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BACKGROUND: There is concern about the cognitive consequences of marijuana consumption. AIM: To assess the influence of current and past marijuana use and frequency on verbal learning and memory in a sample of adults aged 21 years old. MATERIAL AND METHODS: Marijuana use was assessed using a clinician administered interview in 654 participants (56% females), who reported frequency of use, age of first use and whether its use led to problems in their lives. The CogState International Shopping List was administered to assess learning and memory. RESULTS: Seventy percent reported ever using marijuana, 46% consuming during the past year and 27% during the past 30 days. The latter scored significantly lower on delayed recall. Current and frequent use were significantly associated with lower accuracy in verbal learning and memory. CONCLUSIONS: In this cohort of adults aged 21 years old, marijuana use was prevalent and related to worse verbal memory.

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ABSTRACT Background: There is concern about the cognitive consequences of marijuana consumption. Aim: To assess the influence of current and past marijuana use and frequency on verbal learning and memory in a sample of adults aged 21 years old. Material and Methods: Marijuana use was assessed using a clinician administered interview in 654 participants (56% females), who reported frequency of use, age of first use and whether its use led to problems in their lives. The CogState International Shopping List was administered to assess learning and memory. Results: Seventy percent reported ever using marijuana, 46% consuming during the past year and 27% during the past 30 days. The latter scored significantly lower on delayed recall. Current and frequent use were significantly associated with lower accuracy in verbal learning and memory. Conclusions: In this cohort of adults aged 21 years old, marijuana use was prevalent and related to worse verbal memory.

Antecedentes: Existe preocupación acerca de los efectos cognitivos del consumo de marihuana. Objetivo: Estudiar el efecto de consumo de marihuana presente o pasado en la capacidad de aprendizaje verbal y memoria en una muestra de adultos de 21 años. Material y Métodos: El consumo de marihuana fue evaluado mediante una entrevista médica en 654 adultos de 21 años (56% mujeres), quienes informaron acerca de la frecuencia de consumo, edad de comienzo y si el consumo les ha causado problemas en sus vidas. Se les administró el Cogstate International Shopping List para evaluar aprendizaje y memoria. Resultados: El 70% informó haber consumido marihuana alguna vez, 46% la usó durante el último año y el 27% en los últimos 30 días. Estos últimos tuvieron un menor puntaje en memoria tardía. El consumo actual y frecuente se asoció a una menor precisión en la capacidad de aprendizaje verbal y memoria. Conclusiones: En esta cohorte de adultos de 21 años, el consumo de marihuana fue prevalente y relacionado a una menor memoria verbal.

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INTRODUCTION: The use of alcohol and other drugs among medical students has been a theme of growing interest and concern on the part of researchers, teaching institutions and medical associations since the decade of the 1960's. OBJECTIVE: Recent use of alcohol, tobacco, tranquillisers, amphetamines, cannabis, organic solvents, and cocaine among 456 medical students was surveyed. METHOD: Assessment was done by means of a self-report questionnaire according to World Health Organisation guidelines. RESULTS: Among medical students, after alcohol and tobacco, cannabis and solvents are the most frequently used psychoactive substances. As such, they were the most deeply analysed drugs in this study. Factors associated with the recent use of cannabis and solvents were established by logistic regression. Living with parents or a companion appeared as a protective factor for the use of cannabis. However, being male and regularly participating in the activities at the campus Sports Association showed as risk factors for the use of both cannabis and solvents. DISCUSSION: Concepts and misconceptions concerning protective and risk factors must be discussed in the light of cultural and circumstantial interferences. Harm reduction strategies should be seriously considered.

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CONTEXTO: Hepatotoxidade é uma complicação potencial do uso de várias drogas ilícitas, possivelmente como conseqüência do seu metabolismo hepático. Entretanto, informações sobre tal possibilidade são escassas na bibliografia médica. OBJETIVO: Estudar a ocorrência de alterações clínicas e laboratoriais hepáticas que podem ocorrer em usuários crônicos de maconha, isoladamente ou associadas ao uso de outras drogas lícitas e ilícitas. TIPO DE ESTUDO: estudo transversal LOCAL: Hospital Espírita de Marília, Marília - SP, Brasil. PARTICIPANTES: Foram estudados 123 pacientes, internados no Hospital Espírita de Marília de outubro de 1996 a dezembro de 1998, divididos em três grupos: 26 (21%) usuários exclusivamente de maconha, 83 (67,5%) usuários de maconha e crack e 14 (11,4%) usuários de maconha e álcool. PROCEDIMENTOS E VARIAVEIS ESTUDADAS: Os pacientes foram examinados clinicamente, com especial ênfase nos aspectos relativos aos tipos de drogas usadas e rotas de usos, idade de início do uso, tempo e padrão de uso, presença ou ausência de tatuagem, icterícia, hepatomegalia e esplenomegalia. Foram determinados os níveis séricos de proteínas totais, albumina, globulina, bilirrubina total e frações, aspartato-aminotransferase (AST), alanina-aminotransferase (ALT), fosfatase alcalina (FA), gama-glutamiltransferase e atividade da protrombina. RESULTADOS: Entre os usuários exclusivos de maconha foram observados hepatomegalia em 57,7% e esplenomegalia em 73,1% dos casos, e estavam discretamente elevadas a AST (42,3%), ALT (34,6%) e FA (53,8%). Os três grupos não diferiram significativamente nas prevalências de hepatomegalia, esplenomegalia e hepatoesplenomegalia. No grupo maconha/álcool foram observadas as maiores prevalências de alterações e níveis mais elevados das aminotransferases. Os níveis médios da fosfatase alcalina estavam acima do valor normal em todos os grupos. CONCLUSÕES: O uso crônico de maconha, exclusivo ou associado a outras drogas, associou-se a alterações morfológicas e enzimáticas hepáticas, sugerindo serem os canabinóides substâncias possivelmente hepatotóxicas.

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We evaluated alcohol and psychiatric disorders as risk factors for the pattern of drug abuse/dependence in a matched case-control study (370 adults). Cases (drug abusers) and controls were selected in the community using the snowball technique and matched by sex, age, and friendship. Information was gathered using the "Composite International Diagnostic Interview" (CIDI). Three patterns of drug abuse/dependence were evaluated: any drug abuse/dependence, only cannabis, and cocaine and other drugs. Logistic conditional regression showed that alcohol dependence was strongly associated with pattern of drug abuse/dependence. Thus, compared to the "no drug abuse group", the odds ratio for association with diagnosis of abuse/dependence on cocaine and other drugs was 10.2 (95% CI: 4.9-21.2), whereas for abuse/dependence on cannabis only, the odds ratio was 1.0. For affective disorders, the odds ratio was 2.0 (95% CI: 1.10-3.64) for the group that received a diagnosis of abuse/dependence on cocaine and other drugs, whereas no association was found for those with abuse/dependence on cannabis only. In conclusion, there is not a homogeneous group of "drug users", and the role of risk factors depends on the drug use pattern.

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Se revisan los aspectos fundamentales del uso de la marihuana, a la luz del conocimiento actual, junto a los aspectos clínicos descritos por el Profesor Armando Roa sistematizados en su libro La Marihuana; se comenta sobre la importancia de su aporte a la clínica de este fenómeno

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Cannabis has been used in this country for more than a century. At one time regarded as harmless, it has come to be associated with apathy and laziness on the one hand and "madness" and violence on the other. While opinions differ about this drug, there are sufficient pointers that should warrant comprehensive research into the extent of the problem, and programmes to detect and rehabilitate the chronic user. (AU)

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