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The interest on cannabinoids became evident between the and decades. Although the active substance of the plant was not known, a series of compounds with cannabinomimetic activity were synthesized, which were investigated in animals and clinically. The first cannabinoid isolated from Cannabis sativa was cannabinol, although its structure was correctly characterized several years later. Cannabidiol was isolated some years later and was subsequently characterized by Mechoulam and Shvo. In , the National Academy of Medicine and the Faculty of Medicine of the National Autonomous University of Mexico, through the Seminar of Studies on Entirety, decided to carry out a systematic review on a subject that is both complex and controversial: the relationship between marijuana and health. On June 19, , in the Official Gazette of the Federation, reforms and additions were published regarding the use of tetrahydrocannabinol THC , as well as isomers and stereochemical variants, pharmacological derivatives of Cannabis sativa , indica and Americana hereinafter marijuana. The controversy that has developed in the political and academic sphere, as well as the concerns that have arisen in the population in relation to known and poorly-known effects of the use of marijuana, have allowed the writing of this work. Herein, a review is made of reported therapeutic applications with the use of cannabis derivatives, emphasizing on the role cannabinoids play, and thereby contributing to the understanding of the probable therapeutic use of this plant and its derivatives. The cannabis plant is a term that groups the genus Cannabis , which comprises the Cannabis Sativa, Cannabis Indica , Cannabis Americana and Cannabis ruderalis plants. In general, cannabis is known as marijuana and has at least a bit more than different synonyms; Table 1 presents some. Table 1 Marijuana synonyms. Mexico: Laberinto; Worldwide prevalence of marijuana consumption is estimated to be 3. One of the central problems is the consumption of marijuana by individuals under 18 years of age. In 23 member countries, the Organization for Economic Cooperation and Development has estimated that 9. In the population aged 12 to 17, 5. Cannabis , specifically the sativa species, is an herbaceous plant that grows spontaneously in tropical and subtropical regions and contains between and chemical components and nearly cannabinoids. Its origin is located in Central Asia and its use has been described in the Chinese pharmacopoeia as part of traditional medicine. It was an Iranian physician, Sir William B. The use of its compounds throughout history has shown variants, as it occurs with the healing properties associated with its consumption, within the existing medical knowledge framework of every era. The effects it produces, mainly on the brain, were associated with religious practices. Currently, its consumption is widely spread all over the world, without having any relationship with religious aspects as in the past. Its main use, due its psychotropic effects, is ludic, although therapeutic properties are associated. The actions that have been developed for marijuana legal consumption have been diverse and include its growth, marketing and use. Several legal changes have been made in relation with cannabis personal possession and consumption, such as possession and consumption legalization and decriminalization. Table 2 shows the various provisions that have been adopted in some countries of the European Union. Table 2 Legal status of the use and consumption of marijuana in countries of the European Union. The state of the drugs problem in Europe. In Mexico, on June 19, , in the Official Gazette of the Federation, reforms and additions were published with regard to the use of THC, as well as isomers, stereochemical variants and pharmacological derivatives of Cannabis sativa , indica and Americana marijuana. In the study and research of cannabinoids and their pharmacological properties, at least three stages are recognized:. The first Cannabis sativa isolated cannabinoid was cannabis resin cannabinol Wood, Spivey and Easterfield, ; however, its structure was characterized several years later Adams, Baker and Wearn, Cannabidiol was isolated a few years later Adams, Hunt and Clar, and was subsequently characterized by Mechoulam and Shvo. In this context of the development of research on cannabis derivatives, it has been established that this plant has psychotropic and therapeutic effects mediated by cannabinoids. Out of these, three main types stand out:. The identified cannabinoids have been classified in 10 subclasses according to their chemical structure: To understand the physiological and pharmacokinetic effects of any of the three types of cannabinoids, the cannabinoid system or endogenous cannabinoid system has to be understood, which is a complex endogenous signaling system constituted by four elements:. The most widely investigated are cannabinoid receptors CB1 and CB2, located in the neuronal cell membrane, especially at presynaptic terminals. Cannabinoid receptors CB1 and CB2 are differentiated by the