Background: Cannabis use is considered a component cause of psychotic illness, interacting with genetic and other environmental risk factors. Little is known, however, about these putative interactions. The present study investigated whether an urban environment plays a role in moderating the effects of adolescent cannabis use on psychosis risk. Method: Prospective data (n=1923, aged 14–24 years at baseline) from the longitudinal population-based German Early Developmental Stages of Psychopathology cohort study were analysed. Urbanicity was assessed at baseline and defined as living in the city of Munich (1562 persons per km2; 4061 individuals per square mile) or in the rural surroundings (213 persons per km2; 553 individuals per square mile). Cannabis use and psychotic symptoms were assessed three times over a 10-year follow-up period using the Munich version of the Composite International Diagnostic Interview. Results: Analyses revealed a significant interaction between cannabis and urbanicity [10.9% adjusted difference in risk, 95% confidence interval (CI) 3.2–18.6, p=0.005]. The effect of cannabis use on follow-up incident psychotic symptoms was much stronger in individuals who grew up in an urban environment (adjusted risk difference 6.8%, 95% CI 1.0–12.5, p=0.021) compared with individuals from rural surroundings (adjusted risk difference −4.1%, 95% CI −9.8 to 1.6, p=0.159). The statistical interaction was compatible with substantial underlying biological synergism. Conclusions: Exposure to environmental influences associated with urban upbringing may increase vulnerability to the psychotomimetic effects of cannabis use later in life.

Aim: To explore the role of cannabis use for the availability of ecstasy as a potential pathway to subsequent first ecstasy use. Methods: Baseline and 4-year follow-up data from a prospective-longitudinal community study of originally 3021 adolescents and young adults aged 14–24 years at baseline were assessed using the standardized M-CIDI and DSM-IV criteria. Results: Baseline cannabis users reported at follow-up more frequent access to ecstasy than cannabis non-users. Higher cannabis use frequencies were associated with increased ecstasy availability reports. Logistic regression analyses revealed that cannabis use and availability of ecstasy at baseline are predictors for incident ecstasy use during the follow-up period. Testing simultaneously the impact of prior cannabis use and ecstasy availability including potential confounders, the association with cannabis use and later ecstasy use was confirmed (OR = 6.3; 95% CI = 3.6–10.9). However, the association with ecstasy availability was no longer significant (OR = 1.2; 95% CI = 0.3–3.9). Conclusions: Results suggest that cannabis use is a powerful risk factor for subsequent first onset of ecstasy use and this relation cannot be sufficiently explained by availability of ecstasy in the observation period.

Introduction : la période de l’adolescence constitue la tranche d’âge pour laquelle les consommations de cannabis sont les plus élevées en France. L’usage problématique de cannabis à l’adolescence représente un facteur de stress important pour les parents. Cette recherche a pour premier objectif d’identifier une dynamique familiale spécifique ainsi que les stratégies de coping (individuelles et dyadiques) mobilisées par les parents dont l’adolescent est consommateur de cannabis. Le second objectif vise à investiguer les facteurs associés à la détresse psychologique en termes de dynamique familiale et de stratégies de coping (individuelles et dyadiques). Méthode : au cours de cette étude quantitative et qualitative, 50 parents consultant pour l’usage problématique de leur adolescent et 67 parents témoins ont répondu à un questionnaire sociodémographique, au Family Adaptability and Cohesion Scale (FACES IV) et au Family Relationship Index (FRI) pour évaluer la dynamique familiale, à la Brief Cope pour estimer les stratégies de coping situationnelles et au Dyadic Coping Inventory (DCI) pour relever les stratégies de coping dyadique mobilisées par les parents de l’échantillon en couple. Résultats : les parents d’adolescents consommateurs de cannabis présentaient une détresse psychologique élevée et ont obtenu des scores significativement différents aux dimensions de la dynamique familiale en comparaison des parents du groupe contrôle. Ainsi, le fonctionnement familial des parents d’adolescents consommateurs de cannabis était défini par une cohésion et des capacités de communication plus basses mais aussi une intensité de conflit élevée par rapport aux parents du groupe contrôle. Une dimension de la dynamique familiale (conflits) et quatre stratégies de coping situationnelles (expression des sentiments, blâme, utilisation de