The benefits of marijuana: Things are far from all bad for weed

Marijuana can certainly be beneficial.

It’s true that essentially every drug has some abuse liability. However, somewhere in the vicinity of 85% of those who try any given drug will never develop abuse or addiction problems (yes there are probably variations based on specific drugs, but that’s a good estimate).  As we all know, marijuana is a drug that receives a lot of attention and drives intense debate when it comes to its benefits and harms.  While most of the posts on my site focus on the other 15%, there is, and continues to be, evidence for the benefits of marijuana and other drugs that directly activate cannabinoid receptors.

Some of the shown benefits of marijuana

THC, the active ingredient in cannabis, is known to cause sedation, euphoria, decrease in pain sensitivity, as well as memory and attention impairments.  But there are some aspects of the cannabinoid receptors that have been shown to be effective in AIDS, glaucoma and cancer treatments.

Stimulation of cannabinoid receptors causes an increase in appetite and therefore helps with the wasting syndrome often seen as a side effect in AIDS treatments or those with eating disorders. Since THC activation decreases intra-ocular pressure, another area in which marijuana has been proven to be effective is in the treatment of glaucoma.  THC’s anti-emetic (or anti-vomiting) properties also make it a very useful tool for combating the side effects of cancer treatments.

Still, the activation of cannabinoid receptors is not synonymous with smoking weed. In fact, there are a number of other possible ways to consume THC and other cannabinoid-receptor activators. Also, THC is a potent immune suppressing agent, so in someone who already has a compromised immune system, such as AIDS patients, marijuana and other THC compounds could increase the risk of infection.

Future promise for the use of THC in medicine

There is some evidence that of the 2 major THC receptors (CB1 and CB2), one is associated with the immuno-suppression that occurs after chronic usage and the other is associated with the the more beneficial aspects we’d discussed. In the future, we may be able to produce a compound that activate only the behavioral effects and could therefore be used more safely for AIDS patients. Marijuana lovers will say that we should leave things as they are, but I’m all for less immuno-suppression with my cancer therapy.

Again, just because activation of THC receptors can provide the above benefits does not necessarily mean one should smoke marijuana. As usual, the benefits and risks have to be considered and one has to reach an educated, informed, conclusion. Still, there’s little doubt that in some situations, the use of marijuana, or other THC activators is not only prudent, but indeed recommended.

Co-authored by: Jamie Felzer

Great coverage of the prescription drug abuse problem – The oxycontin express on Vanguard

On the way to New York city to visit my father this morning (he’s not doing so well), I saw an amazing journalistic piece on the prescription drug problem, especially as it relates to loose prescription-record keeping laws in Florida, which is apparently the reason for the five times higher rates of prescription pain medication rates in that state!

We’ve talked about this problem here before, and it’s one of (if not THE) the fastest growing drug abuse problems in this country, but what can I say, Mariana van Zeller knows how to tell a story. I’m now not only a fan of hers but also of the Current TV team, and especially of Vanguard Journalism. I’ll be watching them – you should be too.

Abuse of prescription drugs is on the rise

A recent article in the UCLA health system magazine Vital Signs talks about the increased prevalence of prescription drug abuse.

Apparently, at 20%, prescription drugs are now the most commonly abused group of substances after alcohol and marijuana. With the same prevalence among teens, this is certainly a concern.

The article notes a few indicators of abuse, though for those knowledgeable in addiction matters, there are no surprises on this list:

  • Increasing dose or frequency without consulting doctors (sign of tolerance).
  • Going to different doctors for same medication (spending a lot of time getting or using the drug).
  • Getting medications from sources other than physicians (such as illegal sources).
  • Stealing medications from friends and family (interrupting social functioning).
  • Continuing to use the medication despite adverse consequences.

The article goes on to describe possible treatments, but the most interesting suggestion was the inclusion of drug-testing in physicians’ offices and the use of national databases to keep track of the medication that people have and are being prescribed.

Good ideas.

Alcohol, benzos, and opiates – Withdrawal that might kill you

Along with teaching and telling stories, part of my goal here at All About Addiction is to get important information out to those who can benefit from it.

Most drug users who quit drug use “cold turkey” have to go through withdrawal of some sort. Withdrawal is never comfortable, but sometimes it can actually be dangerous. The list below outlines some drugs that should NEVER be quit suddenly without medical supervision. This is the reason why some rehab treatment is preceded by a medical detox period lasting anywhere from 2 days to a week or more.

