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WHO Project on Health Implications of Cannabis Use:

A Comparative Appraisal of the Health and Psychological Consequences of Alcohol, Cannabis, Nicotine and Opiate Use

V. CONCLUSIONS

There are health risks of cannabis use, most particularly when it is used daily over a period of years or decades. Considerable uncertainty remains about whether these effects are attributable to cannabis use alone, and about what the quantitative relationship is between frequency, quantity and duration of cannabis use and the risk of experiencing these effects. Using analogies with the known effects of alcohol and tobacco, the most probable of the health risks of chronic heavy cannabis use over a period of years are; the development of a dependence syndrome; an increased risk of being involved in motor vehicle accidents; an increased risk of developing chronic bronchitis; an increased risk of respiratory cancers; an increased risk of giving birth to low birth weight babies when used during pregnancy; and perhaps, an increased risk of developing schizophrenia among those who are vulnerable. Many of these risks are shared with alcohol and tobacco, which is not surprising given that cannabis is an intoxicant like alcohol which is typically smoking like tobacco.

On existing patterns of use, cannabis poses a much less serious public health problem than is currently posed by alcohol and tobacco in Western societies. This is no cause for complacency, however, as the public health significance of alcohol and tobacco are major, and the public health significance of cannabis could increase if the prevalence of its heavy daily use were to approach that of heavy alcohol use among young adults, or the prevalence of daily cigarette smoking among adults.

REFERENCES

Addiction Research Foundation/World Health Organization (1981) Report of an ARF/WHO Scientific Meeting on the Adverse Health and Behavioral Consequences of Cannabis Use. Addiction Research Foundation, Toronto.

Allebeck, P. (1991) Cannabis and schizophrenia: is there a causal association? In G.G. Nahas and C. Latour (Eds) Physiopathology of Illicit Drugs: Cannabis, Cocaine, Opiates Pergamon Press, Oxford.

Allebeck, P., Adamsson, C., Engstrom, A. and Rydberg, U. (1993) Cannabis and schizophrenia: a longitudinal study of cases treated in Stockholm county. Acta Psychiatrica Scandinavica, 88, 21-24.

American Psychiatric Association. (1987) Diagnostic and Statistical Manual of Mental Disorders (DSM-II-R). (3rd Edition, Revised) Washington: American Psychiatric Association.

Andreasson, S., Allebeck, P. and Rydberg, U. (1989) Schizophrenia in users and nonusers of cannabis. Acta Psychiatrica Scandinavica, 79, 505-510.

Andreasson, S., Allebeck, P., Engstrom, A. and Rydberg, U. (1987) Cannabis and schizophrenia: A longitudinal study of Swedish conscripts. Lancet, 2, 1483-1486.

Andreasson, S. and Allebeck, P. (1990) Cannabis and mortality among young men: A longitudinal study of Swedish conscripts. Scandinavian Journal of Social Medicine, 18, 9-15.

Angrist, B. (1983) Psychoses induced by central nervous system stimulants and related drugs. In I. Creese (ed) Stimulants: Neurochemical, Behavioral and Clinical Perspectives. Raven Press, New York.

Anthony, J.C. and Helzer, J.E. (1991) Syndromes of drug abuse and dependence. In L.N. Robins and D.A. Regier (eds) Psychiatric Disorders in America. Free Press, MacMillan, New York.

Arndt, S., Tyrrell, G., Flaum, M. and Andreasen, N.C. (1992) Comorbidity of substance abuse and schizophrenia: the role of premorbid adjustment. Psychological Medicine, 22, 379-388.

Baumrind, D. (1983) Specious causal attribution in the social sciences: the reformulated stepping stone hypothesis as exemplar. Journal of Personality and Social Psychology, 45, 1289-1298.

Baumrind, D. and Moselle, K.A. (1985) A developmental perspective on adolescent drug abuse. Advances in Alcohol and Substance Abuse, 5, 41-67.

Belkin, B.M. and Gold, M.S. (1991) Opioids. pp. 537-547 in N.S. Miller (Ed.), Comprehensive Handbook of Drug and Alcohol Addiction, New York: Marcel Dekker.

Bell, D. (1973) The experimental reproduction of amphetamine psychosis. Archives of General Psychiatry, 29, 35-40.

Bland, R.C., Newman, S.C. and Orn, H. (1987) Schizophrenia: lifetime co-morbidity in a community sample. Acta Psychiatrica Scandinavica, 75, 383-391.

Bloch, E. (1983) Effects of marijuana and cannabinoids on reproduction, endocrine function, development and chromosomes. In K.O. Fear and H. Kalant (eds) Cannabis and Health Hazards. Addiction Research Foundation, Toronto.

