Background: Marijuana is the most widely used illicit substance in the United States. Public approval of marijuana has driven its legalization in twenty states and the District of Columbia for medical use; and, this year alone (2013), two states have legalized recreational use of the drug. Despite the nation’s growing trend towards marijuana acceptance, the evidence regarding the health effects of its use remains vague. This study was designed to evaluate the health profile of marijuana users by determining the association of marijuana use with quality of life, defined in terms of perceived overall health and as self-reported medical conditions. Methods: The 2007-2010 National Health and Nutrition Examination Survey data was used to evaluate the health profile and quality of life of marijuana smokers. Chi-square and one-way ANOVA analyses were respectively used to compare prevalence and mean differences of select characteristics across different categories grouped by marijuana use. Logistic regression analyses were then performed to determine the association between the reported number of unhealthy days or medical conditions and marijuana use in the past month. All analyses were performed with SAS 9.2 software using weighted data, while 95% confidence intervals were used to determine statistical significance. Results: In total, 7716 cases were included in the study analysis. The prevalence of lifetime marijuana use was 59% (N = 3632), while the prevalence of current (past month) marijuana use was 12.6% (N = 861). Current marijuana users differed significantly from never users with respect to age, gender, income-to-poverty ratio, cigarette smoking, and alcohol and drug use. Current marijuana users also reported more unhealthy days per month, but less frequently reported diagnosis of a medical condition. Results of logistic regression analysis demonstrated that after controlling for confounders, there was no significant association between unhealthy days and current marijuana use, but there was an inverse association with reporting 3+ medical conditions and current marijuana use. Conclusions: This study shows that marijuana users are more likely to engage in health risk behaviors, and report lower quality of life when compared to individuals who have never used marijuana. However, after controlling for confounders, marijuana use was not found to be associated with poor health outcomes.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Craving is a key element of the cannabis withdrawal syndrome that has been associated with continued use and relapse. Although cue-induced cannabis craving has been established in single laboratory sessions, procedures to sustain craving over multiple sessions are needed. The purpose of the present study was to determine if cue-induced craving responses could be elicited in the same subjects across multiple sessions. It was hypothesized that exposure to cannabis cues would produce more robust craving responses than exposure to neutral cues and that elicited craving responses will be sustained across multiple cue exposures. Five experimental cue exposure sessions (1 neutral and 4 cannabis) were conducted. Craving was assessed with the Marijuana Craving Questionnaire (MCQ) Short Form, Visual Analog Scale (VAS), Subject-Rated Physiological Questionnaire, blood pressure, and heart rate. Results revealed significant effects of initial cannabis cue exposure on VAS craving responses and Subject-Rated Physiological measures relative to the neutral cue exposure condition. No significant differences were found on MCQ composite scores or physiological measures. Craving responses following initial cannabis cue exposure were not maintained across sessions. There is a need for a better understanding of the factors that contribute to continued drug use despite quit attempts.

Det pågår en debatt runtom i världen om legalisering av cannabis. Syftet med denna uppsats är att spegla det politiska perspektivet i dagens narkotikapolitiska debatt, för att se vilka tankar de svenska politiska partierna har om cannabis som samhälleligt problem och drogens legalisering. Uppsatsen syftar även till att beskriva legaliseringsdebatten i förhållande till de samhälleliga skadeverkningarna av cannabisanvändning. För att kunna besvara studiens frågeställningar genomfördes kvalitativa strukturerade intervjuer med representanter från sju svenska politiska partier. Den teoretiska ramen för uppsatsen består i huvudsak av teorin om makt och motmakt och resonemang om prohibition och harm reduction. Med denna teori och begrepp kommer det ur ett sociologiskt perspektiv förklaras vilka tankar de svenska politiska partierna har om cannabis som samhälleligt problem och drogens legalisering. Sammanfattningsvis visar resultatet att samtliga representanter från de politiska partierna är negativt inställda till en legalisering av cannabis i Sverige och i andra länder. De menade att legalisering skulle medföra negativa följder både för individen och för samhället. Dessa konsekvenser kännetecknas främst av ökade vårdkostnader.

The frequent consumption of alcohol and cannabis by youth poses both concern and ambivalence to society about the nature of the problem and how to respond. In the last few decades, social science research has devoted considerable attention to substance use among youth, making it an important issue to consider; however, controversy abounds when considering where consumption patterns of youth fall on a continuum from normal to deviant. Central to these debates is the social acceptability of the substances being used, their legal status, the frequency with which they are consumed, and the particular groups most often engaged in their use. Youth who consume alcohol are viewed with less trepidation than those who consume cannabis. Moreover, those who use either substance recreationally or experimentally are deemed to be more typical than those who have escalated their use to more regular or frequent episodes. Finally, drug-using youth who are embedded in conventional society are viewed more positively than those who occupy the margins of society, such as those who are delinquent or homeless. To fully understand the debate about the deviancy versus the normalcy of adolescent substance use, more inclusive approaches that take into account structural, individual and situational explanations are needed; however, existing studies fail to consider all of these influences. Instead, there is debate about the dominance of each of these explanations. This dissertation examines and tests these competing representations and explanations of adolescent substance use by drawing on multiple sociological theories of deviance including control theories, differential association theory, routine activity approaches, and drift theory. Using a combined sample of high school students and street youth, the findings suggest that adolescent substance use is far too complex to be explained by only one theory. Instead, explanations for the variations in substance use must take into account both individual backgrounds and more immediate situational influences. Most importantly, individual beliefs about substances are an important and often ignored aspect of individual substance use patterns.

