Danni alla salute da derivati della Cannabis

Giuseppe R. Brera (a cura di)


Gli articoli esaminati mostrano senza ombra di dubbio,da un punto di vista clinico ed epidemiologico e transculturale che :

a) l'uso della cannabis induce una psicosi schizofrenica (1)(2)(3)(4)(5) ed aggrava il decorso di tale patologia (6)(7) b) che un consumatore di derivati della cannabis rischia 6 volte più di un non consumatore di divenire schizofrenico; tale rischio è proporzionale alla frequenza del consumo Un consumatore di derivati della cannabis che dichiari d'avere fatto uso almeno una volta di derivati della cannabis,rischia 2,5 volte più di un non consumatore di divenire schizofrenico.Il consume della cannabis appare un fattore di rischio indipendente,per l'esordio di una psicosi. (8)

c) che il consumo della cannabis indipendentemente dalla dose può indurre una psicosi che viene discussa come una psicosi specifica da cannabis (Cannabis Induced Psychosis) o come "Drug induced psychosis". (9)(10)

d) che i derivati dalla cannabis hanno un azione psicodislettica provocando fenomeni allucinatori (11)(12)

(1)Article Title: Cannabis and schizophrenia: A longitudinal study of cases treated in Stockholm County. 

AUTHOR(S): Allebeck, Peter; Adamsson, C.; Engstrom, A. 

AUTHOR AFFILIATION: Vasa Hosp, Dept of Social Medicine, Gothenburg, Sweden DOCUMENT TYPE: Journal Article 

SOURCE DOCUMENT TITLE: Acta Psychiatrica Scandinavica 

SOURCE DOCUMENT DESCRIPTION: 1993 Jul Vol 88(1) 21-24 

Studied the association between cannabis use and schizophrenia among 229 Ss who were diagnosed with cannabis dependence and psychosis. Of these, 112 were schizophrenics, and 117 evidenced other psychotic states. Regular cannabis abuse preceded the onset of psychosis by at least 1 yr, suggesting that cannabis use is a risk factor for schizophrenia and not the other way around. Cannabis-associated schizophrenia often has a sudden onset and prominent positive symptoms. 

(2)Article Title: Cannabis and schizophrenia: Is there a causal association?. 

Author: Allebeck P 

DOCUMENT TYPE: Journal Article 

DOCUMENT Title: Physiopathology of illicit drugs: cannabis, cocaine, opiates. 

SOURCE DOCUMENT TITLE: Advances in the biosciences 


Whether or not cannabis consumption is associated with an increased risk of developing schizophrenia has since long been a matter of controversy. In this paper findings from a longitudinal study of 50,465 Swedish conscripts on the association between cannabis and schizophrenia are presented. The relative risk of developing schizophrenia was 6.0 among high consumers of cannabis (use on more than 50 occasions) compared to non-users. The association persisted after control for use of other drugs and social background factors. Scrutiny of medical records confirmed the diagnosis of schizophrenia in all cases and showed that use of cannabis preceded the development of schizophrenia, and not vice versa.

(3)Article Title: Cannabis en schizofrenie. Een literatuuronderzoek. [Cannabis and schizophrenia: Literature review]. 

AUTHOR(S): Heller, H.; Dingemans, P.; Linszen, D. 

AUTHOR AFFILIATION: Academisch Medisch Ctr Amsterdam, Psychiatrisch Ctr AZUA, Netherlands 

DOCUMENT TYPE: Literature Review 

SOURCE DOCUMENT TITLE: Tijdschrift voor Psychiatrie 

SOURCE DOCUMENT DESCRIPTION: 1992 Vol 34(10) 699-708 ISSN: 03037339 LANGUAGE: German 

Reviews the results of studies of the connection between cannabis use and schizophrenia. The conclusions of the researchers fell into 4 basic categories: (1) both excessive cannabis use and schizophrenia are results of social stress, (2) cannabis use causes schizophrenia, (3) cannabis use increases the severity of schizophrenia, and (4) schizophrenics use cannabis to reduce their symptoms. (English abstract) 

(4)Article Title: Cannabis and psychosis: Is there epidemiological evidence for an association? Author: Thornicroft, Graham. 

AUTHOR AFFILIATION: MRC Social & Community Psychiatry Unit, U London Inst of Psychiatry, England 

DOCUMENT TYPE: Journal Article 

SOURCE DOCUMENT TITLE: British Journal of Psychiatry 

SOURCE DOCUMENT DESCRIPTION: 1990 Jul Vol 157 25-33 ISSN: 00071250 LANGUAGE: English 

Evaluates data from experimental research and clinical studies linking cannabis (marijuana) use and psychosis, using A. B. Hill's (1965) epidemiological criteria. These criteria include strength, consistency, specificity, and temporality of the association between cannabis use and psychosis. Other criteria are biological gradient, plausibility and coherence, and experimental evidence. Cannabis can produce brief acute organic reactions and, in moderate to heavy doses, psychotic episodes in clear consciousness can occur. Ingestion in naive users or increasingly heavy use in habitual users can precipitate a schizophreniform episode. Heavy users may have an increased risk of developing chizophrenia. Well-controlled longitudinal studies are required to explore these associations further and to assess their etiological significance. 

(5) Article Title: On the abuse of psychodysleptic drugs: Modern toxicomanias and pharmacopsychoses. 

Author: Deniker, Pierre. 

