Cannabis. Hjärnan Miljön Alkohol Medicinsk marijuana Legaliseringen i Colorado östen2015. Pelle Olsson

Transkript

1 Cannabis Hjärnan Miljön Alkohol Medicinsk marijuana Legaliseringen i Colorado östen2015 Pelle Olsson

2 Olika droger från cannabis Hasch Marijuana Edibles (ätbar och drickbar)

3 Cannabis innehåller bl.a: THC (delta-9-tetrahydrocannabinol) är den viktigaste rusgivande substansen. CBD (cannabidiol) är en skyddande substans mot skadeverkningar.

4 Gårdagens cannabis

5 Dagens cannabis

6

7 Legalt odlat cannabis i Colorado, USA innehåller i genomsnitt 18,7 procent THC och 0,1 procent CBD.

8 Ruset Akut rus Aktiv fas min Passiv fas 1-3 timmar Kroniskt rus Ständigt, om man röker regelbundet.

9 Var hittar man kunskap om cannabis?

10 Korrekta källor Forskning som är publicerad i vetenskapliga tidskrifter Officiell statistik

11 Osäkra källor Allt annat

12 Paula Riggs Professor, beroendeläkare, forskare Colorado University Inom vetenskapen är vi överens om vilka skador som orsakas av marijuana.

13 Vad skadas mest av cannabis?

14 Svar: Tonårshjärnan Alla andra hjärnor Miljön

15 Storskalig cannabisodling tär på jordens resurser Energikrävande Stor vattenförbrukning Giftiga bekämpningsmedel, mögel, skadeinsekter och svamp

16 Cannabisodlingar i USA Det går åt lika mycket vatten att framställa en joint som 10 liter öl. Produktionen motsvarar 1 procent av USA:s elenergi. Koldioxidutsläppen = utsläpp från 3 miljoner bilar. Flera stora floder i Kalifornien håller på att dräneras och silverlaxen hotas och p.g.a cannabisodlingarna. Några odlingar i Colorado har tvingats i karantän p.g.a pesticider, svamp och mögel. Kontrollerna från myndigheterna är nästan obefintliga Källor bland annat: Mills, E. (2012). The carbon footprint of indoor Cannabis production. Energy Policy, 46: 58 67

17 Cannabis och hjärnan

18

19 Cannabisreceptorer binder till Kroppens egna cannabinoider: anandamid + ytterligare 7-8 ämnen Cannabis: THC Syntetiskt cannabis: Spice, m.m.

20 Skador på den unga hjärnan

21 Sänkt intellektuell förmåga Ej utvecklad vuxenhjärna Personlighetsförändring 2-3 gånger ökad risk för schizofreni 10 procent får psykoser 17 procent blir beroende

22 Intellektuell förmåga Bland annat: Minnet Intelligenskvot Tidsuppfattning Språkförmåga sämre skolprestationer

23 Oskar 18 år, cannabisrökare De biverkningarna som jag hört om, att man blir dummare, är sånt jag kan leva med. Jag anser mig själv vara så pass skärpt att jag har råd att förlora lite grann. Men om man är dum från början och börjar röka cannabis, då kan man bli riktigt jävla dum. (Egen intervju med Oskar dec 2010)

24 Harriet Furugård, cannabisbehandlare De missar möten och kommer inte ihåg namn på personer. De glömmer saker de lovat. Långtidsminnet drabbas mindre än korttidsminnet, men de påverkar varandra. De blandar ihop när något hände eller i vilken ordning. Minnet är viktigt för att ha koll på sin historia och de erfarenheter man skaffat sig och samtidigt tänka framåt. Inget av detta klarar en aktiv cannabisrökare av.

25 Madeline Meier Cannabisforskare, USA/ Nya Zeeland Den som röker cannabis i tonåren får upp till 8 enheter lägre IQ, jämfört med den som inte röker alls. Intelligensförsämringen kvarstår vid 38 års ålder även om man har slutat med cannabis.

