Richard Sherva, PhD; QianWang, MS; Henry Kranzler, MD; Hongyu Zhao, PhD; Ryan Koesterer, MS; Aryeh Herman, PsyD; Lindsay A. Farrer, PhD; Joel Gelernter,MD

IMPORTANCE: Cannabis dependence (CAD) is a serious problem worldwide and is of growing importance in the United States because cannabis is increasingly available legally. Although genetic factors contribute substantially to CAD risk, at present no well-established specific genetic risk factors for CAD have been elucidated.

OBJECTIVE: To report findings for DSM-IV CAD criteria from association analyses performed in large cohorts of African American and European American participants from 3 studies of substance use disorder genetics.

DESIGN, SETTING, AND PARTICIPANTS: This genome-wide association study for DSM-IV CAD criterion count was performed in 3 independent substance dependence cohorts (the Yale-Penn Study, Study of Addiction: Genetics and Environment [SAGE], and International Consortium on the Genetics of Heroin Dependence [ICGHD]). A referral sample and volunteers recruited in the community and from substance abuse treatment centers included 6000 African American and 8754 European American participants, including some from small families. Participants from the Yale-Penn Study were recruited from 2000 to 2013. Data were collected for the SAGE trial from 1990 to 2007 and for the ICGHD from 2004 to 2009. Data were analyzed from January 2, 2013, to November 9, 2015.

MAIN OUTCOMES AND MEASURES: Criterion count for DSM-IV CAD.

RESULTS Among the 14 754 participants, 7879 were male, 6875 were female, and the mean (SD) age was 39.2 (10.2) years. Three independent regions with genome-wide significant single-nucleotide polymorphism associations were identified, considering the largest possible sample. These included rs143244591 (β = 0.54, P = 4.32 × 10−10 for the meta-analysis) in novel antisense transcript RP11-206M11.7; rs146091982 (β = 0.54, P = 1.33 × 10−9 for the meta-analysis) in the solute carrier family 35 member G1 gene (SLC35G1); and rs77378271 (β = 0.29, P = 2.13 × 10−8 for the meta-analysis) in the CUB and Sushi multiple domains 1 gene (CSMD1). Also noted was evidence of genome-level pleiotropy between CAD and major depressive disorder and for an association with single-nucleotide polymorphisms in genes associated with schizophrenia risk. Several of the genes identified have functions related to neuronal calcium homeostasis or central nervous system development.

CONCLUSIONS AND RELEVANCE: These results are the first, to our knowledge, to identify specific CAD risk alleles and potential genetic factors contributing to the comorbidity of CAD with major depression and schizophrenia.

JAMA Psychiatry. doi:10.1001/jamapsychiatry.2016.0036

Published online March 30, 2016.

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Abstract
In the Medical Marihuana state of CA, marihuana was found in drivers which resulted in 1,551 fatalities in the last 5 years. Nationally, in the 23 states and D.C. with state-approved Medical Marihuana, there were more than 1,000 fatalities in the single year of 2014. In the 27 states with no legal marihuana of any kind there were 1,619 marihuana related fatalities.

If CA marihuana use increases from the 2014 level of 18.8% to the level of WA and AK (two recreational marihuana states) at 31%, we could expect an additional 223 CA fatalities each year, for about 565 fatalities a year.

Alcohol is also heavily involved in the marihuana fatalities with 46% of the marihuana drivers were also impaired by alcohol at 0.05% and 38% legally DUI at 0.08+ BAC.

Despite the heavy use of alcohol by marihuana drivers, alcohol involvement in fatal crashes has increased less than 1% in the last 5 years.

Drivers with marihuana in Medical Marihuana states had a 29% higher involvement in fatal crashes than No Medical Marihuana states. Every percent increase in CA driver marihuana involvement in crashes will results in 19 more fatalities.

The growing legalization of marihuana for recreational use, along with the present Medical Marihuana use will cause a tidal wave of motor vehicle fatalities and injuries. This has already happened in Washington State where the level of drivers with marihuana is almost equal to the level of drivers DUI, the No.1 preventable traffic safety problem.

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Abstract:
Smoking cannabis daily doubles an individual’s risk of developing a psychotic disorder, yet indicators of specific vulnerability have proved largely elusive. Genetic variation is one potential risk modifier. Single-nucleotide polymorphisms in the AKT1 and catechol-O-methyltransferase (COMT) genes have been implicated in the interaction between cannabis, psychosis and cognition, but no studies have examined their impact on an individual’s acute response to smoked cannabis. A total 442 healthy young cannabis users were tested while intoxicated with their own cannabis—which was analysed for delta-9-tetrahydrocannbinol (THC) and cannabidiol content—and also ±7 days apart when drug-free. Psychotomimetic symptoms and working memory were assessed on both the sessions. Variation at the rs2494732 locus of the AKT1 gene predicted acute psychotic response to cannabis along with dependence on the drug and baseline schizotypal symptoms. Working memory following cannabis acutely was worse in females, with some suggestion of an impact of COMT polymorphism on working memory when drug-free. These findings are the first to demonstrate that AKT1 mediates the acute response to cannabis in otherwise healthy individuals and implicate the AKT1 pathway as a possible target for prevention and treatment of cannabis psychosis.
 
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Sharon S. Kelley, MS, PhD
“The synthetic drug abuse crisis reflects a number of similarities to a viral pandemic. The disease has spread rapidly throughout multiple countries via the assistance of a global carrier (the internet), with the virus mutation (analogue production) occurring at a pace that makes it difficult for agencies to quickly identify and regulate. Therefore, as in any disease outbreak, it becomes imperative for healthcare providers, scientists and law enforcement agencies to foster a mutual relationship of information exchange…”
 
For complete article go to The Journal of Global Drug Policy & Practice! VOLUME 9, ISSUE 4 - Winter 2015 view pdf

Research continues to confirm that cannabis use continues to accelerate, aging, obesity and metabolic dysfunction!

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