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5419 results in Neurosciences

Page 188 of 271

  • 15 - The Nature, Consequences and Treatment of Cannabis Dependence: Implications for Future Research and Policy

  • from Part V - Conclusion
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 343-356

  • Summary

    The phenomenon of cannabis dependence has been a topic of interest and varying levels of concern for well over 100 years. Cannabis's acute effects on attention, reaction time, and motor coordination predict impairment of driving and increased risk for accidents. The frequent coincidence of cannabis and alcohol use, a known contributor to motor vehicle accidents, has made it difficult to directly identify a causal link for cannabis. More recent research has found cannabis to independently increase risk for accidents. The reductions in cannabis use resulting from treatment were often substantial and accompanied by equally large decrements in self-reported problems. Systematic evaluation of treatment for adolescent cannabis users is in its early stages. Education about the risks of cannabis dependence should be part of any policy because it may deter initiation or escalation of use that could lead to dependence.

  • 1 - Anatomical and physiological basis for neural plasticity

  • Aage R. Møller, University of Texas, Dallas
  • Book:
    Neural Plasticity and Disorders of the Nervous System
    Published online:
    08 February 2010
    Print publication:
    23 February 2006, pp 7-41

  • Summary

    Introduction

    The nervous system is plastic and expression of neural plasticity can compensate for losses and adapt to changing demands, but the induced changes in the function of the nervous system can also cause symptoms and signs of disease. In fact, such functional change causes or contributes to the symptoms of many disorders of the nervous system. This chapter provides an overview of the mechanisms involved in expression of neural plasticity in general, its role in compensating for deficits and adapting to changing demands, and in creating signs and symptoms of disease. The mechanisms involved in expression of neural plasticity and the physiological and anatomical basis for expression of neural plasticity are discussed.

    In the following chapters of this book, we will discuss the pathophysiology of neurological disorders and the role of expression of neural plasticity. In these chapters we will discuss the different symptoms and signs that are caused by expression of neural plasticity while this chapter will provide an overview of the role of expression of neural plasticity and the physiological and anatomical basis for expression of neural plasticity.

    Advantages to the organism from neural plasticity

    The beneficial effects of expression of neural plasticity can be divided into three main groups:

    1. a. Necessary for normal postnatal development.

    2. b. It makes the nervous system adapt to changing demands.

    3. c. It can compensate for loss of function and reorganize the nervous system to replace lost functions.

    Postnatal development

    Perhaps the greatest advantage to humans from neural plasticity is the postnatal development of skills and adaptation to different tasks.

  • 12 - The Teen Cannabis Check-Up: Exploring Strategies for Reaching Young Cannabis Users

  • from Part III - Interventions with Cannabis-Dependent Adolescents and Young Adults
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 275-296

  • Summary

    This chapter describes a motivational enhancement therapy (MET) intervention tailored to reach young people who use cannabis. MET intervention also motivates young people to voluntarily participate in a confidential assessment and evaluation of the impact of cannabis on their lives, and offer support to those who wish to quit or reduce use. A general trend toward increased cannabis use for much of the 1990s was particularly marked among teenagers, possibly due to its ready availability and declining perceptions of risk. Developmental tasks of adolescence include increasing psychological autonomy, expanding social roles, development of the capacity for intimacy, and the formation of value systems and life goals. The Teen Cannabis Check-Up is a two-session assessment and feedback intervention developed to reach cannabis users who are neither self-initiating change nor seeking treatment. The chapter describes the variations of cannabis check-up interventions tailored for adolescents and common issues in implementing the check-up approach.