Does Nimbin have a drug problem? This tiny village in north-eastern NSW has an international reputation for its alternative community and its street drug market. Ever since the Aquarius Festival thirty years ago Nimbin has fascinated the media, and recurrent headlines about the village's (undefined) 'drug problem' suggested my research topic. My research aim was to investigate the meaning/s of Nimbin's 'drug problem' in the context of Nimbin's 'alternative' culture. Because the topic of illicit drugs is both ethically challenging and highly sensitive, my research design was strongly participant-focused, with an emphasis on confidentiality balanced by a mixed methodology to cross-validate results. My methods included an anonymous household (door-to-door) survey based on a national household survey; an anonymous mailed-back survey of Nimbin and Lismore drug injectors; taped interviews with health and legal professionals, cannabis activists and drug dealers; semi-structured interviews with 'professional' cannabis crop growers; and participant observation over several years. I found the multi-method research design to be particularly effective for investigating illegal drug marketing and use, and the design provided me with multiple perspectives on a complex issue. Superficially, there appeared to be two drug 'problems' in Nimbin — one was the (largely cannabis) street market, and the other revolved around heroin users, and included complaints about scruffy-looking people hanging around the main street, or overdosing in the public toilet. However, my research suggested that these issues, while immediately comprehensible as 'drug problems', obscured more complex issues. For example, the village's street drug market was intertwined with the local economy and with the alternative community's values and drug use, while close to half of the drug injectors lacked secure housing (which creates problems that are not related to heroin), and all heroin users were blamed for the actions of few. Many factors influence the creation and maintenance of what we might call 'problems', and drugs are frequently blamed for broader social problems. What is Nimbin’s drug problem? The answer depends, in part, on the drug of interest, but more importantly it depends on your definition of a ‘problem’. Some useful and meaningful perspectives on this important social issue include quantified indicators such as death, injury, arrest rates, the economics of black markets, the demographics of drug use, and estimates of ‘social costs’. Qualitative perspectives include people’s opinions about drugs, media-generated moral panics, the effects of social marginalisation, and the role of drug cultures. A number of ‘drug problems’ arise as a direct result of drug illegality. They include black markets, corruption, drug-related violence, theft, stronger forms of the drug, and more dangerous using practices (with the risk drug overdoses and HIV/AIDS), as well as public nuisance issues. Government policy, judicial sentencing and public opinion are moving towards the social reintegration of illicit drug users, but this is almost invariably counter-balanced by a toughening of legal sanctions against supply of the same drug. Most discussions about illicit drugs fail to consider the long-term implications of harsh penalties for, and elaborate and punitive police operations (such as occurred throughout my Nimbin research) against, small-scale independent growers and dealers. The only way to directly engage with drug markets and all the attendant problems, is to legitimise and regulate the supply of recreational drugs. I discuss several examples of the important role of the drug culture in mitigating problems caused by illegality. One example is the influence of Nimbin's alternative community on the style of the drug market. The village drug scene more closely resembles the many north coast village craft markets, than it does Kings Cross, Cabramatta or New York's Bronx. Buyers are north coast locals, along with national and international tourists (the small village is known to cannabis users world-wide, both through media attention and word-of-mouth). Nimbin offers a 'safe' village market ambience and competitive prices to a mainly cannabis using clientele. I suggest that there are two major underlying influences on the experience of a ‘drug problem’, regardless of the drug or the place. They are: 1. Political influences — specifically the effects of government policy on black markets, law enforcement practices, and access to services and resources; 2. Cultural influences — particularly the beneficial effects of norms and functional role models for the safe use of a drug, cultural effects on the drug market, and the role/s of the drug in the day-to-day life of the culture. These influences can operate with, or despite, each other, and can create or ameliorate many ‘drug problems’. In the case of Nimbin’s alternative culture, government policy has created a number of drug problems and the counter-culture has worked to minimise them. In my research into Nimbin’s ‘drug problem’ I have clarified some issues and raised a number of others. I have examined the notion of a ‘drug problem’ from several perspectives using a range of research tools, and discussed some key influences on the problem associated with drug use. Drawing from the Nimbin research and my reading, I suggest legalising the recreational drugs to bring them under the dual controls of supply legislation and social norms. In conclusion, I suggest that we need to be very clear about what ‘drug problem’ it is that we are talking about, and indeed, whether the problem is really about drugs at all.

