Prohibition and Alcohol Intoxication

The effect of total prohibition imposed in Bihar State with effect from April, 1979, was assessed on the basis of the hospital records of Patna Medical College Hospital. During the first seven months of prohibition, there was a significant decrease in the number of alcohol intoxication cases as compared to the numbers of such cases during the corresponding periods of 1976, 1977 and 1978 (P < 0.001). During the subsequent Jive months of prohibition the number of cases increased and the figure was not significantly different from those of previous years (P. > 0.07). Age, sex and urban or rural distributions of cases remained unaltered during prohibition and pre-prohibition periods. A similar trend was observed in Pilgrim Hospital, Goya which is situated 92 km south of Patna. There was however a significant decrease in alcohol related crimes during prohibition compared to previous years (P. < 0.01), and possible reasons for discrepancy between the hospital and arrest indicator are discussed. During the prohibition period there was a 20 per cent increase in illicit trade in liquor. While people from the lower income group favoured prohibition, those from the higher income group did not approve of it. People from both groups got alcohol in the black market. Except for the initial drop in the number of hospital cases, the medical problem of alcohol intoxication was not solved by the ineffective enforcement of prohibition.     

Marijuana craving in the brain

Craving is one of the primary behavioral components of drug addiction, and cue-elicited craving is an especially powerful form of this construct. While cue-elicited craving and its underlying neurobiological mechanisms have been extensively studied with respect to alcohol and other drugs of abuse, the same cannot be said for marijuana. Cue-elicited craving for other drugs of abuse is associated with increased activity in a number of brain areas, particularly the reward pathway. This study used functional magnetic resonance imaging (fMRI) to examine cue-elicited craving for marijuana. Thirty-eight regular marijuana users abstained from use for 72 h and were presented with tactile marijuana-related and neutral cues while undergoing a fMRI scan. Several structures in the reward pathway, including the ventral tegmental area, thalamus, anterior cingulate, insula, and amygdala, demonstrated greater blood oxygen level dependent (BOLD) activation in response to the marijuana cue as compared with the neutral cue. These regions underlie motivated behavior and the attribution of incentive salience. Activation of the orbitofrontal cortex and nucleus accumbens was also positively correlated with problems related to marijuana use, such that greater BOLD activation was associated with greater number of items on a marijuana problem scale. Thus, cue-elicited craving for marijuana activates the reward neurocircuitry associated with the neuropathology of addiction, and the magnitude of activation of these structures is associated with severity of cannabis-related problems. These findings may inform the development of treatment strategies for cannabis dependence.     

Psychopathology and Experience with Marijuana

In looking at the relationship between the use of marijuana and the severity of psychiatric symptomatology among students in a university community, the present study found that students reporting symptom; of greatest severity were significantly more likely to have had experience with marijuana. Additional findings also demonstrated that experience with the drug was significantly associated with students' previous utilization of psychiatric facilities, their contact with others who have sought psychiatric care, and the nature of their identifications within the college community.     

Exploring the Mediational Role of Coping Motives for Marijuana Use in Terms of the Relation between Anxiety Sensitivity and Marijuana Dependence

This study evaluated the prediction that coping motives for marijuana use would mediate the relation between anxiety sensitivity and a marijuana dependence diagnosis after controlling for other co‐occurring marijuana use motives. Participants were 136 current marijuana users (47.1% women; M_age= 21.9, SD = 7.2). Results were consistent with a mediational effect, with the relation between anxiety sensitivity and marijuana dependence being explained by the addition of coping motives into the model. These results provide novel information related to the putative explanatory role of coping motives for marijuana use in the relation between anxiety sensitivity and marijuana dependence. (Am J Addict 2010;19:277–282)     

Marijuana Use and Type 2 Diabetes Mellitus: a Review

Marijuana is used by millions of people, with use likely to increase in the USA because of the trend towards increased decriminalization and legalization. Obesity and diabetes mellitus (DM) rates have increased dramatically in the USA over the past 30 years, with a recent estimate of 29 million individuals with DM. Because there is a plausible link between marijuana use and diabetes due to the known effects of cannabinoids on adipose tissue and glucose/insulin metabolism, it is important to study and understand how marijuana use is related to obesity and diabetes. This paper provides background on the human endocannabinoid system and studies of the association of marijuana use with body mass index/obesity, metabolic syndrome, prediabetes, and diabetes. The studies to date have shown that marijuana use is associated with either lower odds or no difference in the odds of diabetes than non-use.     

In-Hospital Costs and Costs of Complications of Chronic Total Occlusion Angioplasty: Insights From the OPEN-CTO Registry

Objectives

The aim of this study was to describe the costs of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and the association of complications during CTO PCI with costs and length of stay (LOS).

Kava and Prohibition in Tanna, Vanuatu

The drinking of kava is widespread and frequent among adult men on Tanna, Vanuatu (formerly the New Hebrides). Effort to prohibit use of kava created a split between the majority of the people and Western missionary and government influences. The story of prohibition reflects different moral and cultural practices coming in conflict. A declining role of Western influence has led to a resolution of the differences in favour of continued kava use.     

Marijuana use and car crash injury

AIMS: To investigate the relationship between marijuana use prior to driving, habitual marijuana use and car crash injury. DESIGN AND SETTING: Population based case-control study in Auckland, New Zealand. PARTICIPANTS: Case vehicles were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and control vehicles were a random sample of cars driving on Auckland roads. The drivers of 571 case and 588 control vehicles completed a structured interview. MEASUREMENTS: Self reported marijuana use in the 3 hours prior to the crash/survey and habitual marijuana use over the previous 12 months were recorded, along with a range of other variables potentially related to crash risk. The main outcome measure was hospitalization or death of a vehicle occupant due to car crash injury. FINDINGS: Acute marijuana use was significantly associated with car crash injury, after controlling for the confounders age, gender, ethnicity, education level, passenger carriage, driving exposure and time of day (OR 3.9, 95% CI 1.2-12.9). However, after adjustment for these confounders plus other risky driving at the time of the crash (blood alcohol concentration, seat-belt use, travelling speed and sleepiness score), the effect of acute marijuana intake was no longer significant (OR 0.8, 95% CI 0.2-3.3). There was a strong significant association between habitual use and car crash injury after adjustment for all the above confounders plus acute use prior to driving (OR 9.5, 95% CI 2.8-32.3). CONCLUSIONS: This population-based case-control study indicates that habitual use of marijuana is strongly associated with car crash injury. The nature of the relationship between marijuana use and risk-taking is unclear and needs further research. The prevalence of marijuana use in this driving population was low, and acute use was associated with habitual marijuana use, suggesting that intervention strategies may be more effective if they are targeted towards high use groups.