Pregnancy

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Marijuana may cause pregnancies to fail

22:00 01 August 2006
NewScientist.com news service
Michael Day


Smoking marijuana at the time of conception could cause pregnancies to fail, new research in mice suggests. The same problem may occur as a result of taking the slimming drug, rimonabant.

The warnings come from embryologists who have discovered key factors that govern an embryo’s chances of successful implantation. After fertilisation in humans and mice, the egg faces a perilous path from the place of conception in the fallopian tube down into the womb.

The team from Vanderbilt University Medical Centre, Tennessee, US, has shown that precisely the right levels of a chemical called anandamide are required for this passage to be completed safely. Increasing or decreasing the amount of anandamide drastically harms mouse embryos’ chances of normal implantation and survival.

Their research reveals that anandamide levels in the fallopian tubes are governed by two enzymes: one called NAPE-PLD increases levels of anandamide, while NAAH reduces them.


<span class=postbold>Cannabinoid receptor</span>

Significantly, the team also found that exposing the mice to certain drugs disrupted this delicate balance, thereby impeding an embryo's ability to pass into the womb. One such substance is tetrahydrocannabinol (THC), the major psychoactive component of marijuana.

Like anandamide, it binds to the cannabinoid receptor CB1, thereby displacing anandamide and boosting levels of the chemical present in the oviduct.

The discovery poses worrying questions about the ability of marijuana, the most widely used illegal drug among women of reproductive age, to harm pregnancy, says the lead researcher, Sudhansu Dey.

“This is worrying because embryo retention is a significant cause of ectopic pregnancy in women,” he says. He also notes that the incidence of such abnormal and dangerous pregnancies has risen sharply in the past decade.


<span class=postbold>Slimming pills</span>

Another expert in reproductive biology, Herbert Schuel at the State University of New York in Buffalo, US, points out that some new medicines also interacted with CB1 receptors and therefore had the potential to disrupt amandine levels and embryo development. One such drug, the slimming pill rimonabant – sold as Acomplia – is already licensed in the UK.

“Given the results of the study, we need to be very sure that rimonabant doesn’t have unwanted effects on women of reproductive age," Schuel says. CB1 receptors are not just present in the brain but all over the body, including the reproductive system, he adds, "so we shouldn’t be surprised if it has unwanted effects".

A spokeswoman for rimonabant’s manufacturer, Sanofi-Aventis, said the company did not recommend the use of rimonabant during pregnancy and advised patients who are planning to become pregnant to seek immediate medical advice.

Journal reference: Journal of Clinical Investigation (vol 116, p 2087)

<span class=postbold>See Also</span>: Cannabis Without Euphoria?

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The Times
August 02, 2006


Slimming wonder drugs could be a danger for mothers-to-be
By Michael Day and Nigel Hawkes



WOMEN of childbearing age may be at risk from using rimonabant, the latest weight-loss “wonder drug”, leading scientists have said.

The alert comes after evidence that a key chemical that is affected by the drug is needed for embryos to implant normally in the womb. It is feared that even small variations in the level of anandamide, which governs the development and implantation of the embryo, could have disastrous consequences.

The weight-loss pill was introduced in Britain under the brand name Acomplia this summer as a drug that can help a person to lose 10 per cent of their weight in a year. It works by interacting with anandamide to reduce appetite and, it has also been claimed, helps smokers to give up by reducing their cravings.

Test results for rimonabant were quite impressive. In trials involving more than 6,000 patients in the US and Europe, about a quarter of those taking it lost more than 10 per cent of their weight after a year.

But research sponsored by the US Government and published in the The Journal of Clinical Investigation suggests that the drug may also be able to alter levels of anandamide. Experiments with mice have shown catastrophic effects on the development of embryos.

The researchers believe that potential adverse effects could include ectopic pregnancy — in which an embryo fails to move to the womb for correct implantation. This could occur very early in pregnancy, possibly before a woman even knew she had conceived.

Sudhansu Dey, director of reproductive and developmental biology at Vanderbilt University Medical Centre, Nashville, said that his work raised real concerns about the safety of rimonabant in women of child-bearing age.

For example, women might use the drug in the hope that it would help them to quit smoking before they conceived, not realising the potential risks.

Professor Dey said that he had spoken to the manufacturer of rimonabant, the French drug company Sanofi-Aventis, about his concerns. “I gave a talk to them to explain the problems, but I didn’t hear from them again,” he said. “At least they should consider putting a warning on the packets.”

The potential market is huge. Some analysts have predicted that Acomplia alone could generate worldwide sales in excess of £3 billion. The drug was given official European Union marketing approval in June. Sanofi-Aventis also hopes to win a licence in the US, where the Food and Drug Administration has asked for more information.

Herbert Schuel, an expert in reproductive biology at the State University of New York, in Buffalo, said: “Given the results presented by Professor Dey’s study, we need to be very sure that rimonabant doesn’t have unwanted effects on women of reproductive age.”

A spokeswoman for Sanofi-Aventis said that existing packages advised women who were pregnant to consult their GP before continuing with medication. “Sanofi-Aventis takes the safety of all its medicines seriously and will report any adverse events to regulatory authorities,” she said. “We do not recommend the use of rimonabant during pregnancy.”

