Marijuana

MARIJUANA...

A DANGER TO HEALTH AND SAFETY !

      The Council on Alcoholism and Other Chemical Dependencies of the Finger Lakes is opposed to the use of
marijuana as a recreational drug. Research on the health and safety effects of marijuana strongly correlates
with many mental, emotional, psychological, physical and spiritual problems. In addition, many crimes,
accidents, job and school performance problems have been associated with the use of marijuana. While not
everyone that uses marijuana becomes drug dependent, the reality is that as with alcohol and other drugs
marijuana use certainly can lead to profound, chronic and progressive chemical dependency.

     Its use can be very serious, dangerous, and have a profound impact upon the quality of life for hundreds of
thousands of Americans and their families.

     o In 1995, according to the Drug Abuse Warning Network, there were over 47,100 marijuana
              related admissions into hospital emergency rooms (1).
     o According to the Department of Health and Human Services, in 1996 there were over
              196,000 admissions of people into drug treatment programs who stated that marijuana
               was their primary drug of addiction (2).
     o According to a major study of motor vehicle collision victims in a regional Trauma Unit in Toronto,
                marijuana was the most commonly found drug in impaired drivers other than alcohol! (3)

     The consumption of marijuana is not recommended. For many users it causes mild-to-severe distress and
it may have even more profound physical or psychological effects especially for the following: to
individuals who are engaging in activities that could potentially place themselves and others at risk for
personal injury such as operating machinery, use of firearms, swimming, boating, driving, etc.; to women
who are pregnant or trying to conceive; to people who have a family history of chemical dependency
(especially children of addicted parents); to individuals using other drugs including alcohol and/or
prescription medications (even over the counter brands); to all individuals who are predisposed to
emotional issues and problems; to all children and adolescents; and to individuals who demonstrate some
degree of chemical dependency on any substance.

PSYCHOPHARMACOLOGICAL PROPERTIES: Marijuana is a very powerful, mind and mood altering
drug. A very small amount of cannabis, i.e. 2-3 mg of THC, can produce a high for the occasional user. A
single marijuana cigarette may contain as much as 20-30 mg or even more (4). As an euphorohallucinogen,
the effects of this drug are particularly sensitive to individual differences in personality and environment
settings, and may vary widely. At moderate to high doses of THC mood varies considerably while anxiety
and panic have also been reported. Depression may also be enhanced. Impairment of short term memory,
disturbances in thought patterns, lapses in attention, depersonalization, and sensory distraction also occur.
Larger doses can bring on stronger distortions of time and space, illusions, mental confusion and panic
reactions. Extremely large doses can cause hallucinations (5), and marijuana flashbacks have been
reported by some users (6). Depending on dose and type, euphorohallucinogens variously produce
hypoactivity or hyperactivity, aggression or docility, marked autonomic stimulation, incoordination, and
hypersensitivity to sensory stimuli. These compounds alter the electroencephalogram tests in both animals
and humans (7).

THC interferes with the normal functioning of the cerebellum, the hippocampus and portions of the
cerebrum (8). Animal studies have shown an accumulation of THC stored in the synaptic vesicles of the brain
cells. This results in a thickening of the cell wall and synaptic cleft (perhaps hundreds of times thicker than
normal). This profoundly slows the transmission of neurotransmitters and causes interference of the delivery at
the receptor site (9).

PHYSICAL DANGERS OF MARIJUANA USE: Research has consistently demonstrated that there are
potentially serious and damaging physical effects from marijuana use and abuse.

There is documented evidence that marijuana typically causes acute changes in the heart and circulation. It
increases the work of the heart, usually by raising the heart rate by as much as 50%, and in some people by
raising blood pressure. While these effects may only be temporary, it increases the need for oxygen to the body
while at the same time decreasing the supply of oxygen.

This places a threat for persons with hypertension, cerebrovascular disease, and coronary atherosclerosis
(10). Research indicates that it may be especially dangerous for cardiac patients to combine marijuana with
alcohol (11). In fact, the National Academy of Science Institute of Medicine recommends that persons with
cardiovascular disease avoid the drug (12).