  • 7 - Contingency-Management Interventions for Cannabis Dependence

  • from Part II - Interventions with Cannabis-Dependent Adults
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 154-176

  • Summary

    Contingency management (CM) interventions represent one treatment approach that has great potential to effectively motivate and facilitate change in this challenging clinical population. CM interventions are based on extensive basic-science and clinical-research evidence demonstrating that drug use and abuse are heavily influenced by learning and conditioning and are quite sensitive to systematically applied environmental consequences. Behavioral-analytic theory and the empirical literature on behavior change in general suggests that the efficacy of CM interventions is influenced by the schedule used to deliver consequences the magnitude of the consequence, the choice of the target behavior, the selection of the type of consequence, and the monitoring of the target behavior. The chapter uses examples from cannabis CM program to describe these basic principles and illustrate their application. Almost half of those seeking treatment for marijuana abuse have criminal justice involvement and are referred to treatment by the legal system.

  • 6 - Cognitive-Behavioral and Motivational Enhancement Treatments for Cannabis Dependence

  • from Part II - Interventions with Cannabis-Dependent Adults
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 131-153

  • Summary

    Cognitive-behavioral (CBT) and motivational enhancement treatments (MET) are two of the most researched and most empirically supported approaches to the treatment of alcohol and drug use disorders. MET is based on motivational interviewing (MI), an empathic, reflective therapeutic style designed to resolve ambivalence and develop self-motivation for change. CBT targets the functional role that drug use plays in the individual's life. Clients learn to identify the antecedent feelings, thoughts, and situations that precipitate use, and then are helped to generate and master alternate responses. Both group and individual CBT interventions have been found to be efficacious with cannabis-dependent adults, as well as with other drug-dependent populations. For the most part, MET and CBT treatments have been adapted and applied to cannabis-dependent adults in the same way they have been used with alcohol and other drug problems.

  • 1 - Themes in the History of Cannabis Dependence

  • from Part I - The Nature of Cannabis Dependence
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 3-20

  • Summary

    This chapter examines the history of cannabis dependence, particularly emphasizing key themes that have contributed to how cannabis dependence has been perceived by the general public, by the scientific community, and by policy-makers. Variations in cannabis plant species, preparations, and methods of administration result in a wide range of behavioral effects associated with the regular use of this drug. Vivid and evocative imagery, often conveyed in popular literature and the media, has been among the key contributors to the public's perceptions of cannabis, its dependence liability, and the consequences of becoming dependent. In the mid-1800s, a group of French writers and artists, referring to themselves as Le Club des Hachichins, met monthly in Paris, experimented with an eaten cannabis concoction, and mused about its effects on their creative imaginations. Formal boards of inquiry have been established periodically in order to summarize existing knowledge concerning cannabis.

  • 2 - The Diagnosis of Cannabis Dependence

  • from Part I - The Nature of Cannabis Dependence
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 21-36

  • Summary

    This chapter considers the classification and diagnosis of cannabis dependence from several perspectives. It reviews the scientific evidence for the cannabis dependence syndrome, its etiology, course and natural history. The main elements of drug dependence are psychological symptoms, physiological signs and behavioral symptoms. Many patients with a history of drug dependence experience rapid reinstatement of the features of the syndrome following resumption of substance use after a period of abstinence. The chapter describes the classification of cannabis dependence within the two standard nomenclatures used both in the USA and worldwide. The first is the WHO International Classification of Diseases (ICD). The second is the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA). The purpose of diagnosis is to provide the clinician with a logical basis for planning treatment and estimating prognosis. Diagnosis also may serve a variety of administrative, statistical and scientific purposes.

  • 3 - Sensory systems

  • Aage R. Møller, University of Texas, Dallas
  • Book:
    Neural Plasticity and Disorders of the Nervous System
    Published online:
    08 February 2010
    Print publication:
    23 February 2006, pp 68-148

  • Summary

    Introduction

    The five sensory systems, hearing, vision, tactile (somatosensory), smell and taste, provide conscious perceptions of physical stimuli from the environment. In addition to these five senses, temperature receptors in the skin and the mouth mediate the sensations of warmth and cool. These senses, together with motor systems, serve the purpose of communications between an organism and the environment. In fact, all input that the central nervous system (CNS) receives from the environment comes through sensory systems. Several disorders are directly associated with sensory systems. Some disorders are caused by various kinds of insults such as trauma and inflammation. Age-related changes are perhaps the most important cause of disorders of sensory systems. The symptoms of many of these disorders are caused by functional changes in the CNS induced by expression of neural plasticity.

