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PubMed1991

The allergic patient who is noncompliant and abusive: dealing with the adverse experience.

The field of Allergy-Immunology is involved with the care of patients with chronic illness. The care of these patients is enhanced when the physician has established good rapport with the patient. The noncompliant, disruptive behavior of some patients can try the patience of even the most understanding physicians and, in turn, impede the delivery of care. Interactions with this type of patient may leave the physician with feelings of guilt, frustration, and helplessness. We review such an encounter with the purpose of describing how to deal with this type of patient and to guide the physician in responding to this adverse behavior. Such patients will usually require limits to be set on behavioral acting out for their own best interest. Further, it is often necessary to make continued care contingent on compliance with the ground rules set. The physician must be aware of his or her adverse feelings toward the patient and be able to interpret the behavior in the context of the psychiatric disorder so that appropriate psychologic help for the patient can be provided.

Administration, Inhalation↗
PubMedDate not supplied

Effect of snuff on nasal mucosa.

PURPOSE: The inhalation of nasal snuff (powdered tobacco) is a common addiction in the Indian subcontinent. In the western world, there is a resurgence of interest in nasal snuff because it does have the morbidity associated with smoked tobacco. Very few studies have reported the long-term effects of snuff on nasal mucosa. The objective of the present study was to investigate the effect of long-term use of snuff on the nasal mucosa. MATERIALS AND METHODS: We conducted a retrospective study on 29 snuff users. We investigated the reasons for initiation of this particular form of addiction along with the clinical signs and symptoms of long-term snuff usage. At the time of the study, all patients complained of one or more nasal symptoms. Nasal obstruction and nasal discharge taken together were reported by 62.5% of patients. Gross mucosal edema of the septum and turbinates was the main finding on nasal examination. The absolute eosinophil count and total serum immunoglobulin E were elevated in 62.5% and 66.7% of patients, respectively. On skin prick test, 41% of patients reacted positively to snuff and 25% to tobacco. Histopathologic examination of the turbinates (16 patients) showed squamous metaplasia, capillary proliferation, capillary and venous dilatation, inflammatory cell reaction, subepithelial edema, and fibrosis. CONCLUSIONS: Much has been written about the advantages of nasal snuff over products that deliver tobacco smoke. Our study shows that snuff users, after long-term abuse, develop a form of chronic rhinitis, as a consequence of which they develop blocked and stuffy noses. We conclude that nasal snuff is not a suitable substitute for smoked tobacco because it does not avoid ill health.

Adult↗
PubMed2000

Patterns of tooth wear associated with methamphetamine use.

BACKGROUND: Methamphetamine (MAP) abuse is a significant worldwide problem. This prospective study was conducted to determine if MAP users had distinct patterns of tooth wear. METHODS: Methamphetamine users were identified and interviewed about their duration and preferred route of MAP use. Study participants were interviewed in the emergency department of a large urban university hospital serving a geographic area with a high rate of illicit MAP production and consumption. Tooth wear was documented for each study participant and scored using a previously validated index and demographic information was obtained using a questionnaire. RESULTS: Forty-three MAP patients were interviewed. Preferred route of administration was injection (37%) followed by snorting (33%). Patients who preferentially snorted MAP had significantly higher tooth wear in the anterior maxillary teeth than patients who injected, smoked, or ingested MAP (P = 0.005). CONCLUSION: Patients who use MAP have distinct patterns of wear based on route of administration. This difference may be explained anatomically.

Administration, Inhalation↗
PubMed2005

Descending polyneuropathy in an intravenous drug user.

