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As more and more teenagers believe that marijuana is harmless, and do not disapprove of those who use it, there has been a dramatic increase in marijuana use—among 12- to 17-year-olds, use has doubled since 1992. These trends are particularly disturbing because research has shown that marijuana use is associated with a variety of health risks, including lung cancer, short-term memory loss, and amotivational syndrome. Marijuana use also can contribute to risky behaviors and adverse physical and social consequences. These include increased involvement in violence and crime; impaired driving; and unplanned and unprotected sex, which can lead to unplanned pregnancy and acquiring sexually transmitted diseases such as HIV/AIDS.

Nelba Chavez, Ph.D.
Administrator
Substance Abuse and Mental Health Services Administration

Ruth Sanchez-Way, Ph.D.
Acting Director
Center for Substance Abuse Prevention
Substance Abuse and Mental Health Services Administration

September 1997

The listing of materials or programs in this resource guide does not constitute or imply endorsement by the Center for Substance Abuse Prevention, the Public Health Service, or the Department of Health and Human Services. The materials have been reviewed for accuracy, appropriateness, and conformance with public health principles.

This Alcohol, Tobacco, and Other Drugs Resource Guide was compiled from a variety of publications and data bases and represents the most current information to date. It is not an all-inclusive listing of materials on this topic. This guide will be updated regularly, and your comments or suggestions are welcome. To suggest information or materials that might be included in future editions, please write to the National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345, or to info@health.org.

Please feel free to be a copy cat, and make all the copies you want. You have our permission!

Contents

Section 1: Prevention Materials
Section 2: Studies, Articles, & Reports
Section 3: Groups, Organizations, & Programs
Section 4: Internet Access

Rockville, MD 20847-2345; 800-729-6686. (free)

This booklet provides guidance for parents, guardians, and other role models about preventing alcohol, tobacco, or illicit drug use among youth they care for and care about. It is divided into five sections based on the five reasons that young people give for using alcohol and drugs: to feel grown up; to fit in and belong; to relax and feel good; to take risks and rebel, and to satisfy curiosity. It includes action steps and exercises, as well as a list of resources. This booklet also contains responses for parents who used drugs in the past if they are questioned by their children about having used drugs.

Marijuana: What Parents Need to Know
Organization: National Institute on Drug Abuse
Year: 1995
Format: Booklet
Length: 24 pages
Target Audience: Parents of youth ages 12-20
Inventory Number: PHD712
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345; 800-729-6686. (free)

Written to dispel myths and educate parents, this booklet presents scientific information about the consequences of marijuana use. Topics include: what marijuana is, how many people use it, the signs of use and effects of use, how to tell if a child has been smoking marijuana, and how parents can prevent children from getting involved with marijuana.

Marijuana: Facts for Teens
Organization: National Institute on Drug Abuse
Year: 1995
Format: Booklet
Length: 16 pages
Target Audience: Youth ages 12-20
Inventory Number: PHD713
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345; 800-729-6686. (free)

Written especially for young people, this booklet states the facts about marijuana, including what marijuana is, how many teens smoke marijuana, what the short- and long-term health effects are, how to tell if someone has been smoking marijuana, and how to quit using it.

Tips for Teens About Marijuana
Organization: Center for Substance Abuse Prevention
Year: 1996
Format: Brochure
Length: Tri-fold (6 panels)
Target Audience: Youth ages 12-20
Inventory Number: PHD641
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345;800-729-6686. (free)

Designed to attract attention and concern, this colorful brochure states the long-term and short-term effects, physical and psychological risks, and legal implications of marijuana use. Teens are advised to stay away from all drugs and encouraged to seek help from a counselor, friend, or parent whenever necessary.

Let's Talk About Marijuana. An Information and Activities Book
Organization: Channing L. Bete Co., Inc.
Year: 1994
Format: Booklet
Length: 8 pages
Target Audience: Youth ages 9-12
Item Number: 46937H
Availability: Channing L. Bete Co., Inc., 200 State Road, South Deerfield, MA 01373-0200;

800-628-7733. ($$)

This booklet contains information about the dangers of smoking marijuana, why some young people use marijuana, and how to say "no." Activities include crossword puzzles, word puzzles, and decoding puzzles.

Marijuana: An Introduction to the Facts
Organization: Life Skills Education
Year: 1994
Format: Booklet
Length: 13 pages
Target Audience: Jr. and Sr. High School Youth, Parents, General Public
Item Number: 1002
Availability: Life Skills Education, 314 Washington Street, Northfield, MN 55057;

800-783-6743. ($$)

This comprehensive resource for marijuana information answers many common questions about the drug. Topics include the chemical makeup, where it originates, the physical and psychological effects, why reactions are unpredictable, and addiction and dependence. A note to parents and additional resources are also included.

Marijuana and Driving
Organization: Life Skills Education
Year: 1994
Format: Booklet
Length: 13 Pages
Target Audience: Young Adults, General Public
Item Number: 1005
Availability: Life Skills Education, 314 Washington Street, Northfield, MN 55057;

800-783-6743. ($$)

How can using marijuana affect a person's ability to drive? This booklet describes the driving skills that are affected by using marijuana, such as judgment, perception, concentration, and emotional control.

Marijuana: The Personal Effects
Organization: Life Skills Education
Year: 1994
Format: Booklet
Length: 13 Pages
Target Audience: Jr. and Sr. High School Youth
Item Number: 1004
Availability: Life Skills Education, 314 Washington Street, Northfield, MN 55057;

800-783-6743. ($$)

Marijuana use can negatively affect thought processes, communication, and self-image, interfering with a teenager's normal development. The booklet explains these processes, and refutes common misconceptions, such as "lots of people do it," or "it's no worse than cigarettes or alcohol."

FactFile: Marijuana. Drug Abuse Prevention
Organization: The Bureau for At-Risk Youth
Year: 1994
Format: Brochure
Length: Tri-fold (6 Panels)
Target Audience: General Public, Prevention Professionals
Availability: The Bureau for At-Risk Youth, 645 New York Avenue, Huntington, NY 11743;

800-99-YOUTH. ($$)

This brochure educates the reader about the harmful effects of marijuana and its continued use and abuse. The common short- and long-term effects of marijuana use are explained, and the way that it affects the body is described. The reader is referred to a list of organizations for further information.

Marijuana and Your Mind
Organization: Sunburst Communications
Year: 1988
Format: Videotape
Length: 31 Minutes
Target Audience: Students Grades 7-12
Item Number: 204703
Availability: Sunburst Communications, 39 Washington Avenue, P.O. Box 40, Pleasantville, NY

10570; 800-431-1934. ($$)

This videotape shows what happens to two teenagers when they begin smoking marijuana. It explains the physical, psychological, and emotional effects of marijuana as well as the long term and short term effects.

Brain Concepts: Drugs and the Brain
Organization: The Society for Neuroscience
Year: 1992
Format: Brochure
Length: 4 Pages
Target Audience: General Public, Prevention Professionals, College Students
Inventory Number: MS482
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345; 800-729-6686. (free)

This brochure describes in detail how drugs affect the brain and nervous system. Beginning with a brief physiology of neurons, the brochure goes on to describe the neurological effects of marijuana, other hallucinogens, psychostimulants, opiates, and alcohol. Detailed drawings of the brain help to simplify the complexity of the subject.

Marijuana and You... Myth and Fact
Organization: American Council for Drug Education
Year: 1982
Format: Booklet
Length: 10 Pages
Target Audience: General Public
Availability: American Council for Drug Education, 164 West 74th Street, New York, NY

10023; 800-488-DRUG. ($$)

Twelve common misunderstandings about marijuana, such as "marijuana helps me think more clearly," and "it's not addictive," are presented and refuted with the facts. The booklet focuses on the effects of marijuana use on cognition, heart, lungs, and the reproductive system.

