We also found that cannabis lobbying lacked transparency

From February to September 2021, we collected data on lobbying expenditures originating from the cannabis industry and its affiliates, from July 1, 2009 to June 30, 2021 . The Colorado Department of State dataset details payments to registered lobbyists, with information on funders who hire lobbyists , bill/rule titles and positions associated with payments, and lobbyist identifying information . To identify cannabis industry affiliates, we reviewed all funders in this dataset that lobbied on a list of 453 bills in fiscal years 2010–2021 that included the words “cannabis,” “marijuana,” or “hemp”. Using the CDOS business database, the Colorado Marijuana Enforcement Division search tool, and internet searches, we coded funders as cannabis affiliates if they a) held a cannabis business license, b) shared board members, owners, or investors with a cannabis company, c) disclosed members that were cannabis businesses, or d) would directly profit from cannabis sector growth . For each lobbyist employed by a cannabis affiliate we examined their other funders and identified additional cannabis affiliates using the same inclusion criteria. Because the CDOS dataset does not include lobbying payments made without a connection to a specific bill, administrative rule, or issue, we expanded the dataset by manually appending payments from cannabis affiliates in months where no lobbying was conducted for a specific bill/rule. Including these “retainer” payments allowed more accurate assessment of lobbying expenditures, because some funders make monthly payments to paymentslobbyists rather than hiring them on an ad hoc basis. Funders also make payments to lobbyists before and after legislative sessions for work during the session. The completed search yielded a list of 1703 monthly payments from 89 cannabis grow supply store affiliates with linked information on lobbyists they employed, positions on bills, and addresses. Each lobbying report available on the CDOS website included an “industry type” field where lobbyists provide a description of the funder’s business. We coded these disclosures as “transparent” if the name or description contained a reference to cannabis, marijuana, or hemp and “ambiguous” if it did not. Cannabis industry affiliates could be represented by lobbying agencies, lobbyists, and subcontractors.

Cannabis affiliates may pay individual lobbyists or pay lobbying agencies that funnel those payments to salaried lobbyists or subcontractors. Lobbying agencies sometimes list themselves as funders even though this practice was made illegal by the Lobbyist Transparency Act Lobbyist Transparency Act, 2019. We excluded reported self-funding because it was impossible to identify the underlying funder. To prevent double counting, we only included direct payments from cannabis affiliates and excluded payments to subcontractors and employees salaried by lobbying agencies. We reviewed cannabis lobbying expenditures in Colorado over time using Stata 16 and then qualitatively reviewed lobbying positions on proposed legislation. Our analyses assessed total cannabis lobbying expenditures and the share drawn from national sources, the extent to which expenditures were clearly identified as associated with cannabis, and alliances with other industries. We conclude with a case study of cannabis industry efforts to create cannabis consumption establishments. We selected this issue because legislation on the topic was introduced multiple times over the course of three years and under two gubernatorial administrations, allowing insight into changes in lobbying practices over time. We collected data from audio recordings of legislative testimony and floor debate, legislative histories, fiscal notes, and lobbying reports for all legislation dealing with cannabis consumption establishments available through the Colorado General Assembly and Secretary of State websites. We present a narrative description of each bill’s legislative history, including information from lobbying reports and demonstrative quotations made in public testimony that indicate cannabis industry influence in the policy making process. Many cannabis affiliates that appeared independent shared professional or personal ties. In 2019, 14 different funders lobbied in support of HB1090, a bill that allowed publicly traded corporations to own or invest in cannabis businesses and removed residency requirements.

These 14 funders were exclusively cannabis affiliates or lobbying agencies with known cannabis industry connections: LivWell, Buddy Boy, Dixie Brands, Gobi Labs, Gold Dome Access, Lightshade, Medicine Man, MedPharm Holdings, Native Roots, Natural Selections, TEQ Analytic Solutions, The Green Solution, Vicente Sederberg, and Wolf Public Affairs. All but Gobi Labs shared professional ties: John Fritzel was an owner of both Lightshade and Buddy Boy, and Andy Williams was the president of both Medicine Man and MedPharm Holdings . Representatives from Lightshade, LivWell, Native Roots, Vicente Sederberg, Medicine Man, MedPharm Buddy Boy, Dixie Brands, and Columbia Care were board members or donors for the Cannabis Trade Federation. Leadership from Medicine Man, MedPharm Holdings, Native Roots, Dixie Brands, TEQ Analytical Solutions, Vicente Sederberg and the chairman of the Marijuana Industry Group all sat on the Board of Directors for Colorado Leads, an alliance of cannabis businesses. Cannabis industry affiliates with an out-of-state address spent $802,983 between fiscal years 2010–2021 . Given that some cannabis businesses are multi-state operations with locations in Colorado and others use in-state PO boxes, this proportion is likely an underestimate. Immediately following adult-use legalization in November 2012 and prior to the creation of the recreational sales market in January 2014, the Washington D.C. based nonprofit Marijuana Policy Project dramatically increased its expenditures in Colorado. The proportion of out-of-state lobbying expenditures increased from 5.5% of lobbying expenditures in fiscal years 2010–2015 to 12.6% in fiscal years 2016–2021 . California-based cannabis organizations lobbying in Colorado increased from one business spending $14,492 in 2017 to five spending $153,220 in 2020. One cannabis affiliated organization each from Ontario , New York , and Oregon lobbied in Colorado, as well as two from Washington D.C. .The bill survived less than three months before indefinite postponement by the Senate Committee on Business, Labor, and Technology in March 2017. On the same day, SB184, which would allow local governments to permit private membership cannabis clubs and clarify the constitutional definition of consumption that is conducted “openly and publicly” was heard in the same committee.

Kevin Bommer of the Colorado Municipal League testified that the CML brought the bill to the legislative sponsors after it was initiated by the city of Trinidad. Renaissance Solutions, the Drug Policy Alliance, Terrapin Care Station, Denver relief Consulting, Schultz Public Affairs, and Pueblo County supported the bill while health groups including ACS CAN and the American Heart Association, hospital systems, and other local governments opposed. The House and Senate could not agree on amendments and the bill died in May. Onsite cannabis consumption establishments were considered again in the 2018 session through HB1258. This bill proposed “Marijuana Accessory Consumption Establishments” for existing licensees and was supported by Dixie Brands, LivWell, Good Chemistry, Renaissance Solutions, Medicine Man, Native Roots, Gold Dome Access, and the Colorado Hotel and Lodging Association. It was opposed by ACS CAN, local governments, consultants, Colorado Association of Police Chiefs, and Colorado Christian University due to indoor air quality concerns related to indoor use of electronic smoking devices, which were excluded from the definition of “smoking” at the time. However, the Southern Colorado Cannabis Council and My420 tours opposed the bill because it could eliminate party bus cannabis tours and did not create true social consumption establishments. After passing the House and Senate, the bill was vetoed by Governor Hickenlooper amid concerns that it violated the Colorado Constitutional prohibition on “consumption that is conducted openly and publicly” . A parallel bill, SB211, was introduced in March 2018 by Senator Marble and would have allowed smoking in “consumption clubs” through an exemption to the Colorado Clean Indoor Air Act. The bill was again supported by Renaissance Solutions, Inc. and opposed by the City of Colorado Springs, Denver Health, Healthier Colorado, the American Heart Association, Smart Strategies, the Colorado Association of Chiefs of Police, ACS CAN, and the Colorado Association of Local Public Health Officials. It died in the Senate Committee on Business Labor and Technology in April. Our findings suggest that after recreational legalization the cannabis industry expanded its lobbying activities and used tactics comparable to those used by similar industries seeking to promote consumption. The dramatic increase in cannabis industry lobbying expenditures over time mirrored growth of the cannabis industry following recreational legalization in November 2012, which also coincided with an increase in cannabis consumption. Funding originating from out-of-state sources also increased over time, suggesting the development of a national network of cannabis drainage system affiliates with similar interests. Legislators, public health advocates, and community organizers should therefore expect industry resistance to cannabis control measures from local and national sources as well as proactive industry efforts to promote consumption and profits through policy making channels.Colorado lobbyists characterized their clients ambiguously almost half of the time, meaning that cannabis affiliates could only be identified through lengthy investigation. These characterizations resulted in the appearance that many funders supported some proposed legislation, which may have created a false impression of a broad coalition. In reality these interests shared common owners, represented the same professional associations, and used the same lobbyists.

We also found some evidence suggesting that public relations agencies may have hidden cannabis industry funding by paying salaried lobbyists on the behalf of funders without identifying them. To improve transparency, the Colorado Sunshine Law could be strengthened by a requirement in C.R.S. 24–6–301 §1.9 that lobbyists disclose their client’s identity as a cannabis business or any cannabis affiliation they hold under the “industry type” field . To accomplish this, a revision of section 1 of the same statute may also be needed to eliminate the provision protecting clients from disclosure of “the names of any of its shareholders, investors, business partners, coalition partners, members, donors, or supporters, as applicable.” These changes would easily allow researchers and members of the public to identify cannabis clients as such using the CDOS website and facilitate improved legislative accountability. Cannabis affiliates used lobbyists focused solely on cannabis as well as sharing lobbyists with other industries including tobacco, alcohol, pharmaceutical, and gaming. Like other industries, the cannabis industry is likely to work with these business interests to further their own profits. Using the same tactics employed by these industries, cannabis industry representatives self-reported lobbying positions opposing clean indoor air laws, health warnings for pregnant women, and potency restrictions, while supporting investment, onsite consumption, and access to medical cannabis in schools. Cannabis industry funding peaked in 2019, which may be related to the change in state governor: Governor Hickenlooper was moderate on cannabis, vetoing several pro-cannabis bills, while successor Governor Polis had voiced support for the cannabis industry and was publicly supported by cannabis affiliates. The industry may have viewed his first year in office as an opportunity to pass pro-cannabis industry bills, including cannabis hospitality businesses, that had failed in previous years . In light of the sophisticated and well-financed influence campaign conducted by the cannabis industry, policymakers should push for stricter separation between the industry and the policy making process. Frameworks designed to prevent undue influence from other commercial determinants of health including the alcohol, food, and tobacco industries can dampen industry influence by creating firewalls between corporations and policymakers.

Example policies, including the guidelines for implementation of Article 5.3 of the Framework Convention on Tobacco Control , the World Health Organization’s Framework for Engagement with Non-State Actors , and the Office of Economic Co-operation and Development’s recommendations for preventing policy capture , could serve as starting points. These frameworks stand in opposition to the system of private interest institutionalism in Colorado which encourages the inclusion of all stakeholders and prompts regulators to make policies that synthesize stakeholder input. If formal mechanisms preventing cannabis industry influence in policy are not established, legislators should at least guarantee an equal voice to health advocates through balanced and accessible stake holding processes. Our research has limitations. For public relations and law firms who represented multiple interests, expenditures that were not explicitly delineated as being from cannabis companies were not included in our analysis as the origin of funds could not be identified. For this reason, lobbying expenditures are likely undercounted. Second, the exactpositions or intentions of cannabis industry affiliates on proposed bills could not necessarily be determined from the lobbying record; instead, where possible, we relied on legislative testimony. Next, the exclusion of salaries from lobbying agencies with ties to the cannabis industry to their employees may lead to an underestimation of the total influence exerted by cannabis interests. Finally, our description of lobbying expenditures did not include pro-bono industry lobbying activities conducted on behalf of cannabis affiliates.

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Pneumocystis pneumonia diagnoses were obtained from medical record and CDC AIDS diagnosis data

Additionally, there was a trend for female participants to have lower net IGT scores than male participants . In the current study, the trend towards poorer net IGT performance in female relative to male participants appears to be driven by females tending to make more disadvantageous selections from deck B, where rewards are frequent and losses are infrequent, while at the same selecting fewer cards from advantageous deck C in which loss frequency is equal to gain frequency. Females may also be performing worse than males due to differences in the time needed to develop decision-making strategies towards advantageous choices. Male participants may be better at suppressing reward-driven behaviors due to activity in the right dorsolateral prefrontal cortex activity that has been shown in males but not females completing the IGT . A previous study that examined sex differences between young adult male MJ and female MJ users found that life timeMJ use was associated with poorer decision-making performance in male but not female participants . However, this study did not perform an interaction between group and sex on net IGT scores due to the absence of healthy controls. Thus, it is unknown whether similar findings would have also been seen if female and male non-MJ users had been included. The observed trend for sex differences on the IGT may also be attributed to the possible influence of sex hormones on executive functioning. A study examining the interactive effects of dopamine base levels and cycle phase on executive functions found that women were significantly faster on the Stroop during the luteal phase compared to menses and pre-ovulatory phases . This suggests women have improved verbal skills during the luteal phase when levels of progesterone and estradiol are high. Another study found that women ovulating were more likely to choose risky options than men . In the current study, females may have performed worse on the IGT because we may have unknowingly sampled a high percentage of women in a stage of their menstrual cycle where they are more likely to take risks.

