How can I buy cocaine online in Fernando de la Mora

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How can I buy cocaine online in Fernando de la Mora

Introduction: Cocaine abuse represents a major public health concern. The social perception of cocaine has been changing over the decades, a phenomenon closely tied to its patterns of use and abuse. Twitter is a valuable tool to understand the status of drug use and abuse globally. However, no specific studies discussing cocaine have been conducted on this platform. Then, tweets related to cocaine were analyzed to examine their content, types of Twitter users, usage patterns, health effects, and personal experiences. Geolocation data was also considered to understand regional differences. Results: A total of 71, classifiable tweets were obtained. Among these, Media outlets had the highest number of tweets Regarding the experience related to consumption, there are more tweets with a negative sentiment. The 9. The continent with the highest number of tweets was America Discussion: The findings underscore the significance of cocaine as a current social and political issue, with a predominant focus on political and social denunciation in the majority of tweets. Notably, the study reveals a concentration of tweets from the United States and South American countries, reflecting the high prevalence of cocaine-related disorders and overdose cases in these regions. Alarmingly, the study highlights the trivialization of cocaine consumption on Twitter, accompanied by a misleading promotion of its health benefits, emphasizing the urgent need for targeted interventions and antidrug content on social media platforms. Finally, the unexpected advocacy for cocaine by healthcare professionals raises concerns about potential drug abuse within this demographic, warranting further investigation. Cocaine abuse represents a significant public health concern with relevant medical and socioeconomic consequences worldwide 1 , 2. According to their last World Drug Report, approximately Moreover, the escalating annual trend in cocaine consumption since underscores the increasing level of concern associated with its use. For instance, previous studies have linked increased cannabis consumption to a perception of low associated risks, influenced partly by varying legislation on medical cannabis use and exposure to related advertising 6 — 9. Cocaine was first isolated in the middle of the 19 th century and gained popularity in the early s However, due to its addictive properties, widespread abuse and related health issues it was banned in the United States in The public perception of cocaine underwent shifts, notably in the s leading to increased abuse Subsequently, in the s and early s, it became linked to crime, violence, and racial concerns, influencing public policies on its regulation An increasing body of research advocates for the use of social networks as a valuable tool in drug research. They facilitate the understanding and collection of data on social perception, misinformation, and pharmacovigilance 13 — Twitter is seen as a safe and non-judgmental platform for sharing honest experiences, including sensitive topics like drug use and abuse Previous studies have successfully utilized Twitter as a public health tool to analyze and study drug-related issues 17 — Artificial intelligence AI , enables the processing and analysis of vast amounts of data Within AI, Machine Learning ML has become a prominent field, focusing on extracting knowledge from data through computational models. A subset of ML known as Deep Learning DL employs neural networks inspired by the human brain to process information These neural networks find applications in various domains related to substance use, enabling detection of abuse patterns 22 and related harms 23 , also allowing researchers to understand public perceptions and opinions of a drug 5 while exploring potential differences in these points across regions and countries Another essential application is Natural Language Processing NLP , which extensively utilizes neural networks to analyze text, facilitate conversations, and extract key ideas Most studies conducted on Twitter have focused on cannabis and opioids 5 , 18 , 26 , Currently, some preliminary results related to cocaine use have been obtained from different social media by the use of AI and ML 28 , 29 and previous works in Twitter analysis have considered cocaine use in the context of polysubstance use 30 , Given the existing gap in detailed studies on cocaine discussions on Twitter, we propose the following hypotheses: First, we hypothesize that through the use of AI and ML, it is possible to find geographical differences in the opinions and concerns expressed about cocaine that reflect unique regional dynamics and social attitudes. Second, we hypothesize that there are distinct considerations related to cocaine based on user profile. This correlation will influence the nature and tone of their contribution to the platform. By addressing these multifaceted aspects, this study aims to provide valuable insights into the complex dynamics of public