way they transmit the signal and by their distribution in different tissues. CB1s are mainly found in the cortex, spinal cord and peripheral nervous system neurons, although they are also present in certain peripheral organs and tissues, such as endocrine glands, salivary glands, leukocytes, spleen, the heart and in certain areas of the reproductive, urinary and gastrointestinal systems. There are CB1 receptors in both central and peripheral nerve terminals, which inhibit the release of some neurotransmitters. Thus, CB1 receptors activation protects the nervous system against over-activation or over-inhibition elicited by neurotransmitters. CB1 receptors are found in the regions of the brain responsible for movement basal ganglia, cerebellum , memory processing hippocampus, cerebral cortex and pain modulation certain parts of the spinal cord, periaqueductal grey , while their presence in the brainstem is low, which may explain the absence of adverse effects at this level as a result from cannabis use. The brainstem, among other functions, controls breathing and circulation. CB2 receptors are mainly found in immune cells, including leukocytes, the spleen and tonsils. Since the compounds that selectively activate CB2 receptors CB2 receptor agonists do not cause psychological effects, they are increasingly becoming the target of investigation of cannabinoids therapeutic applications as analgesics, anti-inflammatory and antineoplastic agents. In fact, there is evidence of the existence of cannabinoid sub-receptors, such as GPR 55, and the orphan receptors coupled to a G-protein. Other receptors may be only functionally related to the well-known cannabinoid receptors, with a similar structure to that of CB1 and CB2. After cannabinoid receptors were identified, their endogenous ligands, known as endocannabinoids, were discovered. In the brain, they act as neuromodulators. Endocannabinoids so far identified include anandamide N-arachidonoyl-ethanolamide , 2-arachidonoyl-glycerol, 2-arachidonyl-glyceryl ether noladin ether , O-arachidonoyl-ethanolamine virodhamine and N-arachidonoyl-dopamine. Anandamide and N-arachidonoyl-dopamine not bind to cannabinoid receptors, but also share the ability of capsaicin, a component of hot peppers, to activate vanilloid receptors. Endocannabioid signaling is characterized because these molecules are not synthesized or stored in nervous cells, but are generated from their precursors and released on demand. Cannabinoids show different degree of affinity for CB1 and CB2 receptors. Synthetic cannabinoids have been developed that act as agonists or selective antagonists for either receptor. Work is currently underway on the development of synthetic endocannabinoid analogues without the CB1 and CB2-activation side effects, which trigger a therapeutic effect or recreational effect. Endocannabinoids can behave as reverse agonists; they act when, in physiological conditions, the cannabinoid receptor is active without being bound to its direct agonist; the moment the reverse agonist binds to that receptor, it inactivates it and thus hampers its function. This way, sometimes, and only with a certain type of receptors, they can produce increased sensitivity to pain and trigger nausea, for example. Endocannabinoid levels have also been observed to be higher in areas of the brain associated with pain periaqueductal grey. Tonic control of spasticity by the endocannabinoid system is lost, for example, in cases of relapsing chronic experimental autoimmune encephalomyelitis in mice, a classic experimentation model in multiple sclerosis. The number of cannabinoid receptors has also been shown to be increased in models of chronic neuralgia due to neuronal damage in mice, as well as in models of intestinal inflammation. The same has been shown in terms of appetite control and vomiting in the emetic circuits of the brain. THC pharmacological effects depend on activation, as direct agonists, of its specific receivers, both in humans and in laboratory animals, whereas its antagonists can block specific receptor activity passive antagonism or produce the opposite effect active antagonism. In recent years, studies have been carried out on the usefulness of cannabis derivatives in several diseases. By means of controlled clinical trials, the role of these derivatives in spasticity has been investigated in multiple sclerosis and medullary lesions, chronic pain, essentially neuropathic, movement disorders Gilles de Latourette, dystonia, levodopa-induced dyskinesia , asthma and glaucoma. Most studies have been carried out with approved and marketed synthetic substances; however, in most cases, cannabis has shown evidence of lower biological strength. Chronic pain is the reason for cannabis medicinal use most commonly declared by patients. Cannabinoids have shown efficacy in some specific types of chronic pain, such as neuropathic pain associated with human immunodeficiency virus infection, spinal cord injuries, multiple sclerosis and pain of cancer origin; however, cannabinoids are not first-choice drugs in the treatment of chronic pain. They are considered third and fourth-line in the treatment of