However, since we did not ask female participants to report menstrual cycle stage at the time of the study visit, we are unable to confirm whether hormone levels may have influenced IGT performance. No differences were observed between MJ+ and HC mean reaction times during the IGT, cannabis hydroponic setup which is inconsistent with our initial hypothesis. To our knowledge, no studies in MJ users have examined mean reaction times on the IGT. While risky decision-making may be related to impulsivity, it may be important to utilize other neurocognitive measures that assess motor impulsivity and response inhibition. In a fMRI study investigating the relationship between MJ use and inhibitory control processing, MJ users tended to have faster reaction times than healthy controls . Additionally, brain activity differences were observed in the dorsal anterior cingulate cortex, a region of the brain thought to be involved in impulse control. In the present study, as mean reaction time was not significantly related to IGT performance, MJ+ took the same amount of time as HC to make decisions during card selection. This finding suggests that lower net IGT scores in MJ+ relative to HC may be related to maladaptive decisions that are not associated with motor impulsivity during card selection. Although age at first MJ use, 30 day MJ use and lifetime MJ use were not significantly related to IGT performance among MJ+, between group differences on the IGT suggests there may be potential differences between MJ+ and HC that could be related to pre-morbid vulnerability for risk-taking tendencies and/or the effects of substance use itself. Underlying differences in prefrontal cortex development between MJ+ and HC could explain some of these findings. For example, a previous study showed that early-onset frequent marijuana users had a thicker prefrontal cortex than late-onset frequent MJ users, which could indicate reductions in normative grey matter pruning in the prefrontal cortex in participants who begin using MJ at a younger age . While previous studies have found associations between early adolescent MJ use and impairments in executive functioning , we did not find a relationship between age at first MJ use and risky decision-making.

In the current study, we asked participants to report their age at first MJ use instead of age at regular MJ use, which may be more closely associated with patterns of MJ use that could predict neurotoxic consequences of use. Age at first use can be a difficult variable to assess, especially in young adults aged 18–22 years, since age at first MJ use may have occurred very recently in this population and thus, participants may have only had a year or two of substance use prior to the study visit.One limitation of the current study is the modest sample size. Although our sample was relatively well matched in the number of participants in each group, our findings may not be readily generalizable to young adult college students. Another related issue is the over representation of males in the MJ group. Although the prevalence of MJ use is higher in males than females , our findings may not be generalizable to female MJ users. Although onset of cannabis withdrawal symptoms typically occur in frequent MJ users after 24 h of abstinence, and peak 2–6 days post cannabis abstinence , we cannot confirm whether or not participants were in active withdrawal during the study visit. Future studies should administer the Marijuana Withdrawal Symptoms checklist to assess withdrawal symptoms in participants at the time of the study visit. In addition, the potency of MJ is not standard and our study design does not take into account dose-response associations in MJ+. Future studies will need to assess other indicators of MJ use, such as asking participants to report THC content of the MJ they typically use. Another limitation is that we utilized a laboratory task of decision making and provided participants with hypothetical earnings rather than tangible incentives. In future studies, it will be important to use other real-life decision-making measures to determine if our findings are specific to the IGT, are associated with non-monetary risk-taking behaviors, or are associated with decision-making in general. As we only used one task of decision-making, our findings may not generalize across a wide range of decision-making tasks. Future studies may want to utilize additional tasks to assess risky decision-making, such as the Balloon Analogue Risk Task or Cambridge Risk Task . Additionally, as most MJ users are also alcohol users, alcohol was not used as exclusionary criteria for MJ+. While post-hoc analyses suggested alcohol use was not related to IGT performance, we cannot rule out the possibility that the neurotoxic effects of alcohol may play a role in the observed group differences on decision-making performance.

In models examining the effects of both MJ use and alcohol use on net IGT scores, neither significantly predicted decision-making performance in MJ+, which may be due to lack of refined measure to assess frequency of these substances and premorbid characteristics that distinguish MJ+ from HC. Other studies that reported group differences on the IGT between MJ users and healthy controls either did not examine relationships between marijuana use variables and IGT performance , only examined other substance use variables in relation to IGT performance , or did not find associations between substance use variables and IGT performance . One study by Verdejo-Garcia et al. reported greater joints smoked/week was associated with lower net IGT scores in abstinent marijuana users, but did not examine other substance use characteristics in relation to IGT scores within the same model. We believe future studies should consider the relationship between MJ use and decision-making performance, while accounting for poly-substance use. Finally, while we observed a trend for MJ+ to report greater recent anxiety on the Beck Anxiety Inventory , compared with HC , the main effect of group remained significant when controlling for BAI scores in the ANCOVA models with and without sex included as a factor. As anxiety levels may affect decision-making, future studies should ascertain that anxiety levels in MJ users are not driving any observed decision-making differences between MJ users and healthy controls. In summary, the current study examined the effects of frequent MJ on risky decision-making in college-aged young adults. We found a main effect of group on net IGT scores, such that MJ+ had overall lower net IGT scores than HC. These findings may highlight differences in decision-making performance between young adult MJ+ and HC. Results from this study underscore the importance of interventions targeted at reducing risky decision-making in young adult MJ users. As our study is cross-sectional, further longitudinal research is needed to understand whether impairments in MJ users are related to the neurotoxic effects of MJ or if riskier decision-making may be present in MJusers prior to initiation of use, and whether these differences persist after abstinence.Lung disease remains a common comorbidity in persons living with HIV, despite the widespread use of combination antiretroviral therapy that has substantially reduced morbidity and mortality related to opportunistic lung infections. Previous studies in the U.S. have reported higher incidence of both infectious and non-infectious lung diseases in HIV-infected compared to uninfected populations. This increased prevalence is explained, in part, by more tobacco smoking among HIV+ individuals, while HIV disease-related factors including unsuppressed viral load and low CD4 T cell count may also contribute to higher rates of lung disease. The high prevalence of non-infectious obstructive lung disease is expected to continue to increase among HIV+ individuals in the U.S. and globally, yet the potential contributions of other risk factors remain poorly defined.

Smoked cannabis is a potential risk factor for lung disease, as it contains many of the same toxic constituents present in tobacco smoke. In the U.S., the proportion of HIV+ individuals who frequently smoke marijuana is higher than in the general population and has increased in recent years. Previous studies of HIV-uninfected populations reported an association between long-term marijuana smoking and increased respiratory symptoms, chronic bronchitis, and chronic obstructive pulmonary disease and emphysema,hydroponic system for cannabis while other studies reported no significant association between marijuana smoking and these diagnoses or other measures of lung health. Among HIV-infected individuals, few data exist regarding the association between marijuana smoking and respiratory burden, despite high prevalence of lung disease in HIV-infected populations and its associated mortality and morbidity. The aims of this study were to investigate the effects of marijuana smoking on infectious and non-infectious pulmonary diagnoses in HIV-infected individuals in the combination antiretroviral therapy era, and to compare its effects in HIV-infected vs. uninfected individuals with similar demographic characteristics using data from a large prospective cohort of men who have sex with men .Participants were asked if, since their most recent visit, they were newly diagnosed with viral pneumonia, bacterial pneumonia, other pneumonia, or tuberculosis, or if newly diagnosed with or experienced recurring chronic bronchitis. These data were merged with additional variables provided as International Classification of Disease Codes, version 9 or version 10 as follows: influenza or viral pneumonia , bacterial pneumonia , other pneumonia , acute bronchitis , tuberculosis , chronic obstructive pulmonary disease or emphysema , pulmonary hypertension , other non-infectious diagnoses , pulmonary pneumopathy, and other lung disease, not otherwise-specified . Lung cancers were determined from cancer registry linkage data site codes 34.0–34.9, death registry data , and self-report .Chronic bronchitis was defined as the first of multiple bronchitis diagnoses or ICD codes 490–491. HIV serostatus, and CD4+ T lymphocyte count and viral load for HIV + participants, were obtained as previously described. Education level and race at study entry, ART use, and alcohol use were obtained from self-report. Missing time-varying data were imputed by carrying forward values from nearest available previous visit, and by multiple imputation in validation analyses using predictive mean matching with the R mice package .Cross-sectional analyses of baseline characteristics and prevalence of pulmonary diagnoses were stratified by HIV serostatus and marijuana smoking, and HIV serostatus, marijuana, and tobacco smoking, respectively. Marijuana smokers were defined as participants reporting ≥1 year of daily or weekly use in follow-up; tobacco smokers were participants reporting any tobacco smoking in follow-up. Cox proportional hazard models were used to assess the association between marijuana smoking and first incident infectious pulmonary diagnosis, and chronic bronchitis, which comprised the majority of noninfectious diagnoses.

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Patients’ testimonials were central to identifying cannabis as medicine and reducing its stigma

By 1993, 4% of the city’s population were living with AIDS . The outbreak of the AIDS crisis challenged the illegal status of cannabis: now, law-abiding AIDS patients had to take illegal actions that were previously unthinkable, i.e., to purchase an illicit drug on the black market to ease pain and restore appetite . The cause seemed greater than harm, and it raised sympathy and support for AIDS patients among the population. AIDS patients first tried the path that Robert Randall has opened for them: they applied to the Compassionate Investigational New Drug Program to obtain government-supplied cannabis, but the number of applications was so large that the government stopped accepting new applicants in the early 1990s . Unable to get cannabis through legal channels, AIDS patients were pushed to the illegal market where medical cannabis activists developed informal institutions that delivered illegal products to legitimate consumers . In 1991, Dennis Peron, an illegal cannabis dealer and gay rights activist, drafted and organized the passage of the San Francisco medical cannabis initiative , which recommended the State of California and the California Medical Association to include cannabis in the list of available medicines and not penalize doctors for prescribing it.The proposition did not have the force of law but simply declared the city’s support of medical cannabis. The ballot passed with 79 percent of the vote. The backing of the city administration encouraged Peron to launch the San Francisco cannabis buyers’ club, whose main goal was to provide safe access to quality controlled medicine so that patients would no longer have to resort to the black market . Initially founded in a small apartment in the Castro district, the club was moved to a five-story warehouse near the San Francisco Civic Center in 1995 . To join the buyers’ club,vertical farming supplies one had to provide a photo ID and a doctor’s recommendation; senior citizens were granted automatic admission.

The social aspect of the buyers club was no less important than the medical one: it encouraged members to socialize and form support networks, which significantly improved the quality of their lives. The palliative conception of cannabis was integral to gaining public support for Proposition 215 in California in 1996 . By reinforcing the framing of cannabis as a remedy for the sick and dying, social movements gave legitimacy to the use of an illegal product and pushed local governments to recognize the medical qualities of a Schedule I drug.As Lashlly and Pollock point out, “tories […] were designed to challenge stereotypes about who smoked cannabis and to appeal to the societal values of compassion and the belief that individuals should have reasonable access to treatments that reduce their suffering” .48 The idea of medical cannabis incorporated positive elements from the healthcare category while simultaneously dissociated from stigmatizing labels of the black market: cannabis patients are not high, they are medicated . In 1995, the San Francisco cannabis buyers’ club hosted weekly meetings of grassroots activists who worked on a full-scale ballot campaign. The movement consisted of cannabis clubs’ owners, hospice organizers, lawyers, harm-reduction activists, doctors, leaders of pro-cannabis organizations, and other “seasoned activists in a grassroots reform movement” . In November 1996, California voted in favor of Proposition 215 , which ensured the right of patients to obtain cannabis for treating serious illnesses ; guaranteed protection to patients and doctors from criminal prosecution; and encouraged the federal and state government to provide safe and affordable distribution of cannabis.49 Several circumstances can explain why the medical cannabis movement succeeded in the passage of Proposition 215. First, many AIDS patients were politically active and integrated in communities receptive to the civil rights agenda. According to Veronica Terriquez , the recognition and activation of multiple identities by social movements may catalyze intersectional mobilization and facilitate participation and commitment among marginalized groups. The medical cannabis movement was a spillover of the gay rights movement, whose members strongly favored cannabis law reform. Both movements were guided by the same basic principle: people should not be punished for personal lifestyle matters .

Emerging in an era of increasing visibility and acceptance of the LGBTQ movement, the medical cannabis movement empowered its members to disclose not only their sexual orientation but also their use of stigmatized substances. Second, from the very beginning, the movement’s main goal was to win legal recognition of cannabis. Even though the pro-cannabis community occasionally staged boycotts, demonstrations, cannabis giveaways, smoking in public, and other forms of nonviolent civil disobedience,they were seeking reform through legal and bureaucratic processes. Their strategy was to decouple state law from federal law . Activists had a moderate agenda, which shaded away the recreational component of cannabis: Proposition 215 did not legalize cannabis and did not contradict the federal legislation; it merely allowed physicians to recommend cannabis and patients to use it . Tod Mikuriya, a pro-cannabis activist from the physicians’ camp, carefully drafted the language of the initiative. Third, although the AIDS crisis created political and discursive opportunities to shift public opinion about cannabis and cannabis users, the passage of Proposition 215 would not be possible without money. The opinion polls showed that the majority of the population were in favor of medical cannabis, but for the proposition to quality as a ballot measure, the organizers had to gather more than 400,000 valid signatures in 150 days. The medical cannabis initiative got the attention of George Soros, Lawrence Rockefeller, and other investors, who were ready to contribute large sums of money to the cause. Substantial funding professionalized the movement: Peron was replaced with a professional campaign manager, and the movement’s headquarters was moved from the Bay Area to Santa Monica . The broad language of Proposition 215 was both a blessing and a curse. On the one hand, it helped the initiative to pass because the narrative was not in direct conflict with the federal law; on the other hand, it did not guarantee real protection to cannabis patients. Proposition 215 created a medical necessity defense for people arrested for cannabis, but it did not prevent them from being arrested or prosecuted. It was the responsibility of an individual to claim that he has the right to use cannabis.