Block, R.I., Farnham, S., Braverman, K., Noyes, R., Jr. and Ghoneim, M.M. (1990). Long-term marijuana use and subsequent effects on learning and cognitive functions related to school achievement: preliminary study. In J.W. Spencer and J.J. Boren (Ed.), Residual Effects of Abused Drugs on Behavior, National Institute on Drug Abuse Research Monograph 101 Rockville, MD: U.S. Department of Health and Human Services.

Bloom, J.W., Kaltenborn, W.T., Paoletti, P., Camilli, A. and Lebowitz, M.D. (1987) Respiratory effects of non-tobacco cigarettes. British Medical Journal, 295, 1516-1518.

Bondy, S. (1994) Self-reported harm from alcohol, tobacco and marijuana use: Ontario 1992/94. Working paper. Toronto: Addiction Research Foundation.

Breakey, W.R., Goodell, H., Lorenz, P.C. and McHugh, P.R. (1974) Hal,ucinogenic drugs as precipitants of schizophrenia. Psychological Medicine, 4, 255-261.

Brill, N.Q. and Christie, R.L. (1974). Marihuana use and psychosocial adaptation: Follow-up study of a collegiate population. Archives of General Psychiatry, 31 713-719.

Brook, J.S., Cohen, P., Whiteman, M. and Gordon, A.S. (1992). Psychosocial risk factors in the transition from moderate to heavy use or abuse of drugs. In M. Glantz and R. Pickens (eds) Vulnerability to Drug Abuse. American Psychological Association, Washington.

Bruun, K. Edwards, G., Lumio, M., Makela, K., Pan, L., Popham, R.E., Room, R., Schmidt, W., Skog, O.J., Sulkunen, P. & Osterberg, E. (1975) Alcohol Control Policies in Public Health Perspective, Volume 25, Helsinki: Finnish Foundation for Alcohol Studies.

Caplan, G.A. and Brigham, B.A. (1989) Marijuana smoking and carcinoma of the tongue. Is there an association? Cancer, 66, 1005-1006.

Carter, W.E., Coggins, W. and Doughty, P.L. (1980) Cannabis in Costa Rica: A study of chronic marihuana use. Institute for the Study of Human Issues, Philadelphia.

Caviston, P. (1987) Pregnancy and Opiate Addiction. British Medical Journal, 295, 285-286.

Chait, L.D. & Pierri, J. (1992) Effects of smoked marijuana on human performance: A critical review. In A. Murphy & J. Bartke (Eds) Marijuana/Cannabinoids: Neurobiology and Neurophysiology, CRC, Boca Raton.

Chesher, G., Lemon, J., Gomel, M. and Murphy, G. The effects of methadone, as used in a methadone maintenance program, on driving-related skills. National Drug and Alcohol Research Centre Technical Report Number 3. National Drug and Alcohol Research Centre, Sydney, 1989.

Chopra, G.S. and Smith, J.W. (1974) Psychotic reactions following cannabis use in East Indians. Archives of General Psychiatry, 30, 24-27.

Cimbura, G., Lucas, D.M., Bennet, R.C., Warren, R.A. and Simpson, H.M. (1982) Incidence and toxicological aspects of drugs detected in 484 fatally injured drivers and pedestrians in Ontario. Journal of Forensic Science, 27, 855-867.

Cleghorn, J.M., Kaplan, R.D., Szechtman, B., Szechtman, H., Brown, G.M. and Franco, S. (1991) Substance abuse and schizophrenia: effect on symptoms but not on neurocognitive function. Journal of Clinical Psychiatry, 52, 26-30.

Cohen, S. (1982) Cannabis effects upon adolescent motivation. In National Institute on Drug Abuse. Marijuana and Youth: Clinical Observations on Motivation and Learning. National Institute on Drug Abuse. Rockville, Maryland.

Compton, D.R., Dewey, W.L. and Martin, B.R. (1990) Cannabis dependence and tolerance production. Advances in Alcohol and Substance Abuse, 9, 128-147.

Connell, P.H. (1959) Amphetamine Psychosis. Maudsley Monograph Number 5, Institute of Psychiatry, Oxford University Press, London.

Consensus Report, C.D.P. Research Technology Branch, National Institute on Drug Abuse. (1985) Drug concentrations and driving impairment. Journal of the American Medical Association, 254(18), 2618-2621.

Cook, P.J. and Moore, M.J. (1993) Economic perspectives on reducing alcohol-related violence. Pp. 193-212 in S.E. Martin (ed) Alcohol and interpersonal Violence: Fostering Multidisciplinary Perspectives. NIAAA Research Monograph 24, NIH Publication No. 93-3496, Department of Health and Human Services.

