Made available in DSpace on 2015-07-22T20:49:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-27 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / Objetivo: Analisar entre usuários diários de cannabis, os sinais e sintomas da Síndrome de Dependência de Substância, tendo como referência os critérios diagnósticos do DSM-IV. Métodos: Foi utilizado o referencial qualitativo de pesquisa. A amostra intencional, de usuários diários de maconha da omunidade, foi composta por “bola de neve”. Foram realizadas entrevistas semi-estruturadas, individuais e anônimas, com base nos critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV). As entrevistas foram gravadas, para posterior transcrição e análise de conteúdo categorial. Resultados: Participaram deste estudo 24 pessoas (15 homens), com idades entre 18 a 49 anos. Apenas um entrevistado relatou compulsão para o uso. Os demais mencionaram planejamento do uso em suas rotinas diárias,sem identificar redução de atividades consideradas importantes. Prejuízo de memória foi citada por 17 entrevistados.Não foi relatada tolerância para a sensação de relaxamento, principal motivação para a continuidade do uso. Sintomas nos períodos de abstinência (irritação, insîonia e redução do apetite) se aproximaram mais de sentimentos de frustração e/ou dos conceitos de efeito rebote ou off-set. Apesar de apenas quatro terem preenchido diagnóstico de dependência, 16 se consideravam dependentes. Conclusões: Os critérios diagnósticos do DSM-IV podem não identificar usuários diários de cannabis como dependentes, ainda que eles se considerem. As especificidades em relação à tolerância e controle/compulsão parecem diminuir a probabilidade de preenchimento de critérios diagnósticos. / Aim: To study the DSM-IV criteria for substance dependence among daily cannabis users. Methods: A qualitative method and an intentional sample of daily cannabis users in the community were adopted in this investigation, which was conducted in Sao Paulo, Brazil. In-depth, semi-structured interviews based on the DSM-IV criteria for substance dependence were held individually. The interviews were recorded and transcribed for posterior content analyses. Results: 24 people (15 men) aged 18-49 years participated in this study. Only one participant reported compulsive use, while the others planned cannabis use through their daily routine without reducing the frequency in which engaged in important activities. Impairments on the short-term memory were reported by 17 participants. There was no report of tolerance towards the sensation of relaxation, which was claimed to be the main motivation for continued use. Symptoms during the abstinence periods (irritation, insomnia and appetite reduction) were more likely to be some frustration feeling for not being able to smoke marijuana and/or rebound or off-set effects. Despite the fact only four participants were diagnosed dependent (DSM-IV), 16 considered themselves dependent. Conclusions: The DSM-IV diagnoses criteria might not identify cannabis daily users as dependents, despite the fat that they considered themselves dependents. The specificities regarding tolerance and control/compulsion seem to reduce the probability of establishing diagnoses of dependence. / FAPESP: 06/58658-8 / FAPESP: 07/50783-0 / TEDE / BV UNIFESP: Teses e dissertações

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The legalization of cannabis is increasing across the United States, for both recreational and medical use. This has resulted in a change in public opinion regarding the risks of cannabis use. This is particularly true for the current generation of older adults, which experiences a greater prevalence of cannabis use than previous members of this cohort. Due to decreased perception of risk and medical or emotional issues associated with old age, older adults increasingly use cannabis to cope with their psychiatric and medical symptoms. Current studies provide evidence of an association between using cannabis for medical symptoms and the development of a Cannabis Use Disorder (CUD). However, there is a lack of literature addressing the association between types of symptoms treated with medical marijuana and developing symptoms of CUD. This study developed a survey using the Cannabis Use Disorder Identification Test (CUDIT) and measures for motives and symptoms of cannabis use. This was done to evaluate the presence of CUD symptoms in older adults (ages 55+) who used cannabis in the past six months while owning a Medical Marijuana License (MML). Data preparation included an examination of outliers, multicollinearity, and data distributions. The primary analysis regressed cannabis use pathology onto psychiatric motives and physical motives. The results of this study suggest that those utilizing cannabis for anxiety symptoms experience more symptoms of a cannabis use disorder. At the same time, there was a negative association between using cannabis order for medical symptoms and developing cannabis use disorder symptoms. Additionally, there was no correlation between the amount of cannabis used and its use for physical symptoms.