Another gap in Proposition 215 was that it had almost no details regarding how a medical cannabis system should operate and how patients should obtain their cannabis . Activists who drafted Proposition 215 were more concerned with legitimizing a state of affairs than ensuring that patients could avail themselves of cannabis in the future . Finally, most of the regulation was left to the county level and thus resembled a patchwork quilt, with disparate standards and rules. Such regulatory and enforcement loopholes made cannabis patients vulnerable to state and federal prosecution . The passage of Proposition 215 was met with strict resistance from the federal government . Barry McCaffrey, Clinton’s director of the office of National Drug Control Policy, threatened to revoke the license to any physician who prescribed cannabis to a patient due to its Schedule I status. Although the American Medical Association backed up a physician’s right to discuss cannabis therapy with a patient, many doctors shifted away from recommending cannabis to their patients .Local and federal authorities continued to raid medical cannabis dispensaries and private homes, seize cannabis, and arrest patients and caregivers. The backlash from law enforcement only intensified social mobilization. Founded in 2002, Americans for Safe Access became a nationwide support group for the emerging medical cannabis industry . ASA activists monitored the law enforcement activity, maintained a database of legal cases involving cannabis, and developed emergency response strategies for cannabis patients and providers . They also recorded police raids and held demonstrations at DEA offices. Moreover, ASA attorneys filed suits against California cities and counties that banned medical cannabis facilities and against the California Highway Patrol, forcing it to allow the intrastate transit of cannabis.In 2010, California passed Senate Bill 1449, which made the possession of no more than 28.5 grams of cannabis a misdemeanor that shall be punished by a fine of no more than $100.If Proposition 215 was mostly a symbolic gesture that manifested a cultural change, SB 1449 was instrumental in its function . Proposition 215 had quite an adverse effect on law enforcement agencies—after 1996, the number of cannabis arrests continued to grow, reaching its peak in 2008-2009 . SB 1449, on the contrary, influenced the behavior of state officials in a more instrumental manner and finally achieved what Proposition 215 failed to do. The number of arrests dropped significantly in just one year—arrests for cannabis indoor greenhouse possession dropped from 56,000 arrests in 2010 to 10,000 in 2011. Arrest rates for cannabis sales remained stable for a few more years until the passage of Proposition 64, which explicitly legalized cannabis sales—after that, they dropped from 7,600 in 2016 to 2,200 in 2017 .

For several years after the passage of Proposition 215, the situation with medical cannabis in California remained unsettled. Guidelines were provided only in 2003 when Senate Bill 420 finally clarified the scope of Proposition 215 . In particular, SB 420 established a state-regulated identification card program and allowed patients to form “collectives” to grow and distribute cannabis. The new adjustments created a space for the development of the legal cannabis industry. Collectives often worked as storefront dispensaries, and, even though they could only provide cannabis for suggested donations, these “donations” worked as retail prices . In 2015, California issued the Medical Marijuana Regulation and Safety Act , which imposed very specific rules on medical cannabis businesses, including regulations for cultivation, manufacturing, testing, distribution, transportation, and dispensing. According to Sam Kamin, “it was an indication […] that the state was finally getting serious about regulating the marijuana industry” . The symbolic meaning previously attached to cannabis was changing as the substance was placed in a context of increasing legitimacy . By 2016, the California medical marijuana market had grown to over 700,000 patients , and many people knew medical cannabis patients among their friends or neighbors. New cannabis dispensaries attracted a different type of cannabis users, which contrasted with the traditional “stoner” stereotypes . Cannabis providers employed medical symbols and terminology, gave detailed information on the chemical composition and potency of various cannabis strains, incorporated scientific knowledge, and deemphasized the negative effects of cannabis products. Oaksterdam University, a trade school for cannabis businesses, was founded in 2008 in Oakland; within three years of its launch, it had more than 13,000 students . In 2009, the California Board of Equalization imposed a state sales tax on dispensary operators, which signaled that cannabis companies should be treated on par with other legal businesses. These and other practical developments professionalized the field of medical cannabis and established an infrastructure that promoted the image of cannabis as a morally acceptable commodity. By 2016, 49% of Americans replied that both medical and recreational use of cannabis should be legal, and 35% thought that only medical use of cannabis should be legal.55 Although the primary goal of Proposition 215 was to provide safe access to cannabis for seriously ill people, de facto the majority of users consumed it recreationally . Gaining victory with medical cannabis, California activists jumped on the opportunity to fight a longer-term campaign aimed at full legalization. The first attempt to legalize cannabis for recreational use was under the Obama administration in 2010. Although California’s citizens rejected Proposition 19 , its 46% support indicated that the tide was turning .California’s Proposition 64 was considered in a more favorable context. Throughout the 2010s, the media became increasingly supportive of cannabis legalization : documentaries produced by CNBC, CNN, and Discovery Channel, as well as articles published in the mainstream magazines, called for an end of cannabis prohibition and helped to normalize it. Also, the spread of the Internet made it much easier to share information and educate citizens. From 2012 to 2014, three states and the District of Columbia had legalized the recreational use of cannabis, which provided a big morale boost to California’s activists. In 2013, the Obama administration gave the green light to the legal cannabis market by passing the Cole Memorandum, which constrained the federal government from enforcing federal cannabis laws in states that legalized cannabis for medical or/and recreational use.

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The criminalization of cannabis is one of the most mysterious and contested episodes in America’s war on drugs

The basic premise of the constructionist literature is that drugs have an identity beyond pharmacology. To a large extent, these two traditions ignore each other, and their mutual neglect limits our understanding of drugs as a problem: the idea of drugs refers at once to a social construct, a chemical substance, and a legal fiction . Although the current socio-legal literature mostly relies on the constructivist approach, I suggest that we also should not rule out individual experiences that shape the understanding of drugs. In this study, I define the drug problem as: various ways in which societies deal with drugs, i.e., define its meaning, produce competing discourses, establish forms of control and treatment, etc.; and various ways in which individuals experience and respond to drug control, i.e., resist social and institutional pressure, challenge the existing modes of control, mobilize for change, deal with stigma, shape alternative understandings of drugs, etc. The drug problem was on the radar of social scientists for many decades. In the 1960s, drug use became a politically contentious matter. Following the general resentment about drugs, scholarly literature contributed to the policy agenda by questioning the social and historical roots of drug regulation . Typically, scholars framed the drug problem through two perspectives—sociology of deviance and crime control studies . Sociology of deviance described drug regulation as a moral enterprise, and crime control studies—as an essential element of the war on crime. Both approaches complemented each other and provided macro-level, outcome-based explanations of the US’s history of drug regulation. Macro-level explanations—which still prevail in the sociological and socio-legal literature on drugs—are based on several theoretical propositions: the drug problem is socially and politically constructed; drug laws are a product of symbolic struggles that define the borderline between deserving and undeserving social groups; the stakes of the war on drugs are the accumulation of power and status by the elites; the public discourse on the drug problem is shaped by the mass media. Later, I discuss how these features are manifested in the “told” history of cannabis criminalization.

According to Emile Durkheim , normality and pathology are defined in relation to social context; that is,vertical rack what is normal for a particular society in a given historical period may be pathological in other circumstances. Throughout history, human beings have been using plants— e.g., tobacco, alcohol, poppy seeds, coffee beans, tea leaves, sugar cane, coca leaves, cocoa beans, or cannabis—to alleviate pain and distress. Some of those plants were socially constructed as dangerous, immoral, and deviant, and therefore fell under the state authorities’ control. Other plants, in contrast, were valued for their healing properties and potential to provide energy, alertness, or relaxation . In this section, I describe how cannabis from a legal healing herb became one of the most dangerous drugs in the course of the US’s twentieth century.In the scholarly literature, the history of drug regulation is often described as a moral enterprise directed against certain ethnic, racial, social, political, and other “non-American” groups. To understand how cannabis from a harmless intoxicant became a perilous drug, it is important to look at the cultural origins of cannabis legislation. According to Katherine Beckett, the association between drugs, crime, and racialized images of dangerous classes has characterized anti-drug campaigns throughout American history . The first anti-drug law restricting the use of opium was adopted in California in 1875 as a reaction to massive Chinese immigration and the fear of job competition . Similarly, the federal prohibition of opium in Canada at the beginning of the 20th century was a racialized project against Chinese immigrants . The first major campaign against cannabis started in the Southwest during the Great Depression when Mexicans were blamed for high unemployment rates . Until the 1910s, cannabis was a legitimate and innocent plant used for industrial, therapeutic, and recreational purposes. It had deep roots in Asian and European countries as a healing herb and a source of fiber. In the 1850s, cannabis became available in American pharmacies and was included in the 3rd edition of The Pharmacopeia of the United States as medicine helping with rheumatism, tetanus, epidemic cholera, hysteria, and mental depression.

Until the “reefer madness” era, the word “marijuana” was unknown in the US : pharmacists knew the plant by its botanic name cannabis sativa 15 , and recreational users referred to it as “hashish” or “Indian hemp.” There were no laws in Europe and Northern America regulating access to cannabis. Anti-alien sentiment in the United States grew in the mid-1880s as a response to social problems associated with mass migration . The Mexican Revolution caused thousands of immigrants to flee to the United States for safety and work. At the time, cannabis use was flourishing in Mexico, and Mexican laborers brought the plant into the US as a cheaper and more accessible substitute for alcohol and tobacco . Before Mexican immigration, Americans consumed cannabis mainly in chewable or liquid form, while Spanish speaking foreigners introduced a new form of consumption—smoking a mix of dried cannabis buds and tobacco.16 Like immigration, cannabis use was highly racialized: the main target of policymakers was not smoking, but smokers. The advent of the Depression made Mexican workers unwelcome and heightened anti-Mexican sentiment. The growing number of unemployed Mexicans were perceived as a welfare and crime problem, and jailing Mexicans on cannabis charges became part of the general attempt to reduce the labor surplus . The media and state officials popularized the term “marijuana”—a Spanish word used by farm workers—that tied the public perception of cannabis to “dangerous” Mexican migrants . Most Americans were not even aware that “Mexican marijuana” and “cannabis paste they get in the pharmacy” were essentially the same substance. The concern about Mexicans generated a new ideology about cannabis: since the Anglos perceived Mexicans as criminal types, cannabis also became associated with violence . African Americans were the second-largest group consuming cannabis . Both minorities were blamed for violent crimes committed against the white population, the worst of which was considered the seduction of white girls. By the 1930s, cannabis was gradually framed as an evil plant whose consumption damaged the brain and induced violent behavior. The image of cannabis as a “killer weed” justified the prohibition of cannabis at the state and federal level. According to Howard Becker, wherever rules are created and applied, we should expect to find people attempting to establish their code of right and wrong . The Federal Bureau of Narcotics , created in 1930, and its head Harry Anslinger played a pivotal role in criminalizing cannabis. Cannabis was not covered by the Harrison Act of 1914, which regulated the non-medical use of narcotics because pharmaceutical manufacturers confronted the criminalization of such a seemingly harmless drug .

Instead of adding cannabis to the Harrison Act, the FBN issued a special prohibitive taxing scheme—the Marijuana Tax Act of 1937—which established onerous licensing rules, imposed high excise taxes, and introduced harsh penalties to discourage cultivation, distribution, and consumption of cannabis. 18 From the mid-1930s until the early 1960s, the FBN shaped public beliefs about cannabis: it defined what was true about the drug and how it should be handled . Anslinger propagated myths about the criminogenic and psycho-pathological character of the plant. In particular, he claimed that continued use of cannabis produced mental disorders and physical deterioration, blamed doctors for intentionally overdosing patients, stymied all scientific studies on the plant, and repulsed any competing ideas that confirmed cannabis’s harmlessness . The impact of the La Guardia Report19 in 1944—which refuted that cannabis use results in insanity and criminal behavior—was limited because the FBN successfully restricted its distribution. The mass media and anti-cannabis propagandistic movies were at the service of Anslinger’s campaign giving cannabis bad publicity and sowing fears among the American public. Fabricated stories had a tremendous effect, and in 1941, cannabis was excluded from The Pharmacopeia of the United States. Doctors and pharmacists could not withstand Anslinger’s attack and defend their professional monopoly over drug testing, prescription, and distribution, and were ultimately forced to hand it over to state officials. Later, the American Medical Association and the American Pharmaceutical Association joined the crusade against cannabis. In 1951, the Boggs Act20 strengthened the Marijuana Tax Law. Louisiana Congressman Thomas Boggs,indoor hydroponic system who thought that drug laws were too lenient, sponsored a package of tough anti-drug laws establishing the same punishment for all narcotics. For the first time, cannabis and heroin were lumped together. Cannabis possessors could be sentenced to 2 to 5 years in prison for a first offense, 5 to 10 for a second offense, and 10 to 20 for subsequent offenses. Repeat drug offenders were denied parole considerations . In 1956, the passage of the Narcotics Control Act superseded the Boggs Act, and the minimum for a first offense increased to 5 years. The FBN gained tremendous power: by the end of the 1950s, it comprised 2% of the total law enforcement officers but was accountable for 17.6% of the federal prison population . According to Himmelstein , the role of the FBN in cannabis criminalization was more complicated than most authors suggest. The FBN became a dominant actor in shaping public beliefs and policies when states have already limited access to cannabis. In the early 1930s, the FBN was not interested in national cannabis control and was not aggressive or expansionistic. Although it is commonly thought that cannabis prohibition began with the Marihuana Tax Act of 1937, some US states took pre-emptive administrative measures to limit access to cannabis .