A 27-year-old male intravenous drug user presented to the Emergency Department of St James's Hospital with a 1-week history of progressive dysphasia, dysphagia and difficulty 'holding his head up' and 'keeping his eyes open'. He also complained of increasing weakness in his upper limbs, as a result of which he kept dropping things. He was on a methadone program but was using both intravenous heroin and cocaine at the time of presentation. Examination of his motor function revealed generalized hypotonia, hyporeflexia and reduced power in both upper limbs. No sensory loss was observed. Co-ordination was intact. The clinical picture of a proximal symmetrical descending weakness and an absence of sensory loss was suggestive of botulism. Clostridium botulinum is a spore-forming, obligate anaerobe. The three forms of human botulism are food-borne, wound and intestinal. A fourth man-made form is produced from aerosolized botulinum toxin and results in inhalational botulism. A little as 1 g of aerosolized botulinum toxin has the potential to kill 1.5 million people. Toxin is detected in serum or stool specimens in only approximately 46% of clinically diagnosed cases. Treatment involves supportive care and early passive immunization with equine antitoxin. Patients should be regularly assessed for loss of gag and cough reflex, control of oropharyngeal secretions, oxygen saturation, vital capacity and inspiratory force. When respiratory function begins to deteriorate, anticipatory intubation is indicated. Early symptom recognition and early treatment with antitoxin are essential in order to prevent mortality, and to prevent additional cases, it is important to ascertain the presence of similar symptoms in contacts of the patient and local public health officials must be notified as one case may herald an outbreak. Given the continued threat of bioterrorism, the Centre for Disease Control Surveillance System in the United States must also be notified of any cases of botulism.

Adult↗
PubMedDate not supplied

Excretion profile of opiates in dependent patients in relation to route of administration and type of drug measured in urine with immunoassay.

It is accepted that opiates are detectable in urine within three days from the last dose at a cut-off value of 300 ng/mL. In our clinical practice, some patients tested positive for morphine even after a week of detoxification. The present study evaluates the time course of opiate excretion in urine of dependent subjects (F11.25 according to ICD-10) in relation to route of administration and a kind of street heroin. The group comprised 71 men treated for opiate dependency: 33 of them used heroin exclusively by inhalation; 26 i.v.; 12 used i.v. homemade poppy straw decoctions. Opiate levels were measured once a day by fluorescence polarization immunoassay (TDx Abbott). Detection time ranged from 3 to 10 days for cut-off value 300 ng/mL and from less than one up to seven days for cut-off value 2000 ng/mL. The increases in urine drug concentration that result from changes in urinary output may be mistakenly interpreted as a new drug use. Normalization of drug excretion to urine creatinine concentration reduces the variability of drug measurement attributable to urine dilution. The time function of creatinine normalized opiate concentration has a log-linear character, and decreases at a rate of 2.5 per day on average. New "normalized" cut-off values were proposed: 225 ng/mg creatinine, 1500 ng/mg creatinine, and 3750 ng/mg creatinine that corresponds to 300 ng/mL urine, 2000 ng/mL urine, and 5000 ng/mL urine.

Creatinine↗
PubMed1998

Ketoconazole attenuates the cortisol response but not the subjective effects of smoked cocaine in humans.

Attenuation of hypothalamo-pituitary-adrenal (HPA) function in laboratory rodents has been found to reduce the reinforcing effects of cocaine. To examine whether attenuation of HPA function reduces the effects of cocaine in humans, one female and seven male 'crack' cocaine abusers were pretreated with three doses of ketoconazole (0, 600, 1200 mg), an inhibitor of adrenocorticoid biosynthesis, 1 h before receiving cocaine. Three doses of smoked cocaine (0, 12, 50 mg) were administered in counterbalanced order under each ketoconazole condition. Ketoconazole dose-dependently reduced cocaine-induced cortisol, but not adrenocorticotropin (ACTH) release, and attenuated the cocaine-induced increase in heart rate and blood pressure. Plasma ACTH levels were more predictive of blood pressure changes than either cocaine or cortisol levels. Suppression of cortisol secretion was not associated with a reduction in ratings of the subjective effects of cocaine. These results support a role for the HPA axis in the cardiovascular effects of cocaine, but do not support a role for the HPA axis in the subjective effects of cocaine. To the extent that self-administration can be predicted by subjective effects, these results further argue that the HPA axis does not play a critical role in cocaine self-administration by humans.

