01/5/15

E-Cigarettes and E-Joints

E-cigarettes were marketed as safer alternatives to regular cigarettes and even smoking cessation aides. Now they are being modified and marketed as THC delivery systems—an e-joint, if you will. Sound strange? I found several YouTube videos on using or converting e-cigarettes for use with marijuana products like hash oil. Here is a short “how to” video. If you prefer more professional vaporizers, you can try the Wacky Puffer and other commercial products.

It didn’t take too long to get from the first e-cigarette to the e-joint. In was only in 2003 that a Chinese pharmacist developed the first e-cigarette. They were introduced to Europe in 2006 and to the U.S. soon after. In 2008, the WHO said it did not consider the e-cigarette to be a legitimate smoking cessation aid. The first Vapefest was held in March of 2010 in Richmond Virginia. In April of 2011, the FDA announced that e-cigarettes would be regulated like traditional tobacco products under the Food Drug and Cosmetic Act. Any e-cigarette product claiming to help stop smoking or that it provides any other health benefit will be strictly regulated as a drug or medical device.

A July 2014 report by the World Health Organization (WHO) suggested a variety of restrictions for e-cigarettes, including a ban on indoor use of e-cigarettes until “exhaled vapor is proven to be not harmful to bystanders and reasonable evidence exists that smoke-free policy enforcement is not undermined.”  The Fix pointed out how the tobacco industry is entering the e-cigarette industry. Phillip Morris International has purchased the UK company Nicocigs, an e-cigarette maker. The Fix has several articles on e-cigarettes available, including pro and con sounding titles.

In October of 2014, six U.S. senators signed a letter to the FDA urging companies to label e-cigarettes, “listing all of the health threats the products pose.” Then there is Dr. Nathan Cobb, an assistant professor of medicine at Georgetown School of Medicine who thinks e-cigarettes could bring down traditional smoking and save thousands of lives in the process. However, Dr. Stanton Glantz, doesn’t believe that e-cigarettes are as effective in helping people quit smoking as marketing claims they are.

This commentary assumes that e-cigarettes, as currently in the marketplace, will help people quit smoking and ignores the consistent evidence from population-based studies that smokers who use e-cigarettes are about one-third less likely to quit smoking.

There is growing concern that e-cigarettes aren’t really that safe. Ryan Aliapoulios on the AfterPartyChat website noted the obvious problem, “they still deliver the same addictive chemical at the root of so many other health problems: nicotine.”  He mentioned a study, “A Molecular Basis for Nicotine as a Gateway Drug,” that said while e-cigarettes eliminate some of the morbidity from combustible tobacco, they are “pure nicotine-delivery devices.” They have the same effects on the brain as smoking tobacco and they pose the same risk of addiction.

The authors said the use of e-cigarettes is rapidly increasing among adolescents and young adults. “Our society needs to be concerned about the effect of e-cigarettes on the brain, especially in young people, and the potential for creating a new generation of persons addicted to nicotine.”

In “E-Cigarettes Are Not As Harmless As We’ve Been Told,” The Fix reported that Dr. Glantz and his research team found that e-cigarettes produced greater risk than initially thought, “delivering high levels of nano particles which can trigger inflammation and have been linked to asthma, stroke, heart disease, and diabetes.” Glantz was furthered quoted as saying that e-cigarettes are rapidly increasing in popularity with kids. While they are promoted by tobaccos companies that have purchased e-cigarette companies as a way to quit smoking, a safer less polluting alternative to regular cigarettes, “What the evidence to date shows is that while a puff on an e-cigarette isn’t as dangerous as a puff on a regular cigarette, the main effect they seem to be having is to keep people smoking cigarettes.”

So what about e-joints? They actually exist, according to Scientific American. There is a Dutch company, E-Njoint, BV that has released what it says is the first electronic joint—the E-njoint Disposable. It is battery-powered and vaporizes a liquid vegetable-glycerin and polypropylene-glycol with added flavoring. Polypropylene-glycol is the “e-liquid” used in e-cigarettes. Glycerin is colorless and odorless liquid that is widely used in pharmaceutical formulations.