neuropathic pain. Neurological diseases, as well as psychiatric and oncological conditions, have justified cannabis acceptance for medicinal use in several countries around the world. Some cannabinoids have been approved; however, due to the lack of scientific evidence on safety or efficacy, others have not been approved. They can be topically administered, by using vaporizers or ingested as food or oil; the latter method is mainly used in children with epilepsy and other conditions. With the evidence that has been published, different regulatory agencies of the world have approved drugs that act on cannabinoid receptors for human use. In , a pharmacological mixture was approved in Canada, composed of THC and cannabidiol, for use in neuropathic pain in multiple sclerosis and, more recently, in pain caused by cancer. On the other hand, dronabinol, a synthetic form of THC, was approved by the Food and Drug Administration in and, therefore, marketed in the United States for the treatment of nausea and vomiting caused by chemotherapy and anorexia-cachexia syndrome extreme thinness and lack of appetite associated with acquired immunodeficiency syndrome. In addition, it has also been used in the control of certain types of pain, since it enhances morphine derivatives analgesic effect. Table 3 Comparison of the first three jurisdictions in the world that legally regulate the use of marijuana: Colorado, Washington and Uruguay. It should be emphasized that there is a clear difference between the use of cannabinoids as a therapeutic tool and the therapeutic use that has been wanted to give to marijuana, either smoked, ingested prepared with certain meals or topically applied. The differences are shown in Table 4. Table 4 Examples of the association between endocannabinoid receptor localization, probable physiological function and potential effect of marijuana. Cannabinoids: medical implications. Ann Med. There are different forms of cannabis products that are available in some countries to be used for medical purposes, for example, in Canada; some of them are dronabinol pill , nabilone pill and nabiximol spray. In addition to those previously commented, a significant number of possible therapeutic benefits of cannabis and its derivatives is currently under study. For example, CB1 receptors activation by the synthetic cannabinoid compound WIN has been shown to produce an interesting antitussive effect. On the other hand, cannabis administered as an aerosol would produce a significant bronchodilator effect for asthmatic patients; this route of administration would avoid the detrimental effects to the lungs caused by smoked cannabis. In contrast, cannabinoid CB1 receptor block is being investigated as a possible strategy in obesity prevention and in the treatment of addiction to various drugs of abuse tobacco, cocaine, heroin, etc. Current knowledge suggests that cannabinoids appear to be a new alternative to combat pain and other symptoms that fail to respond or partially respond to classical drug treatment. There is a need for more studies to be carried out in order to demonstrate the efficacy of this pharmacological group and thus integrate it into daily clinical practice, since, to this moment, there are few primary indications for its prescription due to the scarcity of available evidence. The scope of cannabinoid drugs appears to range from palliative use to therapeutic purposes. New lines of research point to a likely anti-tumor effect, which would open an alternative for cancer treatment; however, further evidence is needed in this field. Thus, cannabinoids seem promising in a wide range of pathological entities, but there is still a long way to go for their acceptance and use in routine clinical practice. Approval of Cannabis sativa derivatives for therapeutic purposes in Mexico requires informing the health group, as well as the population, on what cannabinoids are and the therapeutic agents that can be used. The National Academy of Medicine of Mexico issued a position document for the use of Cannabis sativa derivatives for therapeutic purposes, where ailments feasible to receive this type of treatment and the actions that have to be deployed to carry out a healthy and regulatory management of these compounds are defined. It is necessary for the generation of scientific evidence of the benefit or impact deriving from the use cannabinoid-based drugs to be promoted in our country. United Nations Office on Drugs and Crime. Organisation for Economic Co-operation and Development. Data for Chart CO4. Francia:Organisation for Economic Co-operation and Development; Contextual factors associated with marijuana use in school population. Salud Mental. Campbell JM, Thompson R. A dictionary of Assyrian botany. Inglaterra:British Academy; Elsohly MA, Slade D. Chemical constituents of marijuana:the complex mixture of natural cannabinoids. Life Sci. Camp WH. The antiquity of hemp as an economic plant. J NY Bot Gard. Di Marzo V. A brief history of cannabinoid and endocannabinoid pharmacology as inspired by the work of British scientists. Trends Pharmacol Sci. The use of cannabis drugs in India. Bull Narc. Durant WJ, Durant