Marijuana and other cannabis preparations are the most widely used illicit drugs in the United States. A review of the literature reveals a number of sex differences in the epidemiology and adverse medical consequences of marijuana use. In 1995, 6.5% of females and 10.5% of males aged 12 and older reported marijuana use in the previous year. Although 4% more males than females used marijuana, the percentage of males using marijuana between 1994 and 1995 had decreased, whereas the percentage of females using marijuana during that same period had increased. Among females, the age of initiation of use is declining and the prevalence of problems with marijuana is on the rise. Both male and female marijuana users may experience adverse effects of cognitive dysfunction and airway inflammation. However, clinicians should be aware of sex-specific effects of marijuana use, including a possible increased risk of prostate cancer for male users and possible adverse effects on reproductive hormones in female users. Review of the available information on this topic indicates that we have much more to learn about the similarities and differences between males and females with respect to patterns of use, adverse consequences, and vulnerabilities to marijuana.
This article reviews the history, pharmacology, and adverse events associated with the use of 3,4-methylenendioxymethamphetamine (MDMA), commonly known as Ecstasy. Past research describing the neurotoxic effects of MDMA in animals, current research on the neurotoxic effects of MDMA in humans, and the attendant changes in psychologic functioning will be highlighted in this review. Finally, the limitations of human research on the effects of MDMA and suggestions for future MDMA research will be discussed.
This article reviews the use of opioid antagonists in the pharmacologic treatment of alcohol dependence. The rationale for using the opioid antagonists naltrexone and nalmefene to prevent relapse in alcohol-dependent subjects is discussed by reviewing past and current clinical trials. The role of psychotherapies, particularly coping skills therapy, in combination with opioid antagonists is highlighted in the presentations of the clinical data. Finally, future research directions for opioid antagonists are discussed.
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