When heroin and heroin-cocaine abusers have been compared, a direct relationship has been found between cocaine abuse and the rate of psychiatric disorders, together with correlation with the severity of self-rated psychopathology. We do not know if this lack of awareness of psychopathological symptoms is due to the use of cocaine or to the underlying excitement that sustains cocaine use. Moreover, if cocaine use represents self-enhancement of one’s level of hypomania, cyclothymia or hyperthymia, the craving for hypomania is likely to be particularly strong in heroin addicts, whose level of excitement is lowered by heroin use. In addition, cocaine has been reported to induce a higher frequency of mixed states when abused by bipolar patients. This evidence suggests that some bipolar patients, after deciding to use cocaine instead of being excited, may have shifted from a manic or hypomanic to a mixed episode. During a manic episode, patients show a high level of consumption of stimulants and cannabinoids. In the literature, the abuse of cannabinoids in bipolar patients has been found to induce manic symptoms, so it is possible that, in our manic patients, as with cocaine use, they may use cannabinoids to optimize their level of excitement. To date, cannabis use is also considered to be one of the most important risk factors for schizophrenia, thanks to its ability to precipitate or exacerbate psychotic symptoms. In line with this assumption, in our sample, cannabis is mainly abused in manic and mixed states that, unlike depressive and hypomanic episodes, are often characterized by the presence of psychotic symptoms. Whatever the causes of the use of cannabis grow system, Khantzian’s hypothesis is not supported in its application to cannabis use. For many subjects, ending cannabis use is difficult to achieve, not only because of prior habits of use, but also because of the attendant psychotic symptoms, including poor insight and judgment, lack of impulse control and cognitive impairment.One widely debated issue is whether Khantzian’s hypothesis is a suitable instrument for interpreting alcohol dependence. In examining patients with a mixed episode, we found that, besides their abuse of cocaineamphetamines and cannabinoids, and in contrast with the other three clinical presentation groups, they often resort to alcohol use.
Patients experience their mixed mood as something undesirable and unpleasant, but they still continue to consume substances that tend to preserve their mixed, dysphoric state. Craving for substances and dependence create a loop, a senseless vicious circle in which patients obtain neither satisfaction nor physical benefit . In line with this observation, a past or current alcohol use disorder has proved to raise the likelihood of a switch from depressive to manic, mixed or hypomanic states in patients with bipolar disorder. Nervousness in alcoholic patients has been hypothesized to be the only negative mood state to predict increases in alcohol consumption later in the course of the day. Further examination of this within-person relationship has demonstrated that men were more likely to consume alcohol when nervous than were women, but this association is unrelated to family history of alcoholism, problem drinking patterns, or traits of anxiety and depression. Consistently with the self-medication hypothesis, alcohol consumption has been associated with lower levels of nervousness, but this effect varies in a way dependent on several demographic and clinical variables. Almost one quarter of individuals with mood disorders use alcohol or drugs to relieve symptoms, with the highest prevalence of self-medication in bipolar I disorder. After checking the effects of substance use disorders, self-medication has been associated with higher rates of comorbid anxiety and personality disorders than those found in individuals who do not self-medicate. On the basis of these data we believe that, in the case of alcohol, Khantzian’s hypothesis accounts for anxiety disorders more satisfactorily than mood disorders, although it must be added that it actually explains controlled rather than addictive use. In fact, enduring use, despite the worsening, or the inadequate balance, of symptoms, is inconsistent with a current self-medicating explanation, although that explanation may have been appropriate in a previous stage of controlled use. It should also be remembered that patients were assessed for mood during current drug use, thus ruling out the ambiguity between spontaneous mood swings and substance-induced intoxication. In fact, our patients had been displaying affective dys regulation for some time before being diagnosed, and had been engaged in substance use, which was bound to worsen the affective core of their clinical pictures .
The hypothesis of symptomatological overlap between temporary substance-related intoxication and mood states is superseded in this way. After reviewing our data we speculate that, setting aside depressive and mixed episodes, the abuse of substances in hypomanic and manic episodes of bipolar disorder is more probably due to patients’ desire to maintain their current affective state rather than to resolve depressed mood. These considerations also provide a possible explanation for the fact that bipolar patients tend not to comply with therapy during hypomanic, manic and mixed states. In the literature, patients’ lack of compliance with prescribed therapy has been principally associated with their lack of insight into their mental illness. We go beyond that in suggesting that, during hypomanic and manic phases, bipolar patients do not comply with prescribed therapies and tend to exacerbate their mental status by means of substances, not only because they are unaware of their mental illness, but also because they somehow live the current episode as a pleasurable and rewarding experience . The obvious limitations of this study are due to the fact that this is a retrospective analysis carried out on a small cohort of patients, rather than a study specifically designed to elucidate this issue. Assessments of the same subject in various different clinical presentations of the natural history of this illness would have provided a better level of information. In addition we must consider the difficulty in determining whether the substance use modifies the mood or the mood state determines the substance used. It is possible that stimulants are seen in those with mania or hypomania because the stimulant produced the mood state. They could have been depressed without it. Lastly, we have no information about the temperament of our subjects. So we cannot exclude the presence of a depressive temperament that is able to moderate the nature of patients’ substance abuse; that would set up the need to modify our hypothesis. One of our earlier findings, however, was that heroin users mainly have a cyclothymic temperament.Cannabis is an adaptive and highly successful annual with the ability to grow in most climates across the globe. Cannabis belongs to the Cannabaceae family, “has a life cycle of only three to five months and germinates within six days.”Cannabis can occur in a wild, reproducing state throughout the California floristic provinces, and is cultivated even outside of areas where it may naturally reproduce.Cannabis planting, growing, and harvesting seasons are similar throughout California and typically take place April through October. “Exposed river banks, meadows, and agricultural lands are ideal habitats for Cannabis” since these ecosystems provide “an open sunny environment, light well-drained composted soil, and ample irrigation.”
