DREHER'S JAMAICAN PREGNANCY STUDY

More Suppression of Marijuana Research

In the 1980s Melanie Dreher and colleagues at UMass Amherst began a
longitudinal study to assess the well-being of infants and children
whose mothers used cannabis during pregnancy. The researchers lived
in rural Jamaican communities among the women they were studying.
Thirty cannabis-using pregnant women were matched for age and
socio-economic status with 30 non-users. Dreher et al compared the
course of their pregnancies and their neo-natal outcomes, using
various standard scales.

No differences were detected three days after birth. At 30 days the
exposed babies did better than the non-exposed on all the scales and
significantly better on two of the scales (having to do with
autonomic stability and reflexes).

Follow-up studies were conducted when the kids were four and five
(just before entering school and after). The moms were defined as
light users (1-10 spliffs per week), moderate (11-20), and heavy
(21-70). Consumption of ganja tea was also taken into account.

The children were measured at age four using three sets of criteria:
the McCarthy scale, which measures verbal ability, perceptivity,
quantitative skills, memory and motor; a "behavioral style" scale
measuring temperament, based on a 72-item questionnaire filled out by
the child's primary caregiver; and a "quality of housing" index to
indicate socioeconomic status.

"No Differences at All."

When they controlled for the household ratings, Dreher recounted
April 8 at the Patients Out of Time Conference in Santa Barbara, her
team "found absolutely no differences" between the children whose
mothers were non-users and the children from the three groups of
users. "No differences at all."

When testing the children at age five, Dreher measured school
attendance and introduced an additional measure, the "home scale,"
accounting for stimulation in the physical and language environment,
and other inputs affecting development. " Low income Jamaican
children do not have a lot of toys," Dreher noted, "but It is not
unusual for a two-and-a-half year old to be washing out her father's
handkerchiefs to learn some adult skills."

As with the age-four studies, no differences were found among the
exposed and non-exposed groups. But analysis of the home scale
revealed that "stimulation with toys, games, reading material" was
significantly related to measures on the McCarthy scale -verbal,
perceptual, memory, and general cognition- and to mood. There was
also a relationship between basic school attendance and
McCarthy-scale measurements.

"We can't conclude that there is necessarily no impact from prenatal
ganja use but we can conclude that the child who attends basic school
regularly, is provided with a variety of stimulating experiences at
home, who is encouraged to show mature behavior, has a profoundly
better chance of performing at a higher level on the skills measured
by the McCarthy scale whether or not his or her mother used ganja
during pregnancy," said Dreher.

"Hello, hello! If you go to school you're going to do better on these
criteria. It doesn't sound like a very interesting finding but given
what everybody else was finding, we thought it was pretty darned interesting."

After recounting her methodology and conclusions, Dreher said: "This
study was published in 1991 -15 years ago. What is the impact of this
study? Absolutely none! A recent article by Huizink and Mulder
reviewing all the literature on cannabis use in pregnancy reports
only two longitudinal cohorts -Peter Fried's Ottawa Prenatal
Prospective study and Richardson and Day's Maternal Health Practices
and Child Development study. They reported increased tremors and
startles (Fried); altered sleep patterns (R&D); signs of stress
(Lester); impulsive and hyperactive behavior at six years old, more
delinquent behavior, more impulsive behavior..." The review article
didn't even mention that Dreher's Jamaican findings differed from those cited!

Peter Fried has been the darling of the National Institute on Drug
Abuse, well funded for decades after discovering that children whose
mothers had smoked marijuana showed impaired "executive function." In
2003 Fried was asked by Ethan Russo, MD, to contribute a review
article to a book on Women and Marijuana. Fried's reference to the
Jamaican study in the Russo book did not identify it as a
longitudinal study, even though he had been a consultant to the project.

When Dreher sought funding to re-examine her cohort at ages nine and
10, "NIDA said they were not interested in funding this study
anymore, but if I made Peter Fried a co-principal investigator, they
would consider funding it... So, the research has languished. Which
is a shame." She's looking for alternative funding. Last summer
Dreher returned to Jamaica and located 40 of her original subjects.
They are now adults and many are parents. "They are doing quite
well," she generalized.

Dreher criticized the media response to research, which tends to
focus on alleged negative aspects of use. "Peter Fried himself has
said 'very little impact up to three years old. Beyond that age, no
impact on IQ. No relationship of marijuana use to miscarriage, to
Apgar status, to neonatal complications, physical abnormalities, no
impact on cognitive outcomes' until, he says, age four. His tremor
and startles findings did not hold up," said Dreher, "neither did
[his findings of differences in] head circumference, motor
development and language expression. None of those data are really in
the literature for people to see. This results in a lot of
misunderstanding on the part of the public."

