This paper analyzes the impact of the 2012 legalization of recreational marijuana in Washington State on opioid abuse. Using synthetic control methodology, this paper finds that the legislation prevented 638 overdose deaths and lead to over 3,600 individuals seeking treatment for opioid abuse disorders. Due to the large health, social, and economic impacts of the opioid epidemic, further research should be conducted into ways to reduce the number of opioid prescriptions, the number of opioid overdoses, and opioid abuse generally.

Economical analysis of market with cannabis products is solved by the master thesis. Emphasis is placed on the situation and specifics of Czech Republic market with focus on price of cannabis drugs. It contains research questions which deal with role of price of drugs users -- if price factor is more significant than other socio-economical factors. The thesis describes development of legislation and anti-drug policy in the Czech Republic and its focus on cannabis products. In the theoretical part of the thesis there are presented economical and social aspects of anti-drug policy and its forms of applications in the Czech Republic. Analytical part of the thesis is focused on analysis of recent situation in the market with cannabis products. There is presented survey dedicated to consumption of cannabis drugs by students of high (secondary) schools. The survey also deals with attitudes of these students towards cannabis drugs. The survey is the source of data for regression analysis. Research has shown the most of users of marijuana do not pay for the drug. In case of act of buying there are frequent volume distcounts. Procurations of anti-drug policy which are trying to influence the price therefore may not have any impacts on buying behavior.

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

ABSTRACT Background: Few studies have focused on early alcohol, tobacco and drug use prior to 18 years of age and their relationship with anxiety; while no study has checked the gender differences of these factors with anxiety. Methods: This study included 6,057 adults with anxiety in the past year and 71,868 controls from the combined data of 2013 and 2014 National Survey on Drug Use and Health (NSDUH). The weighted multiple logistic regression analyses were used to estimate the associations of early alcohol, tobacco and drug use prior to 18 years of age with anxiety. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results: The overall prevalence of anxiety was 6.8% (4.4% and 9.1% for males and females, respectively). Weighted multiple logistic regression showed that cigarettes use, inhalant use, marijuana use and other illicit drugs use revealed significant associations with anxiety (OR = 1.18, 95% CI = 1.04-1.33, OR = 1.31, 95% CI = 1.10-1.56, OR = 1.16, 95% CI = 1.01-1.32, and OR = 1.31, 95% CI = 1.17-1.48, respectively). Stratified by gender, cigarettes use, inhalant use, marijuana use and other illicit drugs use were associated with anxiety in females only. Conclusion: Early tobacco and drug use prior to 18 years of age were found to be associated with increased odds of adult anxiety and that such associations differed by gender.

The prevalence of opioid use has increased in many populations including pregnant women, which has led to a substantial rise in infants born dependent on opioids due to in utero exposure. Many women use multiple substances aside from opioids during pregnancy, and their infants therefore present with a variety of symptoms. With increasing legalization and changing perception of marijuana, it has become one of the most commonly used substances during pregnancy. Few studies have evaluated concomitant use of marijuana and opioids in pregnancy despite both being implicated in adverse newborn outcomes. The primary aim of this study was to determine the association between marijuana use and pregnancy outcomes in opioid-exposed pregnancies. The secondary aim was to identify, in a sample of women already using opioids, maternal characteristics associated with marijuana use during pregnancy. A retrospective chart review was conducted from July 2011 to June 2016 of all births from 6 delivery hospitals in South-Central Appalachia to determine pregnancy and neonatal outcomes of pregnancies exposed to any form of opioid and positive urine drug screen for marijuana at the time of delivery. 2375 pregnancies met the inclusion criteria with 108 pregnancies positive for marijuana. Student t-test and Chi-Square test were used for group comparison for presence and absence of marijuana. Logistic regression was done for significant confounding variables to find aOR for marijuana exposure for neonatal abstinence syndrome diagnosis, premature birth, and low birth weight. Among opioid using women, marijuana positive women were more likely to be unmarried, nulliparous, and use tobacco and benzodiazepines. Infants born to the marijuana users were likely to be of earlier gestational age (3 days), lower birth weight, and preterm; with preterm birth and low birth weight (mean difference = 265 gms) increased two fold even after controlling for parity, marital status, tobacco and benzodiazepine use with aOR of 2.35 (1.30-4.23) and 2.02 (1.18-3.47) respectively. Ultimately, prenatal use of marijuana in opioid-exposed pregnancies carries significant risk of prematurity and low birth weight. For pregnant women continuing their American College of Obstetricians and Gynecologists recommended medical assisted treatment for opioid use disorder, providers should counsel women to abstain from marijuana during pregnancy.