    The vestibular system that monitors head movements and proprioceptive systems that monitor motor activity may also be regarded as sensory systems, but many authors include these systems in their description of motor systems. The balance system and proprioception, together with vision and somesthesia, contribute to our perception of our body position. (The vestibular system, and disorders associated with it, is covered separately in Chapter 6.) Proprioceptive somatosensory systems, the receptors of which are found in muscles, tendons and joints, monitor the motor systems and other bodily functions. The role of the vestibular system in control of posture and walking is discussed in Chapter 5 where other forms of proprioception are also discussed.

  • Foreword

  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp xxvi-xxx

  • Summary

    Marijuana continues to be a hot topic in the news. At the time of this writing (July, 2005), The Seattle Times has published numerous stories about the “green plant” and controversies surrounding its use and potential for abuse. Many featured articles described the debate about medical marijuana and the US Supreme Court's recent decision that federal drug charges can be applied to users and distributors of marijuana even in those states that passed local laws approving cannabis use as a treatment for several disorders (e.g., reduction of nausea associated with chemotherapy, appetite enhancement in the treatment of AIDS, lowering intra-ocular pressure in the treatment of glaucoma, and so on). As Washington is one of the states that voted to approve the medical use of marijuana, press coverage has been sympathetic to the plight of patients who may now be denied access to the healing herb. Based on this press coverage, most readers (as judged by letters to the Editor of the Seattle Times) were outraged by the Supreme Court decision, given the evidence that so many patients reported beneficial effects from smoking pot.

    Other stories about marijuana that have been covered in the local press express criticism and concern over its use. Here in the Pacific Northwest, public officials have expressed outrage about the distribution of potent marijuana that has been smuggled into Washington and adjoining states from our Canadian neighbors to the north.

  • 9 - Guided Self-Change: A Brief Motivational Intervention for Cannabis Abuse

  • from Part II - Interventions with Cannabis-Dependent Adults
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 204-224

  • Summary

    This chapter describes the guided self-change (GSC) treatment as applied to cannabis users. The brief motivational nature of this intervention may be particularly appropriate for cannabis users who approach treatment with less severe problems and ambivalence about reducing use, and who may be reluctant to accept a goal of complete abstinence from marijuana use. Important influence on the development of the GSC treatment was the purported efficacy of brief treatments for alcohol problems, especially less severe problems. In order to evaluate the efficacy of the GSC approach with cannabis users, the chapter uses data from a randomized controlled trial comparing an individual and group format of GSC treatment. The fact that the majority of cannabis abusers in the GSC trial chose a reduced use goal suggests that a harm reduction approach might be a good way to involve cannabis abusers in treatment.

  • 4 - The Epidemiology of Cannabis Dependence

  • from Part I - The Nature of Cannabis Dependence
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 58-105

  • Summary

    This chapter describes selected features of cannabis epidemiology, with a focus upon recent evidence from field studies of cannabis dependence. Recent epidemiological evidence from the USA speaks to the question of how many individuals might need clinical services early in the cannabis dependence process. Among the 14 million current users, roughly 1.6-2.3 million users qualified as a recently active Diagnostic and Statistical Manual, (DSM-IV) cannabis dependence case according to the National Survey field assessment methods and DSM-IV diagnostic algorithm. Research on early-onset drug use and later increased risk of drug problems has encompassed investigations into early-onset cannabis use as a suspected determinant of later increased risk of cannabis dependence. Differences between cannabis users and non-users also complicate other inquiries into the health and social consequences of cannabis involvement. To date, epidemiology's contribution to research on prevention, intervention, amelioration, and control of cannabis dependence has been indirect.

Page 188 of 271