Day, N.L., Wagener, D.K. and Taylor, P.M. (1985) Measurement of substance use during pregnancy: methodologic issues. In T.M. Pinkert (ed) Current Research on the Consequences of Maternal Drug Abuse. NIDA Research Monograph No 59, Department of Health and Human Services.

Day, N.L., Richardson, G.A., Goldschmidt, L., Robles, N., Taylor, P.M., Stoffer, D.S., Cornelius, M.D. and Geva, D.D. (in press) The effect of prenatal marijuana exposure in the cognitive development of offspring at age three. Neonatology and Teratology.

Der, G., Gupta, S. and Murray, R.M. (1990) Is schizophrenia disappearing? Lancet, 1, 513-516.

Dixon, L., Haas, G., Wedien, P.J., Sweeney, J. and Frances, A.J. (1990) Acute effects of drug abuse in schizophrenic patients: clinical observations and patients' self-reports. Schizophrenia Bulletin, 16, 69-79.

Dixon, L., Haas, G., Wedien, P.J., Sweeney, J. and Frances, A.J. (1991) Drug abuse in schizophrenic patients: clinical correlates and reasons for use. American Journal of Psychiatry, 148, 224-230.

Doll, R. and Peto, R. (1980) The Causes of Cancer. Oxford University Press, 1981.

Donald, P.J. (1991a) Marijuana and upper aerodigestive tract malignancy in young patients. In G. Nahas and C. Latour (eds) Physiopathology of Illicit Drugs: Cannabis, Cocaine, Opiates. Oxford, Pergamon Press.

Donald, P.J. (1991b) Advanced malignancy in the young marijuana smoker. In H. Freidman, S. Specter, and T.W. Klein (eds) Drugs of Abuse, Immunity, and Immunodeficiency. London, Plenum Press.

Donnelly, N. and Hall, W. (1994). Patterns of Cannabis Use in Australia. Review prepared for the Australian National Task Force on Cannabis.

Donovan, J.E., and Jessor, R. (1983) Problem drinking and the dimension of involvement with drugs: A Guttman Scalogram analysis of adolescent drug use. American Journal of Public Health, 73, 543-552.

Duggan, A.W. and North, R.A. (1983) Electrophysiology of opioids. Pharmacologic Reviews, 35, 219-282.

Duncan, D.F. (1987) Lifetime prevalence of "amotivational syndrome" among users and non-users of hashish. Psychology of Addictive Behaviors 1, 114-119.

Edwards, G. (1982) Cannabis and the question of dependence. Advisory Council on the Misuse of Drugs. Report of the Expert Group on the Effects of Cannabis Use. Home Office, London.

Edwards, G., Arif, A. & Hodgson, R. (1981) Nomenclature and classification of drug and alcohol related problems: A WHO memorandum. Bulletin of the World Health Organization, 59(2), 225-242

Edwards, G., Anderson, P., Babor, T.F., Casswell, S., Ferrence, R., Giesbrecht, N., Godfrey, C., Holder, H.D., Lemmens, P., Makela, K., Midanik, L.T., Norstrom, Osterberg, E, Romelsjo, Room, R., Simpura, J. and Skog, O-J. (1994) Alcohol Policy and the Public Good Oxford: Oxford University Press.

Fehr, K. O. and Kalant, H. (1983) (eds.) Cannabis and Health Hazards. Addiction Research Foundation, Toronto.

Fligiel, S.E.G., Beals, T. F., Venkat, H. , Stuth, S., Gong, H. and Tashkin, D. P. (1988) Pulmonary pathology in marijuana smokers. In G. Chesher, P. Consroe, and R. Musty (eds) Marijuana: An International Research Report. National Campaign Against Drug Abuse Monograph Number 7, Australian Government Publishing Service, Canberra.

Fried, P.A. (1980) Marijuana use by pregnant women: Neurobehavioural effects in neonates. Drug and Alcohol Dependence, 6, 415-424.

Fried, P.A. (1982) Marijuana use by pregnant women and effects on offspring: an update. Neurobehavioral Toxicology and Teratology, 4, 451-454.

Fried, P.A. (1985) Postnatal consequences of maternal marijuana use. In T. M. Pinkert (ed.) Current Research on the Consequences of Maternal Drug Abuse. NIDA Research Monograph No. 59, Department of health and Human Services.

Fried, P.A. (1986) Marijuana and human pregnancy. In I. Chasnof (Ed.) Drug Use in Pregnancy: Mother and Child. MAP Press, Lancaster.

Fried, P.A. (1989) Postnatal consequences of maternal marijuana use in humans. Annals of the New York Academy of Sciences, 562, 123-132.