By 1937, most states had already passed anti-cannabis laws, and various senators and members of Congress had proposed federal anti-cannabis legislation. Drawing on an established image of cannabis as the “killer weed,” the FBN enhanced—rather than created—the cannabis problem . The “Mexican hypothesis” also requires further elaboration: to what extent are anti-Mexican sentiments responsible for cannabis criminalization? In his thorough analysis of the origins of cannabis prohibition in California, Dale Gieringer shows that cannabis prohibition resulted from bureaucratic initiatives prompted by the Progressive Era ideology. California was the first state that started the anti-cannabis campaign in 1913 by including cannabis in the Poison Act, which prohibited the sale and possession of certain substances except with a doctor’s prescription. At the time, the law did not receive any public coverage because recreational use of cannabis was largely unknown in California. Although the Poison Act’s passage coincides with the Mexican revolution and the mass migration of Mexican citizens to the US, the prejudices against ethnic minorities were not a significant factor in anti-cannabis policies in the 1910s. The connection between cannabis and Mexican communities appeared later when Mexican immigrants themselves were recognized as a“problem. 21” According to Gieringer, the forbiddence of cannabis was a logical extension of prohibitionist principles and the technocratic rationale of the Progressive Era bureaucrats. Even without Mexican immigration, the California government was well on its way to outlawing cannabis. Neither were Mexicans the main object of concern in the passage of the Marijuana Tax Act in 1937. As Himmelstein shows, cannabis’s association with Mexican laborers and other lower class groups influenced anti-cannabis legislation in less direct ways than it is often thought . When the FBN began talking about the federal regulation of cannabis, the image of youthful victims has replaced that of violent Mexican users in the public discussion. The concern was with what cannabis can potentially do to young people who can be seduced and ruined by the drug. In other words, by the end 1930s, the main goal was not to punish Mexicans but to save the youth. From the late 1950s, cannabis and its users were seen in new terms. The focus of cannabis policies shifted to new social groups that did not fit the definition of “good” citizenship—first to jazz players and poets, then to hippies and rock stars, and finally to social and political activists. Cannabis smoking increased among the white middle-class, including college students, and was no longer a chiefly Mexican and African American drug. The large-scale spread of cannabis use to middle-class youth led to a reevaluation of the drug’s dangers and to pressure for its decriminalization . As more young people experimented with cannabis, they came to realize that it did not turn them into miserable addicts but gave a gentle euphoria and relaxation.

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Cannabis growers in Siskiyou’s subdivisions are especially vulnerable to detection

If nothing less than the county’s culture and agricultural order were considered at stake, it is no wonder that absolute, even prohibitionist, solutions emerged in Siskiyou, with the Sheriff’s Office having a central role in defending local culture.Siskiyou’s sparsely populated landscape has been home to illegalized cannabis cultivators at least since the late 1960s, largely in remote, forested, and public lands in the western part of the county. Medical cannabis’s decriminalization in 1996 inaugurated a modest expansion of cannabis gardens throughout the county . However, for the next 19 years, Siskiyou did not establish regulations for medical cannabis, in line with locally dominant ideologies of personal freedoms and property rights. Instead, the county relied on defac to management of cultivation by law enforcement and the court system’s strict interpretation of state law . In 2015, informed by public workshops held by the Siskiyou County Planning Division, supervisors passed the county’s first medical cannabis ordinance, which seemingly balanced concerns of medical cultivators and other county residents. Regulation would be overseen by the Planning Division, which placed conditions on cultivation , limited plant numbers to parcel size and would establish an administrative abatement and hearing process for complaints. The Planning Division, however, had been without code enforcement officers since 2008 budget cuts. Though the county authorized the hiring of one civil code officer in 2015, the Sheriff’s Office felt that the Planning Division “needed outside help” and moved to assist. Soon, the county’s limited abatement capacities were overwhelmed by vigorous enforcement and a wave of complainants. County supervisors, responding to the sheriff’s 2015 reports on the “proliferation” of cannabis gardens on private property, moved to heighten penalties for code violations, place numerous new restrictions on indoor growing and ban all outdoor growing . These strict county measures, which discarded and replaced publicly developed regulations, stoked reaction. When the Siskiyou County Board of Supervisors met in December 2015 to vote on these measures,rolling benches canada advocates and cultivators presented 1,500 signatures to forestall its passage, a super majority of attending residents indicated opposition, and supervisors had to curtail 3 hours of public comment to vote.

Despite this showing, supervisors passed the restrictive measures, prompting cannabis advocates to collect 4,000 signatures in 17 days to place the approved ordinances on the June 2016 ballot. Meanwhile, the Sheriff’s Office enforced the new stricter regulations .The Sheriff’s Office assumption of code enforcement blurred the line between noncompliance with civil codes and criminal acts. Stricter ordinances, still in effect in Siskiyou, created a broad, nearly universal category of “noncompliance.” No one we interviewed, including officials at the Planning Division and Sheriff’s Office, knew of a single cultivator officially in compliance. One interviewee estimated that growing 12 indoor plants would cost $40,000 in physical infrastructure, in addition to numerous licensing and inspections requirements, effectively prohibiting self-provisioning. The Sheriff’s Office notified the public that it would initiate criminal charges against “non-compliant” cultivators, specifically those suspected of cultivation for sale , child endangerment or suspected drug trafficking . Since the county regulations produced a situation where no one could comply, law enforcement could effectively criminally pursue any cultivator.Investigations were “complaint driven,” meaning not only that warrants could be issued in response to disgruntled neighbors upset about a barking dog on a cultivation site, as one person reported, but that police officers could serve as a kind of permanent, general complainant and take “proactive action” when they spotted code violations . Administrative warrants allowed deputies to enter properties with a lower evidentiary bar than they would have needed for criminal warrants, leading one patients rights group — Siskiyou Alternative Medicine — to file a lawsuit alleging county violations of Fourth Amendment protections against unreasonable search and seizure . In effect, cannabis’s criminal valences in the county endured through California’s shift of cannabis from criminal to civil provenance. Formerly illegal activities continued to be formally or informally treated as criminal matters, as researchers have noted with other stigmatized activities and groups, for example, after the decriminalization of sex workers in Mexico . Also, enforcement of civil matters can lead to substantive criminalization when those matters are stigmatized, as in the regulation of homelessness . While it is not unique for police officers to enforce civil codes, what is unique in Siskiyou County is the assumption of the entire civil process under the sheriff’s authority. To understand how this civil process became criminally inflected, in a county that voted for statewide cannabis legalization in 2016, one must first understand significant contextual shifts in who was growing cannabis where — and the challenge this posed to dominant ideas of land use, agriculture and culture.

Since 2014, cannabis gardens have emerged on many of the county’s undeveloped rural subdivisions in unincorporated areas of Siskiyou. Subdivided into over 1,000 lots each in the 1960s, these subdivisions contain many parcels that are just a few acres in size and relatively inexpensive. Previously populated mostly by white retirees, squatters and a few methamphetamine users and makers, the parcels were often bought sight-unseen as investments or potential retirement properties, with most remaining unsold and undeveloped until the mid-2010s. In 2014, these subdivisions became destinations for Hmong Americans from several places, including Minneapolis, Milwaukee and Fresno; many of them cultivated cannabis. The inexpensive, sparsely populated, rural subdivisions enabled Hmong-Americans to live in close proximity to ethnic and kin networks, which multiple interviewees expressed was especially important for elders who had migrated to the United States as refugees after the Vietnam War. The county sheriff estimated that since the mid-2010s around 6,000 Hmong-Americans had moved to Siskiyou, purchasing approximately 1,500 parcels . In an 86.5% white county with just 745 non-cannabis farms and fewer than 44,000 people , this constituted a major demographic shift. Hmong-American residents found themselves susceptible to scrutiny by white neighbors and officials.The subdivisions are often sparsely vegetated, dry and hilly, making them not only unproductive as agricultural lands but also highly visible from public roads, horseback, neighboring plots, helicopter and Google Earth. Green screen fencing, wooden stakes, portable toilets, generators, campers, plywood houses, or water tanks and trucks often signal cannabis cultivation but would be necessary for many land uses, especially since many lots are sold without infrastructure like water, sewer or electrical access. If detection of code violations depends upon visibility, Hmong Americans on subdivisions have been made especially visible and vulnerable to detection. One lawyer, for instance, reported that 90% of the defendants present at administrative county hearings for code violations in fall 2015, when the first complaint-driven ordinance was put in place, were Hmong-American. One Hmong-American resident reported being stopped by police six times in 3 months and subjected to unfriendly white neighbors patrolling on horseback for cannabis — one of whom made a complaint for a crowing rooster, a questionable nuisance in this “right to farm” county. Numerous Hmong-Americans and sympathetic whites echoed these experiences. County residents confirmed their antagonism toward Hmong-Americans by characterizing them in interviews and public records as dishonest, thieves, polluters, negligent parents and unable to assimilate, and making other racializing and racist characterizations. While written regulations and enforcement profess race neutrality, in a nuisance enforcement regime based on visibility, Hmong Americans were more visible than others, leading many to argue that they were being racially profiled. Rhetoric emerging from the county government amplified racial tensions and visibilities.

Numerous Sheriff’s Office press releases located the “problem” in subdivisions and attributed it to “an influx of people temporarily moving to Siskiyou” who were “lawbreakers” from “crime families” with “big money” and who threatened “our way of life, quality of life, and the health and safety of our children and grandchildren” . Just 2 days before the June 2016 ballot on the strict cannabis ordinances, state investigators responded to county reports that newly registered Hmong-American voters might be fraudulent or coerced by criminal actors and visited Hmong-American residences to investigate, accompanied by sheriff’s deputies . The voter fraud charges were later countered by a lawsuit alleging racially motivated voter intimidation; the suit was eventually dismissed for failing to meet the notoriously difficult criteria of racist intent. The raids may have discouraged some Hmong-Americans from voting, charges of fraud may have boosted anticannabis sentiment, and, one government official explained, “creative balloting” measures enabled some municipal voters in conservative localities to vote while others in more liberal places could not. The voter fraud charges, raids and legal contestation drew widespread media attention that further linked Hmong-Americans and cannabis. Amidst these now-overt racial tensions, the restrictive June 2016 ballot measure passed, allowing the Sheriff’s Office to gain full enforcement power over the “#1 public enemy to Siskiyou citizens … criminal marijuana cultivation” . Shortly after the June 2016 ballot measure affirmed stricter regulations, the Sheriff’s Office formed the Siskiyou Interagency Marijuana Investigation Team with the district attorney to “attack illegal marijuana grows” “mostly” around rural subdivisions . Within a month, SIMIT had issued 25 abatement notices and filed 20 criminal charges,flood table in addition to confiscating numerous plants. Meanwhile, the Planning Division’s role had diminished — code enforcement officers were relegated to addressing violations not directly related to cannabis . The November 2016 state legalization of recreational cannabis prompted Siskiyou to examine a possible licensure and taxation system for local growers .

Amidst sustained, vocal opposition, the proposal stalled for several reasons that further aggravated cultural and racial tensions: A key proponent of licensure was discovered to be running an unauthorized grow, three Hmong Americans died of carbon monoxide poisoning due to heaters in substandard housing, and a cannabis cultivation enterprise run by two Hmong-Americans attempted to bribe the sheriff. These developments were interpreted not as outcomes of restrictive regulations and criminalizing strategies, but as proof that, in the words of one supervisor, regulation was impossible until the county could “get a handle on the illegal side of things.” The sheriff encouraged this interpretation, arguing in an interview that statewide legalization was “just a shield that protects illegal marijuana” and efforts to regulate it would always be subverted by criminals. This antiregulatory logic prevailed in August 2017 when the county placed a moratorium on cannabis commerce. Still, the sheriff argued for stronger powers, citing an “overwhelming number of cannabis cultivation sites,” which, according to the Sheriff’s Office, continued to “wreak … havoc [with] potentially catastrophic impacts” across the region . Just 1 month later, at the sheriff’s urging, the Siskiyou Board of Supervisors declared a “state of emergency” aimed at garnering new resources and alliances to address the cannabis cultivation problem. Soon, the Sheriff’s Office enlisted the National Guard, Cal Fire and the California Highway Patrol in enforcement efforts, and, by 2018, numerous other agencies joined, including the Siskiyou County Animal Control Department, California Department of Toxic Substances Control, State Water Resources Control Board, California Department of Fish and Wildlife and a CDFA inspection station. These alliances multiplied the civil and criminal charges cultivators might face . Ironically, California’s cannabis legalization has enabled a kind of multi-agency neoprohibitionism at the county level, one that reinforces older criminal responses with new civil-administrative strategies and authorities. The need to “get a handle” might be regarded as a temporary emergency measure, but it may also propagate new criminalizing methods and institutional configurations. The more enforcement occurs, the bigger the problem appears, requiring more resources and leading to a logic of escalation symmetrical to the much-critiqued War on Drugs . And the more cannabis cultivators are viewed as criminal, the less likely they are to be addressed as citizens, residents and farmers.Given concerns about biased county policy and enforcement, the Sheriff’s Office held the first Hmong American and Siskiyou County Leader Town Hall in May 2018 to “foster a closer, collaborative relationship with members of the Hmong-American community,” exchange information about Hmong and Siskiyou culture and educate attendees on county policies . According to public records, racial tensions surfaced at this meeting when some white participants expressed that “our county” had been “invaded” and that Hmong-Americans were not fitting into local cultural norms . Meeting leaders — both government officials and Hmong-Americans — however, identified cultural misunderstanding, rather than criminalization and racialized claims by whites on what constitutes local culture, as the core problem to be addressed. “Misunderstanding” was an inadequate framing, given that Hmong-Americans had attempted to make themselves understood by attending public meetings, forming advocacy groups, signing petitions, demanding interpreters and administrative hearings, and registering to vote since their arrival in Siskiyou.