substances, désengagement comportemental) étaient positivement liées à la détresse psychologique. Les stratégies de coping dyadique (communication autour du stress, stratégies négatives, ect) étaient positivement liées à la détresse psychologique ressentie par les parents en couple. Conclusion : ces résultats montrent l’intérêt de mieux comprendre le vécu des parents confrontés à l’usage problématique de cannabis de l’adolescent et suggèrent des pistes de futures prises en charge. / Introduction: the period of adolescence is the age group for which cannabis use is highest in France. Cannabis use in adolescence is an important stressor for parents. The first aim of the present study was to better identify specific family dynamics and coping strategies (individual and dyadic) mobilized by parents of adolescent cannabis users. Second, was to investigate the factors associated with psychological distress (family dynamics, coping strategies). Method: during this quantitative and qualitative study, 50 parents consult for a problematic adolescent cannabis use and 67 control parents answered at a sociodemographic questionnaire, the Family Adaptability and Cohesion Scale (FACES IV) and the Family Relationship Index (FRI) to assess family dynamics, the Brief Cope to estimate situational coping strategies and dyadic coping Inventory (DCI) to address the dyadic coping strategies mobilized by the sample's parents couple. Results: parents of adolescent cannabis users had a high psychological distress and have obtained significantly different scores on the dimensions of family dynamics, compare at parental control group. Thus, family functioning of parents of adolescent cannabis users was defined as cohesion and lower communication capabilities but also high intensity conflict from parents in the control group. A dimension of family dynamics (conflicts) and four situational coping strategies (expressing feelings, blame, substance use, behavioral disengagement) were positively related to psychological distress. Dyadic coping strategies (communication about the stress, negative strategies, ect) were positively related to psychological distress experienced by parents couple. Conclusion: these results show the interest of better understanding the experiences of parents facing the adolescent problem cannabis use and suggest directions for future supported.

La presente tesis se basa en el análisis y evaluación legal, operativa y financiera para la creación e implementación de una empresa comercializadora de concentrado de aceite de cannabis (con contenido CBD y THC) orientado al uso medicinal, sobre todo para el tratamiento de enfermedades neurodegenerativas (Alzheimer, Parkinson, esclerosis múltiple), ansiedad, autismo, epilepsia, también a su vez se utiliza para el tratamiento de enfermedades inflamatorias crónicas, como lo es la enfermedad de Chron existe evidencia de la eficacia en el tratamiento de náuseas y vómitos asociados a la quimioterapia de cáncer, además está documentado el uso en el tratamiento de anorexia y pérdida de peso de pacientes con VIH, considerando los estudios de mercado a realizar y los planes y estrategias que en la presente tesis se mostrarán. Actualmente este rubro no está del todo explotado, esto debido a que, en el Perú, el proceso para otorgar licencias para venta e investigaciones de esta planta y productos a base de ésta es lenta, pese a esto, el Perú, tiene una de las regulaciones más avanzadas para el Cannabis en América Latina, y es un mercado prioritario para las grandes multinacionales. Para lograr el objetivo, se ha realizado un análisis del entorno nacional, para determinar las principales características del mercado objetivo que vienen a ser las personas con patologías tratables con cannabinoides en el Perú. Luego de determinar lo antes mencionado, y los factores que determinarían la preferencia por nuestro producto, se realizará el estudio financiero y la viabilidad del negocio. / This thesis is based on the legal, operational and financial analysis and evaluation, for the creation and implementation of a trading company for cannabis oil concentrate (with CBD and THC content) oriented to medicinal use, especially for the treatment of neurodegenerative diseases (Alzheimer, Parkinson, multiple sclerosis), anxiety, autism, epilepsy, it also used for the treatment of chronic inflammatory diseases, such as Chron’s disease, there is evidence of efficacy in the treatment of nausea and vomiting associated with cancer chemotherapy. In addition, the use in the treatment of anorexia and weight loss in patients with HIV is documented, considering the market studies to be carried out and the plans and strategies that will be show in this thesis. Currently this item is not fully, this because, in Peru, the process to grant licenses for sale and research of this plant and products based on it is slow, despite this, Peru has one of the most advanced regulations for Cannabis in Latin America, and it is a priority market for large multinationals. To achieve the objective, and analysis of the national environment has been carried out, to determine the main characteristics of the target market that people with cannabinoid – treatable pathologies in Peru. After determining the aforementioned, and the factors that would determine the preference for our product, the financial study and viability of the business. / Trabajo de investigación