Dreher asked: Why the reluctance to acknowledge this study in the
peer-reviewed literature? She answered first as an anthropologist:
"There is a terrible arrogance and ethnocentrism in the science that
refuses to accept the experience or the science of other cultures."
She cited Ethan Russo's "irrefutable" review of cannabis use by women
in other cultures.

"Contemporary evidence from the UK, Denmark, Jamaica, Israel, the
Netherlands, even Canada tends to be disregarded unless it's funded
by NIDA with Peter Fried as the principal investigator."

Dreher recommended a 1989 Lancet article called "The Bias Against the
Null Hypothesis" in which the authors reviewed all the abstracts
about the maternal use of cocaine submitted to the Society of
Pediatric Research in the 1980s. Only 11% of negative abstracts
(attributing no harm to cocaine) were accepted for publication,
whereas 57% of the positive abstracts were accepted. The authors
determined that the rejected negative papers were superior
methodologically to the accepted positive papers.

Honest Research Impeded

Dreher decried "the politics of trying to get published." She now
sees it as "a miracle" that Pediatrics published her work on neonatal
outcomes, however belatedly, in 1994. (Her paper on five-year
outcomes came out in the West Indian Medical Journal before
Pediatrics ran the neonatal outcomes.) She suspects that a review of
"all the fugitive literature that's out there that didn't get
published" would convey "a very different picture of prenatal
cannabis exposure."

Honest research is also impeded, Dreher said, by "the politics of
building a research career. Most research is done by academics and
academia is a very conservative environment where tenure often is
more important than truth." (Dreher is now Dean of the College of
Nursing at the University of Iowa.)

The end result of biased science, Dreher observed, is a misinformed
public. Recently, she "googled to see what was out there for the
general public regarding pregnancy and marijuana." Typical of the
disinformation was an article entitled "Exposure to marijuana in womb
may harm brain' that began "Over the past decade several studies have
linked behavior problems and lower IQ scores in children to prenatal
use of marijuana..." A reference to Dreher said she had "written
extensively on the benefits of smoking marijuana while smoking pregnant!"

Dreher concluded: "Marijuana use by pregnant women is a big red
herring that prevents us from looking at the impoverished conditions
in which women throughout the world have to bear and raise children.
These women are looking for the cheapest, most available substance to
alleviate their morning sickness and to give them a better sleep at
night in order to get the energy to do the work they have to do every
day in order to support those children.

"A red herring is something that distracts us from what's really
important. Instead of restricting our search for relatively narrow
outcomes, such as exectuive funciton, we need to be looking at school
performance, peer relations, leadership skills in children, prenatal
and family relations, healthy lifestyles. Are they participating in
sports? Are they using tobacco and alcohol and other substances?

"NIDA and the NIH still prefer to fund randomized clinical trials
that have to do with symptom management in specific diseases. We need
research on how marijuana affects the quality of life.

"It's not an evolutionary accident that the two activities needed to
sustain life and perpetuate life, eating and sex, are pleasurable as
well as functional, and that marijuana enhances both of these activities."

FDA Further Discredits Itself

The Food and Drug Administration issued a groundless "statement"
April 20 asserting that "no scientific studies" supported the medical
use of marijuana. The statement was not the work of a panel of
experts reviewing recent research. It was issued, supposedly, in
response to numerous Congressional inquiries, but actually at the
behest of the DEA and the Drug Czar's Office. Its release on 4/20, a
day of special significance to marijuana users, shows the juvenility
of its authors, who apparently regard Prohibition as a little game
they're playing with the American people. (Legend has it that four
twenty was the time that pot smokers at Tamalpais High School in Mill
Valley got together. Or was it the police code for a pot bust in New
Jersey? In any case, millions of cannabis consumers are hip to its
meaning, and so are those wags at the Drug Czar's office.)

NORML was holding its annual meeting in San Francisco when the FDA
issued its statement, and although predictable expressions of outrage
were forthcoming, the additional media attention was not unwelcome.
More than three quarters of the American people know that marijuana
has medical utility, so the FDA statement further undermined the
credibility of the government. (This is the same FDA that recently
approved a stimulant patch for kids with "Attention Deficit Disorder"
even though the patch has induced fatal heart attacks.) In the days
ahead we can expect a wave of op-eds and letters to the editor
referencing the thousands of relevant studies on the medical efficacy
of cannabis.

The New York Times played the FDA-statement story at the top of the
front page 4/21. Reporter Gardiner Harris included three strong
quotes refuting the government line, ending with Dr. Daniele
Piomelli, a professor of pharmacology at the University of
California, Irvine, who said he had "never met a scientist who would
say that marijuana is either dangerous or useless."