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Further analysis is necessary to understand the potential impacts of well use on stream flow depletion

The use of well water for cannabis cultivation, in comparison to other water sources, presents both potential threats and benefits for in stream flow. In upper reaches of small watersheds, streams are dependent throughout the summer months on subsurface water flows from the landscape into the stream. Well water extraction may reduce cold water inputs — limiting stream flow or, in extreme conditions, dewatering stream channels . The extent to which use of subsurface water affects stream flow and water temperature depends on the degree to which well water sources are hydrologically connected to streams. When wells are shallower and closer to streams, and when soil conductivity is greater, subsurface water pumping is more likely to directly capture stream flow. However, if wells are less hydrologically connected to streams, the effects of extraction will be attenuated, resulting in smaller-magnitude and temporally lagged stream flow depletions. With sufficient groundwater recharge in wet months, well water extractions may affect stream flow less than surface water diversions, which were previously assumed to be cannabis cultivators’ predominant means of obtaining water in the region.Such an analysis would incorporate information on well locations and depths and would consider the underlying geology and soil properties at cultivation sites . Meanwhile, the prevalence and distribution of wells relative to other water sources are influenced by broader geospatial characteristics such as topography and precipitation patterns. Understanding these issues will also be important for assessing the threats and benefits associated with subsurface water extraction.

Variation between counties in well extraction patterns demonstrates that, although subsurface water may be the most common source of water in North Coast cannabis cultivation, the availability of alternative sources may play an important role. Humboldt County watersheds included in this study consistently receive more average annual precipitation than do those in Trinity , Mendocino and Sonoma counties . This difference translates into more available surface and spring water in Humboldt County over the course of the growing season. The observation that fewer sites in Humboldt County report well use, microgreen rack for sale compared to other counties in the study, suggests that if surface or spring water is available, cultivators are likely to use it. Conversely, the potential necessity of groundwater use in counties that receive less rainfall holds particular importance in consideration of emerging areas of industry growth throughout California. Further analysis is needed to understand how likely cultivators are to rely on wells if other sources of water are available to them. The winter preceding the 2017 growing season was the wettest on record. It is important to understand how cultivators may source their water during years in which summer water availability is not as abundant. These findings suggest that cultivators may utilize wells both as insurance against surface water scarcity in the summer drought months and as a means of achieving regulatory compliance. The observation that nearly one-third of non-compliant sites reported well extraction indicates that use of subsurface water may be a common means to avoid water scarcity in the late growing season. While Northern California receives considerable seasonal rainfall, there is also significant spatial variability in rainfall totals and in corresponding summer flow persistence of small streams . Considering the ephemeral nature of surface water in many areas , the increasing frequency of drought due to climate change and cannabis cultivation’s consistent demand for irrigation water as crops near harvest , cultivators are strongly motivated to secure reliable water sources for the entirety of the growing season. Therefore, it is likely that water extraction from wells is a common practice for cultivators, beyond those seeking participation in the regulated industry .

Although cannabis regulations place no explicit restrictions on where water is sourced, those currently within or seeking to join the regulated cannabis industry will be subject to a restriction on diversions of spring and surface water during the growing season . This requirement is already in place for permits issued by the California Department of Fish and Wildlife and will also be enforced by the State Water Resources Control Board beginning in 2019. The data provided in this study indicates that, in order to meet the forbearance period requirement, cultivators may be more inclined to drill a well to achieve compliance than to develop water storage for spring and surface water. Determining cultivators’ capability to store the water they need for the growing season may shed further light on the likelihood that growers will seek subsurface water. If compliance necessitates drilling a well, it will be important to account for the impacts of this potential shift in cultivation practices. Successful protection of freshwater resources in Northern California will require a more complete accounting of where cannabis cultivators source their water and the amount and timing of water extracted . Study of cannabis as an agricultural crop has been notoriously inadequate, but data provided by the water quality control board’s cannabis program offers critical new insights into the water use practices of cultivators entering the regulated industry. In this initial analysis, we found that subsurface water may be much more commonly used in cannabis cultivation than previously supposed. Further analyses of cannabis cultivation’s water extraction demand, as well as of geospatial variation in water demand, may help elaborate the ramifications of this finding. Ultimately, a better understanding of cannabis cultivation’s water demand will be useful for placing the cannabis industry in the greater context of all water allocation needs in the North Coast and throughout California.People living with HIV and those at increased risk for HIV are at high risk for other health problems, including substance use, mental health issues, and socioeconomic vulnerabilities.The COVID-19 pandemic and resulting efforts to curb the spread of infection—such as stay-at-home orders and physical distancing mandates—and the resulting social isolation are likely to exacerbate these issues.

A survey of young adults in the USA found that immediately following the declaration of a state of emergency due to COVID-19, levels of depression and anxiety increased with high levels of loneliness and COVID- 19-specific worry being associated with higher levels of depression and anxiety. Factors found to be associated with pandemic-related depression and anxiety include being younger, being a racial/ethnic minority, or being diagnosed with a chronic disease.The pandemic-related increases in mental health issues may also extend to substance misuse. Prior studies of disasters, including the aftermath of the 2003 severe acute respiratory syndrome epidemic, found increased rates of substance use. Emerging data related to the COVID-19 pandemic seem to corroborate these findings, with one study noting a “surge of addictive behaviors” including food, shopping, and increased reported use of cannabis, methamphetamine, and opioids. Studies that specifically focused on men who have sex with men —including both those who were HIVpositive and at increased risk for HIV—found that changes in substance use and mental health were also associated with behaviors that not only increased the risk for SARS-CoV-2 infection—the virus causing COVID-19—but also had implications in terms of STI/HIV transmission.For instance, one study found that those who had sex with casual partners during pandemic restrictions were more likely to report using substances including alcohol as compared to those who avoided interactions with casual sex partners. Engagement in ongoing health care and prevention is especially critical to the health of vulnerable populations living at the intersection of multiple colliding epidemics of COVID-19, substance use, mental health, and HIV. In order to reduce the potential for SARS-CoV-2 transmission, many clinics stopped in person clinical encounters and switched to telehealth visits starting in March 2020. While telehealth outcomes in general — including among those who live with HIV — have been largely positive, telehealth has the potential to miss the most high needs and socioeconomically vulnerable patients.Beyond limited access to technology requirements for telehealth visits including a cell phone or computer and Internet connectivity , privacy concerns and the absence of confidential surroundings may also be an issue. In fact, one study found that even with an intervention to improve telehealth attendance, access to virtual medical care was still challenging among people living with HIV who were experiencing homelessness.Therefore, cannabis grow facility layout the objective of this study was to assess the impact of the COVID-19 pandemic on substance use, changes in mental health, and interruptions in mental health care among HIV-positive and high-risk HIVnegative men. Specifcally, we focus on cannabis use given the high prevalence of use, ease of access, and its use as the substance of choice to manage negative affect including anxiety and depression.

We describe the prevalence and correlates of interruptions in mental healthcare as well as factors associated with cannabis use for COVID-19 related anxiety and depression. We compare those who report interruptions in mental health care to those who did not experience these interruptions and hypothesize that those experiencing interruptions in mental health care will experience increases in depression and anxiety and will also report other negative health behaviors, including increased substance use and increases in sexual risk behaviors.Data for this study were based on those collected from participants in the mSTUDY — a National Institutes of Health /National Institute on Drug Abuse funded cohort of racial/ethnically diverse, HIV-positive, and high-risk HIV-negative MSM. Details of the mSTUDY have been previously described,but briefy, participants were recruited from two study sites in Los Angeles, CA, including a community-based organization providing services for the lesbian, gay, bisexual, and transgender community and a community-based university research clinic. Study enrollment started in August 2014, and cohort participation is ongoing. Eligible participants were between 18 and 45 years of age at the time of enrollment, identifed as male at birth, if HIV-negative, reported condomless anal intercourse with a male partner in the past 6 months, were capable of providing informed consent, and were willing and able to return to the study site every 6 months to complete study-related activities. By design, half of the participants were living with HIV, and half were substance using. Following the COVID-19 pandemic “stay-at-home order” in California, all in-person research activities were stopped on March 13, 2020, and remote study visits were launched starting March 31, 2020. For this analysis, we included all participant remote study visit data collected from March 31, 2020, through August 30, 2021 .The Institutional Review Board at the University of California Los Angeles approved the study, and all participants provided written informed consent prior to study participation. During in-person study visits, which occur every 6 months, participants complete a self-administered, computer-assisted survey and provide biological specimen for HIV testing . During the remote visits included as part of this analysis, no biological samples were collected. HIV status was based on testing done at the previous follow-up visit, which occurred 6 to 8 months prior for most respondents. Participants were sent an electronic link to the study questionnaire for each remote study visit, which was comparable to the survey used as part of the in-person study visits and included additional questions related to the COVID-19 pandemic. In addition to sociodemographic characteristics, the questionnaire collected information on current substance use, mental health, sexual risk behaviors, and COVID-19 experiences and the impact of the pandemic on overall health and well-being.The impact of the COVID-19 pandemic has been vast in terms of who has been impacted and broad in terms of how people have been affected. Our findings highlight the experiences of those living at the intersection of multiple colliding epidemics and vulnerabilities, including COVID-19, substance use, mental health, and HIV. In particular, our results indicate increases in symptoms of depression and anxiety with the highest levels noted in the most immediate time frame following the COVID-19 pandemic and a reversion to pre-pandemic levels within 17 months of follow-up. Our results also indicate changes in substance use linked directly to experiences resulting from the COVID-19 pandemic, with a high proportion of participants reporting cannabis use to cope with their heightened anxiety and depression. Furthermore, we find that interruptions in care due to the COVID-19 pandemic, particularly interruptions in mental health care, can link with negative outcomes along substance use and STI/HIV risk and underscore the intersectional vulnerabilities experienced by these individuals.

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Our analyses revealed a high degree of support for the unidimensionality of cannabis use disorders

A prior genome-wide association study of DSM-IV cannabis dependence, conducted in the sample used in this study, failed to identify genetic variants at a statistically significant level . This has resulted in speculation regarding the biological underpinnings of cannabis use disorders; in particular, the question of whether common variation available in commercially available genome-wide arrays captures it . Aggregating the effects of all single nucleotide polymorphisms on commercial arrays might quantify the overall role of common SNPs as well as causal variants in linkage disequilibrium Table 1 Prevalence of individual DSM-IV and proposed DSM-5 criteria for cannabis use disorder in 3053 lifetime cannabis users of European-American and African American ancestry. When significant, this would indicate that heritable variation in the trait is at least partially captured by these SNPs in a highly polygenic manner. Applying this methodology, investigators have successfully attributed 23–51% of the variation in current smoking, major depression, schizophrenia and human intelligence to genetic influences . The present study uses a multi-pronged phenotypic and genomic approach to evaluate, respectively, the architecture and genetic underpinnings of DSM-5 cannabis use disorders, defined as a quantitative phenotype. Instead of relying on a diagnostic measure, we first utilize item response models to construct a factor representing liability to DSM-5 cannabis use disorders, while accounting for sex and ethnic differences. Second, we use this psychometrically constructed factor score in a genome-wide association analysis. Finally, we evaluate whether genome-wide SNPs and putative causal variants in linkage disequilibrium with them explain a significant proportion of the heritable variation in DSM-5 cannabis use disorders.The genotyping and quality control procedures applied to these data are explained in detail in earlier publications . In brief, DNA samples from 3988 individuals were genotyped on the Illumina Human 1 M bead chip by the Center for Inherited Diseases Research at Johns Hopkins University. As described earlier, 948,658 SNPs passed data cleaning protocols. No imputed data were used for these analyses. HapMap genotyping controls, duplicates, related subjects, and outliers were removed. For the current analyses, data on 3053 individuals reporting a lifetime history of cannabis use were used. Self-identified ethnicity was 2018 European Americans and 1035 African Americans.