Administration, Inhalation↗
PubMed1994

HIV-1 incidence determined retrospectively among drug users in Bangkok, Thailand.

OBJECTIVE: To measure trends in the incidence of HIV-1 infection among drug users in treatment at Thailand's largest drug detoxification unit. DESIGN: A retrospective cohort was established using computed, existing HIV-1 test results of 26,396 inpatients and outpatients admitted for 47,907 drug detoxification treatment courses from August 1987 to August 1992. METHODS: Matching of patient record numbers showed that 10,050 (38.1%) patients had been admitted two or more times during the period. From these, we selected a cohort of 7807 initially HIV-negative patients. Subsequent seroconversions among them were assumed to have occurred with uniform probability throughout the interval between the last HIV-negative and the first HIV-positive tests. RESULTS: There were 2311 (29.6%) seroconversions in the cohort. HIV-1 incidence among the 5974 (76.5%) who were injecting drug users (IDU) escalated from 20 new infections per 100 person-years (PY) of observation in 1987 to a peak of 57 per 100 PY in 1988, then gradually declining to a stable rate of about 11 per 100 PY during 1991 and 1992. Non-IDU (smokers, inhalers) constituted 683 (8.8%) of the cohort patients, and had HIV-1 incidence rates varying from 0.2 to five per 100 PY. 'Mixed' drug users, defined as individuals reporting different routes of drug administration on different admissions, composed 1150 (14.7%) of cohort patients and had an HIV-1 incidence rate between that of IDU and non-IDU. Prevalence of HIV-1 seropositivity among all IDU increased rapidly, from about 1% in early 1988 to a peak of about 40% by early 1989, and has remained stable through 1992. CONCLUSIONS: Prevention efforts must continue for IDU, since recent annual HIV-1 incidence remains high at > 10 per 100 PY. Such a high rate suggests that this group should be considered for HIV-1 vaccine efficacy trials. Stable HIV-1 prevalence can mask substantial incidence in a population with high turnover.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Gender differences in prevalence of drug use among high risk adolescents in Israel.

BACKGROUND: The use of tobacco, alcohol and illicit drugs is considered to be primarily a male problem. Many studies of drug use in the general population have reinforced this assumption. Other recent findings, however, call the extent of gender differences into question. METHODS: Self report data were collected from 911 high risk adolescents who ranged from 12 to 18 years. RESULTS: Last 30 day use was used to compare the youth. Significant findings show girls use cigarettes more than boys; boys use all types of alcohol more than girls; and, boys use marijuana and hashish more than girls. No differences were reported in terms of the patterns of ecstasy, inhalants, prescription drugs, LSD, amphetamines, cocaine, crack cocaine, opium and heroin. Boys more than girls were inclined to binge drink. Boys and girls reported similar patterns of being in a car with a driver who had been drinking and driving a car after drinking. Boys more than girls take loans in order to obtain drugs; girls more than boys were able to acquire drugs without having to use their own money; and boys more than girls gambled to acquire drugs. DISCUSSION: With the exception of cigarettes, boys use drugs and engage in problem behavior more than girls. Underage drinking and driving is a serious behavior problem reported by male and female youth. This factor and binge drinking should be targeted as priority prevention issues. Gender differences in prevalence of drug use among high risk adolescents should be monitored to verify what may be a growing problem among female adolescents in the country and elsewhere (Litt, I., (2003). Drugs and adolescent girls. (editorial). Journal of Adolescent Health, 32, 1-2).

Adolescent↗
PubMedDate not supplied

[Determination of butane in respiratory gases by means of GC/MS and GC/MS-MS].