AUTHOR AFFILIATION: Clinic for Mental & Encephalic Illnesses, Paris, France  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Annales Medico-Psychologiques  SOURCE DOCUMENT DESCRIPTION: 1969, 1(2), 193-211. 

Of the few psychotropic agents responsible for hallucinations, most of the abuse is linked to cannabis and LSD. The acute psychological effects are distinguished between common toxic euphorias and characteristic hallucinatory intoxications; prolonged effects are divided between discreet signs of chronic intoxication and the pharmacopsychoses proper. The hallucinatory intoxications and the pharmacopsychoses "have characteristics that appear to be almost common to the diverse hallucinogenic agents, despite different chemical and pharmacological properties." The syntheses and ecmnesias marking the nonsleep dream phenomenology justify the "oneirogenic" label for drugs producing hallucinatory intoxication. In discussing the pharmacopsychoses due to hallucinogens, the problem of a possible schizophrenic development is raised in view of the unexpected forms of toxic psychoses: paranoid or oneiroid reactions and atypical dysthymia. Therapeutic considerations tie favorable prognoses to detailed studies of the toxic factor and the preexisting personality in each case. While pharmacopsychoses are still rare vis-a-vis the total intoxicated, the steady rise in mental illness of hallucinogenic origin is viewed with concern. (24 ref.) (6) Article Title: Cannabis consumption as a prognostic factor in schizophrenia.  Author: Martinez-Arevalo MJ  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: British Journal of Psychiatry  SOURCE DOCUMENT DESCRIPTION: 164(May), (1994) : 186-976 

Data were analysed from 62 schizophrenic patients between 18 and 30 years of age, treated at the community mental health centres in Navarra, who had relapsed and then completed a one-year follow-up study. Factors influencing the course of illness during follow-up were continuing cannabis consumption; previous cannabis intake; non-compliance with treatment; and stress. Copyright 1994, Royal Society of Medicine. 

(7)Article Title: Cannabis abuse and the course of recent-onset schizophrenic disorders. Author: Linszen, Don H., Dingemans, Peter M., Lenior, Marie E. 

AUTHOR AFFILIATION: U Amsterdam, Academic Medical Ctr, Psychiatric Ctr, Netherlands DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Archives of General Psychiatry 

SOURCE DOCUMENT DESCRIPTION: 1994 Apr Vol 51(4) 273-279 ISSN: 0003990X Conducted a prospective, 1-yr follow-up study to examine the relationship between reported cannabis abuse and the symptomatic course of psychotic, negative, and affective symptoms in recent-onset schizophrenia and related disorders. Ss' ages were between 15 and 26 yrs, and 24 Ss had a history of cannabis abuse, whereas 69 Ss did not. Symptoms were assessed on the Brief Psychiatric Rating Scale. Findings suggest that cannabis abuse and particularly heavy abuse is at least a stressor for psychotic relapse and exacerbation in schizophrenia and related disorders and is possibly a morbid precipitant. In all but 1 of the 24 abusers, cannabis abuse for at least 1 yr had preceded the initial onset of psychotic episodes. 

(8)Article Title: Cannabis and schizophrenia: longitudinal study of Swedish conscripts  Author: Andreasson S  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Lancet (England)  SOURCE DOCUMENT DESCRIPTION: 2 (Dec 26 1987):1483-1486 

The association between the level of cannabis (I) consumption and the development of schizophrenia during a 15 yr follow-up was studied in 45,570 Swedish conscripts.There was a strong association between level of I exposure at conscription and development of schizophrenia during the follow-up period. The relative risk for schizophrenia was 2.4 in the group that reported I use at least once compared with non-users. The relative risk increased with increasing consumption level and was 6.0 (4.0-8.9) among those who had used it more than 50 times.Persistence of the association after allowance for other psychiatric illness and social background indicated that I is an independent risk factor for schizophrenia.

(9)Article Title: Clinical observations on substance abuse related health problems at the Port Moresby General Hospital, National Capital District, Papua New Guinea.  Author: Johnson, Felix Y. Attah  DOCUMENT TYPE: Journal Article 

AUTHOR AFFILIATION: U Papua New Guinea, Faculty of Medicine, Dept of Clinical Sciences, Boroko, Papua New Guinea  SOURCE DOCUMENT TITLE: Medicine & Law 

SOURCE DOCUMENT DESCRIPTION: 1994 Vol 13(3-4) 251-262 ISSN: 07231393 LANGUAGE: English 

Studied health problems related to substance abuse (SAHP) in 30 Ss (28 males, 2 females, aged 15-35 yrs) admitted to the Port Moresby General Hospital, Papua, New Guinea, in the period between 1989 and 1990. A clinical diagnosis is given for each S. Occupation, marital status, substance abused (alcohol, cannabis, or diazepam), duration of hospitalization, and clinical and social outcome are given. Short-term psychological disturbances caused by cannabis are discussed. 12 Ss were diagnosed with schizophrenia and cannabis-induced psychosis (CIP). Six other Ss were diagnosed with CIP. The remaining 12 Ss were diagnosed with alcohol-related problems or diazepam dependency. These observations indicate that SAHP have drastically increased in Papua, New Guinea since 1981. 