Which withdrawals can actually kill?

  1. Alcohol – Yes, after long term use, withdrawal from alcohol can kill. Alcohol withdrawal syndrome can take on mild, moderate, or severe forms. If while withdrawing from alcohol a person develops a fever, extreme nausea, diarrhea, or DT (delirium tremens), they need to be rushed to see a doctor as soon as possible. In fact, alcohol withdrawal after heavy, chronic use is best managed under the care of a doctor or a professional medical detox unit. By using medications that relieve withdrawal symptoms, these professionals can essentially eliminate any of these risks.
  2. Benzodiazepines – Benzos were introduced as a replacement to barbiturates that were causing common overdose cases, many of which resulted in death. Nevertheless, withdrawal from extended use of benzodiaepines can kill. Whether Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam) or other variations, long term use of Benzodiazepines requires medical supervision to be completed successfully with minimal side-effects and risk to the patient. Normally, the withdrawal process is managed by slowly reducing the dose and transferring the patient from a slow acting, to a long acting, form of the drug. Still, full resolution of benzodiazepine withdrawal syndrome can take up to 6 months (or even longer).
  3. Opiates – Many people are surprised to learn that in most cases, withdrawal from many opiates is not deadly. Still there are some very important exceptions. Methadone, a long-acting opiate often prescribed as a replacement for heroin can cause death during withdrawal if it’s consumed in high enough doses for a long enough period. The debate of whether the state should be prescribing something like this should be saved for a later date. It is one of the better ways of getting people off of heroin, though obviously, all it does is replace dependence on one substance with another, more manageable one. Also, some of the recently popular methods of rapid-detox from heroin addiction can themselves cause death, and many other negative side-effects. Overall, I would recommend checking in with a physician and conducting opiate withdrawal in a controlled setting. Withdrawal under Suboxone or Subutex can be far less horrific.

Much of the danger in withdrawal from all of these drugs has to do with the body’s response to the extreme changes in the chemical processes going on in the brain and the rest of the body. Alcohol, Benzos, and Opiates interference with the GABA system, the body’s most common downregulator.

Withdrawal from these drugs is like trying to turn the heat up in a cold house with a broken thermostat and an out of control heater – It won’t always lead to disaster, but it’s a bad idea.

The withdrawal danger summary

That’s pretty much it. “Cold Turkey” withdrawal from cocaine, marijuana, crystal meth, ecstasy, GHB (never mix GHB with alcohol though!!!), and many other recreationally used drugs will not lead to death in the vast majority of cases. While it may make you uncomfortable, and you may feel moody, constipated, dehydrated, hungry or nauseous, and a whole slew of other symptoms, the chances of someone actually dying from withdrawal are very small.

If you have any more specific questions regarding your case though, don’t shy from asking me!

Doctor prescription drug use: Addiction fears no one

The story published today by the Baltimore Sun (see here) is another sad reminder that no one is safe from addiction.

Two doctors of pharmacology at the University of Maryland School of Medicine were apparently developing quite a drug habit buying prescription drugs online and then cooking them and shooting them up. Now one of them is dead and the other is in jail looking at some serious time.

I’m not going to repeat the whole story here, but you should go read it.  Prescription drug use is a growing problem in the U.S., apparently, like other addictions, it doesn’t discriminate.

Drug use and abuse following terrrorism: Lessons from addiction research

A recent addiction research article combined findings from 31 different studies to assess the impact of large terrorism events on rates of alcohol, cigarettes, and drug use. The researchers noted that most of the studies occurred after the World Trade bombing of September 11th, 2001.

  • After controlling for the level of exposure, type of event, and length since exposure, the evidence suggests that somewhere between 7%-14% of the population affected by the terrorism will show an increase in their rates of alcohol use.
  • For cigarettes smoking, the average is somewhere between 7%-10%.
  • Drug use, including narcotics and prescription medication, increased an average of 16% to as high as 50% or more. There’s no doubt that a large portion of that increase is due to increased prescription drug use, most likely anti-anxiety medication, antidepressants, etc.

Overall, the findings certainly show that a large-scale terrorism event affects the daily life of citizens, especially in terms of their coping using drugs and alcohol. Hindsight is 20/20, but hopefully next time, we’ll be ready to help people deal with such catastrophes while helping them steer away from possible dependence on drugs down the line.