discourse on cocaine in the digital sphere, providing a comprehensive understanding about the factors that form and differentiate views on this quality. This mixed-method, quantitative and qualitative analysis focused on the content of tweets related to cocaine posted on the social media platform Twitter. These criteria were chosen to ensure a comprehensive and representative sample of social media discussions on the topic. We employed Tweet Binder, a widely used tool in previous research 32 — 35 , to collect the tweets, providing essential information such as retweet and like counts, publication date, tweet context link, user description, and geolocation. The number of retweets and likes served as indicators of user engagement and interest in the tweeted content 36 , Using the previously mentioned search criteria, we collected 57, tweets in Spanish and 54, tweets in English. Next, with the remaining tweets, the content was analyzed using a mixed inductive-deductive approach to develop a codebook for classifying the tweets into key thematic categories. We created a codebook based on our research questions, our previous experience in analyzing tweets, and what we determined to be the most common themes. After discussing discrepancies and reaching a consensus on the codebook, an additional tweets were analyzed. This process also provided a larger sample for training the Machine Learning model. The tweets were classified as classifiable or non-classifiable. A tweet was considered non-classifiable if it was written in a way that made its meaning uncertain, too brief to contain relevant information, if its content was purely political, if the information was not relevant to the objectives of this study, or if it was a joke. In each of the classifiable tweets, the content was analyzed according to the following themes: 1 Tweet topic; 2 Evaluation of the effect; 3 Sentiment regarding consumption; 4 Type of consumption. Finally, the users were classified into four categories: 1 General Twitter users; 2 Media outlets; 3 Public figures; and 4 Healthcare professionals. The classification criteria and examples of tweets are shown in Table 1. The methodology followed in this project has been validated in prior research studies 38 , First, a preprocessing of the database should be executed. This preprocessing involves a translation of the non-English tweets to English using Google Translator and a normalization of the tweets by removing special characters, splitting negative contractions, and removing repetitions. The training subset was used to fine-tune the network, while the testing subset was used to validate its performance. Additionally, to address some imbalanced categories where certain options had a higher number of tweets compared to others , text augmentation was performed using the library called textattack Furthermore, emotion analysis was conducted using a pretrained neural network called emotion-english-distilroberta-base The emotion analysis was applied to the 71, tweets categorized as classifiable. The results were presented in tables or figures, showing the percentage of tweets or the median of likes and retweets in each category. To evaluate the relationships between tweet content, user type, and other tweet characteristics with the number of likes and retweets, linear regression models were employed. The individual beta coefficients were adjusted for the remaining tweet characteristics. Choropleth maps were generated as a visualization tool to depict the global distribution of tweets. Additionally, these maps were used to illustrate the geographic distribution of tweets expressing support for the legislation and exhibiting a sentiment favorable to cocaine. The study involved analyzing the frequency distribution of tweets across various categories based on tweet characteristics. According to the codebook, a total of 71, classifiable tweets were obtained. Of the total number of users that could be defined, media outlets had the highest number of tweets, with 25, tweets The most frequent theme is social or political claims, with 48, tweets published, accounting for The least frequent theme is trivialization, but it has a higher number of likes and retweets. Regarding the experience related to consumption, there are more tweets with a negative sentiment compared to a positive sentiment. Approximately Regarding the discourse on cocaine consumption, 9. Table 2 Descriptive characteristics of the tweets are considered classifiable in the content analysis. In terms of emotional expression, the most frequent response from Twitter users is to remain neutral in the majority of their posts, as depicted in Figure 1. Figure 1 Sentiment analysis the emotional tone expressed in text. The continent with the highest number of tweets is America, with 39, tweets published, accounting for Among the top 5 countries with the highest number of tweets, the first four are from this continent, in descending order: United States, Colombia, Venezuela, and Argentina, representing Figure 2 Distribution of the number of tweets worldwide. The area with the highest number of tweets about cocaine