(10)Article Title: Zur Psychopathologie und Differentialdiagnose sogenannter Cannabispsychosen. [Psychopathology and differential diagnosis of "cannabis psychoses."]  Author: Taschner, K. L.  DOCUMENT TYPE: Journal Article 

AUTHOR AFFILIATION: Johann Wolfgang Goethe-U Frankfurt Klinikum Zentrums der Psychiatrie, Abteilung fur Klinische Psychiatrie, West Germany  SOURCE DOCUMENT TITLE: Fortschritte der Neurologie, Psychiatrie 

SOURCE DOCUMENT DESCRIPTION: 1983 Jul Vol 51(7) 235-248 ISSN: 07204299 LANGUAGE: German 

Of 237 patients examined for drug-induced psychosis (DIP), 50 patients with cannabis psychosis (CIP) were further studied according to criterion "main cause of addiction," and 107 were studied according to the criterion "consumption during the last 3 mo before hospitalization." Ss with CIP were compared to Ss with other DIPs as well as to a control group of 219 schizophrenics. General agreement was found between the other DIPs and schizophrenia. The variations between the symptomatology of the DIP Ss and the schizophrenics were also seen in the CIP Ss. It is concluded that CIP is not a discrete disorder in its own right. While a certain drug-specific psychopathological undertone does exist, this does not support the existence of a separate nosological entity. Individual differentiation of DIPs cannot be supported. There are also relevant psychopathological differences between CIP and endogenous schizophrenia. Both syndromes may be endogenous psychoses, with the cause not being known in the case of schizophrenia. On the other hand, cannabis psychosis may be a type of triggered schizophrenia. 10 case examples are included. (41 ref)  (11)Article Title: Human EEG spectra before and during cannabis hallucinations.  Author: Koukkou M  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Biological Psychiatry  SOURCE DOCUMENT DESCRIPTION: 11(6) (1976 Dec) :663-77 

EEG correlates of subjective experiences induced by delta9-trans-tetrahydrocannabinol (THC) and EEG correlates of individual disposition to such experiences were investigated. Twelve normal volunteers took 200 mug/kg THC orally. The subjects were asked to signal subjective experiences. The EEG was analyzed (period analysis) before and repeatedly after THC injestion, during resting, attention, eye closure, visual hallucinations, and body image disturbances. EEG frequency spectra differed significantly between resting and visual hallucinations and body image disturbances. The differences included slower alpha and more theta during THC experiences, reminiscent of initial drowsiness EEG, and of some results in schizophrenia. The differences between spectra during visual hallucinations and during body image disturbances indicate different functional brain states. Subjects with a high tendency to cannabinol induced experiences exhibited resting spectra before and after THC with higher modal alpha frequences (reminiscent of subjects with high neuroticism scores) than subjects with a low tendency.

(12)Article Title: Comparison of altered states of consciousness induced by short-term sensory deprivation and (-)-D9-trans-tetrahydrocannabinol.  Author: Dittrich, Adolf.  AUTHOR AFFILIATION: U Zurich, Psychiatrische Klinik, Switzerland  DOCUMENT TYPE: Journal Article 

SOURCE DOCUMENT TITLE: Zeitschrift fur Experimentelle und Angewandte Psychologie SOURCE DOCUMENT DESCRIPTION: 1975 Vol 22(4) 547-560  LANGUAGE: German 

Compared the effects of sensory deprivation, a cannabis derivative, and a placebo as reported by 72 Ss. A specially developed questionnaire was administered before and after the experiment. Both experimental groups reported more visual hallucinations and pseudo-hallucinations than the control (placebo) group; the sensory deprivation group yielded the highest number of acoustic hallucinations. Depersonalization and loss of contact with reality occurred most frequently under the influence of the drug, less frequently during sensory deprivation, and significantly less often in the control group. (English & French summaries) (23 ref)


1) danneggiano la struttura del nucleo cellulare (DNA e RNA),(1)questo comporta un documentato effetto teratogeno nella prole,(2)(3)a livello sperimentale e un probabile aumento delle mutazioni con induzione di tumori e una documentata riduzione della fertilita' nella prole(4)

2) si legano a dei recettori specifici (5)(6)del cervello alterando la trasmissione sinaptica dal punto di vista morfolologico e funzionale ed incidendo dei meccanismi biomolecolari del rinforzo e modulando i recettori oppioidi. Questo significa che i derivati della cannabis agiscono in modo biologico e non possono essere considerati "droga leggera",in quanto la dipendenza dalla droga ha una struttura biologica.( 7)(8)(9)

3) danneggiano la struttura e la funzione del cervello,colpendo le aree limbiche (zona del setto ed ippocampo),(1*)i processi emotivi-affettivi,l'apprendimento e la memoria.(10)(11)(12)(13)agendo a livello della trasmissione colinergica e sull'asse ipotalamo-ipofisi-surrene.E' stato visto sperimentalmente che i danni sono trasmessi alla prole(2*)(3*) 

4) alterano i processi percettivi,l'attenzione,(14)la percezione della distanza e del tempo (15)(16)aumentando la probabilita' d'incidenti stradali causati da soggetti consumatori.(17)(18)(19)

5) alterano il coordinamento motorio(20) potenziando il rischio d'incidenti stradali in soggetti consumatori 6) sono stati stati associati all'insorgenza della discinesia tardiva(21) (1)Article Title: Biomedical aspects of cannabis usage.  Author: Nahas, Gabriel  AUTHOR AFFILIATION: Columbia U, Coll of Physicians & Surgeons  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Bulletin on Narcotics  SOURCE DOCUMENT DESCRIPTION: 1977 Apr-Jun Vol 29(2) 13-27 

