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RESEARCH
STUDY: VETERANS
AND MARIJUANA
ABSTRACT
BACKGROUND
The timing of this study comes as the President of the United States
(https://youtu.be/F0Y3ytZrN_s) has declared the opioid overdose and
addiction epidemic a national emergency.
The goal of our agency's research herein is to measure marijuana's impact
on pain, anxiety and depression. To do so we will be utilizing our combat
veteran population living in states where they are legally able to attain
medical marijuana. Should this study infer a medical benefit, further
research amongst our more highly funded and independent institutions
can and should follow.
METHOD
Measures Used:
Post Traumatic Stress Disorder
(https://www.ptsd.va.gov/professional/assessment/overview/index.asp)
(PTSD) - Rating was based on veterans' VA determination of severity as
provided by the participant. VA ratings for PTSD require exhaustive
evaluations using both objective and subjective measures. The reliability
of a VA rating is far superior than requiring the the veteran to complete a
separate individual subjective questionnaire. For these reasons we are
avoiding the use of additional PTSD measures.
Depression
(http://www.apa.org/pi/about/publications/caregivers/practice-
settings/assessment/tools/beck-depression.aspx) - Was measured using the
Beck's Depression Inventory (BDI) taken prior to and following
utilization of medical marijuana. Pre marijuana utilization scores for
depression in the population sample demonstrated a mean of 24.18
n=11; (SD=13.98) placing the population sample, prior to using
marijuana, within the second highest depression category of "Moderate
Depression"(Beck et al., 1988).
The Beck Depression Inventory (BDI) is a 21-item, self-report rating
inventory that measures characteristic attitudes and symptoms of
depression (Beck, et al., 1961). Internal consistency for the BDI ranges
from .73 to .92 with a mean of .86. (Beck, Steer, & Garbin, 1988). The
BDI demonstrates high internal consistency, with alpha coefficients of .86
and .81 for psychiatric and non-psychiatric populations respectively (Beck
et al., 1988).
Anxiety
(https://www.sciencedirect.com/topics/medicine-and-dentistry/beck-
anxiety-inventory)- Was measured using the Beck's Anxiety Inventory
(BAI) taken prior to and following ingestion of medical marijuana. Pre
marijuana utilization scores for anxiety in the population sample
demonstrated a mean of 23 (n=11); (SD=17.29) placing the population
sample, prior to using marijuana, within the category of "Moderate
Anxiety"(Beck Epstein, Brown & Steer 1988).
The Beck Anxiety Inventory (BAI), created by Aaron T. Beck and other
colleagues, is a 21-question multiple-choice self-report inventory that is
used for measuring the severity of anxiety in children and adults. The
questions used in this measure ask about common symptoms of anxiety
that the subject has had during the past week. Several studies have found
the Beck Anxiety Inventory to be an accurate measure of anxiety
symptoms in children and adults (Leyfer, Ruberg, & Woodruff-Borden,
2006 ). The Beck Anxiety Inventory is a well accepted self-report measure
of anxiety in adults and adolescents for use in both clinical and research
settings (Groth-Marnat, 1990). The BAI is psychometrically
sound. Internal consistency (Cronbach’s alpha) ranges from .92 to .94 for
adults and test-retest (one week interval) reliability is .75 (Beck
Epstein, Brown & Steer 1988).
Pain - Was measured utilizing the Universal Pain Assessment Tool below
taken prior to and following ingestion of medical marijuana. Pre
marijuana utilization scores for pain in the population sample
demonstrated a mean of 4.91 n=11; (SD=2.23) placing the population
sample, prior to using marijuana, within the "Moderate Pain" category.
The Universal Pain Assessment Tool (UPAT) combines the advantages
of four types of pain assessment instruments – Visual Analogue Scale,
adjective scales, Numerical Rating Scales (NRS) and Faces Scales. The
Universal Pain Assessment Tool aims to describe completely the
individual's pain experience. The combination of NRS, verbal
description, association between pain and facial expression and individual
threshold of pain makes this instrument usable in all age groups
(Hockenberry, Wilson, Wilkenstein & Wong, 2005; Hesselgard, Larsson,
Romner, Strömblad &, Reinstrup, 2007; Edelen & Saliba, 2010).
RESULTS
This study has been conducted on the heels of United States President,
Donald Trump declaring an opioid crisis in America. Further, the
President has implored those of us in the fields of medicine, mental
health, research and social work to submit comments to the World
Health Organization specific to marijuana's classification as a Schedule 1
drug.
Such steps will eventually result in political debates within the halls of the
US Congress which will inevitably be delayed, tabled and put off at the
cost of American lives, families and strain within our social service and
prison systems. Such a realization should weigh heavily on the
consciousness of our law makers. Their (US Congressional) delay on this
matter is resulting in more deaths per year due to opioid overdoses
(https://www.cdc.gov/drugoverdose/data/statedeaths.html) than all of
America's war dead since 1965.
When the reclassification does occur, because it will, research will need to
look at this plant in all of its many facets specific to genetic variances,
Strains (https://www.scribd.com/document/374879725/Medical-
Cannabis-in-America-ASA-report-29-online), concentrations, and ratios
of each. Primarily, medical marijuana comes in an Indica, Sativa or
Hybrid blend of both strains. Future studies should also collect on these
variables to ascertain outcomes for each to assist the medical community
in addressing the question of dosage, timing and respective impact on
symptoms as well as ratios of various plant components such as
CBD:THC.
Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J.
(1961). An inventory for measuring depression. Archives of General
Psychiatry, 4, 561-571.
Beck, A.T., Steer, R.A., & Garbin, M.G. (1988). Psychometric properties
of the Beck Depression Inventory: Twenty-five years of
evaluation. Clinical Psychology Review, 8(1), 77-100.
Edelen MO, Saliba D. (2010). Correspondence of verbal descriptor and
numeric rating scales for pain intensity: an item response theory
calibration.J Gerontol A Biol Sci Med Sci. 2010;65(7):778-85.
Steer, R. A., Rissmiller, D. J.& Beck, A.T., (2000). Use of the Beck
Depression Inventory with depressed geriatric patients. Behaviour
Research and Therapy, 38(3), 311-318.
THE MEDICAL
CANNABIS
BRIEFING BOOK
--.TH CONGRESS
AmericansForSafeAccess.org
MEDICAL
CANNABIS
IN AMERICA
Drug Schedules (https://www.dea.gov/druginfo/ds.shtml
(https://www.dea.gov/druginfo/ds.shtml))
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