Objective: To determine whether use of cannabis in adolescence increases the risk for psychotic outcomes by affecting the incidence and persistence of subclinical expression of psychosis in the general population (that is, expression of psychosis below the level required for a clinical diagnosis). Design: Analysis of data from a prospective population based cohort study in Germany (early developmental stages of psychopathology study). Setting: Population based cohort study in Germany. Participants: 1923 individuals from the general population, aged 14-24 at baseline. Main outcome measure: Incidence and persistence of subthreshold psychotic symptoms after use of cannabis in adolescence. Cannabis use and psychotic symptoms were assessed at three time points (baseline, T2 (3.5 years), T3 (8.4 years)) over a 10 year follow-up period with the Munich version of the composite international diagnostic interview (M-CIDI). Results: In individuals who had no reported lifetime psychotic symptoms and no reported lifetime cannabis use at baseline, incident cannabis use over the period from baseline to T2 increased the risk of later incident psychotic symptoms over the period from T2 to T3 (adjusted odds ratio 1.9, 95% confidence interval 1.1 to 3.1; P=0.021). Furthermore, continued use of cannabis increased the risk of persistent psychotic symptoms over the period from T2 to T3 (2.2, 1.2 to 4.2; P=0.016). The incidence rate of psychotic symptoms over the period from baseline to T2 was 31% (152) in exposed individuals versus 20% (284) in non-exposed individuals; over the period from T2 to T3 these rates were 14% (108) and 8% (49), respectively. Conclusion: Cannabis use is a risk factor for the development of incident psychotic symptoms. Continued cannabis use might increase the risk for psychotic disorder by impacting on the persistence of symptoms.

Cannabis use is considered a component cause of psychotic disorder interacting with genetic and environmental risk factors in increasing psychosis risk (Henquet et al., 2008). Recently, two cross-sectional and one prospective study provided evidence that cannabis use interacts additively with trauma to increase psychosis risk (Houston et al., 2008, Harley et al., 2010 and Konings et al., 2011). In an attempt at further replication, we examined prospective data from the German Early Developmental Stages of Psychopathology (EDSP) study (Wittchen et al., 1998b and Lieb et al., 2000).

[pt] O uso de cannabis é um problema de saúde pública crescente, associado a diversos desfechos negativos. A identificação de fatores de risco é relevante para a prevenção, pois nem sempre tratamentos são eficazes. O abuso sexual infantil é considerado um forte preditor de uso e transtorno por uso de cannabis (TUC). Com a expansão da internet a violência sexual assumiu novos formatos, fazendo surgir um fenômeno contemporâneo denominado vitimização sexual on-line (VSO). Esta dissertação se dedicou ao aprofundamento do tema e realizou uma revisão narrativa com o objetivo de sintetizar o conceito de VSO e seus paralelos com abuso sexual off-line. Além disso, foi investigado exploratoriamentea VSO na infância e adolescência e suas associações com o uso de cannabis e TUC. Análises de regressão investigaram o efeito preditivo de VSO no uso de cannabis ao menos uma vez na vida e na idade do primeiro uso de cannabis. Mais de 70 por cento da amostra relatou ter sofrido VSO na infância e adolescência. Mulheres apresentaram quase o dobro de prevalência que os homens, com médias mais elevadas nas subescalas de insistência e ameaça. Minorias sexuais foram mais prevalentes que heterossexuais em todas as subescalas. A VSO foi capaz de prever significativamente o uso de cannabis pelo menos uma vez na vida e a idade do primeiro uso, mas somente a subescala de disseminação. Os resultados sugerem que VSO na infância e na adolescência é um fenômeno com alta prevalência, que pode estar associada ao uso de cannabis. Crianças e adolescentes merecem atenção especial porque utilizam a internet com maior freqüência, ficando expostos a riscos. Dessa maneira, é necessário pensar estratégias para prevenção de ocorrência de VSO e