The study does not address the effects of rimonabant directly but looks at marijuana, which also affects levels of anandamide. Professor Dey’s team showed that very precise levels were required for healthy pregnancies in mice.
<ul>
THE DANGER

<li>Ectopic pregnancies are one of the most dangerous complications faced by women expecting babies </li>

<li>They occur when an egg fertilised in the Fallopian tubes fails to reach the womb </li>

<li>The embryo can implant in the Fallopian tubes, ovaries, abdomen or cervix </li>

<li>Anything that slows the movement of the egg can increase the risk. Research suggests that Acomplia may have that effect </li>

<li>Ectopic pregnancies, which are becoming more common, can cause rupturing of the Fallopian tubes and internal bleeding and kill the mother </li>

<li>A woman who has had an ectopic pregnancy is more likely to have another, and her fertility is likely to be reduced </li>
</ul>

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Pregnancy and Pot Don't Mix
08.01.06, 12:00 AM ET
Forbes

TUESDAY, Aug. 1 (HealthDay News) -- Using marijuana at the time of conception or in early pregnancy can result in pregnancy failure, a new study in mice suggests.

"Marijuana exposure may compromise pregnancy outcome," said Sudhansu Dey, the corresponding author of the study, published in the August issue of the Journal of Clinical Investigation. Marijuana's active ingredient, THC, can disrupt the body's finely tuned signaling system and interfere with a fertilized egg's ability to implant in the lining of the uterus, the study found.

Dey, the Dorothy Overall Wells professor of pediatrics, cell and developmental biology and pharmacology at Vanderbilt University Medical Center, and his colleagues conducted their experiments in mice. It's known that marijuana, the most widely used illegal drug among women of childbearing age, binds to two receptors, called cannabinoid receptors 1 and 2 (CB1 and 2). These receptors are found in the brain and also in sperm, eggs and newly formed embryos.

Typically, the two receptors are activated by a signaling molecule called anandamide, which is synthesized by an enzyme known as NAPE-PLD and then is degraded by another enzyme called FAAH. This balance, or "tone," of the anandamide is crucial for the embryo to develop normally.

Dey and his team suppressed FAAH activity in the mice. This increased the level of anandamide, which mimics what happens when a woman smokes marijuana and increases the level of THC, which binds to the same receptor as anandamide. The results showed that when FAAH activity is suppressed in the embryos and oviduct, anandamide levels rise, preventing the embryos from completing their passage to the uterus and compromising the pregnancy.

"This is a major finding," said Dey, "that if you block FAAH and disturb anandamide levels, there is a compromised pregnancy outcome."

"This occurs very early during pregnancy, right from the start of fertilization," he said. "This may explain tubal pregnancies, it may be one cause of retention of embryos in the oviduct." He stressed that the experiment was only in mice.

What wasn't known before, he said, is what happens if you block the FAAH.

Other research, also in animals, has suggested that pregnant women who smoke pot can pass on memory problems to their offspring. And pot use in women during pregnancy has been linked to low birth weight and to symptoms in the baby, such as excessive crying and shaking, according to the March of Dimes.

In an accompanying commentary in the journal, Herbert Schuel, professor emeritus of anatomy and cell biology at the University at Buffalo, State University of New York, said the Dey study findings "show that exogenous THC can swamp endogenous anandamide signaling systems," affecting many processes in the body.

And Schuel offered another warning: Several drugs in development to suppress appetite work by modifying anandamide signaling. Since many women of reproductive age take weight-loss drugs, he suggested that these drugs must be carefully evaluated to determine the long-term effects on women.

In an interview with HealthDay, Schuel said the Dey study "provides insight into normal mechanisms that regulate early development of the embryo and its transport through the oviduct to the uterus," as well as how marijuana affects that process.

Marijuana use, Schuel said, could also increase the risk of ectopic or tubal pregnancies, a serious situation in which the embryo lodges outside the uterus, typically in the fallopian tube.

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The following study is speifically about the mother's use of cocaine while pregnant but I found the following statement noteworthy, and therefore include the article here.

<i><span class=postbold>Some of the children whose mothers did not use cocaine were exposed to alcohol, tobacco and marijuana, but they did not exhibit the same subtle differences in the brain. </span></i>

Drug Exposure Before Birth Could Affect Kids' Decision-making Skills

Medical News Today
12 Nov 2006

The part of the brain responsible for making most decisions about how to behave seems to develop less quickly in children exposed to cocaine before they were born, University of Florida researchers have found.

Using a new form of magnetic resonance imaging, researchers compared 28 adolescents exposed to a mix of cocaine and other drugs in the womb with 25 children whose mothers did not use cocaine during pregnancy and pinpointed subtle differences in how the brain's frontal lobe developed. Researchers noticed that pathways in the frontal lobe, which connect to other parts of the brain to send information, were not as well-defined in children exposed to cocaine before birth, according to findings published this month in the journal Pediatrics.

