We've seen a surprisingly large amount of patients register for the buprenorphine matching system who were over 50. Timothy Lepak www.NAABT.org

I am please to see the report on Older Adults increased use of illicit drugs. As a treatment provider for an Older Adults Recovery program (50 and up), and have been disappointed in the lack of information available on treatment for this age group (for illicit drugs). There is a lot for Alcohol and prescription drugs. Good going!

While the authors' conclusions make sense, that aging Baby Boomers are carrying their life-long drug use into late middle age, it would be interesting to know whether the researchers made a distinction between illicit cannabis use and medical marijuana (mmj) use (which, in the US, is as much a matter of geography, not lifestyle). Since over one-quarter of the US population lives in states w/ legal mmj programs (and 75% of survey respondents over age 50 nationwide recognize the benefits of mmj and support increasing access for all eligible patients), this would be an important adjustment to make in the study conclusions. Also, since awareness of the anti-cancer properties of cannabis (and the lack of association of cannabis use w/ COPD) is also growing, despite media blackouts, the prevalence of cannabis use may appear to increase in older populations as cannabis users continue to live longer than non-users. Case in point: Madrid, Spain: The administration of selective cannabinoid agonists halt the proliferation of human prostate cells in vitro (in a Petri dish) and in vivo (in laboratory animals), according to preclinical findings published online this week in the British Journal of Cancer and reported by Reuters News Wire.

One important point is that drug use in this study is not use in the past 30 days, but at least once in the past year! Another important point is that most of this is marijuana use. And third, the non-medical use of prescription drugs is definitionally and analytically problematic. Does it include any use other than immediately pursuant to a prescription recently issued by a visit to a physician for that condition? Most persons 50+ have a variety of prescription pain relievers from old prescriptions. If one takes several over several days to self-medicate a twisted ankle or sore shoulder without visiting one's physician, is this counted and if so, is it drug abuse?

I support the legalization of marijuana. But I am tired of hearing the risks associated with use of cannabis minimized. Like alcohol, marijuana may have some benefits for some people with very moderate use. But like alcohol, there are some people who should never use marijuana (those with a family history of psychosis), and everyone who uses should be thoroughly educated about the risks. Marijuana intoxication impairs driving skills as much as alcohol. Marijuana does have cancer risks (research it on the NCBI website). There is an interaction between marijuana and tobacco that does increase the risk of COPD by one third for those who smoke both. There is increasing evidence that cannabis use by adolescents increases risk of mental illnesses and adverse social outcomes. Again the information is there for anyone with a web browser. My point: let's legalize but let's not minimize. We can live with the risks from marijuana like we live with the risks from alcohol and tobacco because criminalizing the behavior doesn't work. We decided to decriminalize alcoholism back in the 70's. Now let's do it for cannabis.

Dave, I do not support legalization of marijuana but I feel compelled to respond to you with a thank you. Most people who post in support of this topic scream that pot can do no harm. Your outlook on this subject is well thought out and written and I appreciate that you recognize that marijuana is NOT a safe product (and neither are alcohol and tobacco). Although our opinions on legalization differ, you are the first person I have seen post about this that truly seems rooted in reality.

I agree with Bernie. There are numerous medical indications for cannabis use. While increased use in alcohol and prescription meds (especially opioids)can be dangerous for the elderly, cannabis is a remarkably safe medicine. While there may be some risks associated with cannabis use as Dave writes, they are quite minimal compared to the other illicit drugs. I believe that Dave doesn't have his facts right regarding the risks related to smoking cannabis - check out the longitudinal pulmonary studies by Donald Tashkin at UCLA. As for cancer, research indicates that cannabis may actually help fight various types of cancer (such as lung, breast, prostate, pancreatic, glioma cell (brain), and skin cancer, as well as leukemia). I would also argue that cannabis use by adolescents does not cause mental illness - rather, many adolescents may be using cannabis to self-medicate for various mental health problems. I urge all to learn more about the therapeutic use of cannabis. Patients Out of Time (www.medicalcannabis.com)sponsors a biennial series of national clinical conferences on cannabis. The 2008 conference proceedings are available for online continuing education through the School of Medicine at UCSF - access this through a link on our website. Our 6th conference will be held in RI in April, 2010. I encourage all who work in the substance abuse field to learn about the efficacy of cannabis as medicine so you can differentiate abuse from medical use. While our government continues the unjust prohibition of cannabis, science supports its safety and efficacy as medicine. The real danger related to cannabis use comes from its prohibition.