seusefeitos adversos. / [en] Cannabis use is a growing public health problem, associated with a variety of negative outcomes. The identification of risk factors is relevant for prevention, as treatments are not always effective. Child sexual abuse is considered a strong predictor of cannabis use and cannabis use disorder (CUD). With the expansion of the internet, sexual violence took on new formats, giving rise to a contemporary phenomenon called online sexual victimization (OSV). This dissertation was dedicated to deepening the theme and carried out a narrative review with the objective of synthesizing the concept of OSV and its parallels with offline sexual abuse. In addition, we exploratory investigated OSV in childhood and adolescence and its associations with cannabis use and CUD. Regression analyzes investigated the predictive effect of OSV on lifetime cannabis use and age of first cannabis use. More than 70 percent ofthe sample reported having suffered OSV in childhood and adolescence. Women had almost twice the prevalence of men, with higher means in the insistence and threat subescales. Sexual minorities were more prevalent than heterosexualin allsubscales. The OSV was able to significantly predict lifetime cannabis use and age atfirst use, but only the spread subscale. The results suggest that OSV in childhood and adolescence is a highly prevalent phenomenon that maybe associated with cannabis use. Children and teenagers deserv especial attention because they use the internet more frequently and are exposed to risks. Thus, it is necessary to think about strategies to prevent the occurence of OSV and its adverse effects.

Den svenska narkotikapolitiken kännetecknas av stränga förbudslagar som har mött motstånd de senaste åren. Detta eftersom dess effektivitet har blivit ifrågasatt. Målet med denna undersökningen är att undersöka svenska socialarbetares åsikter om den svenska narkotikapolitiken och hur den påverkar deras arbete. Vidare vill vi även se hur socialarbetare ställer sig till en eventuell avkriminalisering av cannabis för eget bruk och hur det hade kunnat påverka deras arbete. Undersökningen består av åtta semi-strukturerade intervjuer med personer som stöter på klienter med missbruk på olika sätt. Resultatet visar att intervjupersonerna anser att narkotikapolitiken bör utvärderas. De anser att den nuvarande narkotikapolitiken är repressiv och straffar mer än den hjälper. Vidare påpekar de att en eventuell avkriminalisering kan gynna brukare- och missbrukare även om det är en komplex policyfråga som måste utvärderas noggrant innan det implementeras. Intervjupersonerna nämner en rädsla för att en avkriminalisering av cannabis för eget bruk hade normaliserat drogen och ökat användningen. Den svenska narkotikapolitiken bidrar även till stigmatisering av brukare- eller missbrukare, något som gör att de ses som avvikare och kriminella och förhindrar dem från att söka hjälp. Vår slutsats är att den svenska narkotikapolitiken i sin nuvarande form måste förändras. Huruvida detta är genom en avkriminalisering av cannabis för eget bruk eller genom att förbättra och göra den nuvarande missbruksvården mer lättillgänglig är något som måste övervägas. / The Swedish drug policy is characterized by strict prohibitionist laws which has seen some resistance in recent years due to questioning of its effectiveness. The aim of this essay is to examine Swedish social workers views regarding the Swedish drug policy and how it affects their work with drug users and drug dependent clients. Furthermore we wanted to see what social workers feel about decriminalization of cannabis for personal use and how it could affect their line of work. The study consists of eight semi-structured interviews with social workers who come across clients with addictions in different ways. The results show that the interviewees believe that the drug policy needs to be evaluated. They believe that it’s currently repressive and punishes more than it helps. Furthermore, they point out that decriminalization can benefit users and drug dependent clients even though it’s a complex policy that must be properly evaluated before implementing. The interviewees mention a fear that decriminalization of cannabis for personal use would normalize the drug and in turn lead to an increased use. The Swedish drug policy is also considered to contribute to the stigmatization of users or drug dependent clients. This in turn leads them to be seen as deviants and criminals, something that prevents them from seeking help. Our conclusion is that Sweden's drug policy, in its current form, needs to change. Whether this is through decriminalization of own use or through improving the accessibility and quality of current drug treatment care is something that needs to be considered.