26 Källor cannabis och hjärnan Lundqvist, T. (1995). Cognitive dysfunctions seen in chronic cannabis users, observed during treatment, an integrative approach. Almqvist & Wiksell international. Hall, W. et al (1994). The health and psychological consequences of cannabis use. Canberra: Australian Government Publishing Service. Hall, W. (2014). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction. Aug 4. Solowij, N. (1999). Cannabis and cognitive functioning. Cambridge University Press. Volkow, ND. (2014). Adverse health effects of marijuana use. The New England Journal of Medicine. 370;23: Antonovsky, A. (1991). Hälsans mysterium. Natur och Kultur. Petrell, B., Blomqvist, J. & Lundqvist, T. (2005). Ut ur dimman. En uppföljning av Maria Ungdoms cannabisprogram. Stockholm FoU-rapport 2005:19. Gaffuri, AL. et al (2012). Type-1 cannabinoid receptor signalling in neuronal development. Pharmacology, 90: Devane, WA., Howlett, AC. et al (1988). Determination and characterization of a cannabinoid receptor in rat brain. Mol Pharmacol, 34: Devane, WA. et al (1992). Isolation and structure of brain constituent that binds to the cannabis receptor. Science, 258: Rodriguez De Fonseca, FR. & Schneider, M. (2008). The endogenous cannabinoid system and drug addiction: 20 years after the discovery of the CB1 receptor. Addiction Biology, 13: Ashtari, M. et al (2009). Diffusion abnormalities in adolescents and young adults with a history of heavy cannabis use. Journal of Psychiatric Research, 43:

27 Ashtari, M. et al (2011). Medial temporal structures and memory functions in adolescents with heavy cannabis use. J Psychiatr Res, 45(8): Gutchess, A. et al (2010). Functional neuroimaging of self-referential encoding with age. Neuropsychologia, 48(1): Phan, KL. et al (2008). Cannabinoid modulation of amygdala reactivity to social signals of threat in humans. The Journal of Neuroscience, 28(10): Gruber, SA. & Yurgelun-Todd, DA. (2005). Neuroimaging of marijuana smokers during inhibitory processing: a pilot investigation. Cognitive Brain Research, 23: Gruber, SA. et al (2009). Altered affective response in marijuana smokers. Drug and alcohol dependence, 105: Gobbi, G. et al (2010). Chronic exposure to cannabinoids during adolescence but not during adulthood impairs emotional behaviour and monoaminergic neurotransmission. Neurobiology of Disease, 37(3): Mata, I. et al (2010). Gyrification brain abnormalities associated with adolescence and earlyadulthood cannabis use. Brain Research, 1317: Becker, B. et al (2010). The impact of early-onset cannabis use on functional brain correlates of working memory. Prog Neuropsychopharmacol Biol Psychiatry, 34(6): Fontes, MA., Bolla, KI. et al (2011). Cannabis use before age 15 and subsequent executive functioning. The British journal of psychiatry: the journal of mental science, 198(6): Fontes, MA., Bolla, KI. et al (2011). Frontal Assessment Battery (FAB) is a simple tool for detecting executive deficits in chronic cannabis users. Journal of Clinical and Experimental Neuropsychology, 33(5):

28 Meier, M. et al. (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. PNAS, 109(40): E2657 E2664. Smith, MJ. et al (2013). Marijuana Users Have Abnormal Brain Structure and Poor Memory - Drug abuse appears to foster brain changes that resemble schizophrenia. Journal of Schizofrenia Bullentin. Dec. 16. Gilman, J. et al (2014). Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users. The Journal of Neuroscience, 34(16): Price, JS. et al (2015). Effects of marijuana use on prefrontal and parietal volumes and cognition in emerging adults. Psychopharmacology (Berl), April 30. Smith, MJ. et al (2015). Cannabis-related episodic memory deficit and hippocampal morphological differences in healthy individuals and schizophrenia subjects. Hippocampus. March 11. Riba, J. et al (2015). Telling true from false: cannabis users show increased susceptibility to false memories. Molecular Psychiatry, 20:

29 Källor till psykoser och schizofreni Castle, DJ. & Ames, FR. (1996). Cannabis and the brain. Aust N Z Journal Psychiatr, 30: Johnson, BA. (1991). Cannabis. Glass, IB. (Red.). The international handbook of addiction behaviour. London/New York: Tavistock/Routledge. Sid Thomas, H. (1996). A community survey of adverse effects of cannabis use. Drug and Alcohol Dependence, 42: Johns, A. (2001). Psychiatric effects of cannabis. Br J Psychiatr, 178: Ramström, J. (2009). Skador av hasch och marijuana. Statens Folkhälsoinstitut. Sid 31. Cullberg, J. (2000). Psykoser. Ett humanistiskt och biologiskt perspektiv. Natur och Kultur. Andréasson, S., Allebeck. P., Engström, A. & Rydberg U. (1987). Cannabis and schizophrenia. A longitudinal study of Swedish conscripts. Lancet, 2: Allebeck, P. et al (1993). Cannabis and schizophrenia: a longitudinal study of cases treated in Stockholm county. Acta Psychiatr Scand, 88: Linszen, DH. et al (1995). Samenhang tussen gebruik van cannabis en recidief/exacerbatie van psychose bij patienten met schizofrenie. Ned Tijdschr Geneeskd, 139: van Os, J. et al (2002). Cannabis use and psychosis: a longitudinal population-based study. Am J Epidemiol, 156(4): Zammit, S. et al (2002). Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. BMJ, 325: *Fergusson, DM. et al (2003). Cannabis dependence and psychotic symptoms in young people. Psychol Med, 33(1):

30 *Boydell, J., van Os J. et al (2006). Trends of cannabis use prior to first presentation with schizophrenia, in south-east London between 1965 and Psychological Medicine, 36: McGrath, J. et al (2010). Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Arch Gen Psychiatry, 67(5): Degenhardt, L. & Hall, W. (2006). Is cannabis use a contributive cause of psychosis? Can J Psychiatry, 51: Moore, TH. et al (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet, 370: Manrique-Garcia, E. et al (2012). Cannabis, schizophrenia and other non-affective psychoses: 35 years of follow-up of a population-based cohort. Psychological Medicine, 42(6): Manrique-Garcia E. et al (2014). Prognosis of schizophrenia in persons with and without a history of cannabis use. Psychological Medicine, 44(12): Arendt, M. et al (2005). Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. British Journal of Psychiatry, 187: Olsson P. (2010). Marijuana och frihet. Fri förlag. Sid Liemburg, EJ. et al (2014). The Psychosis Recent Onset Groningen Survey (PROGR-S): defining dimensions and improving outcomes in early psychosis. PLoS One, 9(11): e Arseneault, L. et al (2002). Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ, 325: Moore, TH. et al (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a ystematic review. Lancet, 370: Ajdacic-Gross, V. et al (2007). Changing incidence of psychotic disorders among the young in Zurich. Schizophrenia Research, 95: 9-18.

31 Frisher, M. et al (2009). Assessing the impact of cannabis use on trends in diagnosed schizophrenia in the United Kingdom from 1996 to Schizophrenia Research, 113(2-3): Long, LE. et al (2009). A behavioral comparison of acute and chronic delta9-tetrahydrocannabinol and cannabidiol in C57BL/6JArc mice. Int J Neuropsychopharmacol, 29: NBC News Svenska Dagbladet Di Forti, M. et al (2015). Proportion of patients in south London with firstepisode psychosis attributable to use of high potency cannabis: a casecontrol study. Lancet Psychiatry, (publicerat online 18 febr.). Ceccarini J. et al. (2013). Increased ventral striatal CB1 receptor binding is related to negative symptoms in drug-free patients with schizophrenia. Neurolmage, 79: Smith, MJ. et al (2013). Marijuana Users Have Abnormal Brain Structure and Poor Memory - Drug abuse appears to foster brain changes that resemble schizophrenia. Journal of Schizofrenia Bullentin, Dec. 16.

32 Övriga skador och konsekvenser Inkörsport till andra droger Trafikolyckor Lungskador Hjärt- och kärlsjukdomar Cancer Kortare liv Våld och aggressioner

33 Källor till inkörsporten Guttormsson, U. et al (2014). Vad vet vi om cannabisrökning bland unga? CAN. Ibid. National Survey of Drug Use and Health. National Admissions to Substance Abuse Treatment Services (2013). NSDUH. Kandel, DB. et al (1986). The consequences in young adulthood of adolescent drug involvement. Arch Gen Psychiatry, 43: Fergusson, DM. et al (2008). The developmental antecedents of illicit drug use: Evidence from a 25-year longitudinal study. Drug and Alcohol Dependence, 96: Lynskey, MT. et al (2006). Early onset cannabis use and progression to other drug use in a sample of Dutch twins. Behav Genet, 36: Maria Ellgrens doktorsavhandling: Neurobiological effects of early life cannabis exposure in relation to the gateway hypothesis. Department of Clinical Neuroscience, Karolinska Institutet. Stockholm.