It's Your Business: Drug Awareness —Marijuana
Organization: American Council for Drug Education
Year: 1993
Format: Brochure
Length: Tri-fold (6 Panels)
Target Audience: Employers, Employees, General Public
Availability: American Council for Drug Education, 164 West 74th Street, New York, NY

10023; 800-488-DRUG. ($$)

This brochure addresses the problems associated with marijuana use and abuse; particularly, how the use of this drug affects work performance. The effects of marijuana on learning ability and physical health are also addressed. Marijuana dependence is described, and there are suggestions for the heavy marijuana user who would like to become drug-free.

Getting Your Kids to Say "No" in the '90s When You Said "Yes" in the '60s: Coping with Teenage Sex, Drugs, TV, and Rock 'N' Roll
Author: Strasburger, V.
Year: 1993
Format: Book
Length: 286 Pages
Target Audience: Parents
ISBN: 0-671-79796-4
Availability: At bookstores and libraries; or contact Fireside Books, Simon and Schuster,

Rockefeller Center, 1230 Avenue of the Americas, New York, NY 10020;

800-223-2336. ($$)

This book is intended to help parents understand the difficulties of being a teenager in modern society. The author discusses the complexities of modern society and modern families and the risks to which children and teenagers are potentially exposed-sex, drugs, homicide, suicide, and AIDS.

Marijuana: It's a Bigger Drug Than You Think—Fact Packet
Organization: Center for Substance Abuse Prevention
Year: 1995
Format: Fact Sheets
Length: 5 Pages
Target Audience: Parents, Prevention Professionals, Educators, Youth Ages 12-20
Inventory Number: RP0880
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345; 800-729-6686. (free)

This packet presents information for both adults and youth about marijuana and how to prevent its use. Contents include a fact sheet for adults on female adolescents and marijuana use; ten things every teen should know; action steps for youth; action steps for parents and caregivers; and a list of resources. Suggestions focus upon community action, such as creating positive peer pressure, avoiding paraphernalia that promotes cannabis use, developing spokespersons, and raising awareness of messages in the media.

Marijuana: What Can Parents Do?
Organization: National Institute on Drug Abuse
Year: 1995
Format: Videotape
Length: 15 Minutes
Target Audience: Prevention Professionals, Educators, and Parents
Inventory Number: VHS82
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345; 800-729-6686. ($$)

This videotape is designed to educate families and the community about the resurgence in marijuana use among youth. Featuring science-based facts and real parents and real teenagers, this videotape presents the importance of opening the dialogue between parents and their children about marijuana and other drug use and to encourage parents to communicate a strong prevention message to their children.

Drugs Have No Place in a Healthy Life! Marijuana Can Mess You Up!
Organization: Weekly Reader Corporation
Year: 1995
Format: Poster
Target Audience: Educators, Youth Ages 5-18
Availability: Weekly Reader Corporation, 245 Long Hill Road, P.O. Box 2791, Middletown,

CT 06457-9291; 860-638-2400. (free)

On one side this poster reads "Drugs Have No Place in a Healthy Life" and depicts 14 children of various ages and races. Next to this photograph is a message from Donna Shalala, U.S. Secretary of Health and Human Services, presenting the children with facts about the negative effects of drug use and urging them to stay away from drugs. The other side of the poster reads "Marijuana Can Mess You Up!" and contains photographs of students in school, socializing, and playing basketball. Students are presented with facts concerning the damage marijuana can do to the brain, friendships, and fitness.

Marijuana: Common, Dangerous, and Still Illegal
Organization: National Crime Prevention Council
Year: 1996
Format: Fact Sheet
Length: 1 Page
Target Audience: Community Service Groups, Parents of Youth Ages 10-21, Youth

Ages 10-21
Availability: National Crime Prevention Council, 1700 K Street, NW, Second Floor,

Washington, DC 20006-3817; 202-466-6272. (free)

This reproducible brochure explains that marijuana may be common but it is not safe, and lists the physical and physiological problems that can result with its use. The brochure also explains that marijuana is still illegal and that there are penalties for possession, use, and dealing.

The Truth About Marijuana. Teacher's Guide
Organization: Sunburst Communications
Year: 1996
Format: Videotape and Teacher's Guide
Length: Video (19 Minutes); Teacher's Guide (50 Pages)
Target Audience: Junior High Youths, Junior High Educators
Availability: Sunburst Communications, Pleasantville, NY 10570; 800-431-1934. ($$)

This video presents facts about marijuana and its use. The teacher's guide contains a summary of the video, discussion questions, suggested activities, role-play ideas, handouts, suggested readings, and the script of the video.

Marijuana: Setting Things Straight
Organization: Syndistar, Inc.
Year: 1995
Format: Videotape
Length: 17 Minutes
Target Audience: Youth Ages 10-21
Availability: Syndistar, Inc., 120 Mallard Street, Suite 180, St. Rose, LA 70087-9452;

800-841-9532. ($$)

Laurie's boyfriend is pressuring her to try marijuana, so she turns to her friend Gladys for help. With the help of a medical student, police officer, and former drug users, they learn the facts about marijuana use and its harmful effects on the mind and body. A leader's guide which accompanies the video aids in the facilitation of video presentation and discussion of the video's key themes.

Reality Check
Organization: Center for Substance Abuse Prevention
Year: 1997
Format: Community Kit
Target Audience: Parents, Educators and Community Service Groups of Youth Ages 9-14
Inventory Number: PHD732
Availability: National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345,

Rockville, MD 20847-2345; 800-729-6686. (free)

The Reality Check Campaign was created by the Center for Substance Abuse Prevention, in partnership with other national and local organizations and businesses. It is a multimedia campaign designed to prevent use and reduce existing use of marijuana by 9- to 14-year-olds. This kit includes ready-to-use media materials, camera-ready artwork, prints PSA's, a list of national resource organizations, and practical information on conducting media outreach and local community campaigns.

Marijuana
Organization: National Family Partnership
Year: 1997
Format: Brochure
Length: 6 Pages
Target Audience: Parents of Youth Ages 1-21
Availability: National Family Partnership, 11159 B. South Towne Square, St. Louis, MO

63123; 314-845-1933. (free)

This brochure provides parents with guidelines for discussing marijuana with their children. It prepares parents by having them examine their own attitudes about marijuana. It explains how to convey a no-tolerance position and discuss facts about marijuana with children. Three facts and misconceptions regarding marijuana are examined.

Facts for Young Adults
Organization: University of Wisconsin-Madison
Year: 1996
Format: Brochure
Length: 8 Pages
Target Audience: High School Youth
Availability: University of Wisconsin-Madison, Wisconsin Clearinghouse, P.O. Box 1468,

Madison, WI 53701; 608-263-2797. (free)

This brochure provides information for young adults regarding alcohol and marijuana use. It begins by dispelling some myths with facts, such as the low percentage of young people who use these drugs. It explains what alcohol and marijuana do to the body; the connection between alcohol and violence as well as accidents; the problem of binge drinking; what marijuana can do to the mind; and, the problem of addiction and tolerance with marijuana use.

Marijuana: It's a Drag
Organization: University of Wisconsin-Madison
Year: 1996
Format: Fact Sheet
Length: 2 Pages
Target Audience: Junior High and Senior High Youth, College Students
Availability: University of Wisconsin-Madison, Wisconsin Clearinghouse, P.O. Box 1468,

Madison, WI 53701; 608-263-2797. (free)

On one side of this fact sheet is a photograph of a truck dragging a cart of hay and it reads, "Marijuana: It's a Drag." The other side presents the facts regarding marijuana, including: marijuana hurts the mind and body; it makes some users binge eat and gain weight; it can cause a user to make bad decisions, especially about sex; it can cause cancer, heart attacks and death; and, it can lead to serious accidents.