Smoking marijuana can lead to worse results for the lungs than smoking tobacco (13). There is nearly five
times more carbon monoxide and three times as much tar inhaled into the lungs when one smokes a marijuana
cigarette as opposed to a tobacco cigarette (14). Marijuana smokers may suffer bronchitis, emphysema, and
bronchial asthma (15). Marijuana users are twice as likely to report symptoms of chronic lung disease as
non-users (16), and one finding showed that men who smoked only marijuana on a regular basis displayed
airway obstruction. Marijuana smoke produces 50% more hydrocarbons than tobacco smoke; and
hydrocarbons are the chemicals associated with lung cancer. In fact, marijuana smoke contains 50% more
cancer causing materials than tobacco smoke (17), and has been linked to both pre-cancerous growths and to
cancer (18) (19).

Heavy use of marijuana may affect the endocrine or hormonal systems of both men and women causing
reduced levels of testosterone, lowered sperm count, impotence, and gynecomastia (development of the
mammary glans) in men, and disrupted menstrual cycles in women (20). Furthermore, high doses over a period
of time can lead to depression of libido and impotence (21). In both animal and human studies, heavy use of
marijuana was found to possibly interfere with the T-lymphocyte part of the immune system, reducing
resistance to viral infection and cancer (22). Cannabis can also inhibit the intracellular synthesis of proteins,
DNA and RNA, and inhibit cell division, similar to alcohol and the opioids (23).

AMOTIVATIONAL SYNDROME: Clinical evidence suggests a correlation between chronic use of marijuana
and the development of a syndrome characterized by a marked decrease in personal drive, motivation and
ambition, with apathy about the future, lethargy, shortened attention span, high distractibility, decreased
concentration, and an overall impairment of judgement and memory of the chronic user (24). Very regular high
doses of cannabis may be associated with significant psychological adjustment problems in some users (25). It is
unclear whether the development of an amotivational syndrome is a causative factor of heavy use of marijuana
or an effect of chronic use. Conservatively, it has been suggested that heavy use of marijuana may increase the
likelihood of the development of the syndrome, and that the syndrome does reinforce the chronic use of
marijuana (26).

MENTAL ILLNESS AND ASSOCIATED DANGERS OF MARIJUANA USE: Research has long
implicated cannabis as an exacerbating factor in mental illness where mental illness and/or personality
problems are pre-existing or concurrent conditions. Recent research has largely supported these earlier
findings.

One study found that the severity of depression, anxiety and alexithymic symptoms increased progressively
with the degree of involvement with cannabis, and chronic use of cannabis was associated with a high
prevalence of co-morbid psychiatric disorders (27). Other studies demonstrated that cannabis use predicted an
increased risk of developing clinical psychosis, and cannabis users showed higher scores on schizotypy,
borderline and psychoticism scales than never-users (28); that the risk of developing schizophrenia among
heavy users was six times greater than among non-users (29); that for highly introspective individuals,
marijuana use was associated with self-reports of poorer adult mental health (30); that greater dependence on
alcohol and marijuana was found to be one determining factor predicting worse outcomes for youth in areas of
criminality, conduct disorder, depression, and attention-deficit/hyperactivity disorder (31); and that substance
dependence (including cannabis) related significantly to suicide attempts and self-injury histories of youth (32).
Other studies have implicated marijuana use in depression (33); panic reactions and suicide (34) (35) (36); and
anti-social personality characteristics (37) (38). The American Psychiatric Association demonstrates the
seriousness and severity of marijuana effects beyond simple cannabis intoxication. They include Cannabis
Intoxication Delirium, Cannabis Induced Psychotic Disorder with Delusions, Cannabis Induced Psychotic
Disorder with Hallucinations, Cannabis Induced Anxiety Disorder, and Cannabis Related Disorders not
Otherwise Specified (39). The Cannabis related mental disorders are quite serious, and many people find
themselves as chronic clients in mental health programs or as mentally ill chemical abusers because of the
effects of marijuana.

MARIJUANA AND JOB PERFORMANCE, SCHOOL PERFORMANCE, DRIVING, and CRIME:
Employees who are marijuana users were found less likely to commit to their organizations, had less faith
in management, and experienced more job dissatisfaction (40). These workers reported more absenteeism,
tardiness, accidents, worker’s compensation claims, and job turnover than workers who did not use
marijuana. They were also more likely to report to work with a hangover, miss work because of a
hangover, and be drunk or use other drugs at work (41).