is represented with a darker blue color, and the color tone decreases as the number of tweets decreases. Regarding the evaluation of the effects, Europe has the highest percentage of tweets discussing the harm caused by cocaine, at Additionally, Asia has the highest proportion of tweets expressing negative sentiment related to consumption, with Lastly, Africa exhibits the highest content about frequent cocaine use, comprising Nonetheless, healthcare professionals indicate it as a detriment to health in Additionally, healthcare professionals exhibit the highest percentage Finally, regarding the type of consumption, a notably high percentage If we relate the evaluation of the effect by Twitter users with those who talk about consumption, it has been observed that Regarding individual experiences with the substance, it has been found that almost half However, only In the present work, we have collected and classified 71, tweets discussing cocaine according to the content of the message, geolocation, type of user, and consumption frequency reported. The results obtained in this article go hand in hand with previous results reported in the Twittersphere in which this type of detail has been studied in other drugs such as opioids or cannabis 30 , 44 , 45 ; however, as far as we know this article is the first to deeply explore this type of data about cocaine on this platform. The majority of analyzed tweets Media sources accounted for These findings highlight evidence cocaine consumption is a significant current social and political issue, particularly in the United States and South American countries. The United States has experienced the highest number of cocaine-related disorders and overdose mortality cases globally 46 — Given these statistics, it is understandable that many tweets from the United States focus on denouncing cocaine abuse from a political and social perspective, emphasizing the need for inclusive public policy reforms In the case of South American countries, a broad number of tweets were identified from Colombia, Venezuela, and Argentina. Colombia in particular has a long history of cocaine trade and continues to be involved in its production and cultivation Twitter and scientific articles discuss the complex sociopolitical context of cocaine crops in this country, analyzing the problem comprehensively 50 , Tweets from Europe and Africa primarily focused on the detrimental health effects of cocaine and the frequent consumption of this drug. In the European Union, Among adults aged 15 to 64, 3. Cocaine ranked as the second most problematic drug for first-time treatment seekers and the second most commonly reported substance for acute toxicity by Euro-DEN Plus hospitals in In the same manner, various studies conducted in different European countries have found an increase in cocaine consumption and cocaine-related deaths, also highlighting the multiple health complications related such as psychiatric and psychotic disorders, neurological maladies and cardiovascular diseases 53 — Thus, our results seem to support that Twitter is seen as a valuable tool to raise awareness about the real problem of cocaine in Europe and its overall negative effects on health. On the other hand, fewer studies are available in the literature regarding cocaine use in Africa. However, different platforms like the Africa Organized Crime Index 56 have evidenced the problem of cocaine trade and abuse in some countries like Guinea-Bissau, Cabo Verde or Guinea, as well as in South Africa or the sub-Saharan countries 57 , Therefore, Twitter can be used as a platform to denounce the habitual consumption of cocaine in this region and the detrimental health effects derived in this region. However, additional efforts in this platform are warranted, particularly in light of our results. Despite the trivialization of cocaine consumption being the less discussed topic on Twitter, it accumulated almost double the interactions with other Twitter users likes and 37 retweets versus 64 likes and 35 retweets , as well as those reporting positive versus negative effects. In addition, when considering the type of cocaine consumption on Twitter, frequent consumption was more common than occasional use 9. Previous research has indicated that drugs are often discussed positively on social media platforms like Twitter, and the lack of antidrug content may contribute to the normalization and justification of drug use, highlighting the importance of addressing this issue Furthermore, the dissemination of trivialization may contribute to an increase in hospitalizations due to cocaine consumption, even in the pediatric population In agreement with previous works 62 , 63 , our results support the notion that social media like Twitter can serve as valuable resources for understanding drug patterns, prevailing attitudes, monitoring and intervening in drug abuse and addiction problems. We found a small proportion of tweets promoting the supposed health benefits of cocaine use, which received significant engagement. This is an important issue to address, as there are no safe ways to consume cocaine. Misconceptions