Fysm marijuana


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Fysm marijuana

  1. 1. Test Your Knowledge Marijuana The chemical responsible for the psychoactive effects of cannabis is: A. DXM B. lysergic-acid amide C. THC D. salvia Test Your Knowledge Test Your KnowledgeAlthough rare, people have overdosed A positive correlation between marijuanafrom THC by smoking too much use and lung cancer has beenmarijuana. established.A. True A. TrueB. False B. False Test Your Knowledge Test Your KnowledgeMarijuana use may exacerbate Marijuana use can cause schizophrenia.symptoms in persons with anxiety A. Truedisorders. B. FalseA. TrueB. False 1
  2. 2. Test Your Knowledge Test Your Knowledge Strong evidence links marijuana use to People who use marijuana are more permanent deficits in memory. likely to move on to “harder” drug use A. True than people who do not use marijuana. B. False A. True B. False Cannabis sativa Cannabis sativa  Hemp plant that  Over 60 chemicals unique to the plant grows throughout are collectively referred to as the the world cannabinoids.  For years it  One, labeled delta-9- primarily was tetrahydrocannabinol (Δ9-THC) is harvested for its responsible for its psychoactive fiber to make rope effects. and textiles Psychoactive cannabis Psychoactive cannabis products products Marijuana  Marijuana (~8% THC)  Leaves and buds of the cannabis plant, dried and  Up from ~2% in 1980 shredded. 2
  3. 3. Psychoactive cannabis Psychoactive cannabis products products Sinsemilla  Hash  Spanish for “without seed”  a drug made from the dried resin of the  More potent form of marijuana from cannabis flowers unpollinated buds on the female plant.  Similar levels of THC to sinsemilla  10-30% THC Trichomes Psychoactive cannabis Psychoactive cannabis products products  Hashish oil  Produced by boiling hashish in alcohol (or other solvent), filtering out the alcohol and plant material, and leaving a residue.  20-60% THC Synthetic Cannabis Products Synthetic Cannabis Products  K2, Spice  Blends of synthetic forms of various cannabinoids (not THC)  Designer drug – designed to exploit loopholes in the law.  Legislation pending.  Less of a high + side effects 3
  4. 4. History History  Harry Anslinger  First head of the Federal Bureau of Narcotics.  Launched a propaganda war against marijuana  Marijuana Tax Act of 1937 Epidemiology Pharmacokinetics Today, it is the most  Most rapid and efficient absorption widely used illicit drug route is via the lungs (inhalation). in the Western world.  Effects are felt within a minute. Lifetime prevalence  Peak blood concentration occurs 30- rate in the United 60 min later. States is about 40%  Duration of action ~ 2 to 4 hours.  5.8% used in last 30 days (current). ROA: Inhalation ROA: Inhalation  Joint  Joint  Blunt  Blunt  Bowl/pipe  Bowl/pipe  Water bong  Water bong  Vaporizer  Vaporizer 4
  5. 5. ROA: Inhalation ROA: Inhalation  Joint  Joint  Blunt  Blunt  Bowl/pipe  Bowl/pipe  Water bong  Water bong  Vaporizer  Vaporizer ROA: Inhalation ROA: Oral  Joint  Much slower and inefficient  First-pass metabolism  Blunt  Absorbed in GI tract  Bowl/pipe  Onset of action ~ 1 hr  Water bong  Duration of action ~ 4 to 6 hrs  Vaporizer  About 3x more needed to create a similar high as smoking Mechanism of Action Mechanism of Action Two types of cannabinoid receptors:  CB1 receptors are widely distributed in the  CB1 brain.  Located in brain regions associated with memory,  Brain regions associated with high density cognition, mood, and motor control  Anandamide is a naturally occurring (endogenous) of CB1 receptors: neurotransmitter that binds to these receptors.  Hippocampus, amygdala, prefrontal cortex  Effects on memory, mood, and cognition  CB2  For example, THC inhibits acetylcholine activity in the  Most prevalent in immune cells (e.g., spleen, thymus, hippocampus. tonsils, B and T lymphocytes, mast cells).  Substantia nigra, basal ganglia, cerebellum  Effects movement and coordination 5
  6. 6. Mechanism of Action Mechanism of Action CB1 receptors are minimal in  THC has effects on a variety of other brainstem regions controlling heart neurotransmitters systems, including rate and respiration (i.e., medulla), serotonin, opiate, and dopamine, which is why it is impossible to although the underlying mechanisms are not entirely known. overdose on marijuana.  THC will increase dopamine levels in the reward pathway, but not nearly as much as other drugs of abuse. Tolerance Withdrawal “Reverse tolerance” illusion  These symptoms, if/when they occur, are In controlled laboratory settings, relatively minor and are usually associated tolerance has been shown to develop with sustained heavy use. to marijuana, but the phenomenon is  Sleep disturbances (insomnia) not robust.  Nausea  Irritability Tolerance is more likely to develop  Restlessness with heavy use (higher doses and  Cravings longer periods of time). Acute Effects: Physiological Munchies Mild and not clinically relevant  Increased heart rate  Conjunctiva (bloodshot eyes)  Headache and dizziness  Slight fluctuations in blood pressure and body temperature 6
