Percent of Students Reporting Use of Marijuana in Past Year, by Grade

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What Have We Learned Through Research?
2
Extent of the Problem
Marijuana is the Most Commonly Used Illicit Drug
In the U.S.
Source 2001 National Household Survey on Drug
Abuse, SAMHSA
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Types of Drugs Used By Past Month Illicit Drug
Users Aged 12 and Older 2001
Marijuana Only
Drug Other than Marijuana
24
56
20
Marijuana and Some Other Drug
Source 2001 National Household Survey on Drug
Abuse, SAMHSA
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Percent of Students Reporting Any Illicit Drug
Use in Past Year, by Grade
Source Monitoring the Future Study 2002
5
Percent of Students Reporting Use of Marijuana in
Past Year, by Grade
Source Monitoring the Future Study 2002
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Cannabinoid Receptor
10
Cannabinoid Receptors
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CB1 Cannabinoid Receptors in Rodent Brain
Gifford, A.N. et al., Chemistry and Physics of
Lipids, 21(1-2), pp. 65-72, December 2002.
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Dopamine pathways (reward, eurphoria)
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Recently, Self-Administration of THC Has Been
Demonstrated in A Variety of Animal Models
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AND
A Cannabinoid Antagonist Can Block THC
Self-Administration
Tanda, G. et al., Nature Neuroscience, 3(11),
November 2000.
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Why Do Some People Use and Others Dont?
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Heritabilities Derived From Twin Studies
DRUG
Males
Females
Heroin (opiates) Sedatives Marijuana Cocaine
Hallucinogens Nicotine
54 (Tsuang et al., 1996) 87 (Kendler, et al.,
2000) 33 (Tsuang et al., 1996) 58 (Kendler, et
al., 2000) 44 (Tsuang et al., 1996) 79
(Kendler et al., 2000) 79 (Kendler, et al.,
2000) 53 (Carmelli et al., 1990)
79 (Kendler Prescott, 1998) 81 (Kendler
et al., 1999) 72 (Kendler et al., 1999)
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A Gene Has Recently Been Identified That May
Play A Role in Drug Addiction
This Gene Controls An Enzyme Responsible for the
Breakdown of Endocannabinoids, the Brains Own
Cannabis-Like Compounds
Source Sipe, J.C. et al., PNAS, 99(12), pp
8394-8399, June 11, 2002.
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What are the More Persistent Effects of Marijuana?
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PET Scans Examining Glucose Metabolism 4 Days
After Last Use
Volkow, N.D. et al., Psychiatry Research
Neuroimaging, 67, pp. 29-38, 1996.
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Deficits In Cognitive Function in Heavy Cannabis
Users Have Been Shown to Persist For At Least 7
Days After Discontinuing the Drug
Source Pope, H.G. et al., Arch Gen Psychiatry,
58, October 2001.
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In Very Heavy Marijuana Users, Persistent,
Negative Dose-Related Effects Have Been Shown on
Tests Measuring
Bolla, K.I. et al., Neurology, 59, pp. 1337-1343,
2002.
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Relationship Between Amount of Marijuana Smoked
and Task Performance In 28-Day Abstinent Heavy
Marijuana Users
Note high IQs are less likely to be affected on
tests that require suppression of
habit---frontal cortex function
High Shipley IQ Group
Low Shipley IQ Group
Bolla, K.I. et al., Neurology, 59, pp. 1337-1343,
2002.
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Can Marijuana Cause Permanent Changes?
Long-term, Yes Permanent, Probably
No
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AND
In the Last Decade, Marijuana Use Has Been On the
Rise Among Arrestees
Especially Youthful Ones
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Recent Research Has Validated the Reliability and
Clinical Significance of Marijuana Withdrawal
Effects
Source Budney, A. J. et al., Arch Gen
Psychiatry, 58, October 2001.
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Budney, A.J., et al., Archives of General
Psychiatry, 58(10), pp. 917-924, 2001.
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Marijuana Smokers Show Increased Aggressive
Behavior During Withdrawal
Days of Abstinence
Kouri, E.M. et al., Psychopharmacology, 143, pp.