We used MPlus to conduct exploratory and confirmatory factor analyses of the 12 DSM-IV/DSM-5 criteria in the same sample. Exploratory analyses were conducted in the full sample, while subsequent confirmatory factor analyses were conducted in African-American and European-Americans ,trim tray for weed separately by sex, using a multi-group framework. Initially, factor loadings and thresholds were constrained across the ethnic groups and across sexes. Individual sub-models were tested to determine whether allowing the factor loading and threshold for each criterion to vary across the groups resulted in a significant improvement in model fit. The model that accommodated all statistically significant differences was used to generate factor scores that were subsequently used for genome-wide association analysis.The sample used for analyses was restricted to those who reported at least one lifetime use of cannabis . These individuals are characterized with respect to the 12 individual DSM-IV/DSM- 5 criteria in Table 1. Prevalence of each criterion was higher in males than females for both ethnic groups, and males, regardless of ethnicity, were more likely than females to meet criteria for DSM-IV and DSM-5 diagnoses. However, several intriguing ethnic differences emerged. For both sexes, hazardous use, use of larger amounts or for a longer period of time and desire to quit or multiple failed quit attempts were differentially endorsed by EA and AA. EA men and women were more likely to endorse hazardous use and less likely to endorse using larger amounts or for longer than intended and failed quit attempts than their AA counterparts. In addition, tolerance, time spent using cannabis and the DSM-5 criteria of withdrawal and craving were more commonly reported by AA women than their EA counterparts—similar differences were not noted for men. The prevalence of DSM-IV cannabis abuse/dependence was higher in men compared with women, but no within-sex ethnic differences were noted. For DSM-5, cannabis use disorder was again more common in men than women, and there were no ethnic differences in men. However, AA women were more likely to meet criteria compared with their EA counterparts . Comparing the prevalence of DSM-IV vs. DSM-5 cannabis use disorders—within each group, very modest changes were observed. Decrease in overall prevalence was noted for EA, while AA women showed a slight increase and AA men remained unchanged. Examining the [95%] confidence limits for the point estimates, only the decrease in prevalence in the EA was statistically significant while the estimates in AA subjects could be equated across diagnostic classification scheme .An exploratory factor analysis of the full sample revealed that a single factor solution provided a reasonable fit to the data : 0.996, root mean square error of approximation : 0.054. While a 2-factor exploratory solution modestly improved these fit indices,the inter-factor correlation was 0.90. Hence, we proceeded with the more parsimonious single factor confirmatory analysis, which readily approximates item response parameters.

Confirmatory factor analysis of the 4 DSM-IV abuse, 6 DSM-IV dependence and the DSM-5 withdrawal and craving criteria revealed high factor loadings for all criteria except legal problems , which was excluded from further analyses comparing factor loadings and thresholds for each individual criterion across EA and AA males and females. The factor loadings and thresholds from the model allowing for statistically significant differences across individual items are shown in Table 2. Factor loadings and thresholds could not be constrained across the groups for hazardous use,interpersonal problems, withdrawal,using more than intended , repeated/failed quit attempts,time spent and physical/psychological problems . Factor scores that accommodated these differing thresholds and factor loadings were created for each of the four subgroups and used for genomic analyses.Individual signals did not surpass the Bonferroni corrected genome-wide significance threshold of p < 5 × 10−8. The results for the top 20 SNPs are presented in Table 3 . For the EA sub-sample, 11 SNPs on 17q23-24 appeared to be associated at nominal levels of significance although none surpassed the genome-wide threshold of 5 × 10−8.The top SNP, rs6504555, was an intronic variant in the bromodomain PHD finger transcription factor gene—a regional association plot for this region of chromosome 17 is shown inFig. 1, indicating a high degree of linkage disequilibrium across the associated SNPs. With the exception of rs11870068, the remaining chromosome 17 SNPs were in moderate to high linkage disequilibrium . In the AA sub-sample, results did not aggregate in any particular chromosomal region. The most significant SNP, rs4364205, on chromosome 3, was intergenic. Meta-analysis of the results from the EA and AA sub-samples did not yield a boost in statistical significance . This was evident from a comparison of results in the EA and AA sub-samples. Of all SNPs with p-values < 0.05 in EA sub-sample, only 5% had corresponding p-values < 0.05 in AA sub-sample. However, particularly for the SNPs for the EA sub-sample shown in Table 2, the direction of effect in the AA sub-sample predominantly concurred with the EA sub-sample.We sought to examine the phenotypic and genomic architecture of a continuously distributed cannabis use disorders factor, psychometrically derived from DSM-5 criteria, in samples ascertained for alcohol, nicotine and cocaine dependence.Analysis of ethnic differences indicated a modest reduction in the prevalence of DSM-5 cannabis use disorders, relative to DSM-IV, in EA. Genomic analyses, using a genome-wide scan, failed to identify SNPs that satisfied statistical thresholds for significance; however, gene-based association implicated genes on the q-arm of chromosome 17. A genome wide variance calculation revealed that 21% of the phenotypic variance in cannabis use disorders was captured by the available common variation on the genome-wide array, but this estimate had a large standard error and was not significant. We used the factor score as our phenotype for genomic analyses.

Incorporating withdrawal and craving, excluding legal problems and combining across DSM-IV abuse and dependence criteria, this factor embodies the ‘spirit’ of the new DSM-5 diagnostic scheme while not being encumbered by concerns that the threshold of 2 or more criteria for diagnosis of disorder is too lax . From a psychometric perspective, our results are consistent with the extant literature . For instance, despite our sample being ascertained for alcohol, nicotine and cocaine dependence, which inflated endorsement rates of individual criteria , our high rates of hazardous use were comparable with those reported for lifetime cannabis users from the general population as reflected in data from the National Epidemiological Survey of Alcohol and Related Conditions . Likewise, broadly consistent with numerous other studies, the DSM-IV abuse criterion of legal problems was infrequently endorsed and had a weak factor loading, affirming its proposed exclusion from DSM- 5. The overall prevalence of the remaining criteria, although much higher than in general population cohorts, supports the presence of a unidimensional construct across sexes and ethnicities. Craving and withdrawal, both of which have been added to DSM-5, performed well, with high factor loadings supporting their inclusion. Overall, trimming tray weed rates of diagnostic DSM-5 cannabis use disorders appear to be modestly lower than those for DSM-IV abuse/dependence, but only in EA, particularly men. This finding is highly comparable with epidemiological analyses of alcohol symptomatology in U.S. and with results from the 2007 Australian National Survey of Mental Health and Well being, which reported a decrease in the lifetime rate of cannabis use disorder from 6.2% to 5.4% when transitioning from DSM-IV to DSM-5 . In our sample, this decrease was uniformly attributable to individuals who endorsed hazardous use alone, which results in a DSM-IV diagnosis of cannabis abuse but not a DSM-5 diagnosis of cannabis use disorder, because it falls below the latter’s minimum two-symptom threshold. No differences were noted in AA men , and this is also not surprising. Individuals endorsing this criterion alone tend to be of higher socio-economic standing and tend to, overwhelmingly, endorse this criterion due to a history of drinking and driving . That socio-economic status may correlate with ethnicity is expected—in our data, 45.9% of AA participants reported a gross annual income of less than $20,000, vs. 15.4% of their EA counterparts. Upon examining gender and ethnic differences within classification version , the only significant variation was noted for DSM-5 diagnoses in AA women who were more likely to receive a diagnosis of DSM-5, but not DSM-IV cannabis use disorder, relative to their EA female counterparts. Intriguingly, also relative to their EA counterparts, they were less likely to endorse hazardous use but more likely to endorse numerous other criteria, with the exception of giving up important activities and use despite physical/psychological problems. This finding may be attributable to the larger number of AA women that were ascertained from the cocaine dependence study vs. other studies. Although this observation holds true for the men as well, and the prevalence did not vary across AA and EA women, it is possible that AA women from the FSCD study represent a high-risk group. For instance, when compared to the alcohol and nicotine dependence studies, AA women from the cocaine study were more likely to report lower household income and a greater likelihood of less than a high school education . Thus, this vulnerability might reflect environmental adversity rather than increased genetic susceptibility, and in any case, is accounted for in the genomic analyses by incorporating study sample and gender as covariates. From a genetic perspective, the single SNP analyses did not reveal any genome wide significant signals. This is likely because our sample is under powered, even with a quantitative trait, to detect single variants of modest effect size. Using GWA Power , we estimated power available in our dataset to identify SNPs of varying effect size. Power was 80% when an effect size of 0.01 was anticipated . Increasing efforts to amass larger samples with comparable cannabis-related data would afford greater power to detect variants of more modest effect size via meta- and mega-analyses. However, few current studies have DSM-5 criteria data. In this regard, factor scores such as ours may prove to be useful phenotypes as they can accommodate DSM-IV and DSM-5 based assessments of vulnerability to cannabis use disorders. In contrast,the gene-based analyses conducted with the EA sub-sample identified a cluster of genes, of varied function, on the q-arm of chromosome 17 that appeared to contain an aggregation of variants associated with DSM-5 cannabis use disorders.

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The prevalence of marijuana use was 72% prior to graduate school enrollment and 49% after graduate school enrollment

Existing theories of student attrition, centered primarily on the undergraduate student experience, posit that attrition is influenced by individual, institutional, and social factors . Institutional factors include program characteristics, administrative policies, and academic requirements, and social factors include peer culture, faculty/staff interactions, and social integration. Individual pre- and post-matriculation factors include demographic characteristics, skills and abilities, goals and expectations, external commitments, and academic history. Largely missing from theories of student attrition are health status and health behaviors, particularly substance use prior to and after enrollment in an academic degree program. The relationship between alcohol and marijuana use and graduate degree completion is likely influenced by demographic characteristics. Both heavy drinking and marijuana use are more prevalent among college males than females , and substance use disorders are associated with being male, white, and unmarried . Having children is associated with a lower prevalence of substance use among both men and women . Demographic characteristics are also associated with graduate school completion, with burnout and attrition highest among women . Attrition is also more common among African-American/Black students , domestic students , and students enrolled in master’s degree programs . This study aimed to fill a gap in the literature by assessing the relationships between alcohol and marijuana use before and after graduate school enrollment and graduate degree completion. It is hypothesized that lower levels of alcohol and marijuana use both before and after graduate school enrollment are associated with graduate degree completion after adjustment for potentially confounding variables.The College Life Study is a longitudinal study of young adults who were recruited from a large, mid-Atlantic university. During the first stage of sampling, a ten-minute survey was administered to all incoming first-time, first-year students ages 17 to 19 that contained questions on demographic characteristics and tobacco, alcohol, and other drug use behaviors. During the second stage of sampling, the sample was stratified by race, gender, and substance use history. Students who had tried a drug or used a prescription drug non-medically at least once prior to college entry were over sampled. A random sample was chosen for longitudinal follow-up, and 1253 students completed a personal interview at baseline [Year 1 ; modal age 18].

Follow-up assessments were then conducted annually from Years 2 through 8 and then again in Years 10 and 12 through face-to-face interviews, self-administered surveys, and web based surveys. Follow-up rates were high,grow tent for sale ranging from 91% in Y2 and 73% in Y12. The university’s Institutional Review Board approved the study, and informed consent was obtained. Additional detail on recruitment methods and follow-up procedures can be found elsewhere . From the original sample of 1253 young adults, 541 participants enrolled in a degree-seeking graduate program at some point by Y10 of the study. Of these, 21 participants were excluded from analyses. Five of these participants were excluded because upon further examination of other assessment responses, they had listed graduate school enrollment by mistake, and one participant was excluded because information on their specific graduate degree type could not be identified. In addition, to ensure participants had adequate time to complete their degree, 15 participants who first enrolled in a doctorate or professional degree program in Y10 were excluded, giving a final analytic sample of 520 participants.Alcohol use was measured annually in Y1-Y12. To assess frequency of alcohol use, participants were asked, “In the past 12 months, on how many days have you drank any drink with alcohol in it?”. To assess quantity of alcohol use, participants were asked the number of drinks they had on a typical drinking day . Data on days used during the past year were used to estimate average alcohol use frequency for descriptive purposes. Marijuana use frequency was assessed annually in Y1-Y12 with the question “In the past 12 months, on how many days have you used any type of marijuana?” . Data on days used during the past year were used to estimate average marijuana use frequency for descriptive purposes. Past-month frequency of both alcohol and marijuana use were also assessed, but because of the high degree of correlation with past-year measures , only past-year variables were used in the analyses. For each participant, alcohol use frequency, alcohol use quantity, and marijuana use frequency were averaged separately for each of two time periods: before and after the first year they indicated enrollment in a graduate degree program. The mean for each of the six separate variables was used to capture variation in substance use during the pre- and post-enrollment periods, particularly because the before enrollment period included the undergraduate college years as well as the interim years after college graduation but before graduate school enrollment.Gender was coded by the interviewer in Y1 as either male or female. Race/ethnicity was measured in Y3, and response options included white; Black/African-American; American Indian or Alaskan Native; Native Hawaiian; Other Pacific Islander; Asian; and Hispanic, Latino, or Spanish. Participants could also write in a response or choose “Don’t Know/Refuse to Answer”. Given that the majority of the sample was non-Hispanic white, race was dichotomized into white and nonwhite. Marital status was measured in Y4-Y8, Y10, and Y12.