CSAP Resource Guide: Marijuana
Section 2 -- Studies, Articles, and Reports

Marijuana and Other Drug Use

What's Happening: Tobacco, Alcohol and Marijuana: 'Gateways' to Cocaine
Adolescence 8(2):16, 1995

Youth between the ages of 12 and 17 years who use tobacco, alcohol, and marijuana are up to 266 times more likely to use cocaine than those who haven't used any of these gateway drugs. Research reveals a consistent and powerful connection between the use of cigarettes and alcohol and the subsequent use of marijuana, and between the use of cigarettes, alcohol, and marijuana and the subsequent use of cocaine and other illicit drugs. Nearly 90 percent of all people who have ever used cocaine used all three gateway substances first, although use of any one of the substances increased their risk. The earlier a child starts to use these gateway drugs, and the more frequently, the greater the likelihood of using other drugs.

Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use
Merrill, J.C.; Fox, K.S.; Lewis, S.R.; Pulver, G.E.
Center on Addiction and Substance Abuse at Columbia University, October 1994. 49 p.
(Available from CASA, 152 West 57th Street, New York, NY 10019; 212-841-5200)

This study assesses the impact on both children and adults of gateway drugs-cigarettes, alcohol, and marijuana-and the subsequent use of cocaine, heroin, hallucinogens, inhalants, and other illicit substances. It is based on a review of the literature and analyses of the 1991 National Household Survey on Drug Abuse. It finds a strong statistical relationship between the use of gateway drugs and the use of illicit substances, across all age groups and regardless of gender, race, or ethnicity. The study concludes that the evidence is sufficient to persuade government and the private sector to step up efforts to prevent children from smoking, drinking, and using marijuana, and to support major research on the relationship between gateway drugs and other substances.

Age of Alcohol Onset and Alcohol, Cigarette, and Marijuana Use Patterns: An Analysis of Drug Use Progression of Young Adults in New York State
Yu, J.; Williford, W.R.
International Journal of the Addictions 27(11):1313-1323, 1992

The authors extend the gateway theory by examining the relationship between the onset age of alcohol and the progression of drug use (alcohol, cigarettes, and marijuana) among 16- to 24-year-old young adults residing in New York State. Logit analysis is employed to estimate the impact of the early onset of alcohol use on the subsequent use of the other drugs. The findings suggest that alcohol increases the chance of using cigarettes and marijuana, and alcohol-cigarette use significantly increases the likelihood of using marijuana. The early onset of alcohol use affects the current use of alcohol and drugs. The impact is the strongest when the onset is initiated in a posited critical age period between 13 and 16.

Rural Youth Usage of Alcohol, Marijuana, and "Hard" Drugs
Donnermeyer, J.F.
International Journal of the Addictions 28(3):249-255, 1993

Based on developmental theory, this article tests the relationships between first and current use of alcohol, marijuana and drugs among a sample of 197 rural and small-town youth. Findings indicate that age of first use of alcohol predicts current use of alcohol. The same pattern occurs for marijuana and other drugs. Age of first use of alcohol is also related to first use of marijuana, which in turn is related to first use of other drugs. The order is reversed for current use. Current use of other drugs predicts current use of marijuana, which in turn predicts current use of alcohol.

 

Prevalence of Use

Increases in Marijuana, Hallucinogens Found for Grades 6-12 by PRIDE Survey
Drugs And Drug Abuse Education Newsletter, August 1993, pp.65-66
(Available from Drugs and Drug Abuse Education Newsletter, P.O. Box 21133, Washington,

DC 20009; 202-783-2929)

Findings from a large survey of adolescents concerning drug use, which was conducted by the national drug prevention organization known as PRIDE, indicates the end of a cycle of decreasing drug use by students and the beginning of a new trend back to increasing use and dependence. In most instances, drug use among junior and senior high school students was found to increase or remain the same during the past year. Drug types and categories, included in the survey which covered 40 States and 236,745 students in seven grade levels, were alcohol, cigarettes, marijuana, cocaine, uppers, downers, inhalants, and hallucinogens. This is the second consecutive year that PRIDE has found an increase in drug use over the previous year's level.

Substance Abuse and the American Adolescent: A Report by the Commission on Substance Abuse Among America's Adolescents
(Available from the Center on Addiction and Substance Abuse at Columbia University

(CASA), 152 West 57th Street, New York, NY 10019; 212-841-5200)

This report examines the current state of substance abuse among American teens and what can be done to influence the attitudes, activities and conduct of adolescents. Findings of the report show that teens have little or no trouble obtaining alcohol, buying cigarettes, and obtaining marijuana. Also, more than 70 percent of 15 to 17 year olds report that drugs are used, sold and kept at their schools. Suggestions for helping teens develop the skill and will to say no are included.

National Survey Results on Drug Use From the Monitoring the Future Study, 1975-1995, Volume 1, Secondary School Students
National Institute on Drug Abuse. 1996. 382 pp.
(Available from NCADI, P.O. Box 2345, Rockville, MD 20847-2345; 800-729-6686. Inventory Number BKD213)

This report discusses the prevalence of drug use among American secondary students (specifically 8th, 10th, and 12th graders) and trends in use by those students (seniors, since the study began in 1975 and 8th and 10th graders, since 1991). Also included are data on grade at first use, intensity of drug use, attitudes and beliefs among students concerning various types of drug use, and the students' perception of certain relevant aspects of the social environment.

Perceived vs. Actual Friends' Use of Alcohol, Cigarettes, Marijuana, and Cocaine: Which Has the Most Influence?
Iannotti, R.J.; Bush, P.J.
Journal of Youth and Adolescence 21(3):375-389, 1992

Determinants of the use of alcohol, alcohol without parental knowledge, cigarettes, marijuana, and crack were assessed in predominately black, urban, fourth-and fifth-grade students. Each subject identified three best friends. Logistic and least-square regression analyses indicated that children's perceptions of friends' use, perceptions of family use, and actual use of classmates were better predictors of substance use than friends' actual use. The pattern of predictors suggested that peer behaviors and attitudes are more influential for children's socially censured behaviors-such as using alcohol without parental permission-than for more socially approved behaviors such as using alcohol with parental permission. The importance of perceived friends' use vs. friends' actual use supports Behavioral Intention Theory and Cognitive Development Theory, whereas the importance of classroom use supports Social Learning Theory or may reflect social and environmental conditions, including neighborhood availability of drugs and neighborhood values regarding substance use.

Academic Stream and Tobacco, Alcohol, and Cannabis Use Among Ontario High School Students
Allison, K.R.
International Journal of the Addictions 27(5):561-570, 1992

This paper examines the relationship between academic stream and cigarette, alcohol, and cannabis use among 2,543 high school students as part of the Ontario Student Drug Survey (1987). Students in basic and general academic streams were found to have significantly higher levels of cigarette, alcohol, and cannabis use compared to advanced-level students. The effects of academic stream remain significant (except for alcohol use) when gender, grade average, drug education lessons, and pressure to use these substances are included in multiple regression analysis. The findings indicate that the process of academic streaming needs to be further examined as a possible precipitating factor in drug use.

Longitudinal Study of the Predictors of the Adverse Effects of Alcohol and Marijuana/Hashish Use Among a Cohort of High Risk Youths
Dembo, R.; Williams, L.; Schmeidler, J.; Wothke, W.
International Journal of the Addictions 28(11):1045-1083, 1993

Data gathered from a longitudinal study of juvenile detainees in a southeastern State are used to examine the demographic and life experience factors relating to their reported adverse effects of the use of alcohol and drugs. The results indicate that their use of marijuana/hashish tends to be a vehicle for the expression of personal difficulties in the areas of self-esteem and emotional/psychological functioning. Their use of these two substances needs to be seen in holistic terms. Research and policy implications of the results are drawn.