  7. 7. Long-Term Effects: Long-Term Effects: Physiological Physiological  Respiratory system  Respiratory system  One joint is about the equivalent of four  Even though marijuana smoke contains cigarettes in terms of the tar intake and known carcinogens, to date there has the equivalent of five cigarettes in terms been no established link between of the carbon monoxide intake. smoking marijuana and lung cancer  And people inhale marijuana more deeply.  This is an active area of research. The  However, people smoke more cigarettes possibility that marijuana smoking than marijuana, so overall exposure is causes irreversible lung damage usually higher with cigarettes. remains. Psychological Effects Psychological Effects  Behavioral  Behavioral  Decrease in psychomotor activity and impairments in:  Cognitive  Motor coordination  Signal detection  Emotional  Ability to monitor a moving object  Divided attention  Disjointed speech Psychological Effects Psychological Effects Behavioral – Sexual  Behavioral – Aggression  Lots of individual variability  Some users report enhanced sexual enjoyment.  Others describe a disinterest  Not related to violence in sex and aggression.  Heavy use may result in temporary impotence in men and decreases in sex drive in women. 7
  8. 8. Psychological Effects Psychological Effects Cognitive  Cognitive  Impaired short-term  The impairments in cognitive functioning memory associated with long-term marijuana use usually are reversible with abstinence.  Impairments in attention  This is an active area of research; some  Inability to concentrate studies have shown relatively permanent  Perception that time decrements in cognitive functioning in passes more slowly heavy users.  “Flight of ideas”  The vast majority have not.  Enhanced creativity Psychological Effects Psychological Effects Emotional  Emotional  Among new users,  Carefree and relaxed state often the drug initially  Sense of well being produces anxiety and  Talkativeness restlessness  Laughing  Even among experienced users, negative feelings sometimes alternate with positive ones. Psychological Effects Psychological Effects  Amotivational Syndrome  Amotivational Syndrome  If it exists, it is much more  Loss of effectiveness and reduced prevalent among young users capacity to accomplish conventional who smoke regularly. goals as a result of chronic marijuana  High school students who use. smoke daily earn lower grades, are less likely to continue to college, are more likely to drop out, and miss more classes than those who do not smoke. 8
  9. 9. Psychological Effects Psychological Effects Amotivational Syndrome  Amotivational Syndrome  Fairly infrequent among marijuana users.  Rare even among heavy marijuana users  When it occurs, it probably is the result of in other countries. underlying personality characteristics  Has not been demonstrated in laboratory combining with some drug effects. studies.  Evident in youth who do not use marijuana. The Gateway Hypothesis The Gateway Hypothesis The idea that the abuse of marijuana  One of the most established findings will inherently lead to the abuse of in the drug abuse literature is that other, more harmful drugs. there exist stages of progression in drug-taking behavior.  Alcohol and/or cigarettes  marijuana  other illicit drugs The Gateway Hypothesis The Gateway Hypothesis Marijuana smokers are several times  On the other hand, the vast majority of more likely to consume illicit drugs marijuana smokers do not go on to (e.g., cocaine, heroin) during their use harder drugs. lifetime than nonsmokers.  So, the gateway should just refer to the sequential aspect of drug taking; The greater the frequency of there is nothing inherent about marijuana smoking, the higher the risk. marijuana that causes users to seek other drugs. 9
  10. 10. The Gateway Hypothesis Medical Uses for Marijuana Nevertheless, the sequential nature of  Nausea and vomiting drug taking suggests that if we can  THC counters the nausea and vomiting keep kids from taking marijuana, they associated with chemotherapies (and will be much less likely to try more radiation treatment) for cancer. dangerous drugs.  Cachexia  “wasting away” due to cancer or AIDS  Marijuana increases appetite and helps with this condition Medical Uses for Marijuana Medical Uses for Marijuana Glaucoma  Managing chronic pain associated with  Increases in intraocular pressure that is some conditions the leading cause of blindness in the U.S.  Multiple Sclerosis  Marijuana decreases intraocular pressure.  There are other drugs that are just as  Rheumatoid arthritis effective without the psychoactive side- effects. Medical Uses for Marijuana Medical Uses for Marijuana  “Medical marijuana” is already FDA approved and available in the form of synthesized THC.  Dronabinol (brand name: Marinol)  Nabilone (brand name: Cesamet)  Cannabis Oral Spray (Sativex)  Not currently FDA approved  Prescribed in Canada 10
  11. 11. Medical Uses for Marijuana Medical Uses of Marijuana Some problems with FDA approved “medical marijuana”:  NIDA (and other gov’t agencies) is opposed to the legalization of  Oral form  Delayed onset marijuana for medical purposes  Larger doses are needed and these can because smoking is associated with cause side effects. health risks.  Doesn’t deliver the range of cannabinoids (60+ chemicals) in marijuana smoke  Expensive Decriminalization The National Organization for the Reform of Marijuana Laws (NORML) Decriminalization Talking Points 11