Participants indicated whether they were married, divorced, widowed, separated, in a civil union or domestic partnership, or never married. A dichotomous variable was created to represent whether or not participants were married at any point during Y4-Y12. The number of children participants had was measured in Y4-Y8, Y10, and Y12. A dichotomous variable was created to represent whether or not participants ever had children by Y12.Descriptive statistics were used to analyze the distributions of all study variables. Pearson correlation coefficients were used to analyze the relationships between all six alcohol and marijuana use predictor variables. A series of logistic regression models were fit to assess the relationships between alcohol and marijuana use and graduate degree completion. First, in Stage 1, separate logistic regression models were fit to analyze the relationships between each alcohol and marijuana use predictor variable and graduate degree completion while controlling for demographic and program characteristics. Second, in Stage 2, a best- fitting model was obtained by entering each of the six alcohol and marijuana use predictor variables into the model one at a time, retaining any predictor variable that was statistically significant and dropping those that were not significant. All demographic and program characteristic variables were retained in the final model regardless of significance. The Nagelkerke R2 value was used to examine the variance in graduate degree completion explained by the Stage 2 variables. A similar method has been used in prior work by the research team . SPSS Version 24.0 was used for all analyses, and the alpha level was set at 0.05.The majority of the sample was female and non-Hispanic white , with 42% of participants getting married and 14% having children by Y12 . About two-thirds had enrolled in master’s degree programs and 31% had enrolled in doctorate or professional degree programs, with Y5 as the most common year to begin graduate school. The majority of the sample completed their graduate degree by Y12.The majority of participants drank alcohol during at least one year before graduate school enrollment and after graduate school enrollment . Among drinkers, the average alcohol use frequency was about 75 days during the past year before enrollment in graduate school and 88 days during the past year after enrollment . Among drinkers, mean alcohol use quantity decreased from a mean of 3.9 drinks per drinking day before graduate school enrollment to 2.6 drinks per drinking day after enrollment. The typical quantity consumed for male drinkers was greater than female drinkers both before and after graduate school enrollment . Based on past-year data, it was estimated that about 35% of drinkers drank less than weekly and about 24% drank twice a week or more before graduate school enrollment.

After graduate school enrollment, 32% of drinkers drank less than weekly and about 31% drank twice a week or more.As seen in Table 2, marijuana use frequency among users was about the same prior to and after graduate school enrollment with a mean of about 40 days during the past year. Among those who used marijuana prior to graduate school enrollment, 56% used once a month or less and about a quarter used at least weekly . Among those who used marijuana after graduate school enrollment, 64% used once a month or less and about 18% used at least weekly . The correlations between the six alcohol and marijuana use predictor variables are presented in Table 3. There were moderate to strong correlations between the before enrollment estimates and the after enrollment estimates. Despite this statistical overlap, both before and after enrollment variables were retained due to their importance to the research question of interest. Alcohol use frequency before graduate school enrollment was strongly correlated with alcohol use quantity before graduate school enrollment and moderately correlated with alcohol use quantity after graduate school enrollment . To avoid the potential for multicollinearity effects on the statistical models, only the alcohol use frequency variables were retained for further analyses. There is prior evidence that frequency of alcohol use increases during the post-college period while quantity of alcohol use decreases ,indoor grow tent and alcohol use frequency has higher sensitivity and specificity in identifying alcohol-related problems than alcohol use quantity .Stage 1 results showed that, even after controlling for demographic and program characteristics, marijuana use frequency after enrollment was negatively associated with graduate degree completion . The best-fitting model included alcohol use frequency before graduate school enrollment and marijuana use frequency after graduate school enrollment, which were both significantly associated with graduate degree completion after being entered into a model together and with the demographic and program characteristics. Alcohol use frequency before enrollment was positively associated with the odds of graduate degree completion . In contrast, as marijuana use frequency after enrollment increased, the odds of graduate degree completion decreased . In the best-fitting model, gender, marital status, and first year of graduate school enrollment were associated with graduate degree completion.

Female students had almost two times higher odds of graduate degree completion when compared with male students, and married students had more than two times higher odds of graduate degree completion when compared with those who had never been married. In comparison with students who began their graduate degree in Y10 , students entering graduate school in Y5 , Y6 , and Y7 had significantly higher odds of graduate degree completion. 4. Discussion This study examined whether or not alcohol and marijuana use before and after graduate school enrollment were associated with graduate degree completion. Alcohol and marijuana use were moderate among participants in this sample. Results showed that more frequent marijuana use after graduate school enrollment was associated with decreased odds of graduate degree completion after adjustment for potentially confounding variables. This finding is consistent with prior research that has shown a relationship between frequent marijuana use and degree non-completion among high school and undergraduate college students . Marijuana use was less prevalent after graduate school enrollment as compared with before, which is consistent with research showing that marijuana use declines as young adults age . However, while past-year marijuana use frequency among marijuana users who completed their graduate degree declined from 40 days before enrollment to 35 days after enrollment, frequency among users who did not complete their graduate degree increased from 45 days before enrollment to 85 days after enrollment. There are several mechanisms through which marijuana use might affect degree completion. The first is through decreased academic performance, with underachievement cited as the most well-supported correlate of marijuana use . While little research has been done on the relationship between marijuana use and decreased academic performance among graduate students, existing evidence among high school and college students shows that frequent marijuana use is associated with academic unpreparedness , lower grades , and lower academic achievement . The relationship between marijuana use and degree non-completion might also be explained by the effects of marijuana use on cognition .

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The advantage of hybrid fiber-reinforced composites is that they benefit both synthetic and natural fibers

Mitochondrial dysfunction and oxidative stress are two factors that are thought to play a significant role in the development of PD. As seen in Fig. 1, rotenone and H2O2 both induced dose dependant decreases in cell viability in the TH1 transfected SH-SY5Y cells. The concentrations of rotenone and H2O2 needed to induce this change were higher than those noted in previous studies using the SHSY5Y cell line; this could be due to the transfection of TH1 within these cells incurring increased resistance to rotenone. This hypothesis is supported by our previous studies using the TH1 transfected SH-SY5Y cell line reporting an increased resistance to oxidative stress and treatment with 6-OHDA and H2O2.Cleavage of PARP-1 is commonly used as an index of apoptosis. In this study, treatment with rotenone and H2O2 both induced a dose dependent increase in PARP-1 cleavage indicating the occurrence of apoptosis. Interestingly while oxidative stress is thought to play a major role in cell death induced by both rotenone and H2O2, the two toxins had significantly different effects on TH expression. Rotenone induced an increase in TH expression within our SH-SY5Y cells, this is in contrast to previous studies that suggest rotenone treatment results in a decrease in TH expression in both animal models and cells.It should be emphasised, however, we measured TH protein only in the cells that were still attached to the bottom of the plate but not in the cells that had detached from the plates as these were removed with the media at the completion of rotenone treatment. Therefore, our results suggest that TH protein was increased only per remaining cell and not per total number of cells present at the beginning of the treatment. In contrast H2O2 had no effect on TH protein levels in the remaining cells, suggesting that while oxidative stress may play a role in rotenone induced cell death, the increase in TH seen was not induced by it. Rotenone is also thought to cause inhibition of the proteasome system,grow tent therefore it is possible that the levels of TH protein are increasing in these cells because breakdown and removal of the protein have been altered; however, this requires further investigation. Natural compounds with antioxidant and anti-inflammatory properties have become of interest with regards to PD as the current treatments are associated with harmful side effects.

Curcumin, cinnamon, hemp seed and Polygonum cuspidatum are all naturally occurring products that have been used in traditional Chinese medicine for many years.We found that pre-treatment of our SH-SY5Y cells with compounds isolated from these products did not have an effect on rotenone toxicity. This is in contrast to previous studies that have demonstrated the protective effect of curcumin against rotenone in SH-SY5Y cells.It should be noted that while both studies have utilised SH-SY5Y cells, our cells contain human TH1. Therefore, it is possible that the transfected TH1 and the increase in TH protein expression seen with rotenone treatment could be potentiating rotenone induced cell death and playing a role in our inability to protect against rotenone toxicity. As TH is the rate limiting enzyme in DA synthesis, it is possible that the increased TH protein expression in response to rotenone could have induced an increase in DA production. The increased DA could possibly accumulate within the cytoplasm of the cells and lead to increased oxidative stress, proteasomal inhibition and mitochondrial dysfunction that could be contributing to rotenone induced cell death. This hypothesis is similar to a popular hypothesis that suggests an involvement of hyper-activation of TH and DA production in early PD pathogenesis.Interestingly, the same compounds did display the ability to protect against H2O2 induced toxicity. In addition, all tested compounds also prevented the increase in PARP-1 cleavage seen with H2O2 treatment indicating a reduction in apoptosis and supporting the findings of the viability assay as well as the findings of previous studies that suggest the novel compounds possess antioxidant activity.Moreover a previous study has demonstrated the ability of cinnamaldehyde to modulate the release of catecholamines from a rat pheochromocytoma cell line,indicating this compound has the potential to not only be neuroprotective but may also further ease the symptoms of PD by promoting catecholamine release. While the in vitro antioxidant capabilities of these compounds have been demonstrated previously, this is the first study to demonstrate the neuroprotective properties of cinnamaldehyde, caffeoyltyramide and piceatannol glucoside in a dopaminergic cell line in response to H2O2. In summary, we demonstrated that the effect of rotenone on these cells is more complicated than just the induction of oxidative stress and suggest that perhaps TH may be involved. Curcumin, cinnamaldehyde, caffeoyltyramide and piceatannol glucoside successfully prevented H2O2 induced cell death, making this the first study to demonstrate the neuroprotective potential of these natural compounds in a SH-SY5Y cellular model of oxidative stress.

The combination of traditional and man-made fiber-reinforced composites provides many advantages in different areas of engineering and technology. The commonly used natural fibers in engineering fields are sugar palm, flax, sisal hemp, kenaf, and Abaca fibers. Incorporating natural fibers in high-strength synthetic fibers like carbon and Kevlar improves mechanical properties, namely, stiffness, toughness, moisture resistance. The properties of composite specimens have been enhanced due to addition of nanomaterials and lignocellulose fibers as reinforcement in composites.The properties of composites depend on the individual element characterization like matrix and fibers type, chemical properties of matrix and fibers. The hybrid reinforced polymer composite consists of natural and synthetic fibers with short fiber and random orientation and long fiber in mat form. In short and randomly oriented fiber-based composite, the sliced fibers are mixed in a fixed quantity of thermoplastic resin, melt mixer is used for homogeneous mixing. The product taken from the mixing chamber is a chunk form of fiber-based polymer composites. The small pieces of fiber/ matrix composites are obtained from different techniques: the pultrusion process and injection molding. The different research articles have been available based on the characteristic study of fiber-based composite by varying fibers and resins, fibers length. This type of chopped fiber-based composite fabrication can be used to reduce wastage because of small size of fibers, and also it is economical. The hybrid composite consists of two or more different fibers. Sid ika et al. found the experimental results such as impact, flexural, and tensile strengths of natural fibers, namely, Jute and Coir reinforced polypropylene resin composites. It has also been found from experimental results that variation of fiber content by weight fraction such as 25:75, 50:50, 75:25 in the overall loading fibers and the matrix content remains constant. Likewise, Ranjan et al. carried out research on hybrid fibers reinforced polylactic acid resin composite and found the results, namely, tensile, flexural, and impact strength. Additionally, the investigators observed that the strength of the Sisal/Banana fibers was reduced due to the presence of weak adhesive bonding between the fibers and polylactic acid. It creates lower-strength materials. Per z et al. reported the optimum strength and modulus obtained by varying the weight fraction of banana and coir fiber content in fiber-based composite. In addition, 15% of the coir fiber-reinforced polymer composite gives good impact properties, 10% of coir fiber reinforced polymer composites provide the best modulus and strength under the flexural and impact forces. Per z et al. reported a similar enhancement of results in impact strength.

Especially the coir fiber content contributed more to the improvement of impact properties in composite due to the following reason at higher fiber loading, it requires high energy to break the fibers or fiber pullouts high lingocellulosic content. The composite strength and modulus may be reduced at higher fiber loading due to the non-maintaining homogenous distribution of fiber content, which causes agglomeration in the region. The agglomeration region acts as a stress concentrated region, and it is responsible for the initial crack to the failures. The following are the disadvantages of the natural fibers, lower strength, weaker inter facial bonding, hydrophilic and hydrophobic nature of fiber and matrix, respectively. To enhance the mechanical properties of natural fiber reinforced polymer composites following ways can be adopted, i.e., fiber treatments, the addition of synthetic reinforcements, and coupling agents. The long fiber reinforced polymer matrixes have been made from prepregs or woven mats. The prepregs have formed by the melting and pressing fiber fabrics at high temperatures. The final form of long fiber reinforced polymer composite is formed by stacking the prepregs layer by layer. Kar dumen et al. reported the influence of stacking sequence on the mechanical properties by using woven flax and non-woven jute fiber reinforced on the polypropylene resin. They said additionally that the hybrid composite consists of non-woven jute covered by woven flax, which exhibits good strength. In contrast, the hybrid materials consist of woven flax covered by the non-woven jute, displaying good impact strength. Addition of the 10% glass fiber in jute fiber reinforced polypropylene composite has improved tensile and flexural strengths. Dan Mallam et al. fabricated the hybrid composite from the kenaf fiber and polypropylene terephthalate matrix; the two types of hybrid composite, namely woven interplay and interwoven. Amo g the two kinds of hybrid composite, the interwoven ply exhibit good tensile and flexural properties,grow tent complete kit while the woven interplay displays good impact properties. It is summarized from kinds of literature that the highest mechanical properties of the synthetic and natural fibers in Kevlar and Abaca fibers respectively, also very few works have been done in hybrid composites, however, no work has been carried out in the combinations of the Kevlar and Abaca.

