.—sort of. Here are the ins and outs of the complex pot law. (Gillian Brockell/The Washington Post)

The relationship between marijuana exposure and memory problems was essentially linear. The more pot people smoked, the worse they performed on the memory tests. But just how much worse?

Let’s say we have two groups of 10 people each. You tell each of them a list of 15 words and ask them to memorize them. Then 25 minutes later, you ask them to recall all of the words to the best of their ability.

The first group consists of 10 people who don’t smoke pot or only do so occasionally. Let’s say on average, people in this group would be able to remember nine out of the 15 words.

The second group consists of people who smoked pot every single day over a period of five years. On average, they’d be able to recall 8.5 out of the 15 words.

That doesn’t seem like a huge cognitive difference, and by and large it’s not. But multiply that by every five marijuana years of exposure and the gap can start to get larger. For instance, say you had a group of people who smoked weed literally every single day from age 20 until they turned 45. At age 45, you’d expect these folks to remember, on average, 2.5 fewer words as a comparable group who had smoked occasionally or not at all over the same period.

Few people actually smoke this much pot. Among the 3,385 study subjects, only 311 (8 percent) had more than five marijuana-years of exposure. But many drug policy experts are concerned that legalizing marijuana and making it easier to get will cause rates of heavy, problematic use like this to rise.

One important caveat is that a study like this can’t determine causality. It could be the case that heavy pot use makes your short-term memory bad, or it could be that people who operate at a lower level of cognitive function are more inclined to use marijuana heavily.

It’s also worth noting that the other cognitive abilities researchers tested — focus and processing speed — did not seem to be significantly impacted by heavy marijuana use.

The association between short-term memory declines — potentially permanent ones — and heavy pot use is very real, according to this study, and shouldn’t be discounted. On the other hand, it’s also quite surprising that you can smoke weed every single day for five years, and not have it impact your problem-solving abilities or your ability to focus at all.

These findings also need to be understood in relation to what we know about the severe cognitive effects of persistent, heavy alcohol use, which include irreversible brain damage.

Overall, the take-home message is one of moderation. Whether your preferred vice is pot or alcohol or gambling or Big Macs, it stands to reason that if you overdo it, you’re going to hurt yourself.”

Now align this with the young generation’s attitude as evidenced by this review article.

Sydney Lupkin reported a survey that teens and adolescents increasingly believe it isn’t risky to smoke marijuana occasionally, according to new data from the Substance Abuse and Mental Health Services Administration (SAMHSA).

About 77% of adolescents told surveyors that they perceived “no great risk” from smoking marijuana once a month, according to the Behavioral Health Barometer, which examines trends in substance use and mental health among adolescents, teens, and adults.

This figure has been steadily increasing since 2010, when 70.4% of adolescents said they didn’t find using marijuana once a month to be especially risky.

“As more states go toward having medical marijuana and having legalized marijuana, that creates a public perception — including among our impressionable youth — that it’s safe,” Richard Rosenthal, MD, of Mount Sinai Hospital, who wasn’t involved in the report, told MedPage Today.

“It’s actually probably not that dangerous if you think about it pharmacologically in folks that are adults over 25, but among youth, it actually is hazardous,” Rosenthal said. “They don’t know that it can affect brain development.”

Since the brain doesn’t finish developing until a person is in his or her mid-20s, Rosenthal said using cannabis before then is associated with increased risk of other substance abuse and mental disorders like depression.

“I would hazard a guess most youths don’t know that,” he said.

Using data from the National Survey on Drug Use and Health (NSDUH) — which focused on 12-to-17-year-olds — SAMHSA researchers found that 7.4% said they smoked marijuana in the month prior to being surveyed in 2014 — a proportion that has increased from 6.7% in 2008. It had peaked in 2011 at 7.9%, but decreased to 7.2% in 2012 and 7.1% 2013.

Overall, 9.4% used some kind of illicit drug in the month prior to being surveyed in 2014, which amounts to about 2.3 million youths.

“As you can see, the numbers are pretty high,” said Peter Martin, MD, director of Vanderbilt Addiction Center, who also wasn’t involved in the study. “I think there’s almost a surreal effect in that you look at them and you see how high they are.”

Marijuana is still the most commonly used illicit drug among adolescents and teens, but 2.6% of survey participants reported using psychotherapeutics, 0.6% used inhalants, 0.2% used cocaine, and 0.1% said they had used heroin.

About 6% of adolescents and teens reported binge drinking in the month before the survey, steadily decreasing from 8.9% in 2008. Cigarette smoking has decreased as well, with 4.9% of surveyed adolescents and teens saying they’d smoked in the month before the survey.

Past-month nonmedical use of pain relievers fell to 4% among males and 5.4% among females, down from 5.5% and 7%, respectively.

“There’s a nice, general — slow but general — decline, and that means in some way that youth are starting to understand” the dangers of abusing prescription painkillers that the CDC and other organizations have been stressing for years, Rosenthal said. “That’s starting to sink in.”

He said the decline may also be the result of combined efforts by state programs as well as individual doctors and patients, which have taken steps to keep prescription painkillers from getting into the wrong hands.

Other highlights of the report included:

  • 8 million adolescents, or 11.4%, reported a major depressive episode in the year prior to being surveyed for 2014
  • Serious thoughts of suicide were highest among 18-to-25-year-olds
  • Those who were uninsured, below the federal poverty level, and living in nonmetropolitan areas were more likely to have serious mental illness than those with insurance, above the poverty level, and in metropolitan areas.

Also, of the 9.8 million adults with serious mental illness in the U.S., only 68.5% received treatment or counseling in the year prior to being surveyed. Those who were female and those who were insured were more likely to get treatment.

And now the President wants to finally address the heroin epidemic. One of the suggestions is to have naloxone, the drug used for heroin overdoses to be available over the counter.

  • Heather Caspi reported that Walgreens has announced a two-pronged approach to helping combat opioid abuse in a program that has already begun in New York and will roll out state-by-state throughout the year.
  • One part of the program involves offering the heroin overdose antidote naloxone for sale without a prescription at more than 5,800 of Walgreens’ nearly 8,200 drugstores. In states that require a prescription, Walgreens says it is “eager to work with regulators to help update rules.”
  • The company also plans to provide no-cost medication disposal kiosks at more than 500 of its stores in 39 states and Washington, D.C. to help ease the disposal of medications, including controlled substances, to reduce their misuse.

The problem is that now drug addicts are using naloxone in order to reach higher and higher highs knowing that they can be rescued with naloxone.

Is this crazy?

We have States making marijuana legal and not just for medical use, but also for recreational use, even with the important research showing the adverse effects of long term use. We have our youth believing that it is not that dangerous to take, smoke, ingest, inject. I know that is a stretch but the youth will take the argument and expand it to cover all drugs.

There seems to be multiple disconnects regarding the drug abuse problem.

Where are we really going and how are we really going to solve the drug/ heroin problem? We have to get serious about this very serious problem and not just providing long-term “support” for our drug addicts. We need to allocate the funds appropriately and figure out the real cause and solution to our drug problem. And can we trust our elected government officials to solve this complex health care, social and criminal issue?

 

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