Describes selected studies reporting basic biological effects of cannabis that may account for clinical manifestations of acute or chronic marihuana usage. Major findings include the following:marihuana products remain in the body for at least 8 days after single administration. Cannabinoids disrupt cell metabolism and DNA and RNA formation, and decrease the rate of cell division in tissue cultures. Marihuana smoking decreases sperm count and motility, and markedly increases theabnormal sperm forms in man. A study of rhesus monkeys fed tetrahydrocannabinol (THC) for 3 yrs indicates the possibility of genetic damage. However, THC may be useful in asthma and glaucoma, and cannabidiol in epilepsy. THC acts on the septal limbic brain. Abnormal brain wavepatterns appeared in the limbic area of monkeys exposed to marihuana smoke daily for 6 mo, andpersisted for 3 mo after smoking stopped. Lesions of the nerve cells in the septal limbic area wereapparent. Many psychiatrists believe that marihuana should not be used by anyone prone to mental illness. Daily users of marihuana develop a tolerance to its effects and do not present withdrawal symptoms upon discontinuance; however, changes in behavior and mood have been reported. Daily use is associated with behavioral dependence and drug-seeking behavior. (22 ref) (2)Article Title: Effects of administration of cannabis resin during pregnancy on emotionality and learning in rats' offspring.  Author: Kawash, George F.; Yeung, David L.; Berg, Sheila D.  AUTHOR AFFILIATION: U Guelph, Canada 

DOCUMENT TYPE: Journal Article SOURCE DOCUMENT TITLE: Perceptual & Motor Skills SOURCE DOCUMENT DESCRIPTION: 1980 Apr Vol 50(2) 359-365 ISSN: 00315125 LANGUAGE: English 

Reports that injection of cannabis resin as a saline-Tween 80 solution to pregnant Wistar rats resulted in pups having lower body weight, higher emotionality, poorer learning capacity, andparadoxically higher brain weight and DNA content than pups of 8 mothers that weresham-injected. The cannabis appeared directly to have caused the inferior growth rate of the pups which in turn affected emotionality and learning. (13 ref)  (3)Article Title: Developmental effects of cannabis.  Author: Nahas G  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Neurotoxicology in the fetus and child  SOURCE DOCUMENT DESCRIPTION: 1986, vol. 7, n.2, pp. 381-396 

Cannabis preparations (Marihuana, Hashish) have become the most frequently used illicit drug in the United States and the Western World. Experimental studies have reported that negative developmental effects can be caused by Cannabis in three ways: Preconception exposure with resulting damage to the gametes, sperm or ovum (gametotoxicity). Prenatal exposure with resultingdamage to the embryo and to the fetus during organogenesis. Postnatal exposure through maternalmilk, with resulting damage to the growing offspring, and behavioral toxicity. (4)Article Title: Cannabis administered during pregnancy: First- and second-generation effects in rats.  AUTHOR(S): Fried, P. A.; Charlebois, A. T.  AUTHOR AFFILIATION: Carleton U, Ottawa, Canada  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Physiological Psychology  SOURCE DOCUMENT DESCRIPTION: 1979 Sep Vol 7(3) 307-310 ISSN: 00905046 LANGUAGE: English 

Female Wistar rats were administered cannabis smoke or placebo smoke throughout gestation,and the offspring were injected ip with tetrahydrocannabinol (THC) 2 mo prior to mating. The male and female offspring of experimental Ss were significantly less fertile and had smaller reproductive organs. The experimental 2nd-generation Ss weighed less and were slower in some aspects ofphysiological development compared to 2nd-generation controls. Exposure to cannabis smoke as a fetus and THC as a young adult had a significantly greater effect on fertility than did injections of THC 2 mo prior to mating. (34 ref)  (5)Article title:Enzymatic sinthesis of anandamide an endogenous ligand for the cannabis receptor by brain membranes  Author:Devane WA,Axelrod J.  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Proc. Natl. Acad. Sci. Usa  SOURCE DOCUMENT DESCRIPTION: 1994,91:6698-6701 (6)Article title: Anandamide,a brain endogenous compound interacts specifically with cannabinoid receptor and inhibits adenylate cyclasi  authors:Vogel Z,Barg J.,Levy R.,Saja D,Heldman E.,Mechoulam R.  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: J. Neurochemistry  SOURCE DOCUMENT DESCRIPTION: 1993, 61:352-355 

Gli articoli 5 e 6 identificano i recettori cerebrali della cannabis e i loro ligandi endogeni verificando così la base biologica della tossicodipendenza. L'articolo 6 fornisce la spiegazione della base biologica dei danni all'attenzione,alla memoria,all'apprendimento e alle funzioni superiori causate dai derivati della cannabis.  (7)Article Title: Effects of Cannabis sativa on ultrastructure of the synapse in monkey brain.  Author: Harper JW  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Journal of Neuroscience Research  SOURCE DOCUMENT DESCRIPTION: 1977, 3(2), 87-93 

Electron microscopic study of brain tissues of monkeys chronically exposed to psychoactiveCannabis showed widening of the synaptic cleft, electron opaque material in the cleft and in pre-and postsynaptic regions, and some "clumping" of synaptic vesicles. In contrast, tissues of controlmonkeys showed no ultrastructural changes.