A. The story of civilization. Vol I. Thompson R. A study of American grown cannabis in comparison with various other sources. Am J Pharm. Rawlinson G. The Persian wars. Ware M, Desroches J. Cannabis medicinal y dolor. Pain Clin Update. Madras BK. Update of cannabis and its medical use. Suiza:World Health Organization; Brenneisen, R. Chemistry and analysis of phytocannabinoids and other cannabis constituent. En:ElSohly, Mahmoud A editores. Marijuana and the cannabinoids. Cannabinoids, endocannabinoids, and cancer. Cancer Metastasis Rev. Grotenhermen F. Los cannabinoides y el sistema endocannabinoide. Pertwee R. Receptors and pharmacodynamics:natural and synthetic cannabionoids and endocannabinoids. The medicinal uses of cannabis and cannabinoids. Inglaterra:Pharmaceutical Press; De novo-synthesized ceramide is involved in cannabinoid-induced apoptosis. Biochem J. Ceramide sensitizes astrocytesto oxidative stress:role of cannabinoids. Cannabidiol as a novel inhibitor gene expression in gressive breast cancer cells. Mol Cancer Ther. Allosteric modulation of the cannabinoid CB1 receptor. Mol Pharmacol. Effects of cannabidiol, a nonpsychoactive cannabinoid. J Pharmacol Exp Ther. The endocannabinoid system:drug targets, and potential therapeutic applications. J Med Chem. De la Fuente JR. En:Marihuana y salud. Arch Med Int. Araos P, Calado M. Rev Esp Drogodependencias. Lijarcio JI. Cannabinoids for medical use:a systematic review and meta-analysis. Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy. J Pain. A comparison of the world's first three jurisdictions to legally regulate marijuana:Colorado, Washington and Uruguay. Cannabinoids:medical implications. Clearing the smoke on cannabis. Medical use of cannabis and cannabinoids. An Update. Cannabidiol in patients with treatment-resistant epilepsy:an open-label interventional trial. Lancet Neurol. Rev Med Hosp Gen Mex. Detyniechi K, Hirsch L. Marijuana use in epilepsy:the myth and the reality. Curr Neurol Neurosci Rep. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on patients. Mult Scler. Randomized controlled trial of cannabis-based medicinal extracts in the treatment of neuropatic, pain due to multiple sclerosis. The dilemma of medical marijuana use by rheumatology patients. Arthritis Care Res Hoboken. Baron EP. Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache:what a long strange trip it's been. The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Med J. Clinical practice guidelines for management of neuropathic pain. African Med J. Pharmacological treatment of painful HIV-associated sensory neuropathy:a systematic review and meta-analysis of randomised controlled trials. PLoS One. Abel EL. Effects of marihuana on the solution of anagrams, memory and appetite. Therapeutic use of cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients:systematic review and meta-analysis. Eur J Cancer Care Engl. Association cannabis negative psychosocial parameters in patients with fibromyalgia. Preliminary assessment of the efficacy, tolerability and safety of a cannabis Medicine Sativex in the treatment of pain caused by rheumatoid arthritis. Rheumatology Oxford. Marijuana Smoking does not accelerate progression of liver disease in HIV-hepatitis C coinfection:a longitudinal cohort analysis. Clin Infect Dis. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic Pain from brachial plexus avulsion:results of a randomised controlled trial. Collado K. Appendix 1 Table of evidences and therapeutic uses of cannabinoids. Cannabinoids for medical use: a systematic review and meta-analysis. Appendix 2 GRADE system, quality of evidence classification and strength of recommendation grading Madrid: Editorial Medica Panamericana; Published by Permanyer. Servicios Personalizados Revista. Similares en SciELO. Introduction On June 19, , in the Official Gazette of the Federation, reforms and additions were published regarding the use of tetrahydrocannabinol THC , as well as isomers and stereochemical variants, pharmacological derivatives of Cannabis sativa , indica and Americana hereinafter marijuana. The cannabis plant The cannabis plant is a term that groups the genus Cannabis , which comprises the Cannabis Sativa, Cannabis Indica , Cannabis Americana and Cannabis ruderalis plants. Table 2 Legal status of the use and consumption of marijuana in countries of the European Union Country Legal situation Regulatory law Amount of drug allowed Germany Use and possession for personal consumption BtMG Law 6 g of marijuana and up to 0. Finland Use and possession for personal consumption Law ss. Italy Use and possession for personal consumption Fini law mg marijuana, mg of heroin, mg of cocaine. Belgium Administrative sanctions, misdemeanor Col. Cannabicyclol CBL. Cannabielsoin CBE. Cannabinol and cannabinodiol CBND. Cannabitriol CBT. Affinity for cannabinoid receptors Cannabinoids show different degree of affinity for CB1 and CB2 receptors. Endocannabinoid system tonic activity Endocannabinoids can behave as reverse agonists; they act when, in physiological conditions, the cannabinoid receptor is active without being bound to its direct agonist; the moment the reverse