Text in Afrikaans / Summaries in Afrikaans and English / Na meer as veertig jaar het Suid-Afrika 'n nuwe politieke bedeling wat veranderde wetgewing in die vooruitsig stel. 'n Oorweging van 'n dekriminaliseringsbeleid vir die gebruik van dagga, beskou teen die agtergrond van 'n toename in emstige misdaad soos moord, gewapende roof, taxigeweld en verkragting, weerspieel die realiteite van vandag se oorweldigende misdaadprobleem in Suid-Afrika. Een van die belangrikste take van die kriminoloog is om misdaad te omskryf sodat 'n beleid voorgeskryf kan word wat die strafregsplegingstelsel van hulp kan wees om uiteindelik misdaad te verminder of, meer realisties, meer doeltreffend te beheer. Die omskrywing daarvan is egter nie so eenvoudig nie vanwee die kompleksiteit van die mensdom. Inhierdie studie is 'n meningsopname gebruik van sowel jeugdiges, die toekomstige beleidmakers en algemene daggagebruikers, as kenners op die gebied van dwelmrehabilitasie en -beheer, ten einde die wenslikheid van 'n dekriminaliseringsbeleid te beoordeel. Empiriese data van beide groepe (die wetsgehoorsame en die wetsverbrekende) is vir die voorwaardelike steun vir die wetlike beheer van daggagebruik versamel, met die verskil dat eerste- en eksperimentele daggagebruikers wat geen antler misdaadrekord het of by enige misdaadbedrywighede betrokke is, nie 'n misdaadrekord moet kry nie. Die respondente het dus die behoud van strafmaatreels ondersteun, maar met 'n de facto-dekriminalisasie deur middel van nie-toepassing van die wet. Die respondente is van mening dat 'n verslapping van die huidige dwelmwetgewing tot 'n toename in misdaad aanleiding sal gee. Die respondente betwyfel egter die doeltreffendheid van die kriminele regstelsel. Hulle is selfs van mening dat die SAPD nie in staat is om die probleem te bekamp solank die middel in aanvraag is nie. Die studie beklemtoon verder die kompleksiteit en dikwels teenstrydige opvattings ten opsigte van dekriminalisasie ten einde te illustreer hoe moeilik dit is om 'n staatsbeleid daarop te skoei. / After more than forty years, South Africa has a new political dispensation with prospective new legislation. The consideration of a policy of decriminalization for the use of dagga, seen against the background of an increase in serious crimes such as murder, armed robbery, taxi violence and rape, reflects the realities of the current overwhelming crime problem in South Africa. One of the most important tasks of the criminologist is to describe crime in order to facilitate the system of administration of criminal justice in the diminishing of, or more realistically, better control of crime. The description thereof is, however, not simple due to the complexity of humanity. In this study an opinion survey of both youths as the future policy makers and most common users of dagga, and specialists in the field of drug rehabilitation and control was used, in order to determine the expedience of a policy of decriminalization. Empirical data was obtained from both groups (the law abiders and the law-breakers) for the conditional support of legislative control of dagga use, with the exception that first and experimental users with no criminal record or history of criminality should not be subjected to a criminal record. The respondents therefore supported the retention of punitive measures, but with a defacto-decriminalization by way of non­ enforcement of the law. The respondents were of the opinion that the relaxation of the present drug legislation would lead to an increase in crime. The respondents doubt the effectiveness of the criminal justice system, however, they are of the opinion that the SAPS would never be able to combat the problem as long as a demand for the drug continues to exist. The study further emphasizes the complexity and often diverse conceptions of decriminalization in order to illustrate how difficult it is to base a state policy on these conceptions. / Criminology and Security Science / M.A. (Kriminologie)