Investigating the Age Effects of Family Structure on Adolescent Marijuana Use
Hoffmann, J.P.
Journal of Youth and Adolescence 23(2):215-235, 1994

This study examines differences among older and younger adolescents in the influence of family structure, family relations, and peer relations on marijuana use. Data from a longitudinal sample of adolescents from the United States were stratified by age and used to assess these potential differences. Precise measures of family structure were constructed to account for the various manifestations of family forms. Multivariate analyses indicate that a recent divorce attenuates attachment among younger adolescents and leads to less family involvement among older adolescents. Moreover, older adolescents from stepparent families are less attached to their families. Changes in these family relationship variables influence associations with drug using peers, but these processes differ for the two age groups. Finally, less family involvement and greater drug using peer associations lead to greater marijuana use among younger adolescents, while only peer associations directly affect use among older adolescents.

Do Youths Substitute Alcohol and Marijuana? Some Econometric Evidence
Chaloupka, F.J.; Laixuthai, A.
National Bureau of Economic Research, Working Paper Series No. 4662, February 1994. 53 p.
(Available from the National Bureau of Economic Research, 1050 Massachusetts Avenue, Cambridge, MA 02138; 617-868-3900)

Data from the 1982 and 1989 Monitoring the Future Surveys are used to examine the substitutability of alcoholic beverages and marijuana among youths. Beer prices and minimum legal drinking ages are used as measures of the full price of alcohol, while an indicator of marijuana decriminalization and its money price capture the full price of marijuana. Results indicate that drinking frequency and heavy drinking episodes are negatively related to beer prices, but positively related to the full price of marijuana. The implications of this substitution for one of the consequences of youth substance abuse, driving while intoxicated, is examined using information on youth non-fatal crashes taken from the surveys and on youth fatal motor vehicle crashes constructed from the Fatal Accident Reporting System. These results indicate that the net effect of an increase in the full price of alcoholic beverages on the probability of a youth traffic crash is negative. However, the opposite is found for marijuana. That is, the results imply that the reduction in crashes resulting from substitution away from alcoholic beverages and other intoxicating substances to marijuana as its full price is lower more than offsets the increase in crashes related to marijuana use.

Female Adolescent Alcohol, Cigarette, and Marijuana Use: Similarities and Differences in Patterns of Use
Diem, E.C.; McKay, L.C.; Jamieson, J.L.
The International Journal of the Addictions 29(8):987-997, 1994

Five categories of variables were examined as predictors of alcohol, cigarette, and marijuana use in a sample of 1,416 girls ages 13 to 17 years in northwestern Ontario. A similar pattern of unique predictors emerged for the three drugs for three of the categories: the concurrent use of another drug, conventional educational attitudes and behaviors, and rebellious behaviors. A different pattern was found for the social and demographic categories between the inhaled drugs and alcohol. These differences emphasize the need to determine the specific predictors of drug use for each substance before planning regionally based drug prevention programs.

Marijuana Usage in Relation to Harmfulness Ratings, Perceived Likelihood of Negative Consequences, and Defense Mechanisms in High School Students
Como-Lesko, N.; Primavera, L.H.; Szeszko, P.R.
The American Journal of Drug and Alcohol Abuse 20(3):301-315, 1994

This study investigated high school students' marijuana usage patterns in relation to their harmfulness ratings of 15 licit and illicit drugs, perceived negative consequences from using marijuana, and types of defense mechanisms employed. Subjects were classified into one of five pattern-of-use groups based on marijuana usage: principled nonusers, nonusers, light users, moderate users, and heavy users. Principled nonusers (individuals who have never used marijuana and would not do so if it was legalized) rated marijuana, hashish, cocaine, and alcohol as significantly more harmful than heavy users. A cluster analysis of the drugs' harmfulness ratings best fit a three cluster solution and were named medicinal drugs, recreational drugs, and hard drugs. In general, principled nonusers rated negative consequences from using marijuana as significantly more likely to occur than other groups. Principled nonusers and heavy users utilized reversal from the Defense Mechanism Inventory, which includes repression and denial, significantly more than nonusers, indicating some trait common to the two extreme pattern-of-use groups.

The Characterization of Inconsistencies in Self-Reports of Alcohol and Marijuana Use in a Longitudinal Study of Adolescents
Bailey, S.L.; Flewelling, R.L.; Rachal, J.V.
Journal of Studies on Alcohol 53(6):636-647, 1992

The reliability of self-reported measures remains an important issue for research on adolescent alcohol and drug use. Many studies have concluded that adolescents' self-reports are valid and reliable, but few studies have excluded consistent nonusers from their reliability estimates, and no study has examined in detail the reliability of reported age at first use of substances. This study explores the consistency of self-reports of frequency of use and age of first use of alcohol and marijuana in a sample of 5,770 secondary school students in a southeastern U.S. county. Two waves of data were collected between 1985 and 1988 using state-of-the-art data collection procedures and self-administered instruments. Consistency of reports was examined by comparing reports at T1 and T2, approximately 1 year apart. Results showed that when consistent nonusers were dropped from the analysis, consistent rates of lifetime frequency of use dropped from 82.7 percent to 74.7 percent for alcohol and from 95.6 percent to 83.2 percent for marijuana. Reports were more consistent for lifetime marijuana use than for alcohol use, but these results must be interpreted with caution given differences in the measures for the two substances. When consistent nonusers were dropped from the analysis, only 27.8 percent of respondents made consistent estimates of their age at first alcohol use and 34.4 percent for their age at first marijuana use. Implications and recommendations for this area of research are discussed.

Marijuana Use Associated with First Episode of Psychiatric Illness in an Adolescent Population
Clark, R.R.
The American Journal on Addictions 3(1):67-71, 1994

Marijuana is the most commonly used illicit drug in the United States. Although there have been reports of severe adverse effects, many view its use as relatively innocuous. As millions of adolescents and young adults currently use or have used marijuana, it is important that awareness of both medical and psychiatric risk factors be periodically reinforced. Four case reports are presented in which there appears to be a direct connection between the onset of psychiatric symptoms and the use of marijuana.

Measuring Alcohol and Cannabis Use Disorders in an Adolescent Clinical Sample
Winters, K.C.; Stinchfield, R.D.; Fulkerson, J.; Henly, G.A.
Psychology of Addictive Behaviors 7(3):185-196, 1993

The measurement of Diagnostic and Statistical Manual of Mental Disorders (3rd ed.-Rev.) alcohol and cannabis use disorders with a new structured adolescent diagnostic interview, the Adolescent Diagnostic Interview, is described. Results pertaining to interrater agreement, test-retest reliability, concurrent validity, and criterion validity suggest that the interview offers a psychometrically sound approach to the measurement of alcohol and cannabis use disorders in adolescent clients. Further diagnostic research needs and limitations of the present study are discussed.

Correlates of Alcohol and Marijuana Use within a College Freshman Population
Dull, R.T.
Journal of Alcohol and Drug Education 38(1):1-11, 1992

The correlations between self-reported alcohol and marijuana use by college-age students and peer and parental alcohol use, family alcohol abuse, and legalization attitudes were studied in a random sample of 557 incoming freshman students from a large university. Regression analyses were performed to identify the relative contributions of each independent variable in a prediction formula for the dependent variables of alcohol use and marijuana use. The major predictors for alcohol use were maternal alcohol use followed by peer use. Attitude toward legalization and sibling alcohol abuse contributed to a much lesser degree. The major predictors for marijuana use were desire for legalization (legalization of marijuana) followed by peer use and siblings' alcohol abuse. Maternal alcohol use contributed to a lesser degree. Paternal use, as well as maternal and paternal alcohol abuse, failed to contribute to either prediction equation.