Fried, P.A. (1993) Prenatal exposure to tobacco and marijuana: Effects during pregnancy, infancy and early childhood. Clinical Obstetrics and Gynecology, 36, 319-337.

Fried, P.A. and Watkinson, B. (1990) 36- and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes and alcohol. Development and Behavioral Pediatrics, 11, 49-58.

Fried, P.A., Buckingham, M. and Von Kulmiz, P. (1983) Marihuana use during pregnancy and perinatal risk factors. American Journal of Obstetrics and Gynecology, 146, 992-992.

Fried, P.A., O'Connell and Wakinson, B. (1992) 60- and 72-month follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol: cognitive and language assessment. Developmental and Behavioral Pediatrics, 13, 383-391.

Gawin, F. H. and Ellinwood, E.H. (1988) Cocaine and other stimulants: Actions, abuse and treatment. New England Journal of Medicine, 318, 1173-1182.

Ghodse, A.H. (1986) Cannabis psychosis. British Journal of Addiction, 81, 473-478.

Gieringer, D.H. (1988) Marijuana, driving and accident safety. Journal of Psychoactive Drugs, 20, 93-101.

Gibson, G.T., Baghurst, P. A. and Colley, D.P. (1983) Maternal alcohol, tobacco and cannabis consumption and the outcome of pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology, 23, 15-19.

Goldberg, L. (1968a) Drug abuse in Sweden. Part I. Bulletin on Narcotics, 20, 91), 1-31. (a)

Goldberg, L. (1968b) Drug abuse in Sweden. Part II. Bulletin on Narcotics, 20, (2) 9-36. (b)

Gong, H., Fliegel, S., Tashkin, D.P. and Barbers, R.G. 91987) Tracheobronchial changes in habitual, heavy smokers of marijuana with and without tobacco. American Review of Respiratory Disease, 136, 142-149.

Goode, E. (1974) Marijuana use and the progression to dangerous drugs. In L.L. Miller (Ed.) Marijuana: Effects on Human Behavior. Academic Press, New York.

Greenland, S., Staisch, K.J., Brown, N. and Gross, S.J. (1982a) The effects of marijuana use during pregnancy. I. A preliminary epidemiologic study. American Journal of Obstetrics and Gynecology, 143, 408-413. (a)

Greenland, S., Staisch, K.J., Brown, N. and Gross, S.J. (1982b) Effects of marijuana on human pregnancy, labor and delivery. Neurobehavioral Toxicology and Teratology, 4, 447-450. (b)

Halikas, J.A., Weller, R.A., Morse, C. and Shapiro, T. (1982) Incidence and characteristics of amotivational syndrome, including associated findings, among chronic marijuana users. In National Institute on Drug Abuse. Marijuana and Youth: Clinical Observations on Motivation and Learning. National Institute on Drug Abuse. Rockville, Maryland.

Hall, W. (1995) The public health implications of cannabis use. Australian Journal of Public Health, 19, 235-242.

Hall, W., Solowij, N. and Lemon, J. (1994) Health and Psychological Consequences of Cannabis Use. Report to the National Taskforce on Cannabis.

Hatch, E.E. and Bracken, M.B. (1986) Effect of marijuana use in pregnancy on fetal growth. American Journal of Epidemiology, 124, 986-993.

Hawkins, J.D., Catalano, R.F. and Miller, J.Y. (1992) Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychological Bulletin, 112, 64-105.

Helzer, J.E., Burnham, A. and McEvoy, L.T. (1991) Alcohol abuse and dependence. In L.N. Robins and D.A. Regier (eds.) Psychiatric Disorders in America. Free Press, MacMillan, New York.

Henderson, R.L., Tennant, F.S., and Guerry, R. (1972) Respiratory manifestations of hashish smoking. Archives of Otolaryngology, 95, 248-251.

Hingson, R., Heeren, T., Mangione, T., Morelock, S. and Mucatel, M. (1982) Teenage driving after using marijuana or drinking and traffic accident involvement. Journal of Safety Research, 13, 33-37.

Hingson, R., Alpert, J., Day, N., Dooling, E., Kayne, H., Morelock, S., Oppenheimer, E. and Zuckerman, B. (1982) Effects of maternal drinking and marijuana use on fetal growth and development. Pediatrics, 70, 539-546.

Hollister, L.E. (1986) Health aspects of cannabis. Pharmacological Reviews, 38,1-20.

Hollister, L.E. (1992) Marijuana and immunity. Journal of Psychoactive Drugs, 24, 159-164.

Holman, C.D., Armstrong, B. et al (1988) The Quantification of Drug-Caused Morbidity and Mortality in Australia. Commonwealth Department of Community Services and Health.

