While neuropsychological deficits have been reported in healthy individuals who use cannabis, data in patients with multiple sclerosis (MS) are lacking. Given that MS is associated with cognitive deterioration, the aim of this study was to determine the cognitive effects of inhaled or ingested cannabis in this population. Fifty MS patients (25 cannabis users and 25 non-users) completed the Minimal Assessment of Cognitive Function in MS battery of neuropsychological tests. Cannabis users had significantly poorer performance on measures of information processing speed, executive functions, and visuospatial perception, and were twice as likely to be classified as globally cognitively impaired. Similar results were found after controlling for potential confounding variables. This study provides evidence that prolonged cannabis use in MS patients is associated with poorer performance on cognitive domains commonly affected in this population. The therapeutic benefits patients may derive from using cannabis should be weighed against the associated cognitive side-effects.

The debate surrounding marijuana legalization has increased its popularity in recent years, as the state of California seriously considers the complete legalization of the substance for those ages 21 and over. This would make California the first government in recorded history to regulate the cultivation and sale of marijuana on a commercial level. Advocates back the economic positives concerning high tax revenues, but those opposed argue that the dangers associated with public health greatly outweigh any monetary gain. The present study attempts to reveal the possible public health concerns, even potential benefits, caused by marijuana use and its distribution. Specifically, measures of California’s Medical Marijuana Program will be assessed on the total number of drug treatment admissions in each county, taking into account treatment type and which type of drug is primarily responsible for said admissions. Findings reveal influences by both gateway and substitution effects, creating both positive and negative correlations throughout the field of public health. The influences of intangible variables, like that of the black market, make the results difficult to generalize. However, significant correlations can be found among specific health factors, like Heroin use, Crack/Cocaine use, and Residential Treatment.

INTRODUCTION: Marijuana use, although illegal in the majority of states, is increasingly becoming acceptable for use in the United States. There are dangerous public health consequences associated with marijuana use—including: impaired driving, loss of productivity in workplaces and school settings, as well as mental health impacts. In Atlanta, the majority of residents (54.0%) are African American. Emergency room use is double for African American Fulton County residents compared to their Caucasian counterparts and approximately 1/5 of the total population receiving public health treatment identify marijuana as the primary drug of use, with 57% of those being African Americans. Despite these statistics, the availability of treatment and prevention programs targeting African Americans using marijuana is negligible.AIM: The purpose of this study is to synthesize evidence-based approaches to substance use treatment so that effective components of previous research can be incorporated into an innovative marijuana prevention program to increase post-treatment abstinence targeting a segment of the population that has not been a significant focus in intervention research. METHODS: A review of scientific literature was conducted to identify and appraise evidence based approaches to substance use among young adults. First, the student researcher examined programs targeting marijuana use. Second, the search was expanded to substance use in general. The student researcher identified the population, intervention, control arm, and outcomes of various studies focusing on substance use prevention in a variety of settings. With this appraisal, the most effective components are suggested for a marijuana specific program which could be offered to African-American young adults, as no current programs in Georgia were found. RESULTS: Substance abuse intervention approaches targeting young adult populations were identified. Programs are delivered in a variety of settings: family, school, and community. Evidence supports that cognitive behavioral training, motivational enhancement training, and contingency management are the most effective approaches targeting substance use among young adults. A program that integrates components of each approach would be ideal for targeting African American young adults using marijuana in Metro-Atlanta and assisting them to maintain abstinence post-treatment. DISCUSSION: The results from this study emphasize key program elements that can address marijuana addiction among African American young adults in Metro-Atlanta. As marijuana acceptance increases, the need for prevention programs becomes more urgent. This study’s results can assist program planners in understanding the most strategic interventions that would optimize return on investment when addressing a largely silent public health threat: marijuana use among Africa American young adults in Metro-Atlanta.

Uppsatsen undersöker diskurser om cannabis och hur bilden av ungdomar och vuxna som använder drogen presenteras i tidningarna Aftonbladet, Dagens Nyheter, Expressen och Svenska Dagbladet under år 2012. Studien är en kvalitativ diskursanalys efter Norman Faircoughs tredimensionella metod. Intresset uppkom i och med den diskussion som internationellt växt fram under året. Länder som kulturellt och politiskt stått förebild för svensk utveckling i många frågor rapporterades revidera och omformulera den egna problembilden av cannabis. För en grundläggande förståelse av hur rapporteringen om narkotika sett ut i svensk dagspress har Daniel Törnqvists avhandling “När man talar om knark” legat till grund för arbetets utformning. De medieteoriska utgångspunkterna har varit moralpanik och skiftet från socialpolitik till kriminalpolitik som skett i pressen. Under det analyserade året återkom teman för hur rapporteringen ser ut, beträffande ungdom och narkotika centraliserar samhällets rädsla för den första att komma i kontakt med den senare. Medias förhållningssätt i frågan har tydliga likheter med hur pressen internationellt förhöll sig till subkulturer decennier tillbaka. Den cannabisanvändande kvinnan belyses likaså, tillskrivs en tydlig offerroll och är ur ansvarssynpunkt överskuggad av relationer med män. Mannen är ansvarig för kvinnans missbruk och i förlängningen hennes förfall, en bild som av media presenterats under flera årtionden. Ur vårt material har vi tyckt oss främst finna två diskursiva drag, låt gå och hårdare tag, varandras motsatser.

