To determine if recently abstinent, heavy marijuana (MJ) users show differences in polysomnographic (PSG) measures compared with a drug-free control group.
A group of carefully selected heavy MJ ...users were chosen for study inclusion and matched to a drug-free control group. Questionnaire data were collected prior to cessation of MJ use. PSG studies were conducted during 2 consecutive nights after discontinuation of MJ use in our core sleep laboratory.
Baltimore Maryland, General Clinical Research Center (GCRC) core sleep lab.
17 heavy MJ users discontinuing MJ use and 14 drug-free controls. Men and women were studied, 18 to 30 years. The MJ users reported no other drug use and alcohol use was negligible in both groups. Urine was positive for metabolites of cannabis only.
The MJ users showed differences in PSG measures (lower total sleep times, and less slow wave sleep than the control group) on both nights; they also showed worse sleep efficiency, longer sleep onset, and shorter REM latency than the control group on Night 2. More sleep continuity parameters were significantly worse for the MJ group than the control group on Night 2 versus Night 1, indicating that sleep in the MJ group was relatively worse on Night 2 compared to Night 1. The MJ group did not show improved sleep after an adaptation night as expected. Withdrawal symptoms, craving, and depression did not appear to influence these findings.
During discontinuation of heavy MJ use, PSG measures of sleep disturbance were detected in MJ users compared with a drug-free control group. While this preliminary study cannot identify the extent to which these group differences were present before abstinence, poor sleep quality either prior to or after MJ discontinuation could result in treatment failure for MJ users. Further investigation is necessary to determine the association between the use and cessation of MJ and sleep disturbance.
Abstract Background Abrupt discontinuation of heavy marijuana (MJ) use is associated with self-reports of sleep difficulty. Disturbed sleep is clinically important because MJ users experiencing sleep ...problems may relapse to MJ use to improve their sleep quality. Few studies have used polysomnography (PSG) to characterize changes in sleep architecture during abrupt abstinence from heavy MJ use. Methods We recorded PSG measures on nights 1, 2, 7, 8, and 13 after abrupt MJ discontinuation in 18 heavy MJ users residing in an inpatient unit. Results Across abstinence, Total Sleep Time (TST), Sleep Efficiency (SEff), and amount of REM sleep declined, while Wake after Sleep Onset (WASO) and Periodic Limb Movements (PLM) increased. Furthermore, quantity (joints/week) and duration (years) of MJ use were positively associated with more PLMs. Conclusion The treatment of sleep disturbance is a potential target for the management of cannabis use disorders since poor sleep could contribute to treatment failure in heavy MJ users.
To investigate the dose-related effects of cocaine with or without alcohol use on the CNS by measuring performance on neurobehavioral tests.
Chronic use of cocaine is associated with persistent ...decrements in cognitive function that are most pronounced in heavy users. Specific neurobehavioral deficits in areas such as executive function and impulsivity would make it difficult for the cocaine abuser to discontinue using drugs. Because alcohol is often used in conjunction with cocaine, the CNS effects of alcohol when taken with cocaine deserve further investigation.
The authors evaluated the dose-related effects of cocaine and alcohol use on performance in a variety of neuropsychological tests after 1 to 3 days of abstinence and again after 4 weeks of abstinence. Fifty-six chronic cocaine abusers who had used cocaine during the past 24 to 48 hours volunteered to perform a battery of neuropsychological tests on two separate occasions during a period of enforced abstinence. In addition to using cocaine, most of the volunteers consumed alcohol. Approximately half of the participants consumed more than 10 alcohol-containing drinks per week.
After controlling for the effects of age, sex, and intelligence on performance, the authors found dose-related associations between neurobehavioral performance and cocaine dose and alcohol dose. When the influences of cocaine and alcohol on neurobehavioral performance were taken separately, cocaine and alcohol each selectively affected performance on different neurobehavioral tests after 1 to 3 days of abstinence, with these effects persisting after 4 weeks of abstinence.
The concomitant use of cocaine and alcohol may have additive negative effects on the brain as compared to the use of only one of these two substances.
Phenylpropanolamine (PPA) is frequently used in over-the-counter diet aids and cold medicines, In view of concern about the safety of this sympathomimetic agent, we undertook a double-blind, ...multicenter clinical trial to determine the factors that influence the pressor effect of short-term oral administration of PPA in healthy individuals. Eight hundred eighty-one healthy individuals in four categories of body weight were randomized to receive placebo capsules three times per day (n = 286), a 75-mg sustained-release PPA hydrochloride preparation once per day (n = 296) followed by two doses of placebo capsules, or a 25-mg immediate-release PPA hydrochloride preparation three times per day (n = 299). The median age of the study population was 28 years, 56% were men, 73% were white, and 47% were in excess of 30% above their ideal body weight. Measurements of pulse rate and supine and standing blood pressure were made 11 times during the day of PPA administration. A statistically significant but clinically unimportant pressor effect for the short-term administration of PPA was observed. The effect occurred in the first 6 hours after administration and was greater in the sustained-release group. Significant independent determinants of the pressor effect of PPA were baseline diastolic blood pressure, baseline body weight, and treatment.
A group of alcoholic men were followed-up 8 years after discharge from hospital. The interview included items on sleep, anxiety, and depression. The sample was divided into abstinent and drinking ...subjects. Sleep data were factor analyzed. Only the Alcohol-Abstinence Sleep Factor significantly correlated with drinking status. The Alcohol-Abstinence Sleep Factor was also the primary correlate of anxiety and depression. Fewer abstinent subjects reported anxiety and depression. Sleep variables, anxiety, and depression are considered as possible markers of relapse in persons treated for alcoholism.
The use of phenylpropanolamine (PPA) as an anorectic has provoked commentary and disagreement. Its use in the last decade has been associated with a series of adverse clinical events. As in all case ...reports, these associations may be noncausal, particularly in light of PPAs extensive use. We have reviewed prospective clinical trials in which the administration of PPA was planned to assess impact on blood pressure. Many of these employ sedentary, healthy volunteers but also included are studies of overweight, moderately hypertensive, and ambulatory subjects. An analysis of such studies leads us to believe that PPA is an appropriately marketed over-the-counter drug, with an acceptable margin of safety. Further, we have reanalyzed our own earlier published data, which indicate that the margin of safety may actually be increased in subjects with elevated basal sympathetic tone; eg, those who are overweight and those with slight elevations of arterial blood pressure.
The influence of monetary feedback on Wisconsin Card Sort Test (WCST) performance of 14 male schizophrenics was investigated. Patients were administered the test under standard instructions and with ...monetary feedback in counterbalanced order. Monetary reinforcement reduced perseverative errors and increased correct responses (
p
< .05). These findings suggest that the WCST perseverative errors of schizophrenics reflect motivational as well as cognitive factors.
A group of alcoholic men were asked 8 years postdischarge from hospital if they could drink alcohol with control. Subjects who said "no" (the NCD group) were compared to those who said "yes" (the CD ...group). A majority of the NCD group had been abstinent during the year preceding the 8-year evaluation, whereas none of the CD group had been. In the model developed, troubles resulting from drinking are seen as instrumental in changes from a CD to a NCD belief. The clinical relevance of our results is discussed.
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