The next version of the E-Njoint will be both rechargeable and capable of being filled with cannabis or a derivative. “Once the cartridges are empty, users are able to fill these cartridges with a liquid. Those liquids may be standard liquids bought at any store around the world or it could be an extract of a cannabis plant.” The company also plans to release an e-joint that can be used with “dry herbs,” like marijuana.

Pamela Ling of the Tobacco Control Policy Fellowship at the University of California, San Francisco’s Center for Tobacco Research and Education said that while the Dutch company is the first to call its product an ‘electronic joint,’ “the idea of using electronic vaporizers for THC or marijuana is not new, and this company is far from the first. ”

An NPR report on “vape pens,” handheld vaporizers for marijuana, noted how they are reshaping the marijuana business and culture. Two years ago, one man was selling vape pens out of the trunk of his car. Now his company, Grenco Science, has a 6,000 square foot headquarters in central Los Angeles.

The concentrates used in vape pens can be very strong. As I noted in a previous, article, “A Little Dab Will Do Ya,” hash oil concentrations can reach 90 percent THC, while the most potent marijuana is usually no more than 20 percent. These high THC levels are even a concern for Allen St. Pierre, the executive director of NORML, the National Organization to Reform Marijuana Laws:

Between the fact that you can potentially pass out with a single inhalation, or you can have such property damage and potential bodily harm just producing it … these [issues of the vape pen] definitely need to be addressed. . . . This is a screaming call for regulation if there ever was one.

06/30/14

Is Legalizing Reefer Madness?

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image credit: iStock

The Pew Research Center found that for the first time since 1969, more Americans favor legalizing the use of marijuana (52%) than those who oppose it (45%). The change started after 1991, when 78% of Americans opposed legalization and merely 17% supported it. The greatest support for legalization was found within youngest age group, individuals born since 1980. Sixty-Five percent of these Millennials favor legalizing marijuana.

The past three years have seen a rapid shift in support of legalization. In 2010 only 41% were in support of legalization. “Since then, support for legalization has increased among all demographic and political groups.” Boomers, born between 1947 and 1964, have seen their support for legalizing marijuana increase from 24% in 1994 to 50% in 2013.

Along with the increased support for marijuana legalization, there has been a corresponding decline in negative attitudes about marijuana. Currently, 32% believe that smoking marijuana is morally wrong, an 18 point decline since 2006 (50%). Over that same period, the percentage of people who said that smoking marijuana was not a moral issue rose 15 points from 35% in 2006 to 50% in 2013.

Over the past three decades, attitudes on whether or not marijuana was a gateway drug have shifted as well. A 1977 Gallup survey found that 60% of people believed that marijuana was a gateway drug. In 2013, only 38% believed so. Most of this shift is the result of generational change. Gen X and Millennials were far less likely to say that marijuana use leads to the use of hard drugs (36% of Gen X and 31% of Millennials).

The efforts of organizations like NORML and the Marijuana Policy Project seems to be paying off. They have been working to “legalize the responsible use of marijuana,” so that marijuana is “legally regulated similarly to alcohol.”

But I wonder if the momentum towards legalization is moving in right direction. NORML and the Marijuana Policy Project cited various studies on the safety profile of cannabis, the therapeutic potential of cannabis and how long-term cannabis use does not cause permanent cognitive impairment. But there seems to be an opposing consensus on the potential harmful effects of marijuana use.  Just a few of these concerns are noted below.

  • The potency of marijuana has doubled since 1998; tripled in the past 20 years.
  • In 2010, marijuana was involved in more than 461,000 ER visits nationwide.
  • In 2011 around 872,000 individuals received treatment for marijuana use.
  • In 2012 4.3 million individuals could be diagnosed as dependent upon or abusing marijuana.