Butane is inhaled in order to achieve a pleasurable state of intoxication. An overdose can lead to death. In two deaths from our own investigation material the circumstances were suspicious for the inhalation of liquid gas, and the presence of butane should be demonstrated in the respiratory gases. For detection, a method of ion trap gas chromatography/mass spectrometry (GC/MS) and tandem-mass spectrometry (GC/MS-MS) was developed, whereby the gas samples from the lung tissue were directly injected into the GC. The GC/MS tests revealed the presence of butane. Moreover, it was found that during the MS-MS tests reaction products appeared which had formed in the ion trap. Systematic investigations of these reaction products showed that these appeared regularly and could be used as additional backup for the proof of butane. Thus phenomena in the ion trap were used which would not have been expected to occur in normal mass spectrometry or tandem-MS and had not been described in the forensic literature so far. The detected amount of butane could be quantified by means of serial dilutions with nitrogen and room air. The described method shows that small molecules or gases can be demonstrated with the ion trap mass spectrometer.

Adolescent↗
PubMed1999

Sigmoidal admission rate-dependence of toluene narcotic potency in rats: comparison with nitrous oxide.

Aromatic solvents, such as toluene, can cause depression of the central nervous system functions in both solvent-exposed workers and abusers. The mechanism by which toluene produces its effects is generally thought to be similar to that produced by general anaesthetics, including inert gases and alcohols. However, whether lipophilic compounds indirectly influence activity by perturbing membrane lipids or bind directly to proteins remains a major question. In a recent study, the sigmoidal admission rate-dependence of inert gas anaesthetic potency has been suggested to possibly reflect a direct narcotic-protein interaction. Therefore, experiments have been carried out using seven input toluene flows of 0.5, 1, 2, 3, 4, 5 and 6 l/min. Our results indicate that as the rate of toluene delivery increased, the concentration of toluene required to produce anaesthetic effects increased. Although this was fitted relatively well with linear regression, this fitted better when using a sigmoidal model (r = 0.998 vs. r = 0.971, P < 0.01). In addition, comparison with previous data on nitrous oxide shows a striking similarity between plots (r = 0.991) which appears consistent with a similar site of action for both agents. We suggest that all classes of lipophilic agents could produce their inhibitory effects at similar 'non-specific' sites of action of finite size and limited occupancy.

Anesthetics, Inhalation↗
PubMed2000

Analytical strategy for detecting doping agents in hair.

Lists of banned classes of doping agents are released by the International Olympic Committee, adopted by other sports authorities and updated regularly, including the substance classes stimulants, narcotics, diuretics, anabolic agents, peptide hormones, beta-blockers etc. There are different classes of restriction: anabolic and masking agents (anabolic steroids, diuretics etc.) are always banned for athletes regardless of their topical activity (training or competition) several substances are permitted with certain restrictions (caffeine below a cut-off value, or inhalation of some beta 2 agonists) beta-blockers are prohibited in competitions of certain sports disciplines the majority of the substances (stimulants, narcotics etc.) is prohibited during competitions, so that they do not have to be analysed in out-of-competition samples. A differentiation between training and competition period is impossible by means of hair analysis due to the uncertainty of (especially short-term) kinetic considerations related to hair growth. Therefore, the analytical identification of doping relevant substances in hair is not always a sufficient criterion for a doping offence and the identification of stimulants, beta-blockers etc. in hair would be entirely irrelevant. The most interesting target substances are certainly the anabolic agents, because their desired action (enhanced muscle strength) lasts longer than the excretion, leading to sophisticated procedures to circumvent positive analytical results in competition control. Besides the analysis of out-of-competition control samples, the long term detection of steroids in hair could provide complementary information. An analytical approach to the identification of exogenous steroids in hair requires consideration of the presence of many other steroids in the hair matrix interfering the analysis at trace levels, and of a limited chemical stability. The analysis of endogenous steroids in hair appears to be even more complicated, because the possibility of many biotransformation reactions from (into) other precursors (metabolites) has to be taken into account. Precursor substances of anabolic steroids (especially esters as application forms) are very promising analytical targets of hair analysis, because they can only be detected after an exogenous intake. The quantitative evaluation of active parent compounds like testosterone (which is actively involved in physiological processes of hair growth) in hair is still controversial. Clinical applications under reproducible conditions can be useful, but the biovariability of these parameters will probably prevent the definition of acceptable cut-off levels as a criterion of abuse.