The children exposed to cocaine also fared slightly worse on tests designed to assess skills linked to the frontal lobe, such as when to act and when to stop, said Tamara D. Warner, Ph.D., a UF research assistant professor of pediatrics and the study's lead author.

"We actually found that there is a relationship between the behavior and the brain," Warner said. "There were significant associations with how well children were able to do certain tasks and how well-developed the connections in the brain were."

Some of the children whose mothers did not use cocaine were exposed to alcohol, tobacco and marijuana, but they did not exhibit the same subtle differences in the brain. Because the mothers of children exposed to cocaine used multiple drugs, how these drugs interacted was likely a big part of the problem, Warner said. The mothers had taken cocaine and varying combinations of alcohol, marijuana and tobacco, and the interactions among these drugs often are complicated, sometimes producing additional toxic substances, Warner added.

To get a better glimpse of the frontal lobe, researchers used a form of imaging that allowed them to see how water flows through pathways linked to other parts of the brain. How the water moved through these channels showed the researchers how developed these pathways were in each child's brain. The pathways were more mature in children whose mothers did not use cocaine and not as well-formed in the children whose mothers had, the study showed.

The children, who ranged in age from 10 to 12 and were from similar socioeconomic backgrounds, also participated in two behavioral tests that Warner likened to "Simon Says" types of activities. On one test, children were asked to look at the word "red" but then name the color of the ink used to write the word. This showed how well they were able to ignore the instinct to read the written word and give the correct answer. On another test, which Warner likened to "connect the dots," children were asked to connect a series of numbers in order on a page and then perform a similar exercise alternating between numbers and letters. The children in the drug-exposed group named fewer colors correctly and took longer to adapt to connecting both numbers and letters, Warner said.

Including observations about how the brain looks and behavioral test results in the study is important because it links an actual brain change in children to a behavior change, said Lynn T. Singer, a professor of pediatrics, psychology and general medical sciences at Case Western Reserve University who also studies prenatal cocaine exposure in children.

"This is one of the first findings that shows there is a difference in the way the brain works in (children exposed to cocaine)," Singer said. "It's a very important study in that we're getting new evidence of specific brain changes. The way the brain is wired is different for these children."

Despite these subtle signs of damage, UF researchers say children exposed to cocaine before birth are still faring far better than people predicted in the 1980s, when they were dubbed "crack babies." Past studies at UF and other institutions have shown that children exposed to cocaine before birth exhibit no more behavioral problems as toddlers than other children, have average IQ scores and face only slight problem-solving difficulties in school.

But the biggest questions won't be answered until the children age, Warner said. Researchers do not know yet how these differences in the brain's frontal lobe will affect children as they enter their teen years and are faced with peer pressure and tough decisions.

"Not knowing when to stop and when to inhibit your behavior could have much wider consequences than a Simon Says game," Warner said. "The differences we found were intriguing, but they really are the first piece of the puzzle in understand how these children are developing."

University of Florida Health Science Center
1600 S.W. Archer Rd., Rm. C3-025
Gainesville, FL 32610
United States
http://www.health.ufl.edu/

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<span class=postbold>Drug War Chronicle - world’s leading drug policy newsletter</span>

Feature: Arkansas Law Punishing Mothers Whose Newborns Test Positive for Drugs Accomplishes Little, Study Finds

from Drug War Chronicle, Issue #472, 2/9/07

As legislators at statehouses across the country ponder laws that criminalize or civilly punish drug use by pregnant women, researchers in Arkansas have evaluated the working of a similar law there -- and found it wanting. Meanwhile, bills are pending in at least five states -- Idaho, South Carolina, South Dakota, Virginia, and Wyoming -- that would do the same thing. Proponents of such laws portray them as aimed at "saving the children," but critics argue such laws do little for children and are really aimed at controlling drug use by punishing young, poor, and minority women.

In 2005, Arkansas legislators passed a bill popularly known as Garrett's Law, after a baby supposedly born with methamphetamine in his system. [Editor's Note: Be wary of any law named after a victim; they seem to pass easily in a rush of emotion with science and reason brushed aside.] Under Garrett's Law, the mothers of newborn infants who test positive for illegal drugs are presumed to be guilty of parental neglect under the state's civil code, and medical personnel can report them to police and child protective service workers.

Last fall, at the request of policy analysts studying the law, the Arkansas Department of Health and Human Services, Division of Children and Family Services commissioned a report on how the law had been implemented and what its impact had been. Among that report's key findings:
<ul class=postlist>
<li> There were 412 referrals under Garrett's Law in the 12-month period examined. With some 38,405 births recorded during that period, Garrett's Law referrals amounted to a rate of 10.7 per every thousand births. </li>

<li> Marijuana was by far the most commonly found drug, mentioned in just over half of all cases, while amphetamines and cocaine were found in about 25% of cases and heroin, barbiturates, or prescription drugs were found in about 7% of cases. </li>
<li> In two-thirds of cases, "no health problems" were reported in the infants. On the other extreme, eight infants died, but there is no evidence that the mother's drug use was the cause of death. Marijuana was most likely to be associated with no health problems, while health problems were more likely to be associated with stimulant use by the mother. Instances of death appear to be most commonly associated with barbiturate use. </li>

