4 Drugs of abuse

Publisher Summary This chapter examines the placebo-controlled and observational studies of drugs of abuse. The long history of marijuana use both as a recreational drug and as an herbal medicine for centuries has been reviewed. In an open trial the safety, tolerability, dose range, and efficacy of the whole-plant extracts of Cannabis sativa were evaluated in 15 patients with advanced multiple sclerosis and refractory lower urinary tract symptom. In a parallel group, double-blind, randomized, placebo-controlled study undertaken at three sites in 160 patients with multiple sclerosis a cannabis-based medicinal extract containing equal amounts of delta-9-tetrahydrocannabinol and cannabidiol at doses of 2.5–120 mg of each daily in divided doses for 6 weeks, spasticity scores were significantly improved by cannabis. The criteria for the interpretation of cocaine concentrations in biological samples and their relation to the cause of death have been comprehensively reviewed. It is found that necrotizing fasciitis, a rapidly progressive soft tissue infection with high morbidity and mortality, is most commonly associated with drug abuse by injection.