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Within the United States (U.S.), one-third of those who use cannabis (the most commonly used illicit drug in the U.S.), exhibit cannabis use problems significant enough to warrant a diagnosis of cannabis use disorder (CUD; Compton, Grant, Colliver, Glantz, & Stinson, 2004). Data suggests that quitting cannabis is highly difficult (Copersino et al., 2006), yet, there is little empirical knowledge about the nature of factors that relate to quit processes (e.g., self-efficacy). One potentially promising variable of relevance to CUD is distress intolerance (Leyro, Zvolensky, & Bernstein, 2010). Distress intolerance is referred to as (a) the perceived capacity to withstand negative emotional and/or aversive states, and (b) the behavioral act of withstanding distressing internal states elicited by some type of stressor. Although theoretically nested within a broader network of risk and protective processes, distress intolerance is posited to be related to, though conceptually distinct from, other variables (e.g., anxiety sensitivity; emotion regulation; Leyro et al., 2010). Individuals with higher levels of distress intolerance may be prone to maladaptively respond to distress (e.g., life stressors), and attempt to avoid negative emotions and/or aversive states (e.g., use cannabis to alter the perception or impact of negative mood, or to enhance positive mood). In contrast, persons with lower levels of distress intolerance may be more able to adaptively respond to distress (e.g., seek out alternative, more adaptive coping strategies instead of using cannabis). There is limited knowledge of the explanatory role of the inability to tolerate negative affect and other aversive internal sensations (e.g., withdrawal) in terms of CUD and the nature of the quit experience (e.g., beliefs about barriers to quitting). The aim of the present study was to examine the main and interactive effects of perceived and behavioral indices of distress intolerance in terms of cannabis quit-related variables, including (a) failed quit attempts, and duration of average time to relapse for past quit attempts; (b) greater severity of withdrawal symptoms experienced while quitting in the past, lower self-efficacy for abstaining, and greater perceived barriers for quitting cannabis; and (c) greater CUD problems. The sample recruited was characterized by racially and ethnically diverse (65.2% minority) adult cannabis users, many of whom had not completed college (46.5%). The sample had high rates of co-occuring psychiatric and medical illness (e.g., 36.1% had a current anxiety disorder, 26.4% had a current mood disorder, and half endorsed a medical condition), and over 25% fell below the 2013 Federal Poverty Level. There was no empirical support for an interactive or main effect of perceived or behavioral distress intolerance for any of the dependent variables. Although previous studies did not employ most of the cannabis dependent measures utilized in the current report, the lack of significant effects in the regression models was surprising given previous work on the topic (focused largely on coping motives for cannabis use). At the bi-variate level, there was some modest evidence of a 'signal' for perceived distress intolerance for certain cannabis dependent variables; these effects ranged from small to moderate. These data suggest, at least among the present largely minority sample, neither perceived or behavioral distress intolerance are robustly related to the cannabis dependent measures. One conservative interpretation of these findings is that distress intolerance may not perform the same across all CUD samples. Post hoc analyses focused on perceived distress intolerance subfactors relations to the dependent variables; indirect explanatory role of negative affect in perceived distress intolerance-cannabis relations; and bi-variate relations between perceived and behavioral distress intolerance with other transdiagnostic distress processes. Results suggested (a) no incremental explanatory effect for specific perceived distress intolerance subfactors; (b) a significant indirect effect of negative affect in the relation between perceived distress intolerance and certain cannabis dependent variables; and (c) consistent evidence of convergent validity for perceived distress intolerance with other transdiagnostic affective vulnerability factors. I contextualize the findings in relation to past work, and the methodology employed in the current study. I discuss how future theory-driven work that seeks to uncover the time course and patterning between distress intolerance, negative mood, and cannabis use behavior are needed. I also suggest that this work will likely have the greatest impact when the social contexts of CUD populations (e.g., social determinants of health) are more directly integrated into the theoretical models.

The suitability of the electrically stimulated guinea-pig MP-LM preparation, mouse isolated vas deferens and urinary bladder for the study of cannabinoid receptor ligands was investigated. Cannabinoid receptor agonists produced concentration-related inhibition of the contractile responses in all three tissue preparations, demonstrating high potency, chemical- and stereo-selectivity. The rank order of the inhibitory potency of the cannabinoid agonists in all three tissue preparations correlated with their binding affinity for specific cannabinoid CB1 binding sites in rat brain tissue. These results suggested a receptor-mediated mechanism of action for cannabinoid receptor agonists via prejunctional functional cannabinoid CB1 receptors in these three models, in the absence of an antagonist. The endogenous cannabinoid receptor ligand anandamide, also produced concentration-related inhibitory effects in all three tissue preparations. However, anandamide was found to be metabolically less stable in the guinea-pig MP-LM preparation. SR141716A, a potent, CB1 selective cannabinoid receptor antagonist was found to attenuate the inhibitory effects of cannabinoid receptor agonists investigated in all three tissue preparations. This provided further evidence for a receptor-mediated mechanism of action for cannabinoid receptor ligands in these three tissue preparations. However, further studies with SR141716A suggests that, it may be acting as an inverse agonist rather than a pure antagonist in these three preparations. Finally, this study was further extended to characterise some novel cannabinoid receptor ligands in the guinea-pig ML-LM preparation and mouse isolated vas deferens.