(8)Article Title: Marijuana's interaction with brain reward systems: Update 1991. Special Issue: Pharmacological, chemical, biochemical and behavioral research on cannabis and the cannabinoids. AUTHOR(S): Gardner, Eliot L.; Lowinson, Joyce H.  AUTHOR AFFILIATION: Yeshiva U, Albert Einstein Coll of Medicine Lab of Behavioral Pharmacology, New York, NY, US  DOCUMENT TYPE: Literature Review  SOURCE DOCUMENT TITLE: Pharmacology, Biochemistry & Behavior 

SOURCE DOCUMENT DESCRIPTION: 1991 Nov Vol 40(3) 571-580 ISSN: 00913057 LANGUAGE: English 

Reviews evidence contradicting the view that marijuana and other cannabinoids lack pharmacological interaction with brain reward substrates. It is now clear that Delta-sup-9-tetrahydrocannabinol (Delta-sup-9-THC), marijuana's principal psychoactive constituent, acts on these brain reward substrates in a strikingly similar fashion to non cannabinoiddrugs of abuse. Specifically, Delta-sup-9-THC enhances medial forebrain bundle (MFB) electrical brain stimulation reward and enhances both basal and stimulated dopamine release in reward relevant MFB projection loci. Furthermore, Delta-sup-9-THC's actions on these mechanisms arenaloxone blockable, and Delta-sup-9-THC modulates brain mu and delta opioid receptors.Marijuana's interaction with brain reward systems may be similar to that of other abused drugs. Aneural model of that interaction is proposed.  (9)Article Title: Neurobiology of addiction  Author: Roy A. Wise 

Addictive drugs have habit forming actions that can be localized to a variety of brain regions. The article describes the reward mechanism and brain"trigger zone" for cannabis and other drugs. (10)Article Title: Cannabis: effects on memory and the cholinergic limbic system.  AUTHOR(S): Miller, Loren L.; Branconnier, Roland J. 

AUTHOR AFFILIATION: Burroughs Wellcome Co, Medical Div, Research Triangle Park, NC DOCUMENT TYPE: Literature Review  SOURCE DOCUMENT TITLE: Psychological Bulletin  SOURCE DOCUMENT DESCRIPTION: 1983 May Vol 93(3) 441-456 ISSN: 00332909 LANGUAGE: English 

Reviews the literature on the pharmacological effects of cannabinoids with respect to effects on human memory processes and the possible role of the cholinergic limbic system as a mediator of these cognitive changes. The effects of cannabinoids on memory processes are similar to those found following administration of antimuscarinic drugs and in neurological patients suffering from deficits in limbic cholinergic functioning. Cannabinoids have been found to selectively act on the limbic system, modulating the activity of cholinergic neurons in the septal-hippocampal pathway. (109 ref)  (11)Article Title: Short-term memory impairment in cannabis-dependent adolescents.  AUTHOR(S): Schwartz RH 

AUTHOR AFFILIATION: Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.  DOCUMENT TYPE: Journal Article 

SOURCE DOCUMENT TITLE: American Journal of Diseasesof Children SOURCE DOCUMENT DESCRIPTION: (1989 Oct) 143 (10), 1214-9 

The concentration of delta-9-tetrahydro-cannabinol in marijuana available in the United States has increased by 250% since investigations of the effects of marijuana on short-term memory first appeared in scientific journals. Moreover, previous investigations of short-term memory in long-term marijuana smokers involved adults only. We evaluated the auditory/verbal and visual/spatial memory of 10 cannabis-dependent adolescents and compared the results with performance of 17 subjects in two control groups. The control groups included 8 adolescent drug abusers who had not been long-term users of cannabis and another 9 adolescents who had never abused any drug. All three groups were matched on age, IQ, and absence of previous learning disabilities. Adolescents with a history of frequent alcohol or phencyclidine abuse were excluded from entering the study. A battery of seven neuropsychological tests was administered initially to all subjects and a parallel test battery was administered 6 weeks thereafter. Significant differences between the cannabis-dependent group and the two control groups were obtained initially on theBenton Visual Retention Test (F[2,24] = 6.07) and the Wechsler Memory Scale Prose Passages(F[2,23] = 7.04). After 6 weeks of supervised abstention from intoxicants, subjects in the cannabis-dependent group showed some significant improvement on the Wechsler Memory Prose Passages score and on the Benton Visual Retention Test; however, the improvement failed to achieve statistical significance. We concluded that cannabis-dependent adolescents have selective short-term memory deficits that continue for at least 6 weeks after the last use of marijuana. (12)Article Title: Cannabis and memory loss.  AUTHOR(S): Deahl, Martin  AUTHOR AFFILIATION: U London, St Bartholomew's Hosp Medical Coll, England DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: British Journal of Addiction  SOURCE DOCUMENT DESCRIPTION: 1991 Mar Vol 86(3) 249-252 ISSN: 09520481 LANGUAGE: English 

Research provides sufficient evidence to conclude that people who smoke cannabis experience short memory deficits that persist after several weeks of abstinence. Replication of the study by R. H. Schwarz et al (1989) is urgently required to provide more data on the effects of cannabis. (13)Article Title: Neuropsychological Effects of Chronic Cannabis Use on the Memory and Intelligence of Adolescents.  Author: Millsaps, Cheryl L.; And Others  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Journal of Child & Adolescent Substance Abuse SOURCE DOCUMENT DESCRIPTION: 1994, vol. 3, n. 1, p.47-56 