Citation:

DiMaggio, Charles; Galea, Sandro; Li, Guohua (2009) Substance use and misuse in the aftermath of terrorism. A Bayesian meta-analysis. Addiction, Volume 104, 894-904.

Substance use and misuse in the aftermath of terrorism. A Bayesian meta-analysis

Addiction brain effects : Opiate addiction – Heroin, oxycontin and more

Okay, we’ve talked about crystal meth and cocaine and how they affect the brain during drug use. As I mentioned, both cocaine and meth interfere with the way the brain stores and cleans up important neurotransmitters, including, most importantly, Dopamine and Norepinephrine.

opiates-morphine & heroinThe class of drugs known as opiates, which includes morphine, heroin, codeine, and all their derivatives (including oxycontin), acts on the brain in a completely different manner. Since our goal at All About Addiction is to explain drug use and abuse as comprehensively as possible, let’s turn our attention to this opiate addiction next.

Heroin, morphine, oxycontin, vicodin and other opiates

While cocaine and crystal meth work by disrupting the normal functioning of molecules responsible for cleaning up released neurotransmitters, opiates work by activating actual receptors that naturally occuring neurotransmitters activate. Substance like this are known as agonists; they perform the same action (identically as, to a lesser, or greater extent) as a substance the body already manufactures.

In the case of morphine, heroin, and most other opiates, the most important receptors activated are knownOpiate Receptors as µ-opioid receptors. Activation of the µ-opioid receptors is associated with analgesia (suppression of pain), sedation, and euphoria, which makes sense given the relaxing, pleasure inducing effects of opiates.

Natural opioids (also called endogenous opioids), which include endorphins, are used by the body to relieve pain and increase relaxation, especially during periods of extreme stress. These are the chemicals that make sure we can function during accidents, like after breaking our leg…

Opioids and dopamine

Opioids also increase the amount of dopamine in the brain indirectly. As I mentioned in the earlier posts, dopamine is thought to be the reward indicator in the brain. Unlike crystal meth and cocaine, heroin and its relatives increase the activity of dopamine neurons by releasing the hold that other neurons (that use GABA) have on them. Think of this as the release of pressure on a hose spraying water on a lawn. When the pipe is pinched, only so much water can get through, but once the clasp is released, water can flow in greater quantity; this is essentially what opiates do.

Heroin addiction and long term opiate use

Like I said before, this doesn’t sound so bad, does it? All we’re talking about here is the increasing of the functioning of system that already exists in the brain. The problem isn’t so much in the process, the problem starts when this system gets activated for long periods of time.

HeroinHeroin addicts, and other frequent users of opiates complain about the extreme discomfort they feel when they stop using the drugs. This discomfort has been described as the worse case of the flu you could imagine. Doesn’t sound too appealing, does it? In fact, withdrawal symptoms associated with stopping opiate use are at least one of the main reasons many users return to the drug after trying to clean up. This in addition to all the other effects of the drug on the brain to make wanting to stop so much harder.

The reason for the pains and aches? Given the overactivation of its pain suppression system, the body not only reduces its own supply of opioids, but it also turns up the sensitivity on its pain receptors. Heroin users notice this as an increase in tolerance, but they compensate for it by simply using more. However, when they stop, they’re left with a body unable to suppress its own, hyper sensitive pain system. The results are more than uncomfortable, they’re simply excruciating…

Another common complaint of addicts is diarrhea. This, again, is simply the reversal of the constipation caused earlier by heroin’s actions on opioid receptors that are present in the peripheral system (outside the central nervous system).

I’ve heard addicts speak online about the slow recovery from opiate addiction and I want to dispell a myth here:

Opiates DO NOT stay in your system for weeks or months – The drug itself is gone from the body within days. The reason for the continued suffering is the slow adjustment of your brain and body back to the way things were before the drugs. Think of how long the tolerance took to develop… Now play the tape back in reverse. That’s what happening to you. You can help relieve the pain, but know that if you use anything in the opiate family, you’re making the process last much longer…

So, in summary: As usual, the actions of opiates on the body and brain are not all the severe, extreme, or inappropriate. Opiates are still used in medicine for pain suppression, not only because they work, but because the potential for abuse when used in this way are minimal to non-existent. However, as with all drugs, continued, chronic, abusive use of opiates will change the way your body functions in ways that will produce the exact opposite effects of those users like so much. This leaves people not only with possible addiction problems, but also with a terrifyingly uncomfortable return back to normal functioning.

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