En nuestro país, el número de personas que padecen enfermedades crónicas aumenta cada año, los tratamientos farmacológicos disponibles en el mercado no están mostrando eficacia en los resultados contra estas enfermedades, además de generar una gran cantidad de efectos secundarios por su ingesta o suministración, lo que conlleva a plantear soluciones menos nocivas para la salud que mejoren la calidad de vida de estos pacientes. Asimismo, el apoyo de la familia y de los amigos es importante para acompañar en el duelo (aceptación de la enfermedad y cambios que producirá en la vida diaria) y es por esta razón que aquellos “cuidadores primarios” también requieren del acompañamiento adecuado para poder superar o sobrellevar estas situaciones adversas que afectan su calidad de vida. La demanda en el consumo del aceite de cannabis está en auge dado a los grandes beneficios que ofrece en el tratamiento de enfermedades como el cáncer, la epilepsia y enfermedades degenerativas. En la actualidad en el Perú, no se cuenta con boticas especializadas para la dispensación de aceite de cannabis que ofrezca una trazabilidad comprobada y en muchos casos se debe recurrir al mercado negro para acceder a este oleo. La propuesta de productos naturales “Vida Natural” es ofrecer Aceite de Cannabis en diferentes concentraciones, 4%, 10% y 15%, con calidad y trazabilidad comprobada. El proyecto requiere una inversión total de S/148,720. Nuestro equipo de trabajo asumirá la inversión del 60%, y requerimos el financiamiento de S/59,488 para poner en marcha la idea de negocio. / In our country the number of people who suffer from chronic sicknesses increase each year. The available drug therapies on the market are not showing efficiency in the results against this sicknesses. Moreover, they produce a big quantity of side effects by its intake or supply, which means to develop less harmful solutions for the health that improves the life quality of patients. In the same way, the support of the family and friends is important to accompany in the in the mourning (the approval of the sickness and changes that will produce in the daily life) and that is why for some “primary caregivers” need the appropriate accompaniment to get to cope and overcome these adverse situations that affect their quality of life. The consumer demand for cannabis oil is on the rise given to the great benefits that have on the treatment of sicknesses such as cancer, epilepsy, and degenerative diseases. Nowadays in Peru, there are no specialized drugstores for the dispensation of cannabis oil that offer a proven traceability and in many cases the black market must be resorted to access this Oleo. The proposal for natural products called “Vida Natural” is to offer cannabis oil in different concentrations, 4%, 10%, and 15% with quality and traceability proven. Our project requires a total investment of S/148,720. Our work team will assume the investment of 60% and we require the funding for S/59,488 to start a business of our enterprising. / Trabajo de investigación

Cannabis is widely consumed medically and recreationally due to the presence of cannabinoids, but the phytochemical complexity of different varieties and preparations is a major knowledge gap. This thesis investigated the phytochemicals present in thirteen different cannabis strains using untargeted and targeted phytochemical analysis to determine “strain” differences in cannabis tinctures and oils. In addition, the phytochemical differences between different oil products, namely oils extracted by ethanol and CO2 supercritical fluid, were also determined to evaluate different processing methods. It was found that inter-strain variability was more significant than the preparation methods due to the strain-specific presence of major cannabinoids, specifically THCA and CBDA. Furthermore, a processing step like drying removed phytochemicals contributing to strain differences, most notably terpenes. The results suggested that consumers can expect different strains and products to have different chemical profiles, as CO2 oils were found to be more chemically consistent across products than tinctures. Cannabis can be consumed in many different ways, and one popular mode of delivery is vaporization. Vaporization extracts active principles of cannabis with heated gas and could lead to a different phytochemical profile compared to the original flower counterpart. Consequently, the product label based on the raw material may not be representative of what is phytochemically available during consumption. The results of this study showed a reduction in available chemicals after vaporizing flower and oils, and little new chemical formation through this process. Decarboxylated cannabinoids were the most significant contributors to differences between pre and post-vaporized samples, and different phytochemistry composition was observed after vaporization. The results also demonstrated that vaporization reduces inter-strain and inter-product chemical diversity, but the content of the vapor can still be affected by the strain used. Furthermore, it showed that vaporization could extract phytochemicals differently from oils than flower material. This thesis provides a new understanding of phytochemical differences, extraction and vaporization processes of cannabis, and provides novel insights into cannabis for producers and consumers. Understanding the differences in chemical content of different types of concentrates can better inform producers and consumers about the products they make, sell and use. In addition, this thesis supports the use of vaporization as a harm reduction method for the consumption of cannabis, and increases understanding of cannabis vaporization. The information from this thesis contributes novel insights into cannabis research and provides a foundation for further studies.