In terms of school, studies have found that college students who use marijuana regularly had impaired skills
related to attention, memory and learning twenty-four hours after they had last used the drug, suggesting that
marijuana users may be limiting their ability to learn. Evidence especially shows that heavy marijuana smoking
impairs the cognitive processes (42). Heavy marijuana users, when compared to non-users, show impaired
cognitive functioning across the board, and significant impairment in mathematics (a measure of the ability to
do quantitative thinking), and in verbal expression (a measure of correct and appropriate word use).

Heavy users showed a trend toward impairment in selecting synonyms, in literary comprehension, or overall
ability to learn (not just when "high", but a lingering loss of cognitive skills after the high is gone) (43). Animal
studies show structural damage to the hippocampus, a structure critical in learning and memory, from the
principle ingredient in marijuana (THC) (44). A major study in New York demonstrated that 51 percent of
marijuana using college students engaged in some form of "public misconduct" and 37 percent of users
reported "serious personal problems" due to marijuana use (45).

In terms of driving, marijuana use impairs driving-related functions and there is a definite increased risk for
auto accidents with use of marijuana (46). It impairs motor coordination, alters sense of time and distance, and
makes one drowsy. One study demonstrated severe balance impairment and 2.5 times more errors in
coordination tests in a dose-response fashion (47). One study showed that from 4-to-12 percent of fatal and
non-fatal accident victims had marijuana in their bloodstream, and another study showed that 32% of drivers
in a Baltimore Shock Trauma Unit had marijuana in their bloodstream.

Marijuana use is definitely related to crime. In Omaha, 42% of all males arrested in 1995 tested positive for
marijuana; in San Diego 35% of males arrested tested positive; and in Chicago 41% of arrestees tested positive
for marijuana in 1995 (48). In fact, the percentage of male arrestees testing positive for marijuana was equal to
or greater than that of cocaine in 13 of 23 Drug Use Forecasting cities studied (49).

DANGERS OF MARIJUANA DEPENDENCY: The classic definition of addiction includes: tolerance,
withdrawal, loss of control, unsuccessful or failed attempts to abstain or control use, craving, pre-occupation
with use, and use despite adverse consequences (use despite psychological, social, legal or personal
consequences.) From any and/or all of these perspectives, marijuana is a drug of addiction.

Marijuana is significantly more potent than it was in the sixties, making the drug even more addictive. In
1994, a U.S. Court of Appeals ruled that marijuana should remain a Schedule I drug as it is highly addictive
(50).

While tolerance to marijuana and psychological dependency are commonly accepted as serious syndromes of
marijuana use, some heavy users of marijuana show signs of withdrawal. In one study marijuana withdrawal
subjects demonstrated restlessness, loss of appetite, trouble sleeping, weight loss, and shaky hands (51).
Physical dependence on cannabis may develop in those who use high doses daily, and abrupt termination of
use can produce a mild withdrawal syndrome with symptoms including sleep disturbance, irritability, loss of
appetite and consequent weight loss, nervousness, anxiety, sweating, and upset stomach, chills, increased body
temperature and tremors can occur. The withdrawal sickness usually lasts for less than a week, although the
sleep disturbances may persist for a longer period (52).

One treatment program demonstrated that two-thirds of cannabis-dependent patients reported withdrawal,
and most claimed serious problems from the cannabis (53). Progression from first use to regular cannabis use
was found as rapid as tobacco progression, and more rapid than that of alcohol, suggesting that for this
population - that the drug potently reinforces cannabis-taking, producing both dependence and withdrawal
(54). As for the potency of marijuana dependence, many dependent users state that it is "impossible" for them
to quit. In a study including people who use both cocaine and marijuana, many stated that giving up the use of
marijuana was in some ways more difficult than giving up the cocaine use (55). In all, it is estimated that about
10% of marijuana users become chemically dependent upon the drug during their years of heaviest use (56).

While many researchers believe that marijuana is a mildly physiological addictive substance studies do
indicate that marijuana is harder to kick than many suspect (57), and is as powerful as other drug addictions
(58).