The Cannabis plant has been utilized to produce a diverse set of products with various applications. Today, Cannabis is most commonly produced for its psychoactive properties, though historically it has been used for agricultural production, nutritional value, and industrial purposes. The two species of Cannabis cultivated for psychoactive and physiological effects are Cannabis sativa and Cannabis indica.Marijuana is the most common name referring to varieties of Cannabis produced for mind altering affects. Marijuana contains high levels of chemical cannabinoid compounds including delta-9 tetrahydracannabinol, or THC, the primary psychoactive component of Cannabis. Cannabis has a long history of use in the United States. During the 17th century, the government encouraged hemp production, a fibrous form of Cannabis, for use as rope, clothing, and sails. In the early 20th century after the Mexican Revolution, the recreational use of marijuana grow system was introduced by Mexican immigrants. In 1937, the Marijuana Tax Act was enacted to effectively criminalize marijuana consumption as a result of an anti-marijuana propaganda campaign led by the commissioner of the Federal Bureau of Narcotics, Harry J. Anslinger. During World War II the U.S. Department of Agriculture provided incentives, including draft deferment, for farmers to grow hemp to meet wartime fiber needs. In the 1950s, a series of federal laws were enacted to create mandatory sentencing for people convicted of using drugs classified as illegal, including marijuana. Despite stricter regulation, marijuana was embraced by popular counter-culture movements in the 1960s. This act classified marijuana as a Schedule I controlled substance, the most restrictive schedule of illegal drugs “found by the government to have a high abuse potential, a lack of accepted safety under medical supervision, and no currently accepted medical use.”In fact, the whole Cannabis plant was classified as Schedule I, which means that possession of any portion of the Cannabis plant became illegal under federal law. Petitions to reclassify Cannabis have been proposed since the 1970s based on an ever increasing literature of clinical studies and scientific research that disputes the vague classifications of “high abuse potential, a lack of accepted safety under medical supervision and no currently accepted medical use.”This article of the Comprehensive Drug Abuse Prevention and Control Act was brought to the forefront of legal and political debate in 1996 when the Compassionate Use Act, or Proposition 215, passed in California, followed by 13 other states, to legalize the medical use of marijuana.Criteria for the legal possession of medical marijuana vary from the state to county levels, but Cannabis possession and consumption remain illegal at the federal level. In the pivotal Supreme Court decision of Gonzales v. Raich, the court ruled that the federal ban on cannabis may be enforced at all levels of jurisdiction based on the Commerce Clause of the United States Constitution. Their basis was that “incidents of the traffic which are not an integral part of the interstate or foreign flow, such as manufacture, local distribution, and possession, nonetheless have a substantial and direct effect upon interstate commerce.”
Despite the precedent set by this case, the development of legalized medical marijuana has led to significant changes in domestic Cannabis cultivation. In California, marijuana is cultivated in various amounts ranging from a single plant grown for personal consumption to thousands of plants per plot cultivated for commercial distribution. Law enforcement and US Forest Service reports indicate that Drug Trafficking Organizations control a significant portion of Cannabis cultivation in the United States and are establishing an increasing number of both indoor and outdoor growing sites. The primary DTOs operating in California are of Mexican origin and consist of the most powerful cartels in Mexico. The outdoor cultivation sites developed by DTOs are of special concern because they mainly occur on public lands. Remote areas used by cultivators include land holdings managed by the US Forest Service, the Bureau of Land Management, the National Park Service, the Fish and Wildlife Service, the Bureau of Indian Affairs, and the Bureau of Reclamation.However, DTOs also cultivate marijuana plots on private lands including conservation reserves, game lands, and large private land holdings. Marijuana cultivation on public lands is entrenched in California structurally, institutionally, economically, and culturally. The issues that surround marijuana cultivation and prevention efforts are both complex and large in scale. The systems and processes employed by both cultivators and law enforcement agencies are long established and the product of a dynamic progression. However, the scale of marijuana production and the adverse effects of cultivation have reached unprecedented proportions. Black market revenues have increased with the demand for marijuana, giving rise to criminal enterprises that go to any lengths necessary to maximize profits. The result is an oligopolistic market control, continued natural resource damage and sustained infringement on public safety. Marijuana is California’s largest cash crop, estimated to be worth between 10 and 14 billion dollars annually.This immense profit incentive is the main cause for continual marijuana cultivation on public lands, and is based on high demand and inflated market prices. In the most highly concentrated cultivation counties in California, the economies of which are based on the marijuana industry, only a handful of cultivators are arrested each year.