<li> A finding of child neglect was found to be "substantiated" in two-thirds of all cases referred and a Protective Services case was formally opened in 62% of all cases. </li>

<li> Slightly less than one-fourth (23%) of children involved with referrals were removed from the family home. The drug most associated with removal of children was cocaine, followed closely by amphetamines. </li>
<li> Only 5% of children removed from parents received any medical treatment related to the alleged maltreatment, although the report says it does not have complete numbers.
Either 6.6% or 20% of mothers reported received drug treatment. Again, the report complains of sloppy reporting and does not resolve the different figures. </li>

<li> Some 64% of mothers reported received some sort of "service," but in most cases that "service" was only drug testing. </li>
</ul>
"This report basically says there is nothing in the data that supports the notion these kids have health problems," said Lynn Paltrow, executive director of National Advocates for Pregnant Women. "This law is not about children's health, but has everything to do with controlling drug use in certain populations. They say people who use drugs are bad parents, but I say show me some evidence-based research that documents the extent to which drug use and parenting ability are truly associated," she said. "You have 72 million people admitting to having used marijuana -- are they all bad parents?" Paltrow continued.

While some analysts supported the law because of the broad goals of protecting the health and welfare of infants and their mothers it is supposed to advance, even they had serious concerns about its impact. "While it is critically important that women who are pregnant and giving birth and have an illegal drug in their system need to be looked at closely -- it is an indicator that something is going on -- there are several problems with Garrett's Law," said Paul Kelly, senior policy analyst for Arkansas Advocates for Children and Families, who sits on the Garrett's Law advisory group. "One thing we have found is that there are a lot of women who are not being tested. That means we are relying on the judgment of the attending physician to decide who is and is not being tested."

Kelly raises an interesting question about who is being subjected to the law. The report on the law's working does not provide a race and class breakdown of who is being reported, although that information is presumably readily available. The report does provide a breakdown by age, and not surprisingly, most of the women reported under the law were in their twenties.

"Another problem with the law is that in many cases, the finding of substance use is the sole cause of the finding of mistreatment," Kelly continued. "They may have other children who are doing well, are well-cared for, doing well in school, yet they may be taken from their mother because of substance use without any consideration of other factors involved."

The report's low figures on treatment for women in the report -- either 6.6% or 20%--also raise concerns. "There is a terrible lack of treatment available to these women," said Kelly. "We take their children away from them, yet we are not providing appropriate treatment. Are we here to help or punish? This law has had some consequences that need to be corrected."

An effort to do just that is just getting under way early in the legislative season. "We're in the middle of trying to revise Garrett's Law to make it a little less punitive and more family-friendly," said Cynthia Crone, executive director of the Arkansas Center for Addictions Research, Education and Services (Arkansas CARES), which, among other things, runs the state's largest treatment program specifically aimed at mothers suffering from substance abuse.

Advocates are in the final stages of drafting reform language and now have a sponsor in the statehouse, Kelly said. "There are several things we are looking at. We don't want the fact that an illegal substance was found in the child's body at birth to be the sole determinant of whether there is child abuse going on," he said. "If the only finding is that these women have drugs in their system, they should not be placed on the child abuse registry, but given the opportunity to seek treatment. We don't want to ruin their ability to care for their children and have gainful employment because of making foolish mistakes."

"This report doesn't find a strong association between any kind of prenatal exposure to drug use and health problems in the infant," said Paltrow. "For legislators to focus on maternal drug use as the primary threat to children's health when there are eight million children without health insurance is absurd. If we focus on things like this, it distracts our attention from much larger issues, like the 46 million uninsured, the lack of treatment, no paid maternity leave, those fundamental problems. They say it's about the kids, but the result is not more funding or treatment; instead, we're out arresting mothers."

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Salem-News.com (Jan-03-2008 13:03)

Endometriosis: Marijuana Treatment
Dr. Phil Leveque

<span class=postbigbold>Phillip Leveque has spent his life as a Combat Infantryman, Physician, Toxicologist and Pharmacologist.</span>


(MOLALLA, Ore.) - I don't think I have to explain what this is to anybody. If you have it, you know it. Endometriosis is graded in stages I,II, III & IV, with stage I being "minimized" inconvenience while stage IV is severe and usually requires surgery.

As a physician, I had known about endometriosis for years and that some women become narcotic addicts because of it. Pre Menstrual Tension (PMS) may be concurrent though different and I had many PMS patients as well. Some of them became addicts also. I was not surprised when lady patients came to our clinics offering chart notes that they had been prescribed every conceivable analgesic and other medications but they also told me marijuana works better than any regular prescription.

I have a severe pain problem myself caused by too high of a concentration of spinal anesthesia. I got disgusted by the anesthesiologist telling me he didn't cause it but I got a new understanding for patients in pain.

If the patient says marijuana works for pain, I believe them. Actually in Oregon about sixty percent of patients have some chronic pain syndrome of nerve, muscle, joint, bone, intestinal or genitourinary. It doesn't seem to matter whatever the source of pain, the bottom line is that MJ gives relief.