Cannabis is the illicit drug most widely used in the world (UN, 2011). After twenty years of increased consumption, there has recently been a decline or stabilization in use among young people and European adolescents (EMCDDA, 2011). However, given the impact that can result from its consumption in the health of the young, especially if it’s accompanied by the use of other drugs that can affect their development and learning, further investigation of cannabis remains as a priority. The main objective of this thesis is to determinate the prevalence and pattern of cannabis consumption in a sample of 2.137 university students from Girona aged between 17 and 35 years, and to consider some of the variables in this drug-taking. Quantitative methodology is used, as well as an own designed questionary which has been applied to the sample. The results indicate that 20,4% of participants are defined as cannabis consumers (24% males / 17,2% females). At the same time, while the age of the young is increasing, there are a smaller proportion of non cannabis consumers who have never tried the substance. The role of the consumer status of close friends and family is relevant on the age of first experimentation, the age of general consumption and on the young’s general consumption behaviour. Risk perception of cannabis is associated with the consumption status of the young consumer, so consumers and quitters consider less dangerous to use this substance compared with nonusers. As the youth goes through the different acquisition stages of cannabis (Pallonen, Prochaska, Velicer, Prokhorov and Smith, 1998) value of the negative aspects of the use of this substance decreases and raises the positive ones, while it also increases the degree of temptation to consume. These results show the need to avoid or delay the age of onset of cannabis consume, specially among children, to consider the youth's behaviour concerning to promote healthy behaviours, and to increase the perception of risk from consumption of this substance by providing them with adequate information about their effects and health implications / El cannabis es la droga ilegal de uso más extendido en el mundo (ONU, 2011). Después de veinte años de aumento del consumo de esta sustancia, recientemente se ha observado un descenso o estabilización en su uso, entre la población de jóvenes y adolescentes europeos (OEDT, 2011). No obstante ahondar en el estudio del consumo de cannabis por las repercusiones que puede comportar su uso en la salud del joven, sobre todo si se acompaña del consumo de otras drogas que pueden afectar a su desarrollo y aprendizaje, sigue siendo una prioridad. El objetivo principal de esta tesis es conocer la prevalencia y el patrón de consumo de cannabis en una muestra de 2.137 jóvenes universitarios de primer ciclo de la ciudad de Girona con edades comprendidas entre los 17 y 35 años, así como estudiar algunas de las variables relacionadas con este consumo. Se utiliza la metodología cuantitativa, y se aplica a la muestra un cuestionario de elaboración propia. Los resultados indican que un 20,4% de los jóvenes encuestados se definen como consumidores de cannabis, en mayor proporción los chicos (24%) que las chicas (17,2%). Asimismo, a medida que aumenta la edad del joven se halla una proporción menor de no consumidores de cannabis que no han probado nunca la sustancia. El papel del estatus de consumo de los amigos y familiares cercanos al joven es relevante en la edad de primera experimentación, la edad de consumo habitual y en la conducta de consumo del joven en general. La percepción de peligrosidad del cannabis se relaciona con el estatus de consumo del joven, de manera que los consumidores y los exconsumidores perciben menos peligroso el uso de esta sustancia en comparación con los no consumidores. A medida que el joven avanza en las etapas de adquisición del consumo de cannabis (Pallonen, Prochaska, Velicer, Prokhorov y Smith, 1998) disminuye la valoración de los aspectos negativos de su uso y aumenta la consideración de los aspectos positivos, asimismo se incrementa también el grado de tentación hacia su consumo. Estos resultados muestran la necesidad de evitar o retrasar la edad de inicio del consumo de cannabis, en especial entre los chicos, considerar los referentes de conducta del joven para promover conductas saludables, y aumentar la percepción de peligrosidad derivada del consumo de esta sustancia mediante una adecuada información de sus efectos y repercusiones en la salud