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The purpose of this paper is to review the results and limitations of studies of injury risks associated with cannabis and cocaine use. Three types of fatal and non-fatal injuries are considered: injuries due to collisions, intentional injuries and injuries in general. Four types of studies were reviewed: (I) laboratory studies, (II) descriptive and analytic epidemiological studies on the prevalence of cannabis or cocaine use through drug testing of those injured, (III) studies of non-clinical samples, and (IV) studies of clinical samples of drug users. The research that utilized drug tests showed similar proportions testing positive for cannabis in fatal and non-fatal injury groups, and for collisions, violence and injuries in general. By contrast, large differences in the average proportions testing positive for cocaine were found among these same injury groups. For example, 28.7% of people with intentional injuries (primarily homicides) tested positive for cocaine, while 4.5% of injured drivers tested positive. Studies of non-clinical samples have shown that both cannabis and cocaine use are related to intentional injuries and injuries in general. Results indicate higher risk for all types of injuries among cannabis and cocaine clients in treatment. Strengths and limitations of the different types of studies are discussed. More rigorous studies are needed which should focus on ruling out alternative explanations for relationships between drug use and injuries.

Objective: Comorbidity between anxiety and cannabis use is common yet the nature of the association between these conditions is not clear. Four theories were assessed, and a fifth hypothesis tested to determine if the misattribution of stress symptomology plays a role in the association between state-anxiety and cannabis. Methods:Three-hundred-sixteen participants ranging in age from 18 to 71 years completed a short online questionnaire asking about their history of cannabis use and symptoms of stress and anxiety. Results: Past and current cannabis users reported higher incidence of lifetime anxiety than participants who had never used cannabis; however, these groups did not differ in state anxiety, stress, or age of onset of anxiety. State-anxiety and stress were not associated with frequency of cannabis use, but reported use to self-medicate for anxiety was positively associated with all three. Path analyses indicated two different associations between anxiety and cannabis use, pre-existing and high state-anxiety was associated with (i) higher average levels of intoxication and, in turn, acute anxiety responses to cannabis use; (ii) frequency of cannabis use via the mediating effects of stress and self-medication. Conclusion: None of the theories was fully supported by the findings. However, as cannabis users reporting self-medication for anxiety were found to be self-medicating stress symptomology, there was some support for the stress-misattribution hypothesis. With reported self-medication for anxiety being the strongest predictor of frequency of use, it is suggested that researchers, clinicians, and cannabis users pay greater attention to the overlap between stress and anxiety symptomology and the possible misinterpretation of these related but distinct conditions. [ABSTRACT FROM AUTHOR]

Background: An important challenge in conducting social research of specific relevance to harm reduction programs is locating hidden populations of consumers of substances like cannabis who typically report few adverse or unwanted consequences of their use. Much of the deviant, pathologized perception of drug users is historically derived from, and empirically supported, by a research emphasis on gaining ready access to users in drug treatment or in prison populations with higher incidence of problems of dependence and misuse. Because they are less visible, responsible recreational users of illicit drugs have been more difficult to study. Methods: This article investigates Respondent Driven Sampling (RDS) as a method of recruiting experienced marijuana users representative of users in the general population. Based on sampling conducted in a multi-city study (Halifax, Montreal, Toronto, and Vancouver), and compared to samples gathered using other research methods, we assess the strengths and weaknesses of RDS recruitment as a means of gaining access to illicit substance users who experience few harmful consequences of their use. Demographic characteristics of the sample in Toronto are compared with those of users in a recent household survey and a pilot study of Toronto where the latter utilized nonrandom self-selection of respondents. Results: A modified approach to RDS was necessary to attain the target sample size in all four cities (i.e., 40 'users' from each site). The final sample in Toronto was largely similar, however, to marijuana users in a random household survey that was carried out in the same city. Whereas well-educated, married, whites and females in the survey were all somewhat overrepresented, the two samples, overall, were more alike than different with respect to economic status and employment. Furthermore, comparison with a self-selected sample suggests that (even modified) RDS recruitment is a cost-effective way of gathering respondents who are more representative of users in the general population than nonrandom methods of recruitment ordinarily produce. Conclusions: Research on marijuana use, and other forms of drug use hidden in the general population of adults, is important for informing and extending harm reduction beyond its current emphasis on 'at-risk' populations. Expanding harm reduction in a normalizing context, through innovative research on users often overlooked, further challenges assumptions about reducing harm through prohibition of drug use and urges consideration of alternative policies such as decriminalization and legal regulation. [ABSTRACT FROM AUTHOR]