I presume stage I endometriosis and minor PMS are effectively treated with aspirin-like drugs, but when the pain etc. is in the moderate/severe level, the ladies have found out by themselves that marijuana/cannabis is effective without the hazard of narcotic addiction or alcoholism.

The U.S. government publicizes that as many as 77 million Americans have used marijuana and perhaps ten million use it frequently.

Marijuana as folk medicine has been used in the U.S. since the middle 1800's and probably in Mexico and Latin America since the Spanish introduced it in the late 1500's.

It is no longer amazing to me when a patient tells me of some new disease for which they have discovered marijuana treatment is beneficial.

It is time the DEA and its hoodlums backed off and allow the therapeutic use of medical marijuana, as more and more people are reverting to this tried and true "folk medicine" everyday.

[palmspringsbum]

<small>Salem-News.com (Mar-28-2009 20:36)</small>

Medical Marijuana Questions & Answers with Dr. Phil Leveque

<table class="posttable" width="245" align="right"><tr><td class="postcell"><embed id="VideoPlayback" src="http://video.google.com/googleplayer.swf?docid=-5468019789070670345&hl=en&fs=true" allowScriptAccess="always" type="application/x-shockwave-flash"> </embed></td></tr><tr><td class="postcell">Bonnie King and Dr. Phil Leveque - Salem-News.com</td></tr></table>The latest round of answers for the myriad questions our viewers submit over the use of legal cannabis.

(SALEM, Ore.) - In our ongoing video series on the legal use of medical marijuana, Dr. Phil Leveque and Bonnie King discuss the person many regard as the first medical marijuana pharmacologist; Queen Victoria of England.

Dr. Leveque explains that the Queen used cannabis throughout her 11 pregnancies. Many women will tell you that marijuana has no equal when it comes to suppressing morning sickness.

While some doctors may scoff at the idea of pregnant women using marijuana, there are no proven ill effects, and doctors are trained with out of date material in medical school to take issue with the substance when in reality, there is no sound reason. The standard jargon published in anti-marijuana booklets is turning out to be mostly false. So if a woman is able to avoid being wretchedly ill, how can it be negative?

At any rate, it worked for Queen Victoria whose influence is visible to this day across the western world, and right here in Oregon.

In fact there is a long list of moms who are mostly quiet on a public level about their successful use of marijuana during pregnancy for legal reasons.

The state of Oregon in particular, will essentially kick a woman to the street and strip her of benefits, along with her unborn child in need of pre-natal care, if they discover by sifting through their urine that they have used this herb.

But back to the video.

Who can legally grow marijuana for medicinal patients?

Doctor Leveque addresses this important question by reminding everyone that anything they do should take place within legal boundaries. There are no provisions that he knows of that allow a person to grow without authorization from a state authorized medical marijuana program. Patients can designate both caregivers and growers, but it all has to be conducted according to the voter-approved rules.

The doctor addresses a total of five viewer questions related to diseases or chronic pain and the related use of medical marijuana.

One asks, "how does medical marijuana work in conjunction with other prescribed drugs?" Dr. Leveque says that in many cases, medical marijuana can replace some narcotics that a person is dependent on. We at Salem-News have received contact from many people over the years who tell us this is true from personal experience.

However, there are plenty of situations where this will not be the answer and it is important to remember that in spite of its many applications, marijuana as medicine is not a miracle cure and should not be seen as such. Either way, it is a natural remedy versus one created in a scientific laboratory.

The father of a 14-year old with verbal Asberger's asks Dr. Leveque if, after exhausting traditional treatments that all involve hard drugs, which have failed to work, medical marijuana might be worth exploring?

These questions and more, in this video segment:

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Dr. Melanie Dreher, reefer researcher

By Pete Brady - Sunday, November 1 1998
Cannabis Culture

<span class="postbigbold">Despite political pressure to have it otherwise, Dr. Dreher's research reveals that pot-smoking moms can have smart, healthy babies.</span>

<table class="posttable" align="right"><tr><td class="postcell"><img class="postimg" src="http://www.palmspringsbum.org/bbs/bin/dreher_melanie.jpg"></td></tr><tr><td class="postcell">Dr Melanie Dreher</td></tr></table>When Dreher released solidly researched reports showing that children of ganja-using mothers were better adjusted than children born to non-using mothers, she encountered political and professional turbulence.
Dr. Melanie Dreher is one of a handful of scientists who have researched marijuana objectively and intelligently in the last three decades.

Dr Dreher is Dean of the University of Iowa's College of Nursing, and also holds the post of Associate Director for the University's Department of Nursing and Patient Services. She's a perpetual overachiever who earned honours degrees in nursing, anthropology and philosophy before being awarded a PhD in anthropology from prestigious Columbia University in 1977.

Although Dreher is a multi-faceted researcher and teacher whose expertise ranges from culture to child development to public health, she began early on to specialize in medical anthropology. After distinguishing herself as a field researcher in graduate school, Dreher was hand-picked by her professors to conduct a major study of marijuana use in Jamaica. Her doctoral dissertation was published as a book titled "Working Men and Ganja," which stands as one of the premier cross-cultural studies of chronic marijuana use.