There is also clear evidence of an association between marijuana use and psychosis. NORML gave a summary of the 1995 Lancet study that said smoking cannabis, even long-term use, was not harmful. Yet they ignored the Lancet’s retraction of that support published in the July 2007 edition of the Lancet:

In 1995, we began a Lancet editorial with the since much-quoted words: “The smoking of cannabis, even long term, is not harmful to health.” Research published since 1995, including Moore’s systematic review in this issue, leads us now to conclude that cannabis use could increase the risk of psychotic illness. Further research is needed on the effects of cannabis on affective disorders. The Advisory Council on the Misuse of Drugs will have plenty to consider. But whatever their eventual recommendation, governments would do well to invest in sustained and effective education campaigns on the risks to health of taking cannabis.

A web site, Cannabis & Psychosis, was recently launched to “increase awareness and understanding of the relationship between cannabis use and psychosis from the perspective of youth.”

Public support for the legalization of marijuana is growing. The potency of marijuana is increasing. And the evidence for the harmful effects, especially psychosis and other mental health issues is becoming clearer. Marijuana will likely surpass alcohol and tobacco as a public health concern once it is legalized. For more information on the health concerns with marijuana go to “Marijuana Research Findings” on this website.

Do you think marijuana should be legalized despite its potential harmful consequences? 

06/2/14

Marijuana as a “Gateway” Drug

Marty O’Rourke, who discipled me when I was young in the Christian faith, would sometimes tell others that when he first met me, I was smoking a joint. Technically, I had just taken a toke and was passing the joint to another person. Yes, I did sometimes smoke marijuana in the 1970s and I did inhale. But I never went on to try harder drugs. There was no “gateway effect” with my marijuana use.

There has been a back-and-forth debate for years about whether or not marijuana is a “gateway” drug. Typically three truths support the idea:

  • Marijuana users are more likely than nonusers to progress to hard-drug use.
  • Almost all the individuals who have used both marijuana and hard drugs first used marijuana.
  • A higher frequency of marijuana use raises the likelihood of using hard drugs at a later time.

But like me, the overwhelming majority of marijuana users do not progress to other drugs.  The 2012 National Survey on Drug Use and Health found marijuana was the most commonly used illicit drug, with 18.9 million users in the month prior to the survey. This constituted 79 percent of all the reported illicit drug use. About two thirds (62.8%) of illicit drug users had used only marijuana in the past month.

Sociologists say marijuana is typically used within a specific social context. So the progression to more dangerous drugs happens as a result of the person associating with a subculture that condones drug experimentation. The social group, not marijuana, is the “gateway.”

Similarly, Andrew Morral suggested there was a common factor explanation for the gateway effect with marijuana. The individual’s opportunities and inclination determine the risk of future hard drug use, not prior marijuana use. He commented that his research did not disprove the gateway theory. But it showed another plausible explanation for the association of marijuana use and hard drug use.

The Marijuana Policy Project listed several articles (i.e., Is Marijuana a “Gateway Drug”?) that challenged the marijuana gateway theory. However, the articles tended to conclude there was a common factor explanation or a mediating factor, like stress or genetics, to the gateway effect with marijuana. They debunked the notion of marijuana use as a causative factor leading to harder drug use, but they do not effectively challenge the above three facts supporting the marijuana gateway theory.

Counseling people with drug and alcohol problems has shown me that they often experimented with marijuana before trying harder drugs. The three statements above have been true time and time again. Marijuana use may not be a causative gateway to future experimentation with more dangerous drugs, but it was often a stepping stone taken before an individual tried the cocaine, heroin, or prescription drug high. And a recent study by researchers at Yale concluded that previous alcohol, cigarette and marijuana use were each associated with the current abuse of prescription opioids. “Previous marijuana use was 2.5 times more likely than no previous marijuana to be associated with subsequent abuse of prescription opioids.”