MARIJUANA EFFECTS ON MATURATION PROCESS: Adolescence is a time of life when mind and body
are maturing, and when social and emotional mechanisms of adjustment are being formed. As use of
marijuana generally begins during teen years, risk of impaired emotional growth and development is of crucial
concern. Many psychiatrists have expressed concern that regular marijuana use by youth produces adverse
effects on psychological maturation (59). It has long been said that emotional development ceases at the time
one begins marijuana use. Although not definitive, studies have shown that use may increase the risk of
discontinuing high school education and of increasing job instability in young adulthood (60), and these effects
upon development may cascade throughout young adult life and impact upon the quality of life of the user (as
an adult) and/or their children (61).

MARIJUANA RELATED BIRTH DEFECTS: Studies show that marijuana may seriously affect fetal
development. Lower birth weights, a shorter gestation period, major malformations, and the occurrence of
miscarriages increases with marijuana use (62). There is a risk of harm after birth for breast-feeding
infants if their mothers use marijuana as it passes through breast milk in almost pure form to the infant
(63). Even prior to conception, marijuana use causes changes in both males and females. It causes a
decrease in testosterone, produces fewer sperm, and produces sperm with more abnormal chromosomes
for the fathers-to-be. In addition marijuana may produce more testosterone and tended to produce less
healthy eggs in females. With poorer quality eggs and sperm with abnormal defects there is an increased
occurrence of birth defects. Marijuana also interferes with cell division, a process crucial for reproduction
for healthy fetal growth and development (64) (65). One laboratory study of pregnant rats exposed to
cannabis produced less fertile offspring with smaller reproductive organs (66), and another study
demonstrated that embryonic development may be halted before the three-day stage suggesting that
embryos are prevented from attaching to the uterine wall if exposed to marijuana (67). While studies
demonstrate mixed findings, moderate marijuana use was found to be related to increased risk of ocular
hypertelorism and epicanthus; and other studies have suggested that there may be significant (although
temporary) differences in the behavior patterns and nervous systems of infants whose mothers frequently
used marijuana during pregnancy (68). Preliminary findings from a 15 year study indicate that prenatal
exposure to marijuana impairs decision making, future planning, cognition (reasoning and memory) and
sustained attention among children who were marijuana-exposed babies (69).

     I became extremely paranoid and self-conscious. I knew I didn’t have to deal with the human race, so I’d close the door, light up, and get high instead of dealing with people.

       Hitting bottom for me was just a matter of realizing that my life wasn’t going anywhere. I was 26 years old and smoked dope almost every day for 8 years. I didn’t have friends. I felt awful.
I wasn’t happy

       I was looking for something in pot that I couldn’t get from it, and I didn’t know how to stop the cycle.

                                                                    - Vann

     I entered high school, where smoking pot was "cool." I continued to smoke pot because that was what my new "cool" friends were into. The next three years were filled with many highs and lows, and everything seemed so superficial, including my friendships. This made me sad and depressed. I believe this was my "rock bottom."

     I realized I could not live this way. There was one problem: I could not stop using drugs. It took being arrested twice, losing my license for two years, and my lawyer suggesting 12 Step meetings before I walked into Marijuana Anonymous.

     Since then, my attitude and actions have changed and so has my direction in life. I know that my first priority is staying sober and keeping a clean head. Keep Coming Back. It works if you work it.

                                                                 -- Gary

-- ISSUES FOR FURTHER DISCUSSION --

MEDICINAL MARIJUANA: The Council supports more medical research regarding the clinical use of
marijuana, consistent with the recently published study by the Institute of Medicine. It is important to note
that marijuana is not a cure for any condition, but is for the management of symptoms. Use should only be
under the auspice and regulations of the F.D.A. and there may be other more appropriate medicinal
alternatives than the use of marijuana.

ONLY A SMALL PERCENTAGE DO SMOKE MARIJUANA: According to the 1996 National Household
Survey on Drug Abuse, only 8.6% of Americans smoked marijuana in the past year... and of those who
have used it a significant percentage have quit never to use marijuana again!