agonist binds to that receptor, it inactivates it and thus hampers its function. Medicinal use of cannabis and its derivatives In recent years, studies have been carried out on the usefulness of cannabis derivatives in several diseases. Cannabinoid medicinal use With the evidence that has been published, different regulatory agencies of the world have approved drugs that act on cannabinoid receptors for human use. National Law and Executive Order Regulatory agency Colorado Department of Revenue Washingston State Liquor Board LCB Institute for the Regulation and Control Cannabis a public, non-state entity Definition of marijuana All parts of plant, seed, resin extracted from any part of the plant, and every compound, manufacture, salt, derivative, mixture or preparation of the plant, its seeds or its resin, including marijuana concentrate, which is cultivated, manufactured, distributed or sold by a certified or licensed retail marijuana establishment. Does not include industrial hemp or the weight of any another ingredient combined with marijuana to prepare topical or oral administrations, food, drink or other product. All parts of the plant with a THC concentration greater than 0. Quantity for personal possession 1 ounce Domestic cultivation for personal consumption 6 plants, with 3 in flower and possession of the marijuana produced by plants at the cultivation site None Up to 6 flowering plants per household with a maximum production quantity of g per year. Minimum age 21 21 18 Retail transaction limitation 1 ounce Up to a quarter of that amount for out of state residents. Residency requirements For its purchase, see above. For obtaining a license, a minimum of 2 years residence is required. None for purchasing. For obtaining a license, a minimum of 3 months residence is required. For purchasing, domestic cultivation and membership in cannabis clubs, Uruguayan legal or naturalized citizenship or permanent Uruguayan residency is required. None specified for licenses. User registry for non-medical purposes None. Registration with the Institute of Regulation and Control of Cannabis is required for purchase in pharmacies, domestic cultivation or membership in cannabis clubs. Smoke free zones included. Unlawful to use marijuana in view of general public. Zero tolerance. Outdoor commercial cultivation Allowed Allowed Allowed for those registered for domestic cultivation, cannabis clubs or authorized producers. Commercial cultivation Licensed marijuana cultivation facilities. Licensed marijuana products. Licensed marijuana producers. Commercial retail outlets. Licensed retail marijuana store. Licensed dealer. Licensed pharmacies. Market integration Allowed. Allowed by the law, but not implemented. Taxed by Value Added Tax under a VAT suspension regime, allowing the producers to deduct VAT from their purchases and preventing the transfer of the tax to the final price. There is no tax on agricultural assets. Production and distribution limits. Maximum cultivation is 2 million square feet statewide. Maximum limit of retail licenses issued by LCB is based on population. Currently at Not specified in the law or regulations. The regulatory body will define the authorized production quantity. Packaging and labeling regulations Yes: quantity, serving size, ingredients, potency. Yes: quantity, serving size, ingredients, potency. Yes: specifications, safety conditions and maximum quantity 10 g. Product warning labels of health effects. Child-resistant packaging Required for final sale of marijuana retail product. Required for marijuana-infused products meant to be eaten, swallowed or inhaled. To be established during the call for applications for production licenses. Advertising Permitted but restricted to avoid reaching minors under 21 for retail establishments. Signage permitted at place of business in compliance with local ordinances. Restricted to no more than a sign for retailers at place of business. Prohibited for producers and processors. Not permitted. Advertising warnings Not misleading or safety claims can be made. Detailed and required. No advertising allowed, either directly or indirectly. Internet sale Prohibited. Security systems Required and detailed. Required and detailed. Required and to be specified during the call for applications for production licenses. Cannabis clubs Not permitted. Between 15 and 45 members can collectively grow up to 99 plants, proportional to the number of members, with the maximum annual allotment of g of dried product per year per member. Medical marijuana Yes, continuing in existence with new laws and are tax exempt. Prorated fees when converting medical retailer to non-medical. Yes, continuing in existence with new laws. Yes, regulations currently being prepared. The established Marijuana Cash Fund will be used to pay for enforcement of rules and regulations. Prevention and treatment Yes, law mandates that state agency will establish educational materials regarding appropriate retail marijuana use and prevention of marijuana use by those under Yes, some taxes generated will go to treatment Yes, the national health and education systems required to promote treatment