Describes research involving adolescent marijuana abusers. Using Wechsler MemoryScale-Revised and Wechsler Adult Intelligence Scale-Revised found characteristics consistent with pattern produced by cerebral dysfunction including reduced memory indices in relation to intellectual function and attentional ability. Intelligence was found to be in normal range. Includes 33 citations. (Author/CRR)

(14) Article Title: Effects of long-term cannabis use on selective attention: An event-related potentia lstudy. Special Issue: Pharmacological, chemical, biochemical and behavioral research on cannabis and the cannabinoids.  AUTHOR(S): Solowij, Nadia; Michie, Patricia T.; Fox, Allison M.  AUTHOR AFFILIATION: U New South Wales, National Drug & Alcohol Research Ctr, Sydney, Australia  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Pharmacology, Biochemistry & Behavior  SOURCE DOCUMENT DESCRIPTION: 1991 Nov Vol 40(3) 683-688 

Recorded brain event-related potentials (ERPs) from 9 long-term cannabis users (aged 19-40 yrs) during a complex auditory selective attention task and compared them with the ERPs of 9 non user controls. Stimuli consisted of a random sequence of tones varying in location, pitch, and duration. Ss responded to long-duration tones of a particular pitch and location. Cannabis users' task performance wassignificantly worse than controls. Results indicate that users engaged in unnecessary pitch processing and thus had difficulty in setting up an accurate focus of attention and in filtering out irrelevant information. Data suggest a dysfunction in the allocation of attentional resources and stimulus evaluation strategies.  (15)Article Title: Differential association between chronic cannabis use and brain function deficits. Author: Soueif MI  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Annals of the New York Academy of Sciences  SOURCE DOCUMENT DESCRIPTION: 1976, 282, 323-43 

To summarize, 12 objective tests that generated 16 test variables were administered to 850 male regular cannabis users and 839 nonusers. The tests were designed to assess various modalities, including speed of psychomotor performance, distance estimation, time estimation, immediate memory, and visuomotor coordination. Most of the test variables differentiated significantly between consumers and controls. At the same time, a significant second-order interaction emerged in most cases. This interaction meant that, under certain conditions that relate to the two dimensions "literacy-illiteracy" and/or "urbanism-ruralism," the superiority of controls over cannabis users became impressive, whereas under other conditions it almost disappeared. To account for this complex pattern of results, a working hypothesis was presented to the effect that "other conditions being equal, the lower the non drug level of proficiency on tests of cognitive and psychomotor performance the smaller the size of function deficit associated with drug usage." For an empirical examination of the hypothesis, six predictions were formulated. Three predictions defined specific relationships between level of performance, on one hand, and each of three organismic variables, on the other: literacy, urbanism, and age. The remaining predictions delineated relationships to be expected between size of function deficit and the three organismic variables. All our predictions were confirmed, showing less function impairment to be contingent with cannabis usage among the illiterates, rurals, and older subjects. Level of cortical arousal was suggested as the central process associated with the three organismic variables. Because the version of our working hypothesis was formulated with reference to chronic material, the possibility of a transposition of the paradign to research on the acute effects of the drug was discussed. The suggestion was made that our working hypothesis, in either version, is capable of establishing genuine integration between reports that present conflicting results on possible function deficits contingent with cannabis consumption. (16)Article Title: Chronic cannabis users: Further analysis of objective test results. Author: Soueif,MI  AUTHOR(S): Soueif, M. I.  AUTHOR AFFILIATION: Cairo U, Faculty of Arts, Egypt  DOCUMENT TYPE: Journal Article SOURCE DOCUMENT TITLE: Bulletin on Narcotics  SOURCE DOCUMENT DESCRIPTION: 1975 Oct-Dec Vol 27(4) 1-26  LANGUAGE: English 

Reports in detail the results of 12 objective tests, generating many psychological test variables, which were administered to 850 Egyptian male chronic cannabis users and 839 nonusers, 15-50 yrs old. Functions tested were speed of psychomotor performance, distance and time estimations, immediate memory, and visual/motor coordination. On most variables, non users displayed better performance than users. Clinical literature has reported that some of these same functions are associated with psychiatric illness, thus suggesting an association between chronic cannabis use and manifest psychopathology. (60 ref)  (17)Article Title: Cannabis and road accidents  AUTHOR(S): (Anon)  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Medical Journal of Australia  SOURCE DOCUMENT DESCRIPTION: May 22 1976, 1, 771.  LANGUAGE: English 

A new method of estimating the amount of tetrahydrocannabinol and its metabolites in small samples of blood or urine means that research into the effects of marihuana on the road user can be undertaken.From previously published papers it is obvious that there is a link between marihuana (cannabis) and road accidents. (18) Detection of cannabis and other drugs in 120 victims of road accidents  Author: Michel Aussedat

Cannabis : physiopathology, epidemiology, detection : from the proceedings of the second international symposium, organized by the National Academy of Medicine, with the assistance of the city of Paris, April 8-9, 1992 / edited by Gabriel G. Nahas, Colette Latour. Author IRAC, Jacques (19) Marijuana and alcohol use among 1023 trauma patients  Author Carl A. Soderstrom

