Drug Watch International

MARIJUANA RESEARCH REVIEW  

Increase in unprotected sex in urban minority youth blamed on use of alcohol or marijuana

It is now established that regular condom use can decrease the spread of AIDS. A recent study by Ford and Norris (Journal of the Acquired Immune Deficiency Syndrome, Vol. 7:389-396,1994), studied the effects of the use of alcohol and marijuana in the context of sexual relationships and the impact of these substances on the consistency of condom use by urban minority youth.

The sample design and field work were conducted by the Survey Research Center of the Institute for Social Research at the University of Michigan. A total of 1435 interviews were obtained from Hispanic and African-American young adults, ages 15-24 residing in low-income areas in Detroit.

Results indicated that when alcohol and marijuana were used with a sexual partner, the consistency of condom use decreased even when other variables related to sexual history were controlled. Alcohol use had a greater negative effect on condom use for Hispanic men, and marijuana for African­American women, than it did for Hispanic women and African-American men.

The authors concluded that safe sex intervention programs for urban low income minority youth need to emphasize the risk of AIDS virus exposure that results from substance use, casual sex, and sex with multiple partners.

Commentary: Aside from the many obvious adverse side effects, use of alcohol and marijuana among teenagers may contribute to the spread of AIDS.

Clearly, it is counter-productive to give a safe sex message without also pointing out that the behavior produced by the use of alcohol and marijuana lessens the likelihood that safe sex will be performed. This factor is often overlooked in drug prevention programs and sexual education courses when, in fact, these things should be considered together. ##

Delta 9 THC affects metabolism in human blood cells

Delta 9 THC is known to inhibit a variety of immune functions. Diaz and colleagues, in their paper in the Journal of Pharmacology and Experimental Therapeutics, 268:1289-1296,1994, show that THC, when incubated with cells from the blood of normal humans, caused increased release of a variety of metabolites that stimulate acute inflammation These metabolites are potent agents that can cause asthma, and which enhance the activity of other cells which suppress immune defense against virus and other infectious agents.

Commentary: This paper is one of the first to show that normal human cells, when incubated with concentrations of THC equivalent to that found in the blood of regular smokers of marijuana, cause immune cells to release compounds which promote inflammation within the lungs, and at the same time, suppress the natural defenses against external bacterial and viral agents that cause disease.

While these studies are conducted in the test tube, the implications for smoking marijuana in humans, particularly those who smoke or with a tendency towards asthma or respiratory disease are obvious. ##

Attempt made to use marijuana to treat Tourette's Syndrome

A nurse consultant and a visiting psychiatrist reported on a single case of Tourette's Syndrome treated successfully with smoked marijuana (Hemming and Yellowlees, Journal of Psychopharmacology 7-4 1993 pp.389-391).

Tourette's Syndrome is a disorder character­ized by multiple motor and vocal tics. The tics occur many times daily and may include obscenities and other strange behaviors. Untreated, the disorder tends to be a lifelong disease characterized by remissions and relapses. Haloperidol (Haldol) is the drug of choice in the treatment of this disorder.

The patient they reported started to smoke marijuana at age 35 to get relief while he continued his Haldol. The anecdotal improvement prompted the case report. There was no stopping of the drug to see if symptoms returned, and no rechallenge with marijuana.

Commentary: This report is the type of anecdote used to support claims for the use of smoked marijuana to treat disease. It is interesting that the standard treatment of Haldol was continued throughout the period of marijuana use with this patient, and there was no placebo control or rechallenge involved. There are ways of using drugs in single patients, known as the "n of 1" method. Efficacy as well as side effects can be monitored using this method in a single patient. This was not done here. It is also of interest that there is no objective documenta­tion of improvement in Tourette's Syndrome in the patient. Neither of the authors has any expertise in neurologic diseases. Nicotine is also known to potentiate the effects of Haldol in improving motor tics in this disorder. It is possible that any one of the 4000 compo­nents found in marijuana smoke provided beneficial effects, if, in fact, they did occur. ##  

Study finds self-reporting of illicit drug use differs greatly from actual test results

Self-reporting by users, of the frequency of their drug use, is the measure used In a variety of studies regarding prevention strategies, needle exchange programs, and effects of treatment interventions, to indicate the success rate of these programs.

The report by Hindin in the International Journal of the Addictions, 29:771-789,1994, highlights the fact that when an objective measurement is done, such as an assay of hair for actual determination of cocaine, heroine, and marijuana use, the indication is far greater than that reported by the user.

Among a group of patients followed up post-treatment, only 51 percent of cocaine positive people and 67 percent of heroin positive people gave an accurate history by their own self report. The correlation with marijuana was even weaker.

Commentary: The study emphasizes the folly of depending on self reporting as an outcome variable in any study regarding the efficacy of treatment and prevention programs.

Objective measures of exposure need to be done because of the notorious inaccuracy of self reporting. This self reporting, with its obvious pitfalls, is, however, currently being used to prove "efficacy" of needle exchange programs which claim to limit the spread of HIV by providing "clean" needles to addicts. The purported success of these programs is based, in part, on self reporting by the addict of whether or not they shared needles. ##

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Material used in this publication has been reviewed and commented on by William M. Bennett, M.D., Professor of Medicine, Division of Nephrology, Clinical Pharmacology and Hypertension at Oregon Health Sciences University, Portland, Oregon

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