The executive director of the Connecticut chapter of NORML, Erik Williams, said the Yale study failed to show a strong link between marijuana and the use of harder drugs. “This is just another propaganda study that tries to turn a casual link into a causal relationship.” The Yale’s study lead author agreed there wasn’t proof of a concrete connection between opioid abuse and prior marijuana use. But, she said, “It’s a red flag.” It suggests there is a potential association there.

Marijuana does not seem to be a “gateway” that leads to experimentation with more dangerous drugs. But it often is a stepping stone taken on the path to harder drugs in a person’s addictive career.

Do you think that marijuana use can be a gateway or stepping stone to more dangerous drugs, like heroin and cocaine? 

05/19/14

Remembering Reefer Madness

rmadness31Sometime around 1975, I went to see the film “Reefer Madness.” I was probably stoned, because that was what you did. You smoked pot and went to see the movie. But that was a long time ago. These days I’m on the other side of the movement to legalize marijuana. Being a drug and alcohol counselor for over thirty years and seeing the negative consequences of drug use and abuse can do that to you.

A few years ago I taught a Sociology of Deviant Behavior course at Grove City College, and showed the film to my class. The students didn’t express concerns; I didn’t think they would. But I heard that while some of their parents thought it was “cool” that a professor at a conservative Christian college would show the film, others weren’t pleased.

“Reefer Madness” was released as “Tell Your Children” in 1936. Financed by a small church group, it was supposed to inform parents of the dangers of smoking marijuana. During filming, the cast was asked to “hoke” it up—be campy and melodramatic. Scenes like the one pictured here where the character Ralph demands that the piano be played “Faster … Faster!” come to mind.

Soon after the film was completed, it was purchased by Dwain Esper, who renamed it “Reefer Madness” and put it on the exploitation cinema circuit. Several new movies each year would travel from town to town on the circuit. Each addressed a socially problematic behavior. Films like “Reefer Madness” and “Cocaine Fiends” would be announced in a town with huge posters that screamed, “THE MOST VITAL PICTURE OF ALL TIME” and “YOU MUST SEE IT.”

Theater lobby displays for movies warning of the dangers of drugs contained hypodermic needles, simulated reefers, and other drug paraphernalia. “Esteemed” lecturers would tell of the dangers of drugs, venereal disease, or whichever problem behavior related to the film—and then urge filmgoers to buy their educational booklets.

Amidst this onslaught of hype, the movie itself almost became an afterthought. After a brief release, “Reefer Madness” was forgotten for decades. Neither Esper nor the original filmmakers bothered to copyright the movie and it eventually fell into the public domain. Watch a version of “Reefer Madness” here on YouTube.

In 1971, Keith Stroup, the founder of NORML (National Organization for Reform of Marijuana Laws), bought a print of Reefer Madness for $297. He cleaned it up and started showing it at pro-pot festivals. Robert Shaye, the head of the newly formed New Line Cinema film company, saw the film and recognized its potential as a campy classic. Shaye booked the film onto the college and midnight movie circuits, where it was huge hit. That’s where I first saw it.

I was reminded of the theatre surrounding “Reefer Madness” recently when I read an article on The Huffington Post about the first hemp harvest in Colorado: “This is What the End of Hemp Prohibition Looks Like.” The farmer, Ryan Loflin, had volunteer harvesters from five different state and two different countries. They received a t-shirt and a free lunch for their efforts.

It does seem that the tide has changed, as the legalization of marijuana and hemp continues to gain political support. But it’s not necessarily heading to a better world. “Reefer Madness” was hokey and melodramatic, but it had a core of truth to it. A 2007 study found an increased risk of psychosis later in life from using cannabis. I’ve also gathered and summarized additional studies showing the negative consequences of cannabis use in “Marijuana Research Findings.” Hmmm … Maybe someone needs to make an updated, less hokey “Reefer Madness” film.

Have you seen “Reefer Madness” and do you think it may have a core of truth to it?