Are "Traditional" Sex Differences Less Conspicuous in Young Cannabis Users Than in Other Young People?
Pape, H.; Hammer, T.; Vaglum, P.
Journal of Psychoactive Drugs 26(3):257-263, 1994

Recent research has revealed conspicuously few distinctions between young males and females who use cannabis. Such findings may reflect the general slackening of the sex-role pattern in the younger generations. Alternatively, they may reflect distinctive characteristics of the cannabis culture. Using data from a nationwide representative sample (n=1,478) of young Norwegians (21-24 years old), this study explores whether "traditional" sex differences in respect to mental health and alcohol use are less conspicuous among users than among nonusers of cannabis. The respondents' sex-role related values and preferences were also studied. Results indicate that the sex differences in mental health did not vary between users and nonusers of cannabis; however, female cannabis users were disproportionately young when they experienced their first intoxication by alcohol. Their level of drinking was also disproportionately high. This implied that the sex difference in alcohol use was smaller among users than among nonusers; male users of cannabis consumed 2.8 times more alcohol than their female counterparts, whereas the corresponding male to female ratio was 3:2 in the nonusers. The extensive use of alcohol in female cannabis users did not reflect mental health problems or a rejection of traditional sex-role characteristics. Cannabis-using males were less typically masculine in their values and preferences than other males, but not more feminine. The measures for sex-role-related preferences did not discriminate between female users and female nonusers of cannabis.

Effects of Use

The Residual Neuropsychological Effects of Cannabis: The Current Status of Research
Pope, H.G.; Gruber, A.J.; Yurgelun-Todd, D.
Drug and Alcohol Dependence 38(1):25-34, 1995

Evidence for the residual neuropsychological effects of cannabis must first be separated from evidence regarding (1) the acute effects of the drug, (2) attributes of heavy cannabis users, and (3) actual psychiatric disorders caused or exacerbated by cannabis. The remaining evidence must then be subdivided into (a) data supporting a "drug residue" effect during the 12-24 hour period immediately after acute intoxication and (b) data suggesting a more lasting toxic effect on the central nervous system which persists even after all drug residue has left the system. The authors reviewed the literature, comparing both "drug-administration" studies in which known amounts of cannabis were administered to volunteers, and "naturalistic studies" in which heavy marijuana users were tested after some period of abstinence. The data support a "drug residue" effect on attention, psychomotor tasks, and short-term memory during the 12-24 hour period immediately after cannabis use, but evidence is as yet insufficient to support or refute either a more prolonged "drug residue" effect, or a toxic effect on the central nervous system that persists even after drug residues have left the body. The authors describe possible study designs to address these latter questions.

Chronic Effects of Marihuana Smoking on Luteinizing Hormone, Follicle-Stimulating Hormone and Prolactin Levels in Human Males
Vescovi, P.P.; Pedrazzoni, M.; Michelini, M.; Maninetti, L.; Bernardelli, F., et al.
Drug and Alcohol Dependence 30(2):59-63, 1992

The purpose of this investigation was to assess the chronic effects of marijuana smoking on the basal and stimulated secretion of the pituitary hormones lutenizing hormone (LH), follicle-stimulating (FSH) and prolactin (PRL). Ten male chronic marijuana users and 10 age- and sex-matched healthy volunteers were studied by measuring hormone levels before and after intravenous administration of thyrotropin releasing hormone (TRH) and gonadotropin releasing hormone (GnRH). The basal and stimulated levels of LH were reduced in marijuana users, whereas FSH and PRL levels and responses were not different from the control subjects. The chronic use of marijuana may selectively impair the hypothalamic control mechanisms regulating LH secretion.

Advance Data 8—Restricted and Activity Days and Other Problems Associated with Use of Marijuana or Cocaine Among Persons 18-44 Years of Age: United States, 1991
Keer, D.W.; Colliver, J.D.; Kopstein, A.N.; Hughes, A.L.; Gfroerer, J.C.; et al.
Centers for Disease Control and Prevention, April 1994. 12 p.
(Available from National Center for Health Statistics, 6525 Belcrest Road, Hyattsville, MD 20782; 301-436-8500. Number PHS 94-1250.)

The relationship between restricted activity days and the use of cocaine and marijuana is discussed. Data are presented on problems and drug-related behaviors associated with cocaine and marijuana dependence and abuse. Documentation is provided on the methodology of the National Health Interview Survey Drug and Alcohol Use Survey.

Electroencephalographic Correlates of Marihuana-Induced Euphoria
Lukas, S.E.; Mendelson, J.H.; Benedikt, R.
Drug and Alcohol Dependence 37(2):131-140, 1995

This study was conducted to determine if there is a neurophysiological correlate of marijuana-induced good effects or euphoria. Three groups of six male occasional marijuana smokers were prepared for electroencephalographic (EEG) recording and smoked either placebo or marijuana cigarettes containing 1.26 percent or 2.53 percent tetrahydrocannabinol (THC) in a controlled laboratory setting. Using a continuously available non-verbal joystick device and a questionnaire, subjects reported changes in their subjective mood state while EEG activity was continuously recorded. Subjects reported multiple episodes of intense good effects or euphoria during the first 15 minutes after marijuana. These episodes of euphoria occurred while plasma THC levels were rapidly rising. EEG alpha power during these discrete episodes of euphoria was significantly higher, suggesting that these transient EEG changes may reflect a neurophysiological correlate of the reinforcing effects of marijuana.

Cannabis Abuse and the Course of Recent-Onset Schizophrenic Disorders
Linszen, D.H.; Dingemans, P.M.; Lenior, M.E.
Archives of General Psychiatry 51(4):273-279, 1994

The authors examined the relation between cannabis use and the symptomatic course of recent-onset schizophrenia and related disorders. A prospective cohort study over a year using monthly Brief Psychiatric Rating Scale assessments was conducted. Cannabis-using patients were compared with nonusers. Eleven patients were mild and 13 were heavy cannabis-using patients. Significantly more and earlier psychotic relapses occurred in the cannabis-using group. This association became stronger when mild and heavy cannabis users were distinguished. No confounding effect of other variables was found. In all but one patient, cannabis use preceded the onset of the first psychotic symptoms for at least 1 year. The authors conclude that cannabis use, and particularly heavy use, can be considered a stressor eliciting relapse in patients with schizophrenia and related disorders and possibly a premorbid precipitant.

Short Communication: Possible Role of Marijuana Smoking as a Carcinogen in the Development of Lung Cancer at a Young Age
Sridhar, K.S.; Raub, Jr., W.A.; Weatherby, N.L.; Metsch, L.R.; Surratt, H.L.
Journal of Psychoactive Drugs 26(3):285-288, 1994

After alcohol and tobacco, marijuana is the most frequently used psychoactive substance in the United States. A study was conducted to evaluate the effects of marijuana smoking on the development of lung cancer, including the possible additive effects of tobacco smoking, tobacco smoking status, exposure to other carcinogens, and family history of cancer. Exposure to marijuana smoke is associated with the presentation of lung cancer, particularly in younger patients. Although this association can be found in older patients as well, it is more striking given the infrequent presentation of neoplasia and the relatively brief period of exposure to other carcinogens in younger patients.

Pneumothorax in Polysubstance-Abusing Marijuana and Tobacco Smokers: Three Cases Feldman, A.L.; Sullivan, J.T.; Passero, M.A.; Lewis, D.C.
Journal of Substance Abuse 5(2):183-186, 1993

Three patients are reported who suffered spontaneous pneumothorax, each of whom also had a history of daily marijuana and tobacco use. The patients ranged in age from 24 to 37 years, had smoked marijuana on a daily basis for 10 to 14 years, and had 11- to 50-pack-year tobacco-smoking histories. Marijuana may predispose to pneumothorax both by accelerating tobacco-induced lung disease, and by the frequent performance of the Valsalva maneuver during marijuana smoking. Although there is an association between pneumothorax and heavy tobacco use, an association with chronic daily marijuana use has not previously been reported.