Huber, G.L., Griffith, D.L. and Langsjoen, P.M. (1988) The effects of marihuana on the respiratory and cardiovascular systems. In G. Chesher, P. Consroe, and R. Musty (eds.) Marijuana: An International Research Report. National Campaign Against Drug Abuse Monograph Number 7, Australian Government Publishing Service, Canberra.

Institute of Medicine. (1982) Marijuana and Health. National Academy Press, Washington, DC.

International Agency on Cancer (1990) Cancer: Causes, Occurrence and Control. (Ed.) L. Tomatis. International Agency on Cancer, Lyon.

Jablensky, A., Sartorius, N., Ernberg, G., Anker, M., Korten, A., Cooper, J.E., Day, R. and Bertelsen, A. (1991) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization Ten-Country Study. Psychological Medicine Monograph Supplement No, 20. 1991.

Jacobs, M.R., and Fehr, L., O'B. (1987) Drugs and drug abuse: A Reference Text, Toronto: Addiction Research Foundation.

Jessor, R. and Jessor, S.L. (1977) Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth. New York, Academic Press.

Joe, G.W. and Simpson, D.D. (1987) Mortality rates among opioid addicts in a longitudinal study. American Journal of Public Heatlh, 77, 347-348.

Joe, G.W. and Simpson, D.D. (1990) Death Rates and Risk Factors, pp. 193-202 in S.B. Sells and B.S. Brown (Eds.), Opioid Addiction and Treatment: A 12-year Follow-up. Malabar FL: Robert E. Krieger Pub. Co., 1990.

Johnson, B.A., Smith, B.L. and Taylor, P. (1988) Cannabis and schizophrenia. Lancet, 1., 592-593.

Johnston, L.D., O'Malley, P.M. and Eveland, L.K. (1978) Drugs and delinquency: A search for causal connections. In D.B. Kandel (ed.) Longitudinal Research on Drug Use: Empirical Findings and Methodological Issues. John Wiley and Sons, New York.

Johnston, L.D., O'Malley, P.M. and Bachman, J.G. (1991) Drug Use Among American High School Seniors, College Students and Young Adults, 1975-1990. Volumes I and II. National Institute on Drug Abuse, Rockville MD.

Kandel, D.B. (1984) Marijuana users in young adulthood. Archives of General Psychiatry, 41, 200-209.

Kandel, D. and Faust, R. (1975) Sequence and stages in patterns of adolescent drug use. Archives of General Psychiatry, 32, 923-932.

Kandel, D.B., Davies, M., Karus, D. and Yamaguchi, K. (1986) The consequences in young adulthood of adolescent drug involvement. Archives of General Psychiatry, 1986, 43, 746-754.

Kandel, D.B. and Raveis, V.H. (1989) Cessation of illicit drug use in young adulthood. Archives of General Psychiatry, 46, 109-116.

Kandel, D.B. and Davies, M. (1992) Progression to regular marijuana involvement: Phenomenology and risk factors for near daily use. In M. Glantz and R. Pickens (eds.) Vulnerability to Drug Abuse. American Psychological Association, Washington.

Kaslow, R.A., Blackwelder, W.C., Ostrow, D.G.., Yerg, D., Palenick, J., Coulson, A.H. and Valdiserri, R.O. (1989) No evidence for a role of alcohol or other psychoactive drugs in accelerating immunodeficiency in HIV-1-positive individuals: A report form the Multicenter AIDS Cohort Study. Journal of the American Medical Association, 261, 4324-3429.

Knudsen, P. and Vilmar, T. (1984) Cannabis and neuoleptic agents in schizophrenia. Acta Psychiatrica Scandinavica, 69, 162-174.

Kolansky, H. and Moore, W.T. (1971) Effects of marihuana on adolescents and young adults. Journal of the American Medical Association, 216, 486-492.

Kuijten, R.R., Bunin, G.R., Nass, C.C. and Meadows, A.T. (1990) Gestational and familial risk factors for childhood astrocytoma: results of a case-control study. Cancer Research, 50, 2608-2612.

Lantner, I.L. (1982) Marijuana abuse by children and teenagers: a pediatrician's view. Cohen, S. (1982) Cannabis effects upon adolescent motivation. In National Institute on Drug Abuse. Marijuana and Youth: Clinical Observations on Motivation and Learning. National Institute on Drug Abuse. Rockville, Maryland.

Lenke, L. (1990) Alcohol and Criminal Violence -- Time Series Analyses in a Comparative Perspective. Almqvist and Wiksell, Stockholm.