No description available.

[pt] Existe um grande debate entre acadêmicos e formuladores de política a respeito do efeito potencial da legalização das drogas no crime. Proponentes da legalização das drogas argumentam que a legalização levaria a mais consumo e crime. Já os defensores da legalização (e.g Friedman, 1991) argumentam que a proibição por si só causa mais crimes ao desviar recursos policiais do combate a outros tipos de crime e incentivar a violência por parte de participantes do mercado negro como forma de disputar mercado e cumprir contratos. Nesse artigo, examinamos uma droga específica que responde por uma grande fração do mercado: maconha. Para isso, analisamos a experiência pioneira da Califórnia com a legalização da maconha medicinal, iniciada em 1996. A experiência californiana é particularmente interessante por se aproximar de uma legalização de facto da droga, mesmo para fins recreativos. Nós usamos uma abordagem de controle sintético para estimar um contrafactual qual teria sido a taxa de criminalidade violenta na Califórnia na ausência de legalização da maconha medicinal. Este contrafactual é construído como uma média ponderada de outros estados americanos, cujos pesos são escolhidos de forma ótima para aproximar tal média a Califórnia, antes da mudança de política. Ao comparar a Califórnia com sua contrafactual (principalmente composto por Florida, Illinois e Texas), mostramos que, no ano de 2006, a taxa de crimes violentos da Califórnia foi 13 por cento menor do que o que teria sido na ausência da legalização da maconha medicinal. / [en] There is a large debate among both scholars and policy makers about the potential effects of drug legalization on crime. On the one hand, proponents of drug criminalization claim that legalization would lead to greater consumption and crime. On the other hand, advocates of drug legalization (e.g. Friedman, 1991) argue that prohibition itself can cause more crime by diverting police resources away from deterring non-drug crimes and incentivizing market participants to resort in violence to dispute market share and enforce agreements. In this paper, we examine one specific drug that corresponds to a large share of the drug market: marijuana. For that, we analyze California s pioneer experience with medical marijuana legalization, which started in 1996. California s experience is particularly interesting because it was close to a de facto total legalization of the drug, even for recreational purposes. We use a synthetic control approach to estimate a counterfactual of what would have been the violent crime rate in California in the absence of medical marijuana legalization. This counterfactual is a weighted average of other American states whose weights are optimally chosen to best resemble California before this policy change. By comparing California with its counterfactual (mostly composed by Florida, Illinois and Texas), we show that, by the year 2006, California s violent crime rate was 13 per cent lower than what it would have been in the absence of medical marijuana legalization.

<p>Solid Phase Microextraction (SPME) is a popular sampling technique that can be paired with Gas Chromatography/Mass Spectrometry (GC-MS). SPME-GC-MS is used in forensic chemistry due to its simplification of the sample preparation process. Headspace-Solid Phase Microextraction (HS-SPME) is a technique where the sample is heated to generate volatiles in the headspace of the vial. A SPME fiber is then inserted into the vial and the compounds in the headspace will bind to the fiber. Total Vaporization- Solid Phase Microextraction (TV-SPME) is a technique that is derived from the HS-SPME technique. </p><p>In Chapter 1, the critical comparison of HS-SPME and TV-SPME is discussed. Samples including marijuana, essential oils, and CBD oil were utilized to compare the two techniques. The compounds of interest in marijuana are the three main cannabinoids: cannabinol (CBN), cannabidiol (CBD), and tetrahydrocannabinol (THC). The sample preparation and GC-MS parameters were kept the same for all samples to determine which SPME technique works best for these sample types and yielded the greatest sensitivity. It was found that HS-SPME shows greater sensitivity with CBN and equivalent sensitivity with essential oils, THC and CBD. </p><p>In Chapter 2, the detection of synthetic cannabinoids utilizing liquid-liquid injection as well as HS-SPME and TV-SPME is discussed. The detection of these compounds is important because this type of drug has become more prevalent in the United States because they can be chemically altered slightly so they still have the effects of a drug but can evade drug legislation. The detection of synthetic cannabinoids using liquid injection was found to be successful but detection using HS-SPME and TV-SPME was found to be unsuccessful. </p>In Chapter 3, the analyses of real and artificial saliva utilizing HS-SPME and TV-SPME is discussed. Determining the compounds present in real saliva and artificial saliva will be of importance for future research into determining if the presence of drugs in saliva can be analyzed with these techniques. The analyses of real and artificial saliva were found to be successful using HS-SPME, without derivatization, and TV-SPME, with and without derivatization. Many of the compounds present in the real saliva were detected and were confirmed to be compounds regularly found in saliva by other scientific literature.