Adrenergic beta-Antagonists↗
PubMed2000

Effects of route of administration on cocaine induced dopamine transporter blockade in the human brain.

The route of administration influences the reinforcing effects of cocaine. Here we assessed whether there were differences in the efficacy of cocaine to block the dopamine transporters (major target for cocaine's reinforcing effects), as a function of route of administration. Positron emission tomography and [11C]cocaine, a dopamine transporter radioligand, were used to compare the levels of dopamine transporter blockade induced by intravenous, smoked and intranasal cocaine in 32 current cocaine abusers. In parallel, the temporal course for the self-reports of "high" were obtained. Cocaine significantly blocked dopamine transporters. The levels of blockade were comparable across all routes of administration and a dose effect was observed for intravenous and intranasal cocaine but not for smoked cocaine. For equivalent levels of cocaine in plasma and DAT blockade, smoked cocaine induced significantly greater self reports of "high" than intranasal cocaine and showed a trend for a greater effect than intravenous cocaine. The time to reach peak subjective was significantly faster for smoked (1.4+/-0.5 min) than for intravenous cocaine (3.1+/-0.9 min), which was faster than intranasal cocaine (14.6+/-8 min). Differences in the reinforcing effects of cocaine as a function of the route of administration are not due to differences in the efficacy of cocaine to block the dopamine transporters. The faster time course for the subjective effects for smoked than intravenous and for intravenous than for intranasal cocaine highlights the importance of the speed of cocaine's delivery into the brain on its reinforcing effects.

Administration, Inhalation↗
PubMed1989

Multimodal effects of acute exposure to toluene evidenced by sensory-evoked potentials from Fischer-344 rats.

Male Fischer-344 rats were exposed by inhalation to 500, 2000, 5000, 8000 and 16000 ppm toluene for 30 min in two experiments. Exposures up to 8000 ppm in Experiment 1 caused concentration-related changes in the click-elicited brainstem auditory-evoked response (CBAER), flash-evoked potential (FEP) and somatosensory-evoked potential (SEP). Latencies of CBAER components were prolonged and amplitudes of late components were increased by toluene. Toluene did not detectably alter the latencies of FEP or SEP components. Early FEP component-amplitudes were increased and late component-amplitudes were decreased; toluene also induced a poststimulus oscillation in the FEP. Most component-amplitudes of the SEP were substantially increased, but N2P2 amplitude appeared to be more sensitive than other components to depressant effects of the solvent. The same effects on the CBAER were observed in Experiment 2, but a more substantial increase in the amplitudes of late components elicited by tone pips suggested that frequency-dependent cochlear irritation might underlie previously observed subchronic ototoxicity. These effects were increased by exposure to 16000 ppm toluene. Effects like those observed in Experiment 1 were noted on the FEP, but the oscillations were less with exposure to 16000 than 8000 ppm. Changes in the SEP were evident within 2 minutes of exposure onset, and amplitudes increased over the course of about 15 min, leveling off or decreasing thereafter. The amplitude of the N2P2 component was again less influenced than other components during exposure to 8000 ppm and was reduced to less than baseline amplitude by 16000 ppm. Effects of concentration and rates of development and recovery were systematically related to SEP component latency. Toluene appears to have both enhancing and inhibiting effects on neural pathways serving sensory systems, depending on the modality and the site of generation of the components within modalities. A particular balance between these properties might relate to the hedonic characteristics of this abused solvent.

Acoustic Stimulation↗
PubMed1998

[Hospital detoxification unit: 4-year experience. Treatment and infections].