Effects of Marijuana History on the Subjective, Psychomotor, and Reinforcing Effects of Nitrous Oxide in Humans
Yajnik, S.; Thapar, P.; Lichtor, J.L.; Patterson, T.; Zacny, J.P.
Drug and Alcohol Dependence 36(3):227-236, 1994

 

An experiment using marijuana users and non-users was conducted to assess whether the reinforcing, subjective, or psychomotor effects of nitrous oxide were influenced by a subject's drug history. Subjects in the first four sessions sampled 40 percent nitrous oxide in oxygen and 100 percent oxygen (placebo), and then over the next three sessions, chose which agent they wished to inhale. Choice distributions between the two groups did not differ significantly, and nitrous oxide choice rates were less than 50 percent in both groups. However, a history of marijuana use appeared to intensify some of the subjective effects induced by nitrous oxide inhalation.

Prenatal Tobacco and Marijuana use Among Adolescents: Effects on Offspring Gestational Age, Growth, and Morphology
Cornelius, M.D.; Taylor, P.M.; Geva, D.; Day, N.L.
Pediatrics 95(5):738-743, 1995

The longitudinal study examined the effects of tobacco and marijuana use during pregnancy on the gestational age, growth, and morphology of 310 offspring of adolescents. Data were collected during 1990 through 1993. The adolescents were drawn from a prenatal clinic in Pittsburgh, PA. They were interviewed at mid-pregnancy and at delivery to obtain information on tobacco, marijuana, and other substance use before and during pregnancy. Infants were examined 24 to 36 hours after birth. The average maternal age was 16.1 (range 12 to 18 years); 70 percent were African American. Prenatal tobacco use was associated with reduced birth weight, length, head and chest circumferences, and ponderal default, but not gestational age or the number of morphological abnormalities. Prenatal marijuana exposure was associated with reduced gestational age. Among whites, first trimester marijuana exposure was associated with an increased rate of minor physical anomalies. Prenatal marijuana exposure was not associated with any growth outcomes. These effects of prenatal tobacco and marijuana use were prominent despite lower levels of prenatal exposure in the offspring of adolescent mothers as compared with the offspring of adult mothers from the same clinic. Young maternal age may increase the offspring's risk of negative effects from prenatal tobacco and marijuana exposure.

Analysis of Facial Shape in Children Gestationally Exposed to Marijuana, Alcohol, and/or Cocaine
Astley, S.J.; Clarren, S.K.; Little, R.E.; Sampson, P.D.; Daling, J.R.
Pediatrics Jan 1992. p. 67

The association between fetal marijuana and/or alcohol exposure and facial features resembling fetal alcohol syndrome was investigated in a sample of 80 children. Standardized lateral and frontal facial photographs were taken of 40 children, 5 to 7 years of age, whose mothers reported frequent use of marijuana during the first trimester of pregnancy and 40 children whose mothers reported no use of marijuana during pregnancy. The marijuana-exposed and unexposed children were group-matched on alcohol exposure prior to and during pregnancy, sex, race, and age at the time of assessment. The photographs were assessed clinically by a study staff dysmorphologist and morphometrically by computerized landmark analysis. Fetal alcohol syndrome-like facial features were not associated with prenatal marijuana exposure in this study sample. No consistent patterns of facial features were identified among the marijuana-exposed group. Maternal consumption of two or more ounces of alcohol per day, on average, in early gestation was found to be associated with fetal alcohol syndrome-like facial features identified both clinically and morphometrically. Cocaine use reported by 13 of the 80 women was independently associated with mild facial dysmorphic features of hypertelorism and midfacial flattening. The results demonstrate the usefulness of this diagnostic technique for quantifying anomalies apparently unique to fetal alcohol syndrome and for targeting clusters of anomalies in new conditions for future evaluation.

Marijuana Effects on Actual Driving Performance
Traffic Tech. NHTSA Technology Transfer Series Number 62. Washington, DC: National Highway Traffic Safety Administration, February 1994. 2 p.
(Available from NHTSA, NTS30, 400 Seventh Street SW, Washington, DC 20590.)

Marijuana involvement is second to alcohol in motor vehicle crashes. To determine the extent to which marijuana impairs driver performance, a Dutch research institute studied volunteer subjects in actual on-road driving situations after using controlled recreational amounts of marijuana. They smoked marijuana cigarettes containing predetermined amounts of THC until they felt they had achieved their typical desired effect. Safety measures were taken; a licensed driving instructor rode along to take control if an unsafe situation arose. Subjects first drove for 14 miles along a primary highway that was closed to other traffic, and then in the presence of other traffic in a similar manner. A third study was a 40 minute drive though urban traffic. In the first study, marijuana was found to have a significant impairing effect on the driver's ability to maintain a steady lateral position within a traffic lane, showing a definite dose-effect relationship in this test. No marijuana effect was found for the speed maintenance task. In the second study, marijuana's effect on road tracking ability was similar to that found in the first study, with the exception that the low dose of marijuana used did not produce significant impairment in maintaining a steady lateral position within a lane. Marijuana did produce some cautious effects (e.g., an increase in the distance maintained between vehicles) at the low dose in speed maintenance and car following ability. In the third study, the low dose of marijuana had no effect on driving performance, while a low dose of alcohol did appear to impair driver performance, specifically as related to vehicle handling and traffic maneuvers.

Final Report: Marijuana and Actual Driving Performance
Hindrik, W.J.R.; O'Hanlon, J.F.
National Highway Traffic Safety Administration, November 1993. 133 pp.
(Available from NHTSA, NTS30, 400 Seventh Street SW, Washington, DC 20590.)

The effects of marijuana smoking on actual driving performance are reviewed. Results are presented from one pilot and three actual driving studies, which were conducted between April 1990 and March 1992. Background information is presented about marijuana, its pharmacological properties, the prevalence of its use, and a review of marijuana smoking and traffic safety. The studies of the program are described and certain procedures that were common to all studies are discussed, including subject recruiting, compliance with ethical and legal standards, screening for the presence of other illicit drugs and alcohol, blood sampling procedures, and quantitative analyses. The results of the pilot study are presented; this study was conducted in a hospital under strict medical supervision to identify THC doses that recreational marijuana users were likely to consume before driving. This study provided the opportunity for obtaining valuable information about THC pharmacokinetics and its pharmacodynamic effects after marijuana smoking. The first driving study was conducted on a highway closed to other traffic to determine whether it would be safe to repeat the study on a normal highway in the presence of other traffic and to define the dose-effect relationship between inhaled THC dose and driving performance. The second study was conducted to come a step closer to driving reality, with driving tests conducted on a highway in the presence of other traffic. The major objective of this study was to confirm the relationship between inhaled THC dose and lateral position variability in the context of a standard road tracking test. The program then proceeded into the third driving study, which involved tests conducted in high density urban traffic.

Abuse and Addictive Potential

Progression to Regular Marijuana Involvement: Phenomenology and Risk Factors for Near-Daily Use
Kandel, D.B.; Davies, M.
In: Vulnerability to Drug Abuse, M.D. Glantz, and R.W. Pickens (Eds.), pp. 211-254.
Washington, DC: American Psychological Association, 1992. 533 pp.
(Available from the APA Order Department, P.O. Box 2710, Hyattsville, MD 20784)

Heavy drug involvement is a phenomenon of late adolescence and early adulthood. A surprisingly high proportion of those who ever experiment with marijuana go on to regular use. However, most such users relinquish this pattern of use and shift to more episodic consumption. The rates of substance abuse that meet diagnostic criteria are highest in those in their twenties. The findings that delinquent participation and high educational aspirations both predict marijuana initiation suggest that there may be two groups of young people who start experimenting with illicit drugs. Important differences can be observed in the factors that predict onset and those that predict escalation to regular marijuana use. Academic performance plays a protective role for the escalation to regular use. Bonding to family appears to be especially important in the phase of initiation to marijuana use.