34 Trafikolyckor Ramaekers, J. et al (2009). Neurocognitive performance during acute THC toxication in heavy and occasional cannabis users. Psychopharmacology, 23: Forsman, Å. (2015.) Alkohol, droger och läkemedel hos omkomna personbilsförare VTI notat Jones, RK. et al (2003). State of knowledge of drug-impaired driving. National Highway Traffic Safety Administration. Report No. DOT HS Salomonsen-Sautel, S. et al (2014). Proportion Of Fatal Crash Drivers MJ-Positive In Colorado and 34 States Without Medical MJ, Drug Alcohol Depend, 140: Fergusson DM. & Horwood, LJ. (2001). Cannabis use and traffic accidents in a birth cohort of young adults. Accident Analysis and Prevention, 33: Fergusson DM. et al (2008). Is driving under the influence of cannabis becoming a greater risk to driver safety than drink driving? Findings from a longitudinal study. Accident Analysis and Prevention, 40: Sewell, A. et al (2009). The effect of cannabis compared with alcohol and driving. Am J Addict, 18(3): Hartman, R., Huestis, M. et al (2015). Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol. Clinical Chemistry, 61(6): Laumon, B. et al (2005). Cannabis intoxication and fatal road crashes in France: population based case-control study. British Medical Journal, 331: Li, MC. et al (2012).Marijuana use and motor vehicle crashes. Epidemiol Rev, 34 (1): Asbridge, M. et al (2012). Acute Cannabis Consumption and Motor Vehicle Collision Risk: A Systematic Review of Observational Studies and Meta Analysis. BJM, 344: e536. Crompton, R. & Berning, A. (2015). Drug and Alcohol Crash Risk. Traffic Safety Facts. Research note. National Highway Traffic Safety Admission (NHTSA). Februari Bergamaschi, MM. et al (2013). Impact of Prolonged Cannabinoid Excretion in Chronic Daily Cannabis Smokers Blood on Per Se Drugged Driving Laws. Clinical Chemistry, 59(3):

35 Lungskador Moir, D. et al (2008). A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two smoking machine conditions. Chem Res Toxicol, 21(2): Tashkin, DP. et al (2002). Respiratory and immunologic consequences of marijuana smoking. J Clin Pharmacol, 42(11 Suppl): 71S-81. Mehra, R. et al (2006). The association between marijuana smoking and lung cancer, a systematic review. Arch Intern Med, 166: Torell, U. (2002). Den rökande människan. Bilden av tobaksbruk i Sverige mellan och 1990-tal. Carlssons. Tashkin, DP. (1993). Is frequent marijuana smoking harmful to health? The Western Journal of Medicine, 158: Tashkin, DP. et al (2002). Respiratory and immunologic consequences of marijuana smoking. J Clin Pharmacol, 42(11 Suppl): 71S-81. Tashkin, DP. et al (2006). Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study. Cancer epidemiology, biomarkers & prevention, 15(10): Tashkin, DP. (2013) Effects of marijuana smoking on the lung. Ann Am Thorac Soc, 10(3): Volkow, ND. (2014). Adverse health effects of marijuana use. The New England Journal of Medicine, 370;23: Hall, W. (2014). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction, Aug 4. Aldington, S. et al (2008). Cannabis use and risk of lung cancer: a case control study. Eur Respir J, 31:

36 Lungskador forts. Berthiller, J. et al (2008). Cannabis smoking and risk of lung cancer in men: a pooled analysis of three studies in Maghreb. J Thorac Oncol, 3: Maertens, RM. et al (2013). A global toxicogenomic analysis investigating the mechanistic differences between tobacco and marijuana smoke condensates in vitro. Toxicology, 308: Callaghan, R., Allebeck, P. & Sidorchuk, A. (2013). Marijuana use and risk of lung cancer: a 40 year cohort study. Cancer Causes Control, 24: Tan, WC. (2009). Marijuana and chronic obstructive lung disease: a population-based study. Can Med Assoc J, 180(8): Taylor D., Fergusson, D. et al (2002). Longitudinal study of the effects of tobacco and cannabis exposure on lung function in young adults. Addiction, 97: Joshi, M., Joshi. A., Bartter, T. (2014). Marijuana and lung disease. Curr Opin Pulm Med, 20(29): Miller, WE., Spiekerman, RE. & Hepper, NG. (1972). Pneumomediastinum resulting from performing Valsalva manoeuvres during marihuana smoking. Chest, 62: Feldman, AL., Sulliva, JT., Passero, MA. et al (1993). Pneumothorax in polysubstance abusing marijuana and tobacco smokers: three cases. J Subst Abuse, 5: Goodyear, K., Laws, D. & Turner, J. (2004). Bilateral spontaneous pneumothorax in a cannabis smoker. J R Soc Med, 97(9): The impact of cannabis on your lungs. (2012). British Lung Foundation.

37 Cancer Moir, D. et al (2008). A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two smoking machine conditions. Chem Res Toxicol, 21(2): Tashkin, DP. et al (2002). Respiratory and immunologic consequences of marijuana smoking. J Clin Pharmacol, 42(11 Suppl): 71S-81. Ibid. Aldington, S. et al (2008). Cannabis use and risk of lung cancer: a case control study. Eur Respir J, 31: Taylor, FM. (1988). Marijuana as potential respiratory tract carcinogen: a retrospective analysis of a community hospital population. Southern Medical Journal, 81(10): Endicott, J. & Skipper P. (1991). Marijuana and the upper aerodigestive tract malignancy in young subjects. In: Internationales Symposium gegen Drogen. Zurich: Verlag Menschenkenntnis. Sid Donald, PJ. (1993). Marijuana and upper aerodigestive tract malignancy in young patients. Nahas GG. & Latour C. (Red.). Cannabis. Physiopathology, epidemiology, detection. Ann Arbor: CRC Press. Sid Thomas, AA. et al (2015). Association between cannabis use and the risk of bladder cancer: results from California Men s Health Study. Urology, 85(2): Dalin, J. et al (2009). Association of marijuana use and the incidence of testicular germ cell tumors. Cancer, 115: Bhattarcharyya, S. et al (2015). Cannabis smoke can be a major risk faktor for early-age laryngealcancer- a molecularsignaling-based approach. Tumor Biol, Mar 4. Hashibe, M., Tashkin, DP. et al (2005). Epidemiologic review of marijuana and cancer risk. Alcohol, 35(3): Huang, YH., Tashkin, DP. et al (2015). An epidemiologic review of marijuana and cancer: an update. Cancer Epidemiol Biomarkers Prev, 24(1):

38 Hjärt- och kärlsjukdomar Ramström, J. (2009). Skador av hasch och marijuana. Statens folkhälsoinstitut Sid Hartung, B. et al (2014). Sudden unexpected death under acute influence of cannabis. Forensic Sci Int, 237:e11-3. Hodcroft, CJ. et al (2014). Cannabis-associated myocardial infarction in a young man with normal coronary arteries. J Emerg Med, 47(3): Mittleman, MA. et al (2001). Triggering myocardial infarction by marijuana. Circulation, 103: Mukamal, KJ. et al (2008). An exploratory prospective study of marijuana use and mortality following acute myocardial infarction. Am Heart J, 155(3): Frost, L. et al (2013). Marijuana use and long-term mortality among survivors of acute myocardial infarction. Am Heart J, 165(2): Caldicott, DGE. et al (2005). Keep off the grass: marijuana use and acute cardiovascular events. Eur J Emerg Med, 12: Singh, NN. et al (2012). Cannabis-related stroke: case series and review of literature. J Stroke Cerebrovasc Dis, 7: Ince, B. et al (2015). Both hemorrhagic and ischemic stroke following high doses of cannabis consumption. Presse Med, 44(1): Hackam, DG. (2015). Cannabis and stroke: systematic appraisal of case reports. Stroke, 46(3): Wolff, V. et al (2015). Tetrahydrocannabinol induces brain mitochondrial respiratory chain dysfunction and increases oxidative stress: a potential mechanism involved in cannabis-related stroke. Biomed Res Int. 2015: Jouanjus, E. et al (2014). Cannabis use: signal of increasing risk of serious cardiovascular disorders. J AM Heart Assoc, 3(2): e Ramström, J. (2009). Skador av hasch och marijuana. Statens folkhälsoinstitut. Sid Peyrot, I. et al (2007). Cannabis arteritis: a new case report and a review of literature. Journal of the European Academy of Dermatology and Venereology, 21 (3):