Along with being a widely-published researcher, writer, and college administrator, Dreher is a professor or lecturer at several institutions, including the University of the West Indies. She recently served as president of the 120,000 member Sigma Theta Tau International Nursing Honour Society, has been an expert witness in a religious freedom case involving ganja use by the Ethiopian Zion Coptic Church, and is one of the most well-respected academicians in the world.

Governmental and private organizations, including the US State Department, have funded Dreher's many research projects, some of which focused on ganja's role in Jamaican culture, and the effects of ganja and cocaine on Jamaican women and children.

Dreher has impeccable credentials and a wealth of proprietary information on ganja use, but when she released solidly-researched reports showing that children of ganja-using mothers were better adjusted than children born to mothers who did not use ganja, she encountered political and professional turbulence. Some observers accuse the government and anti-pot groups of working to suppress her findings, but Dreher continues to speak openly about her research.

When Dreher spoke to Cannabis Culture from her office at the University of Iowa, she was affable and intriguing, pleasantly but firmly defending her right to study ganja use and to publish valid scientific findings regardless of political pressure.

[: How did you first become involved in studying ganja in Jamaica?

Dr Dreher: I had already spent one summer in jamaica studying obeah, a kind of black magic, and my professor, Dr Lambros Comitas, felt that if I could study an illegal and underground practice like obeah then I could probably get information on ganja use.

This was in the 70's, when American pundits were saying that marijuana caused people to be lazy and dysfunctional. We were especially interested in testing the notion that ganja caused an amotivational syndrome. My dissertation research studied various kinds of men's work, primarily agricultural work, and how ganja interacted with that.

Jamaica was a great place to study because these men used ganja every day for eight to ten years, unencumbered by cocaine or other drugs, and just a little bit of tobacco or alcohol, so you could really measure how ganja affected them. After nearly two years of study in Jamaica, I'd found ganja was used to stimulate work. The amotivational syndrome, whatever it was, certainly didn't manifest itself in the people I studied.

[: So you just walked up to Jamaican villagers and started asking them about ganja? Weren't you afraid they'd think you were a police agent?

It was an interesting experience! I had never smoked anything, not even a cigarette. I'm a white woman, a former cheerleader, about as 'American' as you could get. I didn't have an intermediary or liaison. I went into villages and politely introduced myself as an American student. I established trust by going to church and schools and living with these people, telling them I was there to study certain aspects of their culture, especially herbs and particularly marijuana, and people began to trust me. They gave me a few social tests to see if they could really trust me, and after I passed those tests pretty soon I was going into their fields and seeing where ganja was grown, dried, stored, processed and sold.

There is a cultural division between men and women in this culture, but even though I was a woman, as a white American researcher I had more privilege and access to men's rituals than a Jamaican woman. I got to sit with the men surrounded by these big clouds of smoke, and as they smoked their chillums I asked questions about ganja use and took notes.

[: So ganja use had its own cultural identity and rules?

Yes. Ganja use is governed by customs, beliefs, and social rules. Ganja arrived in Jamaica through the Indian indentured labour; Indians brought with them this whole tradition of preparation of teas, tonics, hash, cooking ganja in food.

The Jamaican ganja-users, except for the Rastas who tend to use more ganja than the people we studied, had strict cultural contexts in which to use marijuana. It isn't like in the US where people indiscriminately light up and walk around all day stoned. The Jamaicans prescribed certain situations and ways to use ganja.

There were people prohibited from using it. When you smoked you had to act a certain way ? serious, intelligent, reasonable. A man who used ganja and got silly or got the munchies or laughed too much or acted like a fool ? the other men stopped smoking with him because they felt the ganja was a spiritual thing. It's to be taken seriously in a mature and responsible way.

A whole set of cultural rules guided use and made sure it was positive. The set and setting and cultural traditions in Jamaica made ganja use a positive thing. It's useful to study ganja in a place where its use is not just a recreational activity ? its use is sacramental, medicinal and social, but it is designed to be a thoughtful activity ? not like you stop at the store and get a six pack of beer to get drunk.

[: Did ganja culture affect how men and women used ganja?

It did. The men believed that ganja inhaled went to the brain and had a psychoactive effect, but that ganja consumed as tea or tonic went into the blood and had a health effect rather than intoxication. They only allowed men to smoke ganja because they didn't believe women had the right kind of brain for it.

Now there are physiological differences between men and women, and it's also true that ganja eaten or ingested as tea follows a different route in the body than ganja smoked, but I am not expert enough in this to comment on whether the cultural tradition is supported by science.

Women were allowed to control the medicinal use of ganja. I spent lots of time with rural women, who taught me how to make ganja tonics and teas. They were the administrators of ganja, often the producers and sellers of ganja. It gave them some power and income, like a cottage industry. They gave ganja to men and children as teas, and they knew how to titrate the strength of marijuana teas so a new baby would get just a leaf's worth but men and boys got more, so they could go and work in the fields with enough strength to survive the hard days.

[: So women never got to smoke ganja?