THE "PRO-MARIJUANA" LITERATURE: Don’t be mislead by all the pro-marijuana literature that’s
available. Our review of that literature suggests that much of it is written from a biased point of view and is
suspect, misleading, or dismisses accurate findings by confusing or negating primary factors.

MARIJUANA USE WILL DEFINITELY INCREASE IF IT’S LEGALIZED: Accessibility and availability are
prime determinants in the level of drug use and as marijuana use increased with decriminalization,
experts acknowledge that it will most certainly dramatically increase if legalized.

DENIAL: Chemically dependent people protect their drug use, and denial is one of the preferred defense
mechanisms in all chemical dependencies. We often hear, "I don’t have a problem" or "People over-react to
marijuana" or "I can control the use" or "It doesn’t have any bad effects." Denial is often profound but
frequently others can see what chemically dependent individuals fail to see or recognize themselves.

SYNERGISM: Research suggests that marijuana "reacts" with other substances in a synergistic manner,
thereby making "mixing drugs" even more dangerous to life, health and safety.

CHEMICAL DEPENDENCY and TREATMENT: As with alcohol and all drugs, marijuana can
certainly lead to chronic and progressive chemical dependency. With treatment and a good 12-Step program
people can and do recover. We strongly encourage those who are dependent and their families to access the
available programs in their region, and we encourage government to make more prevention and treatment
programs available and affordable - especially to those within the criminal justice and human service delivery
systems.

PREVENTION: The Council supports ongoing discussion around national, state and local policies pertaining
to drug abuse (including insurance and health care issues, criminal justice, workplace, child welfare, etc.) and
development of prevention education, intervention and treatment services.

"We admitted we were powerless over marijuana,
that our lives had become unmanageable."

- The First Step of Marijuana Anonymous!
In fact it is significant that many researchers and
physicians who originally thought marijuana to be a
harmless substance and who had a tolerant or lenient
stance, have been fully compelled to revise their views
and now find that marijuana is a dangerous drug.

     My love of pot started the first time I got stoned. I was 14. The first time I smoked pot I didn't see the point, because I didn't feel high. I'd been drinking for a year already and I liked alcohol. But the first time I did feel stoned from weed, I dropped the bottle and picked up the pipe. That was the beginning of 2 years of hell.

     For the first few months, I didn't think pot controlled my life because I didn't smoke like everyone else. I just smoked on occasion.

     I thought my parents were idiots... but my parents knew what was up. My 1.6 grade point average was a big clue that I had something more important to do than homework. When I got caught dealing, I was busted. Big deal. I thought I could stop using pot anytime I wanted to. I just didn't want to.

     My home life was awful. I was in a constant battle with my parents and my little brother was being hurt as a result of my selfishness. I thought I was the only person in the whole world. I was using every day when everything finally hit the fan. I vowed never to use again. I told my parents that I had a problem, and I needed help. I came into Marijuana Anonymous a week later. Since then, I haven't smoked pot once. I have noticed a vast improvement in my life, and it can only get better. So, the best advice I can give you is read the literature, get a sponsor, and make a commitment. But more importantly, KEEP COMING BACK, because your life is still worth living.

                                                   -- Michael

Having worked as a professional in both prevention and treatment in the addictions field for the past 20 years, I have seen the effects of this mind altering drug in schools, in community organizations, local employment settings, jails, and medical
facilities. The effects on memory, motivation, critical thinking ability, health and interpersonal relationships is obvious when talking to a person abusing or addicted to this drug.
While the young people I come in contact with are quick to talk about how harmless it is, they remain unable to see that this is their primary means of coping with life and that they may become adults with limited social and life skills.

I have found that the psychological power of marijuana addiction is as powerful as addiction to alcohol, cocaine and heroin. It fools the user into believing that there is no problem with use or deleterious effects on their lives. The relationship
with the drug that began as a romance eventually turns into a love/hate affair for the user as well as their loved ones. I have seen the disease of marijuana addiction join with alcohol addiction as a part of our society that we pay for not only in terms of
dollars but also in terms of human potential.

I fully support a message to young and old alike that the intoxicant marijuana is a threat to the well-being of us all, and I invite all of you to join me in support of this message.