Similarly, Glass and Hemp fibers also have specific advantages compared to other fibers. In this work, an attempt has been made to bring benefits of both synthetic and natural fibers in hybrid composites. The mechanical properties namely tensile, flexural, and impact testing, have been performed numerically and experimentally. Aba a, Hemp, Glass, and Kevlar fibers have been used to prepare the composite specimens. The hybrid composite materials consist of Glass/Abaca, Glass/Hemp, and Kevlar/Abaca.In this work, all four fibers, namely, Abaca, Hemp, Glass, and Kevlar fibers, were purchased in the form of long fiber. The thickness of the Abaca fiber is 0.35 mm, length is 200e300 mm, which is obtained from the stem of pseudostem of Musa sepientum. Yellowish Kevlar 49 grade with bidirectional woven fabric has been used, Hemp fibers, with the thickness of 0.08 mm and length of 15e35 mm have been used, Glass fiber in mat form, length of 6e12 mm and 0.01 mm diameter. All fibers were purchased from Vruksha composite, Chennai, Tamilnadu. The hybrid composites were fabricated by alternating natural and synthetic fibers into the matrix. In the present work, epoxy resin was used as a matrix material. The liquid resin is a colorless, highly viscous liquid, at 25 C the density and viscosity are 1.16 gm cm 3 and 900 cps, respectively. Harer is used to reduce the curing time, namely, Amine purchased from Bangalore-based company, namely, Naptha resin and chemicals. The natural fibers are purchased from Maruthi Peach Company, Tirupur district, Tamil Nadu, India. The synthetic fibers, namely Kevlar and Glass fibers, are purchased as yarns from Go Green products, Coimbatore, Tamilnadu, India, and weaved of fibers alternatively with 6.7 6.7 yarns per cm. The composite specimen is bidirectional, and the bulk and linear densities were used to calculate the cross-section of yarns. The cross sectional area of yarn is 0.015 cm2 . The area is calculated by dividing linear density by its bulk modulus. The density of the different fibers is listed in Table 1.The three different combinations of natural and synthetic fibers-based composites were prepared. The following loads were applied: tensile, flexural, and impact; then, results were reported. In each experiment, three times repeated and took the average value for the graph. A similar work has been carried out by Mohanavel et al., who characterize the mechanical properties of the hybrid composite, which consists of Glass, Jute, and Madar fibers. Also, they fabricated the hybrid composite with a similar type of stacking sequence, that is, the first and last layer was synthetic fibers, due to the lesser water-absorbing characteristics of the fibers.

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Women have shown slightly more severe neurocogntive deficits related to marijuana use compared to men

This report focuses on spectroscopy findings.In addition to the K-SADS-PL,the Personal Experience Inventory was used to further assess alcohol and marijuana use in both the MJU group and in the healthy controls.Briefly,the PEI consists of two main sections,one focused on patterns and severity of substance use,and the other focused on psychosocial consequences of use.In most cases,participants endorse items from the inventory using a four-point Likert response format.Different versions of the PEI have been developed for adolescents versus adults.Participants younger than 18 years of age received the adolescent version and participants older than 18 years of age received the adult version; both versions were computer administered.All MJU participants received the adult version.Scoring was implemented to create comparable metrics across the two versions.Finally,an in-house questionnaire based on guidelines provided by the National Institute on Alcohol Abuse and Alcoholism was implemented to assess detailed daily,weekly,yearly and lifetime use patterns of alcohol and marijuana in the sample,considering frequency and amount of use.The MR spectroscopy voxel was positioned in the right basal ganglia using the T1-weighted image.The caudate and putamen were the primary regions of interest.The voxel was positioned in the following way: left/right—the voxel was positioned so that it was as medial as possible,without containing any portion of the lateral ventricle,anterior/posterior—the voxel was positioned as anterior as possible in the caudate,without entering the anterior horn of the lateral ventricle,superior/inferior—the voxel was positioned such that the inferior portion of the voxel was as close as possible to the most inferior aspect of the putamen,and such that the superior portion of the voxel was approximately 3 mm inferior to the most superior aspect of the caudate.Fig.1 illustrates the voxel placement in a typical subject.confirmation of consistent voxel placement across subjects was achieved by segmenting and parcellating the T1-weighted image.

A high-resolution structural scan was acquired to position the voxel during data acquisition and to determine the tissue composition of the voxel through segmentation.The T1-weighted scan was processed using the standard Free Surfer pipeline for tissue segmentation and anatomical parcellation.Further details related to the Free Surfer processing can be found online,and in one of our previous publications.In-house software was used to compute the transformation matrix from the scanner coordinates to the FreeSurfer-processed T1-weighted image.A mask representing the spectroscopy voxel in the anatomical image space was then created using tools from the FMRIB Software Library,planting racks which was subsequently segmented and parcellated using the Free Surfer anatomical information.Thus,each T1-weighted voxel within the spectroscopy volume,was classified as either white matter,gray matter,cerebrospinal fluid,or non-brain,and was further parcellated into subcortical and cortical structures.This was done to confirm a consistent voxel placement across all subjects and to determine the basic tissue composition within the voxel.Further details of the voxel composition can be found in the results section below.Data were analyzed with the Statistical Package for the Social Sciences,version 19.Data were examined for normality in order to ensure appropriateness of parametric statistics.Univariate analyses of covariance were used to test group effects between the MJU individuals and the controls,with age and alcohol use entered as co-variates.Group and sex were both entered as between-subjects variables.Alcohol use frequency over the past 12-month period summarized by the PEI was used in the above model as the alcohol use co-variate.Two-way interaction effects between group and sex,when present,were examined further by running the model separately in males and females,or by examining sex effects within MJU individuals and controls.Finally,significant effects were re-evaluated by matching the MJU and control samples by age to verify that patterns remained significant with more stringent control over developmental differences that might otherwise impact the findings.There was no group by sex interaction for age or for IQ.

Marijuana users were college students of middle to high-middle socioeconomic backgrounds and most were free of a non-substance DSM-IV Axis I diagnosis.None were psychotic.Nearly all met DSM-IV diagnostic criteria for marijuana abuse or dependence.Use of other recreational drugs within the MJU group was limited,with no participants meeting DSM-IV criteria for abuse or dependence.One subject met diagnostic criteria for current alcohol dependence,and a small proportion met criteria for alcohol abuse.Compared to controls,alcohol use over the past twelve months use was found to be significantly higher in the MJU group,F = 43.93,p b 0.001.Marijuana users on average had a PEI score of 3.7,which corresponds to endorsing use of alcohol between 21 and 100 times in the previous 12 months.Controls on average had a PEI score of 1.5,which corresponds to endorsing use of alcohol between 1 and 20 times in the previous 12 months.When the sample is restricted to include only individuals aged 17 and higher,the difference in alcohol use remains significant but the mean value for control participants is slightly higher at 1.9.Thus,the amount of alcohol use endorsed over the past twelve months was entered as a covariate in analyses comparing metabolite concentrations between groups.The marijuana users reported that their age of first use of marijuana was 15.2 ± 1.2 years,and also reported smoking 9.8 hits per day during the past year.In addition,supplemental analyses were conducted to verify that female users did not differ from male users in their self-reported patterns of use,age of use onset,use of alcohol,or symptoms of psychopathology.Findings are presented in Table 3.The only group difference to emerge was that female users reported fewer symptoms overall of alcohol abuse/ dependence than did males.Otherwise,they did not significantly differ in variables that would suggest an increased frequency or duration of marijuana use,use of other substances,or presence of concomitant psychopathology.The spectroscopy voxel was consistently placed in the same anatomical location,centered in striatum,in both marijuana users and controls.

The voxel was primarily composed of gray matter,as determined by the Free Surfer parcellation procedure.The majority of the voxel composition was statistically similar between groups,with the exception of the pars opercularis,which accounted for less than 1% of the total voxel composition.The remaining 2% of the voxel composition was relatively variable.Moreover,these additional regions always represented very small amounts of tissue,and were not represented in all subjects.This study examined a cohort of college-aged heavy marijuana users and a control group of non-using young-adults.Using MR-spectroscopy,it was shown that females,but not males,who used marijuana heavily starting in mid-adolescence and persisting for several years have lower levels of glutamate and glutamine in the dorsal striatum when compared to controls,even after accounting for age and alcohol use.Similarly,female but not male users differ from controls in their estimated concentrations of myo-inositol,demonstrating higher levels than controls.These patterns are interpreted as pathological in the female users given that male users had comparable levels to controls of both sexes.Female users did not differ from male users in their overall rates of self-reported marijuana use,in their concomitant level of alcohol use,in their numbers of symptoms of marijuana dependence,or presence of other conditions that might impact brain metabolism.These findings have broad parallels in the extant literature,both in relation to the overall patterns observed but also in relation to sex differences.Decreased glutamate/glutamine concentrations have been reported in two other MRS studies of marijuana users,one that focused on the basal ganglia and one that targeted the anterior cingulate cortex.First,in an older cohort of marijuana users than is described in the current study,Chang et al.reported lower glutamate levels in the basal ganglia,suggesting that heavy marijuana use during young adulthood as well as later in life is associated with disruptions in glutamate signaling as has been shown for other drugs of abuse.Recently,Prescot et al.reported lower glutamate concentrations in the anterior cingulate cortex,which was nonetheless strongest when females were eliminated from the analysis.Interpretation of the current findings is complicated by poor resolution of the glutamate versus glutamine signal.Glutamate is present in all cell types with the largest pools evident in glutamatergic neurons; smaller pools are evident in GABA-ergic neurons and astroglia.

Upon release,astroglia convert glutamate to glutamine,which in turn is transferred back to the neuron for conversion once again to glutamate.Glutamine is primarily located in astroglia.Thus,low glutamate levels would be difficult to ascribe to a particular neuronal process.In contrast,if glutamine levels are low,then glial dysfunction may be present,a finding that would be consistent with white matter aberrations in marijuana users.Others have not reported specific metabolic disruptions in female marijuana users; indeed,within young samples,marijuana is more commonly used in males.Although it has been recognized that females are at an increased risk for some behavioral consequences of drug use such as sexual risk-taking and an increased risk of depression and anxiety following a pattern of daily marijuana use,sub irrigation cannabis there are relatively few human studies of brain-based sex differences associated with marijuana.McQueeny et al.showed adolescent girls had larger amygdalae and increased internalizing symptoms when compared to both control and marijuana using boys.Moreover,certain behavioral problems have also been linked to prenatal marijuana exposure in girls,but not in boys.Recent neuroimaging work suggests that young female users may be vulnerable to marijuana-induced alterations in brain volume,given suggestions of greater prefrontal cortex volumes and relatively poorer levels of executive function.Alcohol is similarly disruptive to females’ cognitive function and regional brain morphology,and it has long been recognized that females are more vulnerable to psychomotor sensitization with psychostimulant exposure.Preclinical data are somewhat stronger and indicate that female adolescents are particularly vulnerable to the effects of long-term THC administration on the CB1 receptor system in multiple brain regions,including the prefrontal cortex,striatum,and periaqueductal gray.A recent study of THC in mid-adolescent rats during the period of drug administration and following abstinence indicated greater sensitization of THC-induced locomotor depression in females versus males.Moreover,high doses resulted in increased anxiety-like behaviors during THC administration,particularly in females,although a general tendency is for females to experience greater anxiolytic effects of the drug.Glutamate is critically important in the neuroplasticity that accompanies the transition from drug use to abuse.Under conditions of extreme trauma or stress,its release is associated with neurotoxicity and cell death.Endocannabinoids block glutamate release under such conditions,which could lead to neuroprotection.However,the concomitant observation of high mIns levels argues against this interpretation.Given that mIns is considered to be a glial marker,high levels would be associated with gliosis as well as white matter injury as occurs in the context of neural injury.High mIns concentrations have been observed in early dementia,in frank Alzheimer’s disease,as well as in abstinent methamphetamine users,although this latter observation was in the frontal lobes.This pattern is intriguing given that deficits in learning and memory represent one of the robust areas of reported cognitive dysfunction in marijuana users.Although our data analyses do not suggest that female marijuana users in this sample are more vulnerable to cognitive impairments,this is a relatively young and high functioning sample.It may be that frank behavioral deficits will emerge more strongly in females over time as chronicity of use progresses.We hypothesize,too,that we may have observed altered NAA levels had we also measured frontal concentrations of each metabolite.Even though our statistical analyses do not show any significant effect of alcohol,it is important to consider the possibility of an underlying biological interaction between the two substances.Male marijuana users in this study had the highest levels of alcohol use,but did not show significant neurochemical alterations relative to controls.

Females showed the greatest apparent impact of marijuana use on Glx and mIns,but in the context of lower levels of alcohol use.These findings could suggest a neuroprotective effect in individuals who use both marijuana and alochol,as described by others.Alternatively,previous work has shown greater levels of Glx in the anterior cingulate of chronic alcohol users relative to controls.Considering this,taken together with the findings of the present study,it is possible use of the two substances together may drive metabolite concentrations to “normal” levels via opposing processes,as has also been suggested by others in the context of brain morphology.Differences in metabolic function in heavier versus lighter alcohol users can also impact the conversion of acetate into glutamate.It is possible,then,that the male marijuana users in this study who were heavier alcohol users as compared to females,demonstrated differences in glutamate metabolism,contributing to the observed sex difference.However this assertion is only speculative.While our data do not fully support these conclusions,the issue of alcohol use in the context of marijuana use requires careful examination in future studies.Sex but not group-related effects were also observed in total choline estimated concentrations.Independent of marijuana use,males showed higher estimated concentrations of tCho compared to females.

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