When I first started research in Jamaica in 1970, women were the ganja medicine specialists but there was a social rule that women should not smoke. The only time women were allowed to smoke was in a pre-sexual context. Everybody believed ganja was an aphrodisiac, they said it made both sexes more powerful, makes you like sex more, makes you concentrate on lovemaking more.

It was not used as a clandestine seduction tool like alcohol. That's not to say that like at a dance if young men were smoking, a young woman wouldn't say "Give me a draw," but it was very innocent, I never saw an attempt to use marijuana as seduction or date rape.

Back then, women were smoking secretly. If a man didn't finish the whole spliff then after he went to work the women might smoke a little. Women said it helped them do their housework and be good to their children. So the women had to sneak around to smoke it but they were expected to openly administer its medicinal use.

The real focus of the women was to have marijuana to prepare for tea for their children to make them healthier and smarter and help them have better school performance and help them concentrate.

[: Has your subsequent research found changes in the use of ganja by Jamaican women?

Yes, as the role of women has changed economically and socially, some women have been able to smoke ganja openly with the men. They're called "roots daughters", which is a term of respect meaning that they can smoke as hard as a man and maintain a dignity of conversation and behavior. They can smoke ganja and reason with men, have debates about serious topics like politics and religion. They are considered to be principled women who are astute and trustworthy.

Another characteristic of these women is they tend to be economically independent and resourceful. They don't expect that men will have the sole burden of supporting households. Many of these women are working for themselves, and a significant number of them are involved in ganja sales, along with work such as farming and other commercial enterprises. They build their own houses and become less dependent on men, or on one man, for their livelihood.

Part of this change came from Rastafarianism, because Rasta women do smoke ganja chronically as part of their religious rituals. Older women have built up their roles as ganja administrators, while older men may have to decrease their ganja use once their days in the fields are over. The society is changing, experience with ganja is changing, and women smokers are becoming more visible then before.

[: Give us a general overview of the studies you've done on ganja use during pregnancy

When I noticed that increasing numbers of women were smoking marijuana, I decided to study prenatal marijuana exposure and its effects on children. Most of the studies done in North America had serious confounds and results which just did not hold up under scrutiny.

We did ethnographic studies which examined the lifestyles of mothers who used ganja and mothers who didn't use ganja, and compared behavioral characteristics of neonates from both groups in the first month of life. We later went back and looked at the children with a five-year follow-up study.

[: How did your studies differ from other studies?

Up to that point, most studies which examined marijuana use during pregnancy were flawed by serious methodological problems. They couldn't control for so many variables, and the negative effects they blamed on marijuana could well have been caused by other things.

My studies are among the few which actually measured how much ganja a woman has consumed. I wasn't sitting in a clinic somewhere divorced from women's lives asking them how much marijuana they'd used ? my research team is in a community and in the field where we can observe these women and check out their reports. We know how much ganja, and what type and potency, they are consuming. We had ways of verifying the amount of ganja they consume; neighbors would come and tell us what was going on, so we could compare that to what we had been told by the mother.

We had a setting in which we knew that the women were only exposed to marijuana. In most North American studies the women were using all kinds of drugs like alcohol, tobacco, speed and cocaine during prenatal studies, and there was no way for the researchers to know what or how much. We knew what our test subjects were doing and this gave extra credibility to our work.

A lot of media publicity had been given to US studies which purported to show that marijuana caused birth defects or serious developmental problems, but most of this research involved participants who were multi-drug users who had a terrible social support network that probably caused the problems. Instead, these problems were blamed on marijuana.

[: Is it possible that American women didn't know how to use marijuana intelligently? Did you find that Jamaican women had more ganja wisdom?

American drug use often takes place without cultural rules and in an unsupervised context. The Jamaican women we studied had been educated in a cultural tradition of using marijuana as a medicine. They prepared it with teas, milk and spices, and thought of it as a preventive and curative substance. Smoking it during pregnancy was a way of relieving nausea, increasing appetites, combatting fatigue and depression, providing rest and relaxation. Some of these women were in dire socioeconomic straits, and they found that smoking ganja helped allay feelings of worry and depression about their financial situation.

Our testing showed that the children of women who used ganja had better alertness, stability and adjustment than children of women who didn't use ganja. This was measured at the age of one month. We measured children again at four years and at five years of age, and found that there were no apparent deficits in the children of marijuana-using mothers. In fact, in many ways, they were better off than children of non-smoking mothers. The ganja-using mothers also seemed better off than non-users.

[: Since these results contradicted the hysteria of drug war assertions, did you find it hard to get your studies published?

I insisted on publishing in a medical journal ? I wanted the academic community to understand that the jury was still out on marijuana and that's why we do cross-cultural studies to determine how drugs really affect people. It isn't logical to look just at one culture's problems with a drug and conclude that that's a universal situation.

The medical community needed to see that these results, which came from very solid research methods, were far different than what they are usually exposed to. They needed to see that women who smoked marijuana are not bad mothers. I am so damned sick of picking up a woman's journal or a tabloid and seeing some article saying that if you smoke even one marijuana cigarette during pregnancy you are a bad mother and you're doing permanent damage to your baby. There's no evidence to back up these warnings, and in my studies the evidence points in the other direction.