-- A Local Chemcial Depewndency Expert

RESEARCH and FACT SHEET CITATIONS:

(1) As reported in Prevention Pipeline, Center for Substance Abuse Prevention, January/February 1997; (2)
Department of Health and Human Services, Substance Abuse and Mental Health Services Administration,
DHHS Publication (SMA 98-3244, 1998); (3) Addiction Research Foundation, 1992; (4) Drug and Drug Abuse, A Reference Text, Second Edition, Jacobs and O’B. Fehr, Addiction Research Foundation, 1987; (5) Drugs - Third Edition, Schlaadt, Shannon, Prentice Hall, 1990; (6) Marijuana and Health, Ninth Report to U.S. Congress; (7) Modern Synopsis of Comprehensive Textbook of Psychiatry/II, Freedman, Kaplan, Sadock, Williams and Wilkins; 1980; (8) Mind Over Matter, National Institute on Drug Abuse publication #98-3592, December 1997; (9) Marijuana in the Nineties, D. Ohlms, MD, AMS Video Resources; (10) Drugs - Third Edition, Schlaadt, Shannon, Prentice Hall, 1990; (11) Side Effects of Simultaneous Alcohol and Marijuana Use, Sulkowski, Vachon, American Journal of Psychiatry; 134, June 1977; (12) Drugs in Society: A Biological Perspective, Jones-Witters, Witters, Wadsworth Health Services, 1983; (13) Marijuana: Right Stuff, Harvard Medical School Health Letter 14, November 1988; (14) Drugs - Third Edition, Schlaadt, Shannon, Prentice Hall, 1990; (15) Drugs of Abuse, US Department of Justice Drug Enforcement Administration, 1997 Edition; (16) Marijuana: Right Stuff, Harvard Medical School Health Letter 14, November 1988; (17) Marijuana and the Lungs, Doyle, American Lung Association Bulletin No. 65, November 1979; (18) Marijuana, W.R. Spence, MD, Health Edco, 1992; (19) Marijuana in the Nineties, D. Ohlms, MD, AMS Video Resources; (20) The Encyclopedia of Psychoactive Drugs: Marijuana - Its Effects on Mind and Body; Hermes, Galperin, Chelsea House Publishers; 1992; (21) Drugs in Society: A Biological Perspective, Jones-Witters, Witters, Wadsworth Health Services, 1983; (22) Drugs in Society: A Biological Perspective, Jones-Witters, Witters, Wadsworth Health Services, 1983; (23) Drugs in Society: A Biological Perspective, Jones-Witters, Witters, Wadsworth Health Services, 1983; (24) Skinner, M.H., Thompson D.A., Pharmacologic consideration in the treatment of substance abuse, South Medical Journal 85 (12) 1207-19,1992; (25) Drugs and Drug Abuse, A Reference Text, second edition, Addiction Research Foundation, 1987; (26) Drugs and Drug Abuse, A Reference Text, second edition, Addiction Research Foundation, 1987; (27) Psychiatric Symptoms in Male Cannabis Users not using other Illicit Drugs, Troisi, Pasini, Saacco, Spalletta, Addiction, 93(4) April 1998; (28) Cannabis use correlates with schizotypy in healthy people, Williams, Wellman, Rawlins, Addiction, 91(6), June 1996; (29) The human toxicity of marijuana, Nahas, Latour, Medical Journal of Australia 156(7), April 1992; (30) Marijuana use, introspectiveness, and mental health; Zablocki, Aidala, Hansell, White; Journal of Health and Social Behavior
32(1); March 1991; (31) Substance-dependent, conduct-disordered adolescent males: severity of diagnosis
predicts 2-year outcome, Crowley, Miikulich, MacDonald, Young, Zerbe, Journal of Drug and Alcohol