Dave, I don't know if you were confusing this discussion thread with another one somewhere else. I don't see any post above yours in this thread where the risks of cannabis use are minimized. However, as Mary Lynn pointed out, those risks are certainly minimal compared with alcohol and most psychoactive prescription meds. The evidence that certain cannabinoids do have potent anti-cancer properties is growing, thanks in great part to research overseas like the Spanish study I quoted earlier. But then, we've had similar research findings from US med schools since the mid 70s (with the Medical College of Virginia study). It's just that this homegrown research has never gotten the time of day within either the corporate media or "drug worrier" forums. Tis a shame. Public policy should be based on sound science and real "truthiness", don't you think? However, I do appreciate your call for cannabis legalization as an explicit acknowledgement that the real harms associated with cannabis use are, as Mary Lynn pointed out, associated with its prohibition.

It is my experience that "most people who post in support of this topic" don't scream about anything, and pose intelligent, thoughtful comments. The message is not that cannabis causes no problems, but rather that cannabis should be regulated rather than prohibited, so that there can be some oversight and moderation, and that the potential medical, spiritual and industrial benefits of cannabis use far outweigh the problems. This cannot be said of alcohol or tobacco, yet we have found ways of dealing with the problems associated with those two substances without criminalizing the users, and producers.

respectfully bernie, you used the term "truthiness" incorectly. sound science goes well with truth, but truthiness, the quality of stating concepts or facts one wishes or believes to be true- rather than concepts or facts known to be true, is not related.

The truly enlightened MMJ users are vaporizing the medicine,NOT smoking it. This allows for better absorption of the medicine without the smoke. The medicine lasts much longer this way. This is just one example of why the REAL info must get out to the public, since everyone seems to think that legal marijuana use is somehow similar to tobacco use. It just is NOT!

Tony - thanks for the info! MJ is a source of positive medical attributes and we all need more and better education regarding this topic all around. Brinna - I agree with the legalization of MJ. Placing a "sin tax" on it would allow for more dollars to go towards research, education, and (hopefully) medical application. The costs from the legal use of alcohol and other illicit drigs within the social and public protection perspectives is not anywhere near what MJ has produced. Violence is not a behavior produced by the use of MJ and there is certainly a stronger argument for its use and application.

Carl, not to be misinterpreted, I thought the juxtaposition of "real" with "truthiness" showed my sarcastic intent, but I guess it did not. I agree completely with you that our public policy should be influenced by the truth, as identified, determined and verified by rigorous and intellectually unencumbered research. To be clear, I agree that "truthiness" is a practice that well describes the operating principle of much of the drug war rhetoric of the past four decades. It is refreshing to see a confluence of forces that is opening up our discussions, here and elsewhere, more broadly these days.

Weed should be a PERSONAL choice as should opiates be. (A lot of us would love to see the surreal day come that control-freak "Big Brother" took a more lax attitude toward issues they will NEVER fully get under control in the FIRST place!) I say just make EVERY state "Weed-Friendly." NOT fair for those of us whose states didnt make the "list!" Weed is a natural, g-d given HERB for us to enjoy and use to our benefit. I'll bet that you 'goody two shoes' that speak negatively of Weed would change your tune if you were to get Cancer or one of the many ailments that Weed actually helps! If it helps terminal people in the slightest bit, I'm all for legalizing!!