Does Nimbin have a drug problem? This tiny village in north-eastern NSW has an international reputation for its alternative community and its street drug market. Ever since the Aquarius Festival thirty years ago Nimbin has fascinated the media, and recurrent headlines about the village's (undefined) 'drug problem' suggested my research topic. My research aim was to investigate the meaning/s of Nimbin's 'drug problem' in the context of Nimbin's 'alternative' culture. Because the topic of illicit drugs is both ethically challenging and highly sensitive, my research design was strongly participant-focused, with an emphasis on confidentiality balanced by a mixed methodology to cross-validate results. My methods included an anonymous household (door-to-door) survey based on a national household survey; an anonymous mailed-back survey of Nimbin and Lismore drug injectors; taped interviews with health and legal professionals, cannabis activists and drug dealers; semi-structured interviews with 'professional' cannabis crop growers; and participant observation over several years. I found the multi-method research design to be particularly effective for investigating illegal drug marketing and use, and the design provided me with multiple perspectives on a complex issue. Superficially, there appeared to be two drug 'problems' in Nimbin — one was the (largely cannabis) street market, and the other revolved around heroin users, and included complaints about scruffy-looking people hanging around the main street, or overdosing in the public toilet. However, my research suggested that these issues, while immediately comprehensible as 'drug problems', obscured more complex issues. For example, the village's street drug market was intertwined with the local economy and with the alternative community's values and drug use, while close to half of the drug injectors lacked secure housing (which creates problems that are not related to heroin), and all heroin users were blamed for the actions of few. Many factors influence the creation and maintenance of what we might call 'problems', and drugs are frequently blamed for broader social problems. What is Nimbin’s drug problem? The answer depends, in part, on the drug of interest, but more importantly it depends on your definition of a ‘problem’. Some useful and meaningful perspectives on this important social issue include quantified indicators such as death, injury, arrest rates, the economics of black markets, the demographics of drug use, and estimates of ‘social costs’. Qualitative perspectives include people’s opinions about drugs, media-generated moral panics, the effects of social marginalisation, and the role of drug cultures. A number of ‘drug problems’ arise as a direct result of drug illegality. They include black markets, corruption, drug-related violence, theft, stronger forms of the drug, and more dangerous using practices (with the risk drug overdoses and HIV/AIDS), as well as public nuisance issues. Government policy, judicial sentencing and public opinion are moving towards the social reintegration of illicit drug users, but this is almost invariably counter-balanced by a toughening of legal sanctions against supply of the same drug. Most discussions about illicit drugs fail to consider the long-term implications of harsh penalties for, and elaborate and punitive police operations (such as occurred throughout my Nimbin research) against, small-scale independent growers and dealers. The only way to directly engage with drug markets and all the attendant problems, is to legitimise and regulate the supply of recreational drugs. I discuss several examples of the important role of the drug culture in mitigating problems caused by illegality. One example is the influence of Nimbin's alternative community on the style of the drug market. The village drug scene more closely resembles the many north coast village craft markets, than it does Kings Cross, Cabramatta or New York's Bronx. Buyers are north coast locals, along with national and international tourists (the small village is known to cannabis users world-wide, both through media attention and word-of-mouth). Nimbin offers a 'safe' village market ambience and competitive prices to a mainly cannabis using clientele. I suggest that there are two major underlying influences on the experience of a ‘drug problem’, regardless of the drug or the place. They are: 1. Political influences — specifically the effects of government policy on black markets, law enforcement practices, and access to services and resources; 2. Cultural influences — particularly the beneficial effects of norms and functional role models for the safe use of a drug, cultural effects on the drug market, and the role/s of the drug in the day-to-day life of the culture. These influences can operate with, or despite, each other, and can create or ameliorate many ‘drug problems’. In the case of Nimbin’s alternative culture, government policy has created a number of drug problems and the counter-culture has worked to minimise them. In my research into Nimbin’s ‘drug problem’ I have clarified some issues and raised a number of others. I have examined the notion of a ‘drug problem’ from several perspectives using a range of research tools, and discussed some key influences on the problem associated with drug use. Drawing from the Nimbin research and my reading, I suggest legalising the recreational drugs to bring them under the dual controls of supply legislation and social norms. In conclusion, I suggest that we need to be very clear about what ‘drug problem’ it is that we are talking about, and indeed, whether the problem is really about drugs at all.

Thèse (Ph.D.)--Université Laval, 2006. / Bibliogr.: f. 291-290. Publié aussi en version électronique dans la Collection Mémoires et thèses électroniques.

Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008. / Full text also available online. Scroll down for electronic link.

Thesis (Ph.D.)--Virginia Commonwealth University, 2010. / Prepared for: Dept. of Pharmacology and Toxicology. Title from title-page of electronic thesis. Bibliography: leaves 109-123.