Cannabis : physiopathology, epidemiology, detection : from the proceedings of the second international symposium, organized by the National Academy of Medicine, with the assistance of the city of Paris, April 8-9, 1992 / edited by Gabriel G. Nahas, Colette Latour. Author IRAC, Jacques (20)Article Title: Marijuana-produced impairments in coordination: Experienced and inexperienced subjects.  AUTHOR(S): Milstein, Stephen L.; MacCannell, Keith; Karr, Gerry; Clark, Stewart  AUTHOR AFFILIATION: INRS, Sante, Hopital St Jean-de-Dieu, Montreal, Canada DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Journal of Nervous & Mental Disease  SOURCE DOCUMENT DESCRIPTION: 1975 Jul Vol 161(1) 26-31 

The effects of marihuana and a placebo on perceptual-motor coordination, motor ability, and visual perception were compared in 16 cannabis-experienced and 16 naive 21-59 yr old adults. Impairments in coordination were observed in both groups. However, the impairment was greater in the experienced than in the naive group.  (21) Article Title: Current cannabis use and tardive dyskinesia. Special Issue: Dedicated to the memory of Professor John M. Cleghorn.  AUTHOR(S): Zaretsky, Ari; Rector, Neil A.; Seeman, Mary V.; Fornazzari, Ximena  AUTHOR AFFILIATION: Mt Sinai Hosp, Dept of Psychiatry, Toronto, ON, Canada DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Schizophrenia Research  SOURCE DOCUMENT DESCRIPTION: 1993 Dec Vol 11(1) 3-8 

Examined the relationship between substance abuse and tardive dyskinesia (TD) in 51 chronic, neuroleptic-treated, community outpatients with a Diagnostic and Statistical Manual of Mental disorders-III-Revised (DSM-III-R) diagnosis of schizophrenia. In the presence of a clinical researcher, Ss completed a questionnaire on past and current alcohol and drug use, and provided information pertaining to variables that have, in the past, been implicated in the development of TD: smoking habits, caffeine consumption, and current neuroleptic dose. Ss were also administered the Abnormal Involuntary Movement Scale (AIMS) in an interview format with 2 or 3 trained raters in the room. Results indicate a trend for females and older patients with a longer duration of illness to show elevated scores on the AIMS. In a hierarchical multiple regression analysis, however, cannabis use was found to correlate best with the presence of TD, outranking other putative factors.  3) DEPRESSIONE DEL SISTEMA IMMUNITARIO DA DERIVATI DELLA CANNABIS ED INDUZIONE DELLA CARCINOGENESI E' stata evidenziata una depressione del sistema immunitario in vitro ed in vivo causata dai derivati della cannabis 1) soppressione sperimentale dell'attivita' citolitica dei natural killer (NK) .Questo significa una maggiore vulnerabilita' alle infezioni e all'insorgenza dei tumori. 2) riduzione capacita' di formazione di anticorpi 3) nei consumatori cronici sembra esservi una maggiore probabilita' di tumori della testa e del collo (2) 4) è stata riscontrata un'associazione tra insorgenza di leucemia acuta non linfoblastica e consumo di MJ(3) (1) Immunosuppression by Marjiuana and components (Review)  Author(S): Herman Friedmann,Thomas Klein and Steven Spencer  SOURCE DOCUMENT TITLE: Psychoneuroimmunology  SOURCE DOCUMENT DESCRIPTION: 1991, Academic Press, 931-953 