regarding the health benefits of cocaine may stem from historical events and practices, such as its traditional use in South America for over 5, years as a stimulant in the form of teas or by chewing the leaves of the Erythroxylon coca plant Additionally, influential figures like Sigmund Freud, as well as the incorporation of cocaine in beverages like Coca-Cola and coca wine during the late 19th and early 20th centuries, contributed to its popularity As previously mentioned, despite being banned in the USA in , during the s, cocaine regained a positive image, fueled by perceptions of glamour and media influence. Even the Ford White House in released a white paper stating that cocaine was not physically addictive and generally did not have serious consequences Conversely, cocaine use leads to a wide range of harmful effects including tachycardia, hypertension, acute coronary syndrome, stroke, and even death Mixing cocaine with substances like sugar, talc, and cornstarch exacerbates these adverse effects Previous Twitter analyses have shown that polysubstance use involving cocaine and other drugs is a common topic in discussions about overdose and drug-related concerns 18 , 30 , 31 , Although our study did not focus on polydrug use, it is important to consider these findings, as the low perception of risks associated with cocaine use obtained in our study may even be more concerning in such contexts. Furthermore, long-term consumption of cocaine is associated with significant brain changes in the dopaminergic reward system, resulting in addiction, persistent cravings and a high risk of relapse, even with treatment Cocaine use disorder CUD represents a serious global health concern, and while psychosocial and pharmacological interventions can assist in the medical management of this condition, the efficacy is limited and ineffective for most patients Moreover, despite some specific clinical cases in the 20 th century, the risks of cocaine use outweigh any potential benefits, and there are safer alternatives for various purposes attributed to this substance Therefore, it is crucial to address and intervene in the content on Twitter that trivializes or supports the alleged health benefits of cocaine use. Intriguingly, our study shows that healthcare professionals on Twitter were among the strongest advocates for the health benefits, frequent use and positive experiences related to cocaine This could be relevant considering previous studies that have identified drug abuse among healthcare professionals as a concern 73 , especially when considering certain risk factors such as certain medical specialties, psychopathological or social factors, positive attitudes toward drugs, unhealthy lifestyle habits and so on Although we could not explore all contributing factors, further investigation is needed to understand the relationship between drug abuse and healthcare professionals on social media platforms like Twitter, as our findings imply that they may use it to share personal experiences and concerns related to drug use and abuse. Finally, we also observed a notable proportion of tweets 8. This is not a novel issue as previous works have also identified social media like Twitter as a conduit for the sale and supply of illicit drugs like opioids 74 , We encourage the regulation of this type of illegal cocaine sale, proposing the inclusion and use of possible programs implicated in the detection, classification and reporting of illicit online sale tweets, as promoted in previous works This research has some notable limitations. Second, just like practically all qualitative investigations, the construction of the codebook and the analysis of the tweets involve certain subjectivity. Similarly, it is also possible that bots or fake accounts have to some extent affected our data. Finally, the inclusion of tweets with 10 or more retweets could also be a limitation of the study, as it might have overlooked relevant tweets for this article. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Burden of disease due to amphetamines, cannabis, cocaine, and opioid use disorders in South America, a systematic analysis of the Global Burden of Disease Study Lancet Psychiatry. The burden of mental disorders attributable by cocaine use: Global Burden of Diseases Study in Brazil, and Rev Soc Bras Med Trop. United Nations: Office on Drugs and Crime. World drug report Google Scholar. JRSM Open. 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Psychiatry , 19 March Insights from the Twittersphere: a cross-sectional study of public perceptions, usage patterns, and geographical differences of tweets discussing cocaine. Table 1 Category, definitions and examples of classification. Table 3 Number of tweets by continent and category of the codebook. Table 4 Number of tweets by user type and category of the codebook. Table 5 Number of tweets by consumption type and category of the codebook.

Age-Specific Rates of Onset of Cannabis Use in Mexico

How can I buy cocaine online in Fernando de la Mora

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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