BACKGROUND: Analysis of the main infections complications in drug-dependents and their relation between the way of consumption and sexual activity; the detoxification treatments used are taken into consideration. MATERIAL AND METHODS: We studied the patients admitted to the HDU (Hospital Detoxification Unit) between 1991 and 1995 revising their Clinical Histories with a protocol made for the occasion; the statistical calculations were subjected to the SPSS program, applying the Fisher's and Chi-square tests. RESULTS: 458 patients were included (males = 365); drug were taken intravenously in 290 cases (distribution from 1991 to 1995: 61, 92, 72, 88-p = 0.05), smoked in 120 cases (distribution: 18, 57, 60, 67-p = 0.01), inhaled in 29 cases (2, 16, 4, 6-p = 0.01) and taken orally 176 cases (29, 50, 46, 50). The Hepatitis B Virus (HBV) was positive in 186 of 403; the Hepatitis C Virus (HCV) was positive in 259 of 374 (known = 115/discovered = 144) and incidence with respect to the human immunodeficiency virus (HIV) has p < 0.000001; HIV was positive in 85 (known = 69). Sexually Transmitted Diseases (STD) were present in 94 patients, 27 of whom were women (p = 0.03), HBV(+) = 38, HCV(+) = 49 and HIV(+) = 52 (p = 0.02). Candida infections is present in 31 HIV(+). Phlebitis antecedents are found in 79 (424), 48 of whom were HBV(+) (p = 0.00003), 60 were HCV(+) (p = 0.000008) and 29 HIV(+) (p = 0.00003). The patients were mainly treated with Clonidina (450) and tricyclic antidepressants (242). CONCLUSIONS: In our study, we observe the increase of intravenous drug users, being phlebitis the most frequent antecedent in HBV(+), HCV(+) and HIV(+); we have also detected a higher number of STD both in these groups and in women as well.

Female↗
PubMed1990

[HTLV-I infection in a high-risk group].

The aim of this study is to detect the presence of HTLV-1 in a high-risk population in west Andalusia. We studied 267 samples of serum from 255 patients: 179 of these patients being intravenous drug-users, 14 had ADVP sexual partners, 16 were inhalation drug-users, 4 were hemophiliacs, 9 had other high-risk habits and 25 hematological patients afflicted with leukemia or lymphoma. All of them were tested for antibodies against HTLV-1 by means of an in vitro qualitative ELISA technique (ELISA Du Pont HTLV-1). The positive results were confirmed by the Western blot technique. Additionally, the p24 antigen and the antibodies against VIH-1 and VIH-2 (ENV/CORE) were analysed, except in the 25 hematological patients. We found 20 serum samples positive to HTLV-1 by ELISA (7.4%), but only 1 (0.3%) was confirmed by the Western blot technique. The prevalence of VIH-1 was 46%; 9% had p24 VIH antigen and 26% had false positive ELISA to VIH-2. We found a statistically significant relationship (p = 0.0005) between positive ELISA to HTLV-1 and antibodies against VIH. We conclude that HTLV-1 has penetrated into the high-risk population of west Andalusia , although not yet to a great degree, and point out the need for seric epidemiological surveillance to prevent the spread of the retrovirus in these groups.

False Positive Reactions↗
PubMed2006

Two-choice reaction time performance in Sprague-Dawley rats exposed to alcohol during adolescence or adulthood.

Adolescent alcohol abusers display subtle attention impairments. This study used a two-choice reaction time task to examine the effects of ethanol on sustained attention following adult or adolescent exposure. Sprague-Dawley rats were exposed to ethanol vapor for 14 days starting on postnatal day 30 (adolescence) or 60-64 (adulthood) and were then trained to perform the two-choice reaction time task. Ethanol exposure resulted in blood ethanol levels averaging 215 mg/dl. Behavior following adult ethanol exposure was characterized by increased accuracy and omissions during the two-choice reaction time task, reduced fixed ratio lever pressing, and reductions in the highest fixed ratio completed on a progressive ratio schedule. Adolescent ethanol exposure transiently increased two-choice reaction time accuracy and slightly reduced fixed ratio lever presses. Improved accuracy was unexpected, but might be related to ethanol-induced increases in central nervous system arousal and/or mild behavioral perseveration. Increased omissions, reduced lever pressing, and reductions in the highest fixed ratios completed most likely reflect decreased 'motivation to work' and index generalized anhedonia. This study is the first to demonstrate that rats exposed to ethanol during adulthood are more sensitive to the effects of ethanol on sustained attention than rats exposed to ethanol during adolescence and to ethanol-induced anhedonia, as indexed by two-choice reaction time performance.