[: It sounds like you're frustrated about the influences of politics and inaccuracy in the reporting of marijuana research findings.

I just want researchers to use good research methods and to tell women the truth. I think these hyperbolic warnings about marijuana and pregnancy have made women absolutely nuts.

I got a call from a woman who was in tears because she and her husband had waited several years to adopt a baby and finally she had found a baby to adopt, but somebody told the couple they couldn't adopt the baby because the baby had tested positive for marijuana. "Oh for god's sake," I said, "Go adopt your baby. Love your baby. Your baby is going to be just fine."

Now they're talking about charging women with child abuse if they test positive for drugs during pregnancy. It's a slippery slope. Where's it going to stop? Are we going to arrest women for sitting on the couch eating junk food watching television during pregnancy? We are on the way to the Stepford Wives.

So one of my goals with this research was to get the message to physicians: so women smoke a little marijuana ? big deal. Let women enjoy their pregnancies. If there's something seriously wrong with their baby it would have occurred no matter what ? marijuana or not. Things have gotten so strange in regard to babies. We have to have the perfect baby and if not, well somebody or something has to be blamed. It must have been a whiff of paint she smelled, or a glass of wine, or a cigarette, or a draw of marijuana? It's ridiculous.

[: Can you comment on the issue of crack babies?

I have tended to be vary skeptical of crack baby findings. I have studied cocaine use in Jamaica, and have studied children exposed to crack pre-natally who are doing fine.

I think the problem with crack is what happens after birth. The babies are often abused by mothers or others in the home; cocaine is just part of a terrible environment. Ironically, Rastas are the only group who refuse to participate in the cocaine trade. They think it's poison. Women use ganja to kick cocaine withdrawal; they use ganja during cessation to get enough of a comfortable anti-depressant feeling so that they don't have to use crack.

Some start using what they call a seasoned spliff, which is a marijuana cigarette seasoned with crack. Having the pot in there seems to relieve the precipitous drop from the crack high to a paranoia which would otherwise force them to smoke crack immediately again. They are high enough on the pot and the crack drop doesn't make them crazy like it would if they were using crack by itself.

The American government's approach to cocaine and ganja in Jamaica has been very counterproductive. The DEA finds it easy to see and go after ganja fields, but almost nothing is being done to stop cocaine, which is ravaging the country. It's very sad.

[: I heard that political pressure influenced your subsequent research grants and the academic journal that you were going to publish your findings in.

It did take us a while to get published. We had to do revisions that I thought were unnecessary. It would be hard to classify the request for us to do revisions as politically motivated. I just thought that these people who wanted the changes made haven't got a clue about Jamaica or ethnographic research. They went on vacation once to Jamaica and drew some incomplete conclusions.

I felt that the revisions suggested were often based on ignorance of Jamaican culture and prejudice against ganja. The same problems were evident in letters that the journal received after publication. The letters contained unfounded criticisms, and I had to explain that I was doing anthropological research that nobody else was doing. I wasn't measuring physiology with test tubes. I was measuring behavior, reporting how these women and their children acted.

These babies are doing great. It wasn't necessarily due to marijuana, but pot-smoking mothers were apparently good mothers and the marijuana didn't appear to be hurting the babies. I have said repeatedly that I am not recommending that you smoke pot to have a healthy baby, but I am saying let's not castigate women who use a mild substance during pregnancy.

After doing research in Jamaica funded by the National Institute on Drug Abuse (NIDA) from 1988 to 1991, I submitted two follow-up proposals in 1993 and 1994 and got news that never ever do they want to see those proposals again. They had done one of the worst reviews of a proposals that I had ever seen. Really weak.

I thought I should call NIDA and tell them this shows a lack of understanding of any type of unbiased research on the issues involved and what we're trying to do. It was a damning review, misguided and misinformed. I have to think that this was due to a political consideration, not an honest review of my work.

I'm 55, in my 15th year as dean, I testified in a trial and the prosecution brought out that I was once on the board of NORML, and involved with a group called POT (Patients Out of Time) and wrote an article for a medical marijuana book. So what? I am a good researcher. Nobody knows more about marijuana use in Jamaica than I do, and I am prepared to speak about that and don't care what people try to do against me because of it. I felt that this last denial at NIDA was motivated by anti-pot ideology, but since that time I was funded by the National Institute of Health.

[: Has your career suffered because you've objectively researched marijuana? Do you feel you've been persecuted because of your research?

There may well be persecution, but if there is, I don't obsess over it. I'm a very good dean and highly regarded in the nursing and academic communities. Somebody asked me if I was worried about DARE coming after me, and I thought: Isn't that the organization that gets children to report on their parents?

I am going to continue doing good research and disseminating the results. Am I worried about persecution? Well, I have a secure academic position and could be a nurse again if I had to, but some of these researchers haven't got something to fall back on so they have to please NIDA and find what they're supposed to find. To a large degree, the politicization of such research has corrupted the research process. I'm never going to be a part of that.
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