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1. Effects of Maternal Marijuana and Cocaine Use on Fetal Growth
http://www.nejm.org/doi/pdf/10.1056/NEJM198903233201203
We conclude that the use of marijuana or cocaine during pregnancy is associated with impaired fetal growth and that measuring a biologic marker of such use is important to demonstrate the association. (N Engl J Med 1989; 320:762–8.)
2. The Residual Cognitive Effects of Heavy Marijuana Use in College Students
Results. —Heavy users displayed significantly greater impairment than light users on attentional/executive functions, as evidenced particularly by greater perseverations on card sorting and reduced learning of word lists. These differences remained after controlling for potential confounding variables, such as estimated levels of premorbid cognitive functioning, and for use of alcohol and other substances in the two groups.
Conclusions. —Heavy marijuana use is associated with residual neuropsychological effects even after a day of supervised abstinence from the drug. However, the question remains open as to whether this impairment is due to a residue of drug in the brain, a withdrawal effect from the drug, or a frank neurotoxic effect of the drug.(JAMA. 1996;275:521-527)
3. Psychosocial Correlates of Marijuana Use and Problem Drinking in a National Sample of Adolescents
Adolescents whose scores reflect greater theoretical proneness for problem behavior tend to be more involved in the use of marijuana than are adolescents whose personality, social, and behavioral scores indicate lower problem-behavior proneness. Higher instigations for problem behavior, lower personal controls against problem behavior, greater orientation toward friends than toward parents, greater perceived support and models for drinking and drug use, greater involvement in other forms of problem behavior, and lesser involvement in conventional behavior are all associated with greater involvement in the use of marijuana. Some of the correlations, especially those for measures of the proximal environment such as perceived pressure and perceived models for marijuana use, reach substantial magnitudes.
4. The human toxicity of marijuana.
The pathophysiological effects of marijuana smoke and its constituent cannabinoids were reported first from in-vitro and in-vivo experimental studies. Marijuana smoke is mutagenic in the Ames test and in tissue culture and cannabinoids inhibit biosynthesis of macromolecules. In animals, marijuana or delta 9-tetrahydrocannabinol (THC), the intoxicating material it contains, produces symptoms of neurobehavioural toxicity, disrupts all phases of gonadal or reproductive function, and is fetotoxic. Smoking marijuana can lead to symptoms of airway obstruction as well as squamous metaplasia. Clinical manifestations of pathophysiology due to marijuana smoking are now being reported. These include: long-term impairment of memory in adolescents; prolonged impairment of psychomotor performance; a sixfold increase in the incidence of schizophrenia; cancer of mouth, jaw, tongue and lung in 19-30 year olds; fetotoxicity; and non-lymphoblastic leukemia in children of marijuana-smoking mothers.
5. Dose-related neurocognitive effects of marijuana use
Results: As joints smoked per week increased, performance decreased on tests measuring memory, executive functioning, psychomotor speed, and manual dexterity. When dividing the group into light, middle, and heavy user groups, the heavy group performed significantly below the light group on 5 of 35 measures and the size of the effect ranged from 3.00 to 4.20 SD units. Duration of use had little effect on neurocognitive performance.
Conclusions: Very heavy use of marijuana is associated with persistent decrements in neurocognitive performance even after 28 days of abstinence. It is unclear if these decrements will resolve with continued abstinence or become progressively worse with continued heavy marijuana use.
6. Pulmonary Hazards of Smoking Marijuana as Compared with Tobacco
As compared with smoking tobacco, smoking marijuana was associated with a nearly fivefold greater increment in the blood carboxyhemoglobin level, an approximately threefold increase in the amount of tar inhaled, and retention in the respiratory tract of one third more inhaled tar (P<0.001).
7.Abstinence symptoms following smoked marijuana in humans
Abstinence from active marijuana increased ratings such as “Anxious,”“Irritable,” and “Stomach pain,” and significantly decreased food intake compared to baseline. This empirical demonstration of withdrawal from smoked marijuana may suggest that daily marijuana use may be maintained, at least in part, by the alleviation of abstinence symptoms.
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