39 Kortare liv Fugelstad, A. & Rajs, J. (1998). Narkotika - ett livsfarligt beroende. Nya Doxa. Callaghan, RC. et al (2012). All-cause mortality among individuals with disorders related to the use of metamphetamine. A kohort study. Drug Alcohol Dependence, 125(3): Arendt, M. et al (2010). Mortality among individuals with cannabis, cocaine, amphetamine, MDMA, and opioid use disorders: a nationwide follow-up study of Danish substance users in treatment. Drug Alcohol Depend, 114: Calabria, B., Degenhardt, L., Hall, W. & Lynskey, M. (2010). Does cannabis use increase the risk of death? Systematic review of epidemiological evidence on adverse effects of cannabis use. Drug Alcohol Rev, 29: Manrique-Garcia, E. (2014). Cannabis, schizofrenia and other psychoses: longitudinal studies on Swedish conscripts. Thesis for doctoral degree. Department pf public health sciences. Karolinska Institutet Sid 27. Calabria, B. et al. (2010). Does cannabis use increase the risk of death? Systematic review of epidemiological evidence on adverse effects of cannabis use. Drug Alcohol Rev, 29: Price, C., Allebeck, P. et al (2009). Cannabis and suicide: longitudinal study. The British Journal of Psychiatry, 195 (6): Jamison, E. et al (2014). Adolescent Suicide in Colorado, Colorado Violent Death Reporting System, Vital Statistics Program, Colorado Department of Public Health and Environment, nr 94, Serafini, G. et al (2012). Can cannabis increase the suicide risk in psychosis? A critical review. Curr Pharm Des, 18(32):

40 Aggressioner och våld Ramström, J. (2009). Skador av hasch och marijuana. Statens folkhälsoinstitut. Sid Spunt, B. et al (1994). The role of marijuana in homicide. In J Addict, 29(2): Niveau, G. & Dang C. (2003). Cannabis and violent crime. Med Sci Law, 43(2): Arseneault, L. et al (2000). Mental disorders and violence in a total birth cohort. Arch Gen Psychiatry, 57: Friedman, AS. et al (2001). Violent behavior as related to use of marijuana and other drugs. Journal of Addictive Diseases, 20(1): Hoaken, PNS. & Stewart, SH. (2003). Drugs of abuse and the elicitation of human aggressive behaviour. Addictive Behaviours, 28(9): Smith, PH. et al (2013). Marijuana withdrawal and aggression among a representative sample of U.S. marijuana users. Drug & Alcohol Dependence, 132(1-2): Kouri, E. et al (1999). Changes in aggressive behavior during withdrawal from long-term marijuana use. Psychopharmacology, 143(3): Moore, TM. & Stuart GL. (2005) A review of the literature on marijuana and interpersonal violence. Aggression and Violent Behavior, 10: Vreugdenhil, C. et al (2003). Substance use, substance use disorders, and comorbidity patterns in a representative sample of incarcerated male Dutch adolescents. Journal of Nervous and Mental Disease, 191(6):

41 Aggressioner och våld forts. Fals-Stewart, W. et al (2003). Intimate partner violence and substance use: a longitudinal day-to-day examination. Addictive Behaviors, 28: Smith, PH. et al (2014). Couples marijuana use is inversely related to their intimate partner violence over the first 9 years of marriage. Psychol Addict Behav, 28(3): Rodriguez-Arias, M. et al (2013). CB1 cannabionoid receptor-mediated aggressive behavior. Neuropharmacology, 75: Marwaha, S., Gibbs, M. et al (2015). Cannabis use and mania symptoms; a systematic review and meta-analysis. Journal of affective disorders, 171: Ansell, EB. et al (2015). Effects of marijuana use on impulsivity and hostility in daily life. Drug and Alchohol Dependence, 148: Häftet är på 28 sidor och kan beställas genom European Cities Against Drugs, ecad@ecad.net Friend-Robel-Phillipos-Convicted-of-Lying-to-FBI/382013/