Variability in Subjective Responses to Marijuana: Initial Experiences of College Students
Davidson, E.S.; Schenk, S.
Addictive Behaviors 19(5):531-538, 1994

A short self-report questionnaire that probed initial and most recent experiences with marijuana was administered to 197 undergraduate psychology students. Measures of Global Positive and Global Negative responses to marijuana use were obtained. There was substantial variability in the response to marijuana on both of these scales, which were moderately correlated with each other. The self-reported Global Positive score for initial use of marijuana was correlated with latency to next use of marijuana and with lifetime use of the drug, suggesting that abuse potential of the drug is related to magnitude of initial positive effect. Self-reported Global Negative scores for initial use did not correlate with either of these outcome measures. These data are compared with those from a study that examined these responses to cocaine. The findings suggest that the abuse potential for both of these drugs is related to the magnitude of the positive response to first use.

Adult Marijuana Dependence
Stephens, R.S.; Roffman, R.A.
In: Addictive Behaviors Across the Life Span: Prevention, Treatment, and Policy Issues, J.S. Baer, G.A. Marlatt and R.J. McMahon (Eds.), pp. 202-219. Newbury Park, CA: SAGE Publications, 1993. 358 p.
(Available from SAGE Publications, Inc., 2455 Teller Road, Newbury Park, CA 91320)

A significant adult marijuana dependent population exists and is in need of treatment intervention. Most of these individuals do not appear to be abusing alcohol or drugs, although epidemiological studies are needed to address the prevalence of both marijuana and polydrug problems. A specific treatment focus on marijuana dependence may be more attractive to marijuana users because it avoids negative connotations associated with community drug abuse treatment programs. It also allows attention to issues that may be relatively unique to marijuana dependence. Marijuana dependent clients are likely to be struggling to reconcile beliefs and feelings about drug use that developed in the more tolerant decades of the 1960s and 1970s with the current war on drugs. The demographic characteristics and types of problems reported by marijuana users seeking treatment suggest a largely functional group, perhaps held back by their sole reliance on marijuana for coping, who nonetheless experience little objective evidence of the negative effects of marijuana in their lives. Treatments need to foster a greater awareness of the personal dissatisfaction with marijuana use and the significant ways in which it limits the lifestyles of those dependent on it. The relapse prevention support groups described for marijuana dependent adults are based primarily on a cognitive behavioral model that emphasizes the acquisition of coping skills to deal with high-risk situations and the modification of lifestyle to reduce temptation; however, this active change is preceded by consciousness-raising exercises designed to increase motivation and commitment to the change process. Similarly, it is followed with increased attention to rationalization and denial processes that may set the individual up for a relapse and to the cognitive-affective aftermath of a single lapse that may further promote relapse. Throughout each of these stages, social support processes are enlisted to bolster motivation and establish alternative reward systems. An initial study of outcomes following participation in this relapse prevention group treatment supports its efficacy.

Testing the Abstinence Violation Effect Construct with Marijuana Cessation
Stephens, R.S.; Curtin, L.; Simpson, E.E.; Roffman, R.A.
Addictive Behaviors: An International Journal 19(1):23-32, 1994

It has been proposed that internal, stable, and global attributions for the cause of a lapse following a period of abstinence and concomitant feelings of guilt and loss of control increased the probability of a return to regular substance use. The Abstinence Violation Effect (AVE) hypotheses were tested in a sample of 75 adult marijuana users who reported a lapse into marijuana use following completion of either a relapse prevention (RP) or social support group treatment aimed at abstinence. Results showed that more internal, stable, and global attributions for the cause of the lapse and perceived loss of control were related significantly to concurrently reported relapse. Further, internal and global attributions predicted marijuana use during the subsequent 6 months. Results are discussed in terms of support for the AVE construct, treatment implications, and the failure of the RP treatment to modify reactions to a lapse.

International/Cross-Cultural Perspectives

Cross-Cultural Comparison of Students' Connotative Meanings for Alcohol, Marijuana, Cocaine, and Hashish
Manning, B.; Tuguz, H.K.
Journal of Alcohol and Drug Education 38(1):86-97, 1992

This study was an exploration of the usefulness of the semantic differential technique as a means of comparing connotative meanings of alcohol, cocaine, hashish and marijuana held by Indonesian and American graduate students. Significant differences were found between Indonesian and American subjects on six adjective pairs for alcohol, for marijuana on four adjective pairs, and for cocaine and hashish on three adjective pairs. Indonesians and Americans also differed in their identification of the four study substances as "strong" or "weak," "modern" or "traditional," "aggressive" or "passive," "unacceptable" or "acceptable," and "stimulating" or "boring." The significance of these differences for prevention and intervention programs is discussed.

Psychosocial Correlates of Alcohol, Tobacco and Cannabis Use: Findings from a Nigerian University
Adelekan, M.L.; Abiodun, O.A.; Imouokhome-Obayan, A.O.; Oni, G.A.; Ogunremi, O.O.
Drug and Alcohol Dependence 33(3):247-256, 1993

The possible correlates of alcohol, tobacco, and cannabis use were investigated in a survey conducted among undergraduate students of the University of Ilorin, Nigeria. Factors that emerged as common correlates to the three substances investigated were peer influence, self-reported poor mental health, religiosity, parental/guardian supervision, perceived availability, and perceived harmfulness. In addition, drinking and smoking were found to be more common among males and among respondents who reported study difficulty. There was also a significant positive relationship between cannabis use and polygamous family background and belonging to an older age group. Although the data used in the analysis is limited due to its cross-sectional nature, the observations made are useful enough for the formulation of primary prevention strategies. A further and more elaborate longitudinal survey is, however, suggested.

Public Opinion and the Legal Status of Marijuana in Australia
Makkai, T.; McAllister, I.
Journal of Drug Issues 23(3):409-427, 1993

Since the late 1950s, when the medical use of heroin was banned in Australia, government policy toward marijuana has been based on prohibition. Despite an upsurge in the use of marijuana in the 1960s, government policy has remained virtually unchanged, except for the introduction of the expiation notice in South Australia in 1986. The authors use a wide range of opinion poll data to show that attitudes toward marijuana have remained stable over the past two decades, although the most recent data suggest that public support for reform of the legal status of marijuana may be increasing. There are notable differences in opinion between sociodemographic groups, with men, the young, and those who have been exposed to marijuana being more likely to support reform. The authors argue that as more people who have been exposed to marijuana enter the electorate and as New Politics issues become more prominent, the legal status of marijuana could become a political party issue. Data collected during the 1990 Federal election among candidates suggest that the potential for political party conflict already exists.

Illicit Drug Use, Harm Reduction and the Community: Attitudes to Cannabis Law and Needle and Syringe Provision in Western Australia
Lenton, S.
Curtin University of Technology. May 1994. 100 p.
(Available from Curtin University of Technology, Kent Street, Bentley, West Australia 6102)

This report contains the results of a telephone survey conducted in Western Australia in December 1993. The survey was conducted to determine the knowledge and attitudes of the Australian general public regarding the provision of needles and syringes to injecting drug users, and the possibility of changing the laws relating to cannabis, as strategies to reduce the harm associated with illegal drug use in the community. The majority of respondents broadly understood the rationale behind the harm reduction approach, agreed with its principles, and were even more supportive when the rationale was explained. The majority of the sample were aware of the potential for spread of blood-borne viruses, notably HIV, through the sharing of injecting equipment and were supportive of providing needles to drug injectors, and changing the laws related to cannabis possession and use. This support existed across the political spectrum, and from both metropolitan and country respondents.