This study is a qualitative examination of twenty current and former users of marijuana, using in-depth interviews as the units of analysis. The relationship between the participants’ perceived costs and rewards, type and amount of linguistic accounts used, as well as frequency of use are explored using Homans' exchange theory and Lyman and Scott’s theory of accounts. Reasons for continuation, regulation, and cessation of use are also studied. It is found that the participants use marijuana for a varied amount of reasons; these reasons directly influence how they account for their behavior as well as their frequency of use, particularly whether or not they use marijuana on a daily basis.

Health risk behaviors are responsible for the majority of morbidity and mortality among adolescents. Researchers have identified three sources of risk-taking in adolescents – dispositional, ecological and biological. The Bioecological Model incorporates these three sources of risk-taking, however it lacks explanatory power. For this reason, this thesis focused on explaining risk perception of health risk behaviors (smoking cigarette, alcohol and marijuana use), and health risk behaviors by integrating the Bioecological Model with a more specific Health Belief Model. The relationship between risk perception and health risk behavior was also investigated as a first step in understanding adolescent decision-making using the Health Belief Model. Adolescents from a suburban Indiana area were asked to complete the Adolescent Health Risk Behavior Survey which assessed egocentrism, self-esteem, social norms, risk perceptions, and the incidence and prevalence of health endangering behaviors. Hierarchical linear regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain risk perception of health risk behaviors. Hierarchical logistic regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain health risk behaviors and to moderate the relationships between risk perception and health risk behaviors. Based on the results, it was confirmed that the Bioecological Model is important in understanding adolescent’s risk perception of health risk behaviors, and their self-reported health risk behaviors. It is also important in understanding the relationship between risk perception and health risk behaviors. Adolescent Variables, Microsystem, and Mesosystem were significant in predicting adolescent risk perception of all health risk behaviors examined, and self-reported smoking cigarette behavior and marijuana use. Adolescent variables and Microsystem were the only systems to predict adolescent self-reported alcohol use. The relationship between risk perception and reported smoking cigarette behavior was moderated by Adolescent Variables, Microsystem and Mesosystem, however for alcohol use the path was moderated by Adolescent Variables and for marijuana use the path was moderated by the Mesosytem. Results of this thesis imply the importance of considering the contribution of Bioecological Model variables when implementing prevention intervention programs specific to adolescent health risk behaviors.

Low life satisfaction and substance use in adolescence are causes for concern as each problem is known to be associated with many concurrent and later negative outcomes. To date, only four studies have examined links between these variables in youth. This study added to the literature by examining adolescents' life satisfaction in relation to their frequency of use of a variety of substance types, using an understudied population (i.e., a predominantly Hispanic sample of 130 high school students). Results included significant, inverse bivariate links between adolescent life satisfaction and use of alcohol, cigarettes, and marijuana. When examined simultaneously, adolescents' use of any of the three substance types accounted for a significant but small proportion (6%) of variance in global life satisfaction scores. Other notable results include that gender (but not ethnicity) moderated the relationship between life satisfaction and one type of substance use; specifically, adolescent males who drank alcohol in the past year did not experience diminished life satisfaction. Contrary to hypotheses, high life satisfaction did not protect students who experienced increased risk factors (e.g., poor academic achievement, conduct problems, emotional problems) from actual use of substances. Implications of these findings for future research and practice are outlined and discussed.