302-308, 1999.
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We Are Beginning to Better Understand What Makes
Marijuana Addictive
And How These Mechanisms Are Affected by Other
Drugs of Abuse
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For Example
Research Shows that the Central Mechanism
Involved in Cocaine Relapse Is Closely Linked to
the Sites Where Marijuana Has Its Effect
Source DeVries, T.J., et al., Nature Medicine,
7(10) October 2001.
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And So cannabinoid agonist reinstates
cocaine-seeking
Cannabinoid Receptor Antagonists May Prove To Be
Useful Anti-Craving Agents
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In Addition to Its Effects on the Brain
We Have Learned A Lot About Marijuanas Potential
to Affect Other Organ Systems
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Percentages of Persons Aged 12 to 25 Reporting
Past Month Marijuana Use
Source SAMHSA, 1999 and 2000 NHSDAs
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Changes in Marijuana Treatment Admission Rates
1993-1999
Source 1999 SAMHSA Treatment Episode Data Set
(TEDS).
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Number of Adolescent Marijuana Admissions, by
Referral Source
Source 1999 SAMHSA Treatment Episode Data Set
(TEDS).
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Less than 1/10th of adolescents with substance
dependence problems receive treatment Under 50
stay 6 weeks, 75 stay less than the 3
months recommended by NIDA From 1992 to 1998,
admissions for treatment of primary, secondary or
tertiary marijuana use disorders increased 115
(51,081 to 109,875) Source Dennis,
Dwaud-Noursi, Muck, McDermeit, 2002 Hser et
al., 2001 OAS, 2000
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Marijuana Abstinence at End of Treatment
Motivational enhancement plus coping skills plus
voucher-based incentives
Motivational enhancement plus behavioral coping
skills therapy
Motivational enhancement therapy
Budney, A.J. et al., Journal of Consulting and
Clinical Psychology, December 2000.
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Pharmacological Therapy
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Cannabinoid Antagonists for Treatment
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Cannabinoid Antagonist Reduces Marijuanas Effects
80
30
70
25
60
20
50
Mean Increase in Heart Rate (beats/min)
Maximum Mean Rating of Drug Effect
15
40
30
10
20
5
10
0
0
Feeling High
Feeling Stoned
Strength of Drug Effect
Heart Rate
Huestis, M.A. Archives of General Psychiatry,
58(4), pp. 322-328, 2001.
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Cannabinoid Antagonist Blocks Major Triggers of
Drug Relapse in Rats
Impact of SR141716 on Response to Priming Dose
of Cocaine
Impact of SR141716 on Response to
Cocaine-Related Cues
Cocaine-Seeking Responses (per 30 min)
Cocaine-Seeking Responses (per 120 min)
De Vries, T.J., and Shaham, Y. et al., Nature
Medicine, 7(10), pp. 1151-1154, 2002.
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Naloxone Reverses Brain Reward of THC
Gardner, E.L., Chemistry and Physics of Lipids,
121, pp. 267-290, 2002.
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Naloxone Reverses THC-Induced Increases in NAcc
Dopamine
Gardner, E.L., Chemistry and Physics of Lipids,
121, pp. 267-290, 2002.
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Does Marijuana Have Therapeutic Utility?
58
Comprehensive Reviews of the Medical Utility of
Marijuana Were Undertaken By
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These Reviews Concluded That
Smoking marijuana reduces intraocular pressure in
glaucoma and is claimed to ameliorate pain,
nausea, poor appetite, and other debilitating
conditions
Source Strauss, S.E. PNAS, 97(17), August 15,
2000.
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The Problem Is
Large controlled trials have not been conducted
to support the majority of such claims
Moreover
There are better, well-defined treatments for
most such indications
Source Strauss, S.E. PNAS, 97(17), August 15,
2000.
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NIDA Is Helping to Put Science-Based Information
On Marijuana and Other Drugs of Abuse to Work in
Our Schools and Communities
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Visit Our Website _at_
www.drugabuse.gov