Use of Marijuana and Other Drugs by College Students of Sao Paulo, Brazil
Silva, M.T.A.; Barros, R.S.; de Magalhae, M.P.
The International Journal of the Addictions 29(8):1045-1056, 1994

Drug usage in a sample of 1,069 college students of Sao Paulo, Brazil, was investigated. The highest lifetime prevalence was reported for alcohol (82 percent) and tobacco (39 percent) followed by inhalants (28 percent), marijuana (26 percent), over-the-counter tranquilizers and stimulants (17 percent), and cocaine (10 percent). Current use is considerably smaller. Marijuana users were classified as having a "Stable, " "Descending," and "Once" pattern of consumption frequency. These patterns were orderly related to gender, socioeconomic status, use of drugs, drug approval, and peer group. Drug usage appeared as predominately social-recreational in this population, although the risk of misuse for "Stable" students should be evaluated.

Prevention

Comparison of Methods for Alcohol and Marijuana Anticipatory Guidance with Adolescents
Rickert, V.I.; Graham, C.J.; Fisher, R.; Gottlieb, A.; Trosclair, A.; Jay, M.S.
Journal of Adolescent Health 14(3):225-230, 1993

Methods of alcohol and marijuana guidance for adolescents are compared. The research sample included 89 male and female low-to-middle income adolescents, ranging in age from 13 to 18 years, who were attending a general medical clinic. The subjects were randomly assigned to one of three conditions: no treatment; physician-delivered anticipatory guidance; or computer-assisted instruction. The following results of the study were seen: (1) significant main effects for group and sex, with those in the intervention groups and males more knowledgeable; (2) females were more satisfied with the computer-assisted instruction; and (3) males were more satisfied with anticipatory guidance. It is concluded that the use of computer technology can be effective and efficient for adolescent guidance and that anticipatory guidance, in the form of educational information provided by a physician, may be an important intervention component that may minimize health-risk behaviors.

Do Drug Prevention Effects Persist into High School? How Project ALERT Did with Ninth Graders Bell, R.M.; Ellickson, P.L.; Harrison, E.R.
Preventive Medicine 22(4):463-483, 1993

This article reports follow-up results during grade 9 for a multisite drug prevention program that curbed both marijuana and cigarette use during junior high. Based on the social influence model of prevention, the curriculum sought to motivate young people against drug use and to teach them skills for resisting pro-drug pressures. Thirty schools drawn from eight urban, rural, and suburban communities in California and Oregon were randomly assigned to three experimental conditions, two treatment groups and one control. Students in 20 schools received 11 lessons, 8 during grade 7 and 3 in grade 8; in 10 of the treatment schools, older teens assisted an adult teacher in program delivery. Students were pretested prior to the program (grade 7) and post-tested 24 months later (grade 9). Earlier effects on cognitive risk factors (perceived consequences of drug use, normative beliefs, resistance self-efficacy, and expectations of future use) persisted through grade 9 in the teen leader schools; in the condition under which adults taught the lessons without teens, the prior beneficial effects on beliefs largely eroded. All of the earlier effects on actual use disappeared by grade 9, regardless of who taught the lesson. Continued reinforcement of earlier lessons may be required to sustain prevention gains through the transition to high school.

Stages of Drug Use Acquisition Among College Students: Implications for the Prevention of Drug Abuse
Werch, C.E.; Meers, B.W.; Farrel, J.
Journal of Drug Education 23(4):375-386, 1993

This study examined the stages of drug use acquisition among college students and the relationship between stage status and motivation to avoid drugs and the frequency of drug use. Six hundred and sixty-nine students from a mid-size public university were selected to participate in the survey. College students were found to differ with regard to their stage of habit acquisition across five drugs. Stage status for a particular drug was associated with motivation to avoid that drug, with less motivation generally being related to greater stage advancement. Stage of acquisition for certain drugs was also found to be related to the frequency of use of other drugs, with alcohol and marijuana stage status being associated with the consumption of the greatest number of drugs. These results suggest that an acquisition stage heuristic holds promise in increasing our understanding of important developmental stages of drug use.

CSAP Resource Guide: Marijuana
Section 3 -- Groups, Organizations, & Programs

Marijuana Anonymous World Services
P.O. Box 2912
Van Nuys, CA 91404
800-766-6779

National Clearinghouse for Alcohol
and Drug Information (NCADI)
P.O. Box 2345
Rockville, MD 20847
301-468-2600, 800-729-6686
http://ncadi.samhsa.gov

National Council on Alcoholism
and Drug Dependence (NCADD)
12 West 21st Street
New York, NY 10010
Tel: 212-206-6770
http://www.ncadd.org

National Crime Prevention Council
1700 K Street NW, 2nd Floor
Washington, DC 20006
202-466-6272

National Drug Information
Center of National Families in Action
2296 Henderson Mill Road
Suite 300
Atlanta, GA 30345-2739
770-934-7137

National Family Partnership
9220 Southwest Barbur Blvd.
#119-284
Portland, OR 97219
503-768-9659

National Head Start Association
1651 Prince Street
Alexandria, VA 22314
703-739-0875

National PTA Drug and Alcohol
Abuse Prevention Project
330 North Wabash Avenue
Suite 2100
Chicago, IL 60611-3690
312-670-6782

National Urban League, Inc.
Substance Abuse Programs
120 Wall Street
New York, NY 10005
212-558-5300

Office of Minority Health
Resource Center
P.O. Box 37337
Washington, DC 20013-7337
800-444-6472

Parents' Resource Institute for
Drug Education, Inc. (PRIDE)
3610 Dekalb Technology Parkway
Suite 105
Atlanta, GA 30340
770-458-9900
800-853-7867

CSAP Resource Guide: Marijuana
Section 4 -- Internet Access Sites

Federal Resources

The Centers for Disease Control
and Prevention (CDC)
http://www.cdc.gov/cdc.aspx

Federal Bureau of Investigation (FBI)
http://naic.nasa.gov/fbi/fbi_homepage.aspx

National Health Information Center (NHIC)
http://nhic-nt.health.org

National Institutes of Health
gopher://gopher.nih.gov
http://www.nih.gov

National Library of Medicine (NLM)
gopher://gopher.nlm.nih.gov
http://www.nlm.nih.gov

National Clearinghouse for Alcohol
and Drug Information (NCADI) PREVLINE
http://ncadi.samhsa.gov

National Institute on Drug Abuse
http://www.nida.nih.gov

United Nations Crime and Justice
Information Network (UNCJIN)
gopher://uacsc2.albany.edu/11/newman
United Nations International Drug Control Programme
http://www.ccsa.ca

US Department of Justice
WWW Server
http://www.usdoj.gov
gopher://gopher.usdoj.gov

Other Resources

Canadian Centre on Substance Abuse
http://www.ccsa.ca/

Center for Injury Research and Control,
University of Pittsburgh
http://www.pitt.edu/~hweiss/injury

The Center For Substance Abuse Research
(CESAR at the University of Maryland)
http://www.bsos.umd.edu/cesa/cesar.aspx

Family World HomePage
http://family.com/homepage.aspx

GMU Higher Education—Vision
gopher://vision.gmu.edu/
http://vision.gmu.edu/

Join Together Online
http://www.jointogether.org/jointogether. html

Men's Issues Page
http://www.vix.com/men

Natural Highs
http://homepage.seas.upenn.edu/~lzeltser/
natural_highs.aspx

ParentsPlace.Com Home Page
http://www.parentsplace.com/default.aspx

World Health Organization (WHO)
gopher://gopher.who.ch
http://www.who.ch

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