What Do I Need to Know about Marijuana?

Key Points Strong evidence marijuana causes psychosis The more marijuana you use, the greater the incidence of psychosis This dose-response relationship suggests causality.

Marilyn A. Huestis, PhD, recently retired as chief of chemistry and drug metabolism at the Intramural Research Program of the National Institute on Drug Abuse but remains highly active in the field. She is a senior fellow at the Lambert Center for the Study of Medicinal Cannabis and Hemp at Thomas Jefferson University in Philadelphia, Pa.; consultant to the US Department of Transportation; and serves on the Science Advisory Boards of Smart Approaches to Marijuana and National Families in Action. She is known for her research on how marijuana use affects driving and how exposure to parents’ marijuana use affects the developing fetus, breast-feeding newborns, and young children, as well as the new psychoactive substances. Key Points Israel has had marijuana for medical use for a long time. Mechoulam first discovered THC in 1964. Not until 1988 did we discover the cannabinoid receptor. First International Medical Cannabis meeting Doctors expected patients to return to them but found patients got their advice from untrained dispensary workers. This meeting changed that. Israel has no recreational use at all. Advice for US researchers

Wilson Compton, MD, is deputy director of the National Institute on Drug Abuse, an agency of the National Institutes of Health. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. Dr. Compton works with the director to provide scientific leadership of NIDA’s research portfolio. Key Points ABCD Study=children ages 9 & 10 Healthy BCD Study=infants, toddlers What can we learn from alcohol, tobacco marketing to kids? Can we learn anything from Canada? What about edibles? Next Up? Dr. Huestes on Israel’s Experience & Advice for Researchers

Marilyn A. Huestis, PhD, recently retired as chief of chemistry and drug metabolism at the Intramural Research Program of the National Institute on Drug Abuse but remains highly active in the field. She is a senior fellow at the Lambert Center for the Study of Medicinal Cannabis and Hemp at Thomas Jefferson University in Philadelphia, Pa.; consultant to the US Department of Transportation; and serves on the Science Advisory Boards of Smart Approaches to Marijuana and National Families in Action. She is known for her research on how marijuana use affects driving and how exposure to parents’ marijuana use affects the developing fetus, breast-feeding newborns, and young children, as well as the new psychoactive substances. Key Points 1999 Institute of Medicine stated no medicine should be smoked and there was a critical need for research National Academies of Medicine looked at this again in 2017 Unbiased look at where we are now Lessons learned from Colorado about marijuana-infused edibles Next Up? Dr. Compton on More on Executive Function: What is the ABCD Study?

Ryan G. Vandrey, PhD, is associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine. His research focuses on the behavioral pharmacology of marijuana in adult research volunteers, clinical trials, web-based survey research, and patients using marijuana or cannabinoids for therapeutic purposes.   Key Points Lay term for marijuana infused into a food stuff Risk that people may eat something but not know it contains marijuana, especially children Route of administration impacts drug effect CBD (Epidiolex) has been shown to be safe for use by children. FDA has issued warning letters against false medical claims for unapproved CBD products. Describes synthesis Pet peeves Next Up? Dr. Huestis on Marijuana Edibles

Marilyn A. Huestis, PhD, recently retired as chief of chemistry and drug metabolism at the Intramural Research Program of the National Institute on Drug Abuse but remains highly active in the field. She is a senior fellow at the Lambert Center for the Study of Medicinal Cannabis and Hemp at Thomas Jefferson University in Philadelphia, Pa.; consultant to the US Department of Transportation; and serves on the Science Advisory Boards of Smart Approaches to Marijuana and National Families in Action. She is known for her research on how marijuana use affects driving and how exposure to parents’ marijuana use affects the developing fetus, breast-feeding newborns, and young children, as well as the new psychoactive substances. Key Points In utero drug exposure—growth, behavior, IQ, learning, memory Some obstetricians in Colorado are recommending marijuana to pregnant women Infants and toddlers are exposed if parents smoke Exposed via breast feeding Adolescents Whole spectrum of ways children can be exposed Next Up? Dr. Vandrey on Marijuana Edibles, CBD & What is Synthesis?

Mahmoud A. Elsohly, PhD, is a pharmacologist known for his work on marijuana. He is professor of pharmaceutics in the school of pharmacy at the University of Mississippi where he directs the Marijuana Project which grows pharmaceutical-grade marijuana for research. He is an expert in the processing, testing, and detection of drugs of abuse. Key Points Epidiolex is a very well-defined pharmaceutical preparation of CBD Difference between it and other CBD is like night and day. Difference between Epidiolex and CBD on the Internet and in stores What is the OTC process? What is biphasic activity? What is low bioavailability? Is there an entourage effect? Next Up? Dr. Huestis on How Marijuana Affects Kids

Marilyn A. Huestis, PhD, recently retired as chief of chemistry and drug metabolism at the Intramural Research Program of the National Institute on Drug Abuse but remains highly active in the field. She is a senior fellow at the Lambert Center for the Study of Medicinal Cannabis and Hemp at Thomas Jefferson University in Philadelphia, Pa.; consultant to the US Department of Transportation; and serves on the Science Advisory Boards of National Families in Action and Smart Approaches to Marijuana. She is known for her research on how marijuana use affects driving and how exposure to parents’ marijuana use affects the developing fetus, breast-feeding newborns, and young children, as well as the new psychoactive substances. Key Points Occasional user needs lower amount of THC to get high  Chronic frequent user needs quite a bit more to get the same high Some evidence showing cannabis can change the proteins that surround your DNA and determine what genes are going to reproduce. Next Up? Dr. ElSohly on Is Marijuana the Same as Epidiolex?

Wilson Compton, MD, is deputy director of the National Institute on Drug Abuse, an agency of the National Institutes of Health. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. Dr. Compton works with the director to provide scientific leadership of NIDA’s research portfolio. Key Points What we don’t know Our two legal drugs, nicotine and alcohol, are responsible for devastating morbidity and mortality. What might the unintended consequences be of legalizing a third addictive drug? Exposure to adolescents and prenatally Teen vaping Next Up? Dr. Huestis on Marijuana Tolerance

Ryan G. Vandrey, PhD, is associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine. His research focuses on the behavioral pharmacology of marijuana in adult research volunteers, clinical trials, web-based survey research, and patients using marijuana or cannabinoids for therapeutic purposes. Key Points Impact of marijuana industry deciding how to regulate itself Lack of industry standards based on science States don’t have capability, infrastructure, or financing to deliver regulation Testing-lab shopping to find best “safety” results Hemp legalization potentially a game-changer because it opens pathway for regulation by federal agencies with knowledge of regulatory science Next Up? Dr. Compton on Predicting Future Marijuana Problems