"Conclusion and summary" It is important to recognize that the clinical information obtained to date indicates that if Marjiuana (MJ) does increase incidence and depression of immunity,it is principally a chronic disease state.This suggests that alteration of immune function seen by us and by others,although using concentrations of THC which are higher than those readily observed in the plasma of smokers,probably has little impact on systemic acute disease in normal healty individuals.However,the observations obtained by a number of investigators,including us,present the possibility that localized disease in area where MJ concentrations in the body may eceed those in the plasma may be affected detrimentally by MJ.More importantly,individuals with compromised immune systems,owing to the presence of existing tumors or immunosuppression by infections,may be at higher risk of developing AIDS when smoking MJ.Initially MJ smokers may be at higher risk for infection with other immunosuppressive viruses bacteria,or other microbes. Cancer patients who use MJ to negate nauseating effects of chemotherapy could be incresing their risk of remaining immuno depressed.Thus they might be at greater risk for tumor emergence during therapy.Likewise,bone marrow transplants patients are administered Marinol (a THC containing product) to relieve nausea.The immune depressive effects of THC in this instance could provide either negative effects (increasing susceptibility to infections) or positive effects (decreasing potential fo graft versus host disease).No studies have been performed to ascertain whether administration of MJ in such a clinical settings has any effects on the general well being of the patient. Experiments with animals have shown in a number of laboratories over 1980s that a variety of MJ substances,including MJ ectracts, may affect the function of lymphocites and macrophages.The size and cellularity of limphoid organs may be affected by MJ and these changes may be related to drug induced alterationsof a variety of cell functions including cytokine productions.The addition of cannabinoids to cultures of mouse or rat lympocytes and macrophages readily suppressed cell proliferation in a dose-related manner. The lymphocites also gave evidence of being deficient in their ability to produce antibodies, respond to IL 2 and produce cytokines especially IFN. It seems possible that MJ may be interfering with early events in lymphocite signal trasduction.Injection of MJcomponents into mice or rats often results in a suppression of antibody forming capacity as well as the capacityto develop hypersensivity responses and to resist to challenge to lethal infection by a virus or bacterium. However, repeated injections with high doses of cannabinoids usually causes greater suppressive effects.Nevertheless,there is a little correlation between the psychoactive potential of cannabinoids and the immune suppression observed. Recent results, however, have also suggested that treatment with MJ or its component does not always resultin immune suppression. Sometimes an immunoenhancement is evident,but this occurs only with relatively low concentration (0,1-1 THC/ml) of MJ components. In addition,the production of IL1 is augmented by THC treatment,and it is possible that cachectin/TNF production also may be enhanced . Immune cell function dependent on arachidonic acid metabolism may be either enhanced or suppressed by cannabinoids,which are known to modulate this pathway.The cytolithic activity and responsiveness to cytokineof murine NK cells as well as human NK cells can be readily suppressed by MJ treatment.This may be related to the effects of the drug to cytokine binding to cell surface receptor and/or othe events involved in signal transduction and cell activation.Mouse or human macrophages are also inhibited by cannabinoid treatment,probably via interference with cell membrane events. Such observations suggest that the biological impact of MJ components on immune mechanism may be quite extensive,and that they may be negatively affect the host by increasing susceptability to chronic infections and neolasia.However,it is apparent from the published studies to date that little informations is available concerning the molecular basis of immunomodulation induced by this drug or its components.Thus future investigations should focus on revealing the mechanism by which MJ depressed immune cell function.  ( 2) Marijuana smoking possible cause of head and neck carcinoma in young patients  AUTHOR(S): Donald P.J.  DOCUMENT TYPE: Journal Article  SOURCE DOCUMENT TITLE: Otolaryngology and Head and neck surgery  SOURCE DOCUMENT DESCRIPTION: 94,517-521 ( 3) A case-control study of acute nonlymphoblastic leukemia - Evidence for an association with marihuana exposure  Author :Jonathan Buckley  Cannabis : physiopathology, epidemiology, detection : from the proceedings of the second international symposium, organized by the National Academy of Medicine, with the assistance of the city of Paris, April 8-9, 1992 / edited by Gabriel G. Nahas, Colette Latour.  Author: CHIRAC, Jacques List of Contributors Foreword Jacques Chirac Preface Henri Baruk Introduction Paul Lechat Greetings from the Academy Henri Baylon

I:Physiopathology 1:Toxicology General toxicity of cannabis Gabriel Nahas 2:Visualization of brain alterations Use of Positron Emission Tomography to study drugs of abuse Nora Volkow 3:Effects on psychomotor performance Marihuana carry-over effects on psychomotor performance: A chronicle of research Von O Leirer Chronic marihuana smoking and short-term memory impairment Richard H. Schwartz Detection of cannabis and other drugs in 120 victims of road accidents Michel Aussedat Marijuana and alcohol use among 1023 trauma patients Carl A. Soderstrom 4:Psychopathology and behavior Historical outlook of the psychopathology of cannabis Gabriel Nahas Prospective study of 104 psychiatric cases associated with cannabis use in a Moroccan medical center Taieb Chkili Effects of cannabis on schizophrenia Juan C. Negrete Schizophrenia and cannabis : cause-effect relationship? Peter Allebeck Schizophrenia and cannabis. How causal a relationship? Bernard Defer Cannabis-associated deaths in medico-legal postmortem studies. Preliminary report Jovan Rajs 5:Effects on immune function and carcinogenesis Delta-9-tetrahydrocannabinol suppresses macrophage extrinsic anti-herpes virus activity Guy Cabral A case-control study of acute nonlymphoblastic leukemia - Evidence for an association with marihuana exposure Jonathan Buckley Marihuana and upper aerodigestive tract malignancy in young patients Paul J. Donald 6:Effects on reproductive function Effects of cannabis on reproduction Herbert Tuchmann-Duplessis II:Epidemiology Report from North America Mitchell Rosenthal Medical aspects of cannabis abuse in Latin America Raul Jeri Trends and policies regarding cannabis and other narcotics in Sweden Peter Allebeck Cannabis consumption in the French population (12 to 44 years age) in 1992 Lionel Gaillaud The epidemiology of adolescent drug use in France and Israel Denise Kandel Drug reform: The Dutch experience Richard H. Schwartz The Dutch drug policy: A physician's commentary Karel F. Gunning Cannabis and the law Georges Lagier Cannabis : Point of view of W.H.O. Juhana Idanpaan-Heikkila III:Detection, Identification and Testing 1:Identification and detection Identification and measurement of cannabinoids and their metabolites in biological fluids Pierre Levillain Detection of illegal drugs in body fluids and interpretation of results Paul Lafargue Salivary THC following cannabis smoking correlates with subjective intoxication and heart rate David B. Menkes 2:Testing Testing for illicit drugs in the workplace Peter Bensinger Screening students for cannabis Richard H. Schwartz Testing for drugs in the military and transportation industry Paul Mulloy Drug use and drug detection in the French armed forces Pierre Juillet General Conclusions Henri Baylon Appendix Hashish and mental illness. The experience and observations of Moreau Helene Peters Effects of THC on brain and social organization of ants Peter Waser Drug use and the lognormal distribution William D. Paton The distribution of consumption of marihuana and alcohol Gabriel G. Nahas Just Say Now : The London Times, July 24, 1992 The Swedish addiction epidemic in global perspective Nils Bejerot Index Copyright 1997: Università Ambrosiana - C.I.S.P.M.  

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