42 Cannabis i narkomanvården Europa 28 % av klienterna inom narkomanvården är cannabisrökare = cirka personer USA 38 % = personer Afrika 63 % Källor: Europeisk narkotikarapport Word Drug Report

43 Cannabis och alkohol

44 Ungdomar väljer inte att berusa sig med cannabis istället för alkohol. Tvärtom har cannabisrökare mycket högre alkoholkonsumtion än icke cannabisrökare.

45 Cannabisrökare dricker mer Sverige: Gymnasieungdomar som röker cannabis: 56% ofta fulla De som inte röker cannabis: 12% ofta fulla Källa: CAN-rapport. Vad vet vi om cannabisanvändning bland unga? Mars 2014 USA: år som ofta är fulla: 58 % cannabis varje månad Sällan alkohol: 3,3 % cannabis varje månad Källa: NSDUH 2013 National Survey of Drug Use and Health

46 Man kan inte jämföra skadeverkningarna Cannabis stannar kvar längre i hjärnan. De allra flesta tycker att alkohol ska vara tillåtet och cannabis förbjudet. De legala drogernas skadeverkningar tobak och alkohol - är bra argument för att inte legalisera cannabis. För unga är cannabis skadligare.

47 Key figures addiction care 2013,

48 Beroendevård i USA år 80 Alkohol och cannabis som huvuddroger i % Alkohol Cannabis

49 Cannabis är inte ett läkemedel

50 Vi ska använda medicinsk marijuana som ett lockbete för att ge marijuana ett gott rykte. Ketih Stroup, National Organization for the Reform of Marijuana Laws, NORML, 1979

51 Wayne Hall Drogforskare, Australien: Bevisen att cannabis har bra medicinska effekter är mycket svaga.

52 Vad säger vetenskapen? Cannabis kan lindra illamående, smärta och kramper (vid MS) samt ev. vid epilepsi samt öka aptiten. Några källor: *Harold Kalant, Amy Porath-Waller: Clearing the smoke on cannabis CCSA (Kanadensiska centret om drogmissbruk), * Nora Volkow et al. Adverse Health Effects of Marijuana Use. The New England Journal of Medicine, juni 2014.

53 Medicinsk cannabis = kvacksalveri Samma drog som vanlig cannabis. Cannabis är inte godkänt som läkemedel i något land. Det finns läkemedel mot samma åkommor Det finns redan läkemedel som innehåller THC och CBD ej rusgivande, liten användning

54 Rekommenderar ej medicinsk marijuana: American Medical Association American Cancer Society American Glaucoma Society National Multiple Sclerosis Society American Society Addiction Medicine American Academy of Pedriatrics

55 Colorado, USA 2009 Medicinsk marijuana möjlig för alla åldrar 2014 Legalisering regleras och beskattas som alkohol Idag ca 800 affärer för nöjesbruk och/eller medicinsk marijuna personer (av 5 milj invånare) får medicinsk marijuana Cannabis = Big Business

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60 Källa: National Highway Transportation Safety Administration, Fatality Analysis Reporting System (FARS), and CDOT/RMHIDTA 2014

61 Källa: Colorado Hospital Association, Emergency Department Visit Dataset. Statistics prepared by the Health Statistics and Evaluation Branch, Colorado Department of Public Health and Environment

62 Källa: United States Postal Inspection Service, Prohibited Mailing of Narcotics, as of January 21, 2015

63 Källa: Colorado Bureau of Investigation,

64 Skatteinkomst 2015 för marijuanaförsäljning = 63 miljoner dollar. Det mesta går åt för att reglera marijuanaindustrin.

65 Det finns inte samma drivkrafter för oss som är emot droger av moraliska och hälsomässiga skäl jämfört med dem som är för laglig narkotika därför att de kan tjäna pengar på det. Ben Cort, SAM

66 Tack för att ni lyssnade!