La marijuana existe dans l'environnement humain depuis des milliers d'années, tant pour ses usages récréatifs que médicaux. Pour ces derniers, elle tend à être de plus en plus valorisée; voire considérée comme un produit « non dangereux» et même bénéfique. Pourtant, ses vertus médicinales soulèvent toujours interrogations et controverses au sein du monde médical et scientifique. Ce mémoire examine l'encadrement normatif applicable à l'utilisation de la marijuana à des fins médicales. Dans un premier temps, il présente de façon simplifiée la composition chimique de cette plante et évoque l'histoire mondiale de la marijuana. Le chapitre II expose les Conventions internationales adoptées pour surveiller la production, la distribution et l'usage de marijuana. Le chapitre III est consacré à la législation européenne et en particulier à celle de la France, de la Suisse, du Royaume-Uni et des Pays-Bas. Enfin, la situation en Amérique du Nord est présentée dans le chapitre IV de façon à comparer la position des États-Unis et celle du Canada. Tout au long de ce mémoire, l'auteur note l'interaction entre le législatif et le judiciaire dans le débat entourant l'accès légal à la marijuana à des fins thérapeutiques. / The marijuana has been known to humanity for thousands of years, for its recreational as weil as medical uses. In this contexts, it seems to be seen as "not dangerous" and even useful. However, among medical and scientific experts, discussions still occur about its medical characteristics. This paper studies the normative structures applicable to the use of marijuana for medical purposes. Firstly, it presents in a simplified way the chemical composition of this plant and describes its history. Chapter II introduces the International Conventions adopted in order to supervise the production, distribution and use of marijuana. Chapter III is dedicated to the European legislation and in particular the situation in France, Switzerland, the United Kingdom and the Netherlands. Finally, the situation in North America is presented in chapter IV comparing the positions of the United States of America and Canada. In this document, the author observes the interaction between the legislative regulations and the courts leading to the legal right to use marijuana for therapeutic purposes. / "Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de Maîtrise en droit, option recherche (LL.M.)"

The theory of planned behavior is a great tool for understanding predictors of drug use, specifically marijuana. Although the theory has been applied in the U.S. and European context, research on the predictors of behavioral intention for marijuana use within the Arabian Gulf context is limited. This thesis provides an overview of the theory of planned behavior as used in the U.S. and European context. An argument for the need to better understand predictors of behavioral intentions to use drugs, in the Arabian Gulf Region, prior to developing interventions and preventions is presented. Data was collected from 95 participants between the ages of 18-25 who were from the six GCC countries. Participants had the option to complete the survey in English or in Arabic. Results of the study suggest attitudes are the strongest predictor for behavioral intentions to use marijuana. Knowledge and sensations seeking were not significantly related to behavioral intentions for marijuana use within the current sample.

The primary focus of this thesis was to examine the relationship of reward sensitivity and outcome expectancies, variables traditionally associated with alcohol use, to cannabis use behaviour and to explore the relationship of affect and locus of control to alcohol and cannabis use. It was hypothesised that hazardous alcohol and cannabis use would be related to higher levels of reward sensitivity and to the endorsement of more positive outcome expectancies. It was also hypothesised that positive outcome expectancies would mediate the relationship between reward sensitivity and cannabis use, and that the relationship between reward sensitivity and both alcohol and cannabis use would be moderated by punishment sensitivity. No specific hypotheses were formulated for the relationship of negative outcome expectancies, affect and locus of control of reinforcement to substance use. A total of 465 young adults aged between 18 and 35 years completed a questionnaire which assessed substance use patterns, reward and punishment sensitivity, outcome expectancies, locus of control, and affect. Results indicated that higher levels of reward sensitivity reliably distinguished hazardous from non-hazardous alcohol and cannabis users as well as cannabis users from cannabis non-users. The relationship between reward sensitivity and substance use was partially mediated by outcome expectancies, but not moderated by punishment sensitivity. An exploratory factor analysis demonstrated a high rate of concordance between alcohol and cannabis outcome expectancies. Locus of control of reinforcement was found to be unrelated to alcohol and cannabis use behaviour. There was little commonality in the relationship of sensitivity to punishment, negative outcome expectancies, and affect to alcohol and cannabis use. The second focus of this thesis was to pilot an intervention aimed at reducing alcohol use via the challenging of expectations regarding the rewarding outcomes associated with alcohol use in a group of young adult Australian males. A three session intervention was completed by three males aged between 19 and 31 years. The results demonstrated no reduction in hazardous alcohol use or global positive alcohol outcome expectancies at the completion of the intervention program or at a 3-month follow-up. Furthermore, there was no reduction in expectancies of increased sexual interest for any of the participants at the 3-month follow-up compared to baseline, despite a reduction in these expectancies for one of the three participants at the completion of the intervention. A reduction in monthly drinking levels and in expectancies of increased confidence compared to baseline was noted for two of the three participants at the 3-month follow-up. It was concluded overall that there is consistency between the relationships of reward sensitivity and positive outcome expectancies to alcohol and cannabis use and that outcome expectancies may be a proximal mechanism through which reward sensitivity influences alcohol and cannabis use. It was further concluded that whilst causal inferences regarding the effectiveness of the intervention could not be made, the results provide some evidence for the usefulness of this treatment in changing a proportion of the studied outcomes. This potentially provides an incentive for future controlled design research in larger samples and with alternate substances.