and prevention. Monitoring and evaluation Yes, required by law for Department of Health to monitor health effects every two years, starting in Yes, required by law to independently by Washington State Institute for Public Policy to evaluate policies and impacts related to health, security, economic effects, etc. Yes, by a specialized independent unit to evaluate the impact of the policy year by year. Other therapeutic applications In addition to those previously commented, a significant number of possible therapeutic benefits of cannabis and its derivatives is currently under study. Conclusions Current knowledge suggests that cannabinoids appear to be a new alternative to combat pain and other symptoms that fail to respond or partially respond to classical drug treatment. References 1. Nabiximols Rheumatoid arthritis 2B Brunet L. Cannabidiol Hepatitis C 4 Whiting P. Dronabinol Post-chemotherapy nausea and vomiting 2B Whiting P. Cannabidiol Glaucoma 2B Whiting P. Appendix 2 GRADE system, quality of evidence classification and strength of recommendation grading 45 Degree of recommendation Level of evidence Type of study A 1A Systematic review with homogeneity of controlled clinical trials. B 2A Systematic review with homogeneity of cohort studies. D 5 Expert opinions based on non-systematic review of results or pathophysiological models. Received: December 14, ; Accepted: December 17, Dama de la ardiente cabellera lady with the burning hair. Marijuana: 25 g of resin and g of grass; 7. Institute for the Regulation and Control Cannabis a public, non-state entity. All parts of plant, seed, resin extracted from any part of the plant, and every compound, manufacture, salt, derivative, mixture or preparation of the plant, its seeds or its resin, including marijuana concentrate, which is cultivated, manufactured, distributed or sold by a certified or licensed retail marijuana establishment. Up to 6 flowering plants per household with a maximum production quantity of g per year. For its purchase, see above. Consumption in the public spaces is with the exception of closed public spaces, workplaces, public transportation, educational centers, health establishments or sports institutions. Allowed for those registered for domestic cultivation, cannabis clubs or authorized producers. Required for final sale of marijuana retail product. Permitted but restricted to avoid reaching minors under 21 for retail establishments. Yes, continuing in existence with new laws and are tax exempt. Administrative sanctions or fines for violations or noncompliance. Yes, law mandates that state agency will establish educational materials regarding appropriate retail marijuana use and prevention of marijuana use by those under Yes, the national health and education systems required to promote treatment and prevention. Yes, required by law for Department of Health to monitor health effects every two years, starting in Dorsal afferent spinal cord and peripheral nociceptors. Increased heart rate and blood pressure in sitting or decubitus position. Systematic review with homogeneity of controlled clinical trials. Controlled clinical trials with narrow confidence interval. Systematic review with homogeneity of cohort studies. Systematic review with homogeneity of case-control studies. Expert opinions based on non-systematic review of results or pathophysiological models.

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The demand for illicit drugs can leverage dramatic changes in land cover and associated native biological diversity. These changes, in turn, can lead to loss of critical habitats and rare species of plants and animals, in addition to the degradation of remaining habitats and the contamination of water bodies. Concomitantly, demand can transform social and economic processes, acting against the interests of long-time residents, such as indigenous groups, by attracting new colonists and fomenting crime and violence. Given these potential interconnections between illicit drugs and grave social and environmental consequences, it is more than peculiar that so much scholarly work on environmental transformations does not consider drug-related causes in those countries that supply or transship the drugs. Examples of this myopia include most of the literature on tropical deforestation, where illicit drugs are ignored e. I find great spatial heterogeneity in the negative impacts, at least some of which can be explained by the values and practices of particular social groups. A political ecology approach is helpful in this assessment because by definition illicit drugs intermix the power of governments and economic forces with outcomes toward and resistance by local peoples. Finally, I outline the known environmental consequences. In the conclusion, I provide the elements necessary for a more complete research agenda that, in turn, could provide the information needed to explore policy alternatives for the social actors involved. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:. Typically, access is provided across an institutional network to a range of IP addresses. 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