Indiana University-Purdue University Indianapolis (IUPUI) / Solid Phase Microextraction (SPME) is a popular sampling technique that can be paired with Gas Chromatography/Mass Spectrometry (GC-MS). SPME-GC-MS is used in forensic chemistry due to its simplification of the sample preparation process. Headspace-Solid Phase Microextraction (HS-SPME) is a technique where the sample is heated to generate volatiles in the headspace of the vial. A SPME fiber is then inserted into the vial and the compounds in the headspace will bind to the fiber. Total Vaporization- Solid Phase Microextraction (TV-SPME) is a technique that is derived from the HS-SPME technique. In Chapter 1, the critical comparison of HS-SPME and TV-SPME is discussed. Samples including marijuana, essential oils, and CBD oil were utilized to compare the two techniques. The compounds of interest in marijuana are the three main cannabinoids: cannabinol (CBN), cannabidiol (CBD), and tetrahydrocannabinol (THC). The sample preparation and GC-MS parameters were kept the same for all samples to determine which SPME technique works best for these sample types and yielded the greatest sensitivity. It was found that HS-SPME shows greater sensitivity with CBN and equivalent sensitivity with essential oils, THC and CBD. In Chapter 2, the detection of synthetic cannabinoids utilizing liquid-liquid injection as well as HS-SPME and TV-SPME is discussed. The detection of these compounds is important because this type of drug has become more prevalent in the United States because they can be chemically altered slightly so they still have the effects of a drug but can evade drug legislation. The detection of synthetic cannabinoids using liquid injection was found to be successful but detection using HS-SPME and TV-SPME was found to be unsuccessful. In Chapter 3, the analyses of real and artificial saliva utilizing HS-SPME and TV-SPME is discussed. Determining the compounds present in real saliva and artificial saliva will be of importance for future research into determining if the presence of drugs in saliva can be analyzed with these techniques. The analyses of real and artificial saliva were found to be successful using HS-SPME, without derivatization, and TV-SPME, with and without derivatization. Many of the compounds present in the real saliva were detected and were confirmed to be compounds regularly found in saliva by other scientific literature.

The District of Colombia poses a unique challenge to private employers because the passage of a local medical marijuana policy was instituted in a federalized district that is obligated to abide by federal Schedule 1 narcotic laws. Using punctuated equilibrium as the theoretical foundation, the purpose of this case study was to understand how managers maintain compliance and address the conflict between different levels of government. Data were collected from interviews with 8 private industry hiring personnel who operate within the District of Columbia. These interviews were transcribed, inductively coded using a 2 cycle coding procedure, and then subjected to a thematic analysis procedure. Two primary themes emerged; cognizance of the policy, and fear and safety concerns related to enforcement. In the case of the theme of cognizance, punctuated equilibrium was confirmed in that unbalanced policy development had negative or positive interpretations that created a significant subsystem effect. The second theme of “fear” is also explained through punctuated equilibrium as marijuana legalization is perceived as an emotional policy issue in the establishment of new policy. Implications for positive social change stems from recommendations to policy makers to clarify remaining ambiguity about the requirements associated with the juxtaposition of federal and local policy and law. Reconciling the differences between policies may improve the capacity for hiring authorities to better understand and practice effective talent recruitment while at the same time be attentive to the social needs in the District of Columbia related to workplace medical marijuana policies.