Leuchtenberger, C. (1983) Effects of marihuana (cannabis) smoke on cellular biochemistry of in vitro test systems. In K.O. Fehr and H. Kalant (Eds.) Cannabis and Health Hazards. Addiction Research Foundation, Toronto.

Linn, L., Schoenbaum, S., Monson, R., Rosner, R., Stubblefield, P.C. and Ryan, K.J. (1983) The association of marijuana use with outcome of pregnancy. American Journal of Public Health, 73, 1161-1164.

Maddux, J.F. and Desmond, D.P. (1981) Careers of Opioid Users, New York: Praeger.

McBay, A.J. (1986) Drug concentrations and traffic safety. Alcohol, Drugs and Driving, 2, 51-59.

McGee, R.O. and Feehan, M. (1993) Cannabis use among New Zealand adolescents. New Zealand Medical Journal, 106, 345.

Martin, C.A. and Martin, W.R. (1980) Opiate dependence in women, pp. 465-486 in O. Kalant (Ed.) Alcohol and Drug Problems in Women: Research Advances in Alcohol and Drug Problems, Volume 5, New York: Plenum Press.

Martin, S.E. (Ed.) (1993) Alcohol and Interpersonal Violence: Fostering Multidisciplinary Perspectives. NIAAA Research Monograph 24, NIH Publication No. 93-3496, Department of Health and Human Services.

Martinez-Arevalo, M.J., Calcedo-Ordonez, A and Varo-Prieto, J.R. (1994) Cananbis consumption as a prognostic factor in schizophrenia. British Journal of Psychiatry, 164, 679-681.

Mason, A.P. and McBay, A.J. (1984) Ethanol, marijuana and other drug use in 600 drivers killed in single-vehicle crashes in North Carolina 1978-1981. Journal of Forensic Science, 29, 987-1026.

Malinger, G.D., Somers, R.H., Davidson, S.T. and Manheimer, D.I. (1976) The amotivational syndrome and the college student. Annals of the New York Academy of Sciences, 282, 37-55.

Moore, M.H. and Gerstein, D.K. (Eds.) (1981) Alcohol and Public Policy: Beyond the Shadow of Prohibition. National Academy Press, Washington.

Munson, A.E. and Fehr, K.O. (1983) Immunological effects of cannabis. In K.O. Fehr and H. Kalant (Eds.) Cannabis and Health Hazards. Addiction Research Foundation, Toronto.

Nahas, G.G. (1984) Toxicology and pharmacology. In G.G. Nahas Marihuana in Science and Medicine. New York, Raven Press.

Nahas, G. and Latour, C. (1992) The human toxicity of marijuana. Medical Journal of Australia, 156, 495-497.

National Institute on drug Abuse. (1992) National household survey on drug abuse: population estimates 1991 - Revised November 20, 1992. Rockville, MD: National Institute on Drug Abuse.

Neglia, J.P., Buckley, J.D. and Robinson, L.L. (1991) Maternal marijuana use and leukemia in offpsring. In G. Nahas (Eds.) Physiopathology of Illicit Drugs: Cannabis, Cocaine, Opiates. Oxford, Pergamon Press.

Negrete, J.C. (1989) Cannabis and schizophrenia. British Journal of Addiction, 84, 349-351.

Negrete, J.C., Knapp, W.P., Douglas, D. and Smith, W.B. (1986) Cannabis affects the severity of schizophrenic symptoms: results of a clinical survey. Psychological Medicine, 16, 515-520.

Newcombe, M.D. (1992) Understanding the multidimensional nature of drug use and abuse: The role of consumption, risk factors and protective factors. In M. Glantz and R. Pickens (Eds.) Vulnerability to Drug Abuse. American Psychological Association, Washington.

Newcombe, M.D. and Bentler, P. (1988) Consequences of Adolescent Drug Use: Impact on the Lives of Young Adults. Sage Publications, Newbury Park, California.

Norton, R. and Colliver, J. (1988) Prevalence and patterns of combined alcohol and marijuana use. Journal of Studies in Alcohol, 49, 378-380.

O'Donnell, J.A. (1969) Narcotic Addicts in Kentucky, (US Public Health Service P. No. 1881). Washington, DC: US Government Printing Office.

O'Donnell, J.A., Voss, H.L., Clayton, R.R., Slatin, G.T. and Room, R.G.W. (1976) Young Men and Drugs: A Nationwide Survey. NIDA Research Monograph No. 5, DHEW Publication No. (ADM) 76-311. Rockville, MD: U.S. Department of Health, Education and Welfare, National Institute on Drug Abuse.

Osgood, D.W., Johnston, L.D., O'Malley, P.M. and Bachman, J.G. (1988) The generality of deviance in late adolescence and early adulthood. American Sociological Review, 53, 81-93.

