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Cannabis

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Cannabis-related disorder

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Cannabis

  1. 1. NAME : LOKESH AGRAWAL CCT-ID : 9034 SEMESTER : 6th TOPIC : CANNABIS RELATED DISORDERS 6/22/2018 1
  2. 2. CANNABIS-RELATED DISORDERS :  CONTENTS :  INRODUCTION:  CANNABIS PREPARATIONS :  SOURCE  CHEMICAL NATURE  METHODS OF USE  NATURE OF DISEASE :  PROBLEMS OCCUR TO CANNABIS USE :  SIGNS AND SYMPTOMS :  ETIOLOGY :  PSYCHOSOCIAL REGIONS :  TREATMENT :  DIAGNOSTIC  CLINICAL FEATURES 6/22/2018 2
  3. 3. Introduction : 6/22/2018 3  Cannabis, more commonly called marijuana, refers to the several varieties of Cannabis sativa , or Indian hemp plant, that contains the psychoactive drug delta-9- tetrahydrocannabinol (THC). Cannabis-related disorders refer to problems associated with the use of substances derived from this plant.  Description  Cannabis—in the form of marijuana, hashish (a dried resinous material that seeps from cannabis leaves and is more potent than marijuana), or other cannabinoids—is considered the most commonly used illegal substance in the world. Its effects have been known for thousands of years, and were described as early as the fifth century B.C., when the Greek historian Herodotus told of a tribe of nomads who, after inhaling the smoke of roasted hemp seeds, emerged from their tent excited and shouting for joy.
  4. 4. PREPARATION OF CANNABIS :  SOURCE : Cannabis preparations are obtained from the plant CANNABIS SATIVA ,which has been used in china ,india and europe.It is introduced in europe in early 19th century by napolean’s army returning from egypt.  Canabis was most often used for fiber and therapeutic purposes.  Chemical nature : most commonly used canabinoids are Delta-9- tetrahydrocannabinol(THC) and cannabidiols(CBD). -BOTH ARE NEUROPROTECTIVE THROUGH THEIR ANTIOXIDATIVE ACTIVITY. -RECEPTORS : THERE ARE AT LEAST TWO TYPES OF RECEPTORS CB1 AND CB2 . -CB1 PRESENT IN BRAIN AND MEDIATES THE PSYCHOLOGICAL AND BEHAVIORAL EFECTS -CB2 RECEPTORS IS ASSOCIATED WITH THE IMMUNE SYSTEM AND APPEARS TO MODULATE INFLAMMATORY RESPONCES. -MOST COMMON PREPARATIONS ARE MARIJUANA,HASHISH AND HASH OIL. 4
  5. 5. METHODS OF USE : - Cannabis smoked as marijuana in hand-rolled cigarettes , in joint tobacco to assist burning. - Hashish may be mixed with tobacco as a joint in pipe. - Oral route of administration may also be used by eating hashish backed in brownies and cookies. - Hashes oil also used in smoking substances due to high potent effect. -In india bhang is a common form , that is used frequently at various occasions. 6/22/2018 5
  6. 6. Problems related to cannabis use : 6/22/2018 6 Intoxication Delirium : psychotic symptoms ,such as delusions and hallucinations ,are appear at very high dose of THC. Visual and auditory hallucination,delusional ideas are reported by using heavy dose of cannabis. Cannabis-induced Anxiety disorder: these effects are most commonly reported by new users who are unfamiliar with the effect of the drug. Cannabis induced palpitations and feeling of faintness are interpreted .
  7. 7. Problems related to cannabis use : 6/22/2018 7 Cognitive impairment : long term cannabis use produces more subtle form of impairment in higher cognitive functions of memory , attention ,organization and integration of complex information. Effect on Cardiovacular system : within 3 to 15 minutes after cannabis is smoked or swallowed, THC increase heart rate by 20 to 50 percent for up to3 hours . Blood pressure also increases while the person is sitting and decreases while standing.
  8. 8. Problems related to cannabis