Despite the growing literatures on cannabis dependence, and urgent declarations as to treatment need, there is a scarcity of data on cannabis problems as a primary reason for treatment. This article compares characteristics of cannabis treatment seekers with those of a nontreatment sample of users. Findings are reported from two independent studies that included items from the DSM-IV criteria for diagnosing substance dependence and abuse. Other survey items covered different drug reactions, both positive and negative, commonly attributed to cannabis consumption. Adverse reactions, as expected, were more often reported by users in treatment, and positive effects by those in the nontreatment group. Expected differences on DSM measures of impairment were least pronounced for symptoms of compulsion as compared to other problems of dependence or indicators of abuse. Put otherwise, adverse effects are more germane or distinctive to the treatment seeker's profile than dependence in and of itself. The findings are interpreted as evidence in favor of expanding harm reduction oriented treatment options to target cannabis misuse, or psychosocial and health problems, as opposed to “chronic” use of cannabis per se. [ABSTRACT FROM AUTHOR]

Based on structured interviews with 104 experienced users in Toronto, Canada, this article examines the perceived costs and benefits of cannabis consumption. A pretested questionnaire that was developed by Cohen and Sas ( 1998 ) in the Netherlands, and later translated for use in the U.S. and Germany as part of a three-city cross-national comparative study [(Reinarman et al . ( 2000 ). Is availability destiny? Drug use prevalence and discontinuance in Amsterdam, San Francisco and Bremen. Paper presented at the 11th International Conference on the Reduction of Drug-Related Harm, St. Helier, Jersey, Channel Islands, April 9-13, 2000; Cohen and Kaal ( 2001 ). The Irrelevance of Drug Policy: Patterns and Careers of Experienced Cannabis Use in the Populations of Amsterdam, San Francisco and Bremen. Centre for Drug Research, University of Amsterdam)] guided data collection on a range of drug effects, including measures of dependence inspired by DSM-IV criteria. The findings support a rational choice view of cannabis use insofar as reported advantages outweigh negative use outcomes. Top reasons for use pertain to relaxation and enhancement of recreational activities followed by coping with stress and anxiety. The frequency of respiratory and throat problems attributed to using cannabis underscores the perceived risk of pulmonary damage due to long-term heavy use. Whereas concerns about use levels nonetheless overshadowed other dependency indicators, including concern for personal health, however, no association was found between amounts nor frequency of use and the number of DSM-IV items reported by respondents. Users acknowledged and accepted the potential for dependence, adapting use levels accordingly when seen as problematic. [ABSTRACT FROM AUTHOR]

This paper builds on Stebbins' (1996) concept of tolerable differences, an underused tool for analysis of deviant activities and lifestyles that tend not to elicit the kind of collective condemnation traditionally reserved for serious moral and legal transgressions. Our analysis centers on two case studies of criminal tolerable deviance in Canada, the widespread use of marijuana for recreational purposes and the illegal ticket scalping trade. Whereas the former has inspired a vast body of literature, the latter has been thus far overlooked by sociologists. Consideration of the two together, in terms of Stebbins' framework, betters our understanding of the social construction of these practices, further developing theory and research on deviance more generally. [ABSTRACT FROM AUTHOR]

Recreational marijuana use has, in the past four decades, evolved from a practice prevalent only within certain marginalized groups, or subcultures, to one that is now broadly established throughout modern Western culture. With this diffusion, particularly among the middle classes, use of the drug has become increasingly tolerated by law enforcers as well as the general public. Despite continuing prohibition, significant numbers of otherwise conventional adults persist in using marijuana on a regular basis. Based on in-depth interviews with 30 middle-class adult users, this article updates Howard Becker's early work on marijuana use and social control. As tolerable deviance, marijuana use has become individualized and is now commonly found outside of the subcultural groups with which it was once associated. Accordingly, it is argued that the practice needs to be studied at a more personal level, as a practical, routine component of people's everyday lives. [ABSTRACT FROM AUTHOR]