Pernanen, K. (1991) Alcohol in Human Violence. New York and London: Guilford.

Pohorecky, L.A., Brick, J. and Milgram, G.G. (Eds.) (1993) Alcohol and Aggression. Journal of Studies on Alcohol, Supplement No. 11, September.

Polen, M.R., Sidney, S., Tekawa, I.S., Sadler, M. and Friedman, G.D. (1993) Health care use by frequent marijuana smokers who do not smoke tobacco. Western Journal of Medicine, 158, 596-601.

Robinson, L.I., Buckley, J.D., Daigle, A.E., Wells, R., Benjamin, D., Arthur, D.C. and Hammond, G.D. (1989) Maternal drug use and the risk of childhood nonlymphoblastic leukemia among offpsring: An epidemiologic investigation implicating marijuana. Cancer, 63, 1904-1911.

Roffman, R.A., Stephens, R.S., Simpson, E.E. and Whitaker, D.L. (1988) Treatment of marijuana dependence: preliminary results. Journal of Psychoactive Drugs, 20, 129-137.

Room, R. (1983) Alcohol and crime: behavioral aspects. Pp. 35-44 in S.H. Kadish (Ed.) Encyclopaedia of Crime and Justice, Vol. 1. Free Press, New York.

Room, R. (1994) Alcohol and ethnography: A case of problem deflation? Current Anthropology, 25, 169-191.

Rottanburg, D., Robins, A.H., Ben-Arie, O., Teggin, A. and Elk, R. (1982) Cannabis-associated psychosis with hypomanic features. Lancet, 2, 1364-1366.

Rounsaville, B.J., Bryant, K., Babor, T., Kranzler, H. and Kadden, R. (1993) Cross-system agreement for substance use disorders. Addiction, 88, 337-348.

Rubin, V. and Comitas, L. 91975) Ganja in Jamaica: A Medical Anthropological Study of Chronic Marihuana Use. Mouton, The Hague.

Schneier, F.R. and Siris, S.G. (1987) A review of psychoactive substance use and abuse in schizophrenia: patterns of drug choice. Journal of Nervous and Mental Disorders. 175, 641-652.

Scheier, L.M. and Newcombe, M.D. (1991) Psychosocial predictors of drug use initiation and escalation: an expansion of the multiple risk factors hypothesis using longitudinal data. Contemporary Drug Problems, 18, 31-73.

Shedler, J. and Block, J. (1990) Adolescent drug use and psychological health. American Psychologist, 45, 612-630.

Simpson, D.D., Joe, G.W., Lehman, W.E.K. and Sells, S.B. Addiction Careers: etiology, treatment and 12 year follow-up outcomes. The Journal of Drug Issues, 1986, 16(1), 107-121.

Simpson, H.M. (1986) Epidemiology of road accidents involving marijuana. Alcohol, Drugs and Driving, 2, 15-30.

Smart, R.G. (1983) The epidemiology of cannabis use and its health consequences in Western countries. In K.O. Fehr and H. Kalant (eds.) Cannabis and Health Hazards. Addiction Research Foundation, Toronto.

Smart, R.G. and Fejer, D. (1976) Drug use and driving risk among high school students. Accident Analysis and Prevention, 8, 33-38.

Smiley, A. (1986) Marijuana: on-road and driving simulator studies. Alcohol, Drugs and Driving, 2, 121-134.

Soderstrom, C.A., Triffilis, A.L., Shankar, B.S., Clark, W.E., Cowley, R.A. (1988) Marijuana and alcohol use among 1023 trauma patients. Archives of Surgery, 123, 733-737.

Soueif, M.I. (1971) The use of cannabis in Egypt: A behavioural study. Bulletin on Narcotics, 23(4), 17-28.

Spooner, C. and Flaherty, B. (1992) Comparison of Data Collection Methodologies for the Study of Youth Illicit Drug Users. Sydney: Drug and Alcohol Directorate, N.S.W. Health Department, In House Report Series No. 92-2.

Stefanis, C., Dornbush, R. and Fink, M. (Eds.) (1977) Hashish: Studies on Long-Term Use. Raven Press, New York.

Tashkin, D.P. (1993) Is frequent marijuana smoking harmful to health? Western Journal of Medicine, 158, 635-637.

Tashkin, D.P., Coulson, A.H., Clark, V.A., Simmons, M., Bourque, L.B., Duann, S., Spivey, G.H. and Gong, H. (1987) Respiratory symptoms and lung function in habitual heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers. American Review of Respiratory Diseases, 135, 209-216.