Dependence, 49(3), February 1, 1998; (32) Treated delinquent boys substance use: onset, pattern, relationship to conduct and mood disorders, Young, Mikulich, Goodwin, Hardy, Martin, Zoccolillo, Crowley, Journal of Drug and Alcohol Dependence, 37(2) February 1995; (33) Correlates of Depression in Primary Care, Rowe, Fleming, Barry, Manwell, Kropp, Journal of Family Practice, 41(6), December 8, 1995; (34) Health aspects of cannabis, Hollister; Journal of Pharmacological Review, 1986, 38(1); (35)The general pharmacology of cannabinoids in eds Cannabis and its derivatives, Paton, Pertwee, Temple, Oxford University Press, 1972; (36) Neurobiology of marijuana abuse, Abood, Martin, Trends in Pharmacological Sciences, 13(5), May 1992 (9); (37) The association of anti-social personality symptoms with marijuana abuse/dependence. A Monozygotic co-twin study, Scherrer, Lin,Eisen, Goldberg, True, Lyons, Tsuang; Journal of Nervous and Mental Disorders; 184(10); October 1996; (38) Anti-social behavior: Its relation to Selected Sociodemographic Variables and Alcohol and Drug Use Among Mexican Students, Substance Use and Misuse, Vol 33 (7) 1998; (39) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, American Psychiatric Association, 1994; (40) NIDA Notes, Jan/Feb 1996; (41) Ibid; (42) NIDA Notes Nov/Dec 1995; March/April 1996; (43) Effects of Chronic Marijuana Use on Human Cognition, Block, R. & Ghoneim, M., Psychopharmacology, Vol. 110, 1993; (44) NIDA Notes May/June 1996; (45) Alcohol and Drug Use Among College Students in New York State, NYS Office of Alcoholism and Substance Abuse Services, 1996; (46) Lancet Heath News, 14th Issue, Nov. 13, 1998; (47) NIDA Addiction
Research Center Report; (48) Reality Check, Marijuana Backgrounder, Prevention Pipeline, January/February 1997; (49) Drugs and Crime, Drug Abuse Update, National Families in Action, Issue 62, Fall 1997; (50) Say it straight: The Medical Myths of Marijuana, Community Anti-Drug Coalitions of America; (51) Marijuana: Facts Parents Need to Know, National Institute of Drug Abuse, revised November 1998; (52) Drug and Drug Abuse, A Reference Text, Second Edition, Jacobs and O’B.Fehr, Addiction Research Foundation; 1987, (53) Cannabis Dependence, Withdrawal, and Reinforcing Effects Among Adolescents with Conduct Symptoms and Substance Use Disorders; Drug and Alcohol Dependence, Vol. 50(1), 1998; (54) Ibid; (55) Strategies for breaking marijuana dependence, Zweben, Oconnell, Journal of Psychoactive Drugs, 24(2), April-June 1992; (56) Adverse Effects of Cannabis, Hall, Solowij; Lancet 1998, 352; (57) Smoking Pot: The Hidden Addiction, Japenge, A., Los Angeles Times, May 29, 1991; (58) Marijuana: Hit Below the Belt, Waite, K., Listen, 43(6), 1990; (59) New York State Division of Substance Abuse Services; (60) Newcombe and Bentler, 1988, as reported in World Health Organization Project on Health Implications of Cannabis Use, 1999; (61) World Health Organization Project on Health Implications of Cannabis Use, 1999; (62) Holister, L.E., Health Aspects of Cannabis, Pharmacological Reviews, American Society for Pharmacology and Experimental Therapeutics, 1986; (63) Holister, Health Aspects of Cannabis; (64) Cocaine, Marijuana, Designer Drugs: Chemistry, Pharmacology and Behavior, Redda et al., Florida, CRC Press, 1989; (65) Jones, R.T., Marijuana: Health and Treatment Issues, Psychiatric Clinics of North America, 1984; (66) Holister, Health Aspects of Cannabis; (67)as reported in Substance Abuse Funding News, October 28, 1996, No. 96-20; (68) the Ottawa Prenatal Prospective Study as reported in the Encyclopedia of Psychoactive Drugs: Marijuana: Its Effects on Mind & Body, Chelsea House Publishers, 1992; (69) Prenatal Exposure to Tobacco and Marijuana: Effects During Pregnancy, Infancy and Early Childhood, Fried, Peter, Clinical Obsteretics and Gynecology, 36:319-337, 1993.

Join with the Center for Substance Abuse Prevention
(Department of Health and Human Services - SAMSHA)
in full support of the annual

"REALITY CHECK CAMPAIGN"

With the Theme:

"Marijuana is a Drug... Help Our Kids to Understand!!!"