Administration, Inhalation↗
PubMed2003

Pharmacokinetics and pharmacodynamics of cannabinoids.

Delta(9)-Tetrahydrocannabinol (THC) is the main source of the pharmacological effects caused by the consumption of cannabis, both the marijuana-like action and the medicinal benefits of the plant. However, its acid metabolite THC-COOH, the non-psychotropic cannabidiol (CBD), several cannabinoid analogues and newly discovered modulators of the endogenous cannabinoid system are also promising candidates for clinical research and therapeutic uses. Cannabinoids exert many effects through activation of G-protein-coupled cannabinoid receptors in the brain and peripheral tissues. Additionally, there is evidence for non-receptor-dependent mechanisms. Natural cannabis products and single cannabinoids are usually inhaled or taken orally; the rectal route, sublingual administration, transdermal delivery, eye drops and aerosols have only been used in a few studies and are of little relevance in practice today. The pharmacokinetics of THC vary as a function of its route of administration. Pulmonary assimilation of inhaled THC causes a maximum plasma concentration within minutes, psychotropic effects start within seconds to a few minutes, reach a maximum after 15-30 minutes, and taper off within 2-3 hours. Following oral ingestion, psychotropic effects set in with a delay of 30-90 minutes, reach their maximum after 2-3 hours and last for about 4-12 hours, depending on dose and specific effect. At doses exceeding the psychotropic threshold, ingestion of cannabis usually causes enhanced well-being and relaxation with an intensification of ordinary sensory experiences. The most important acute adverse effects caused by overdosing are anxiety and panic attacks, and with regard to somatic effects increased heart rate and changes in blood pressure. Regular use of cannabis may lead to dependency and to a mild withdrawal syndrome. The existence and the intensity of possible long-term adverse effects on psyche and cognition, immune system, fertility and pregnancy remain controversial. They are reported to be low in humans and do not preclude legitimate therapeutic use of cannabis-based drugs. Properties of cannabis that might be of therapeutic use include analgesia, muscle relaxation, immunosuppression, sedation, improvement of mood, stimulation of appetite, antiemesis, lowering of intraocular pressure, bronchodilation, neuroprotection and induction of apoptosis in cancer cells.

Biological Availability↗
PubMed1991

Immunodeficiency associated with ethanol abuse.

A number of study findings have shown that ETOH has a profound effect on the immune system. The work from my laboratory has established in animal models that the effect of ETOH is complex. It is well established that ingestion of ETOH-containing diets results in a loss of lymphoid cells from the peripheral blood, spleen, and thymus. Some of the cell loss from the thymus is the result of corticosteroid release as a result of the withdrawal from ETOH, but the loss from the spleen and some of the thymocyte loss is independent of corticosteroids, as demonstrated by studies using ADX mice and rats. We have also established that ETOH ingestion is associated with a loss of lymphocyte function, especially T-cell-dependent immune responses. One aspect of the T-cell defect is an inability to use IL-2, an important growth factor for T cells. Similar changes in lymphocyte function have been demonstrated in animals exposed to ETOH only in utero. The inability of a person to respond immunologically in an appropriate fashion to foreign antigens has a profound effect on the survival of the person. It would be predicted that ETOH-associated immunosuppression would result in increased incidences of infections. From the data generated from my laboratory it could also be predicted that these infections would be primarily opportunistic infections that are associated with defects in T-cell function. The available literature would support these predictions. It is also likely that changes in T-cell function would alter immunosurveillance mechanisms with the end result being an increased incidence of tumors. Again, the available literature would support this prediction.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