Tashkin, D.P., Wu, T.C., Djahed, B. and Rose, J.E. (1988) Smoking topography and delivery of insoluble particulates and carbon monoxide to the lung during the smoking of tobacco and marihuana of varying potency in habitual smokers of both substances. In G. Chesher, P. Consroe, and R. Musty (Eds.) Marijuana: An International Research Report. National Campaign Against Drug Abuse Monograph Number 7, Australian Government Publishing Service, Canberra.

Tashkin, D.P., Fligiel, S., Wu, T.C., Gong, H., Barbers, R.G., Coulson, A.H., Simmons, M.S., and Beals, T.F. (1990) Effects of habitual use of marijuana and/or cocaine on the lung. In C.N. Chiang and R.L. Hawks (Eds.) Research Findings on Smoking of Abuse Substances. National Institute on Drug Abuse Research Monograph 99, National Institute on Drug Abuse Research Monograph 99, National Institute on Drug Abuse, Rockville, Maryland.

Taylor, F.M. (1988) Marijuana as a potential respiratory tract carcinogen: a retrospective analysis of a community hospital population. Southern Medical Journal, 81, 1213-1216.

Tennant, F.S., Preble, M., Prendergast, T.J. and Ventry, P. (1971) Medical manifestations associated with hashish smokers. In L.S. Harris (Ed.) Problems of Drug Dependence, 1979, Volume 127. National Institute on Drug Abuse, Rockville Maryland.

Tennes, K., Aritable, N., Blackard, C., Boyles, C., Hassoun, B., Holmes, L. and Kreye, M. 91985) Marihuana: prenatal and postnatal exposure in the human. In T.M. Pinkert (Ed.) Current Research on the Consequences of Maternal Drug Abuse. NIDA Research Monograph No. 59, Department of Health and Human Services.

Terhune, K.W. (1986) Problems and methods in studying drug crash effects. Alcohol, Drugs and Driving, 2, 1-13.

Thomas, H. (1993) Psychiatric symptoms in cannabis users. British Journal of Psychiatry, 163, 141-149.

Thornicroft, G. (1990) Cannabis and psychosis: Is there epidemiological evidence for association. British Journal of Psychiatry, 157, 25-33.

Turner, W.M. and Tsuang, M.T. (1990) Impact of substance abuse on the course and outcome of schizophrenia. Schizophrenia Bulletin, 16, 87-372.

USDHHS (1993) National Household Survey on Drug Abuse: Main Findings, 1991. DHHS Publication No. (SMA) 93-1980. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration.

Vaillant, G.E. (1973) A 20-year follow-up of New york narcotic addicts. Archives of General Psychiatry, 29, 237-241.

Weil, A. (1970) Adverse reactions to marihuana. New England Journal of Medicine, 282, 997-1000.

Wells, J.E., Bushnell, J.A., Joyce, P.R., Oakley-Browne, M.A. and Hornblow, A.R. (1992) Problems with alcohol, drugs and gambling in Christchurch, New Zealand. In M. Abbot and K. Evans (Eds.) Alcohol and Drug Dependence and Disorders of Impulse Control. Alcohol Liquor Advisory Council, Auckland.

Williams, A.G., Peat, M.A., Crouch, D.J., Wells, J.K. and Finkle, B.S. (1985) Drugs in fatally injured young male drivers. Public Health Reports, 100, 19-25.

Woody, G.E., Cottler, L.B. and Caciola, J. (1993) Severity of dependence: data from the DSM-IV field trials. Addiction, 88,1573-1579.

Woody, G.E. and O'Brien, C.P. (1991) Update of Methadone Maintenance, pp. 1113-1125 in N.S. Miller (Ed.), Comparison Handbook of Drug and Alcohol Addiction, New york: Marcel Dekker.

Wu, T., Tashkin, D.P., Djahed, B. and Rose, J.E. (1988) Pulmonary hazards of smoking marijuana with tobacco. New England Journal of Medicine, 318, 347-351.

Yamaguchi, K. and Kandel, D.B. (1984a) Patterns of drug use from adolescence to adulthood. II Sequences of progression. American Journal of Public Health, 1984, 74,668-672.

Yamaguchi, K. and Kandel, D.B. (1984b) Patterns of drug use from adolescence to adulthood. III Predictors of progression. American Journal of Public Health, 1984, 74, 673-681.

Zuckerman, B., Frank, D., Hingson, R., Amaro, H., Levenson, S., Kayne, H., Parker, S., Vinci, R., Aboagyen, K., Fried, L., Cabral, H., Timperi, R. and Bauchner, H. (1989) Effects of maternal marijuana and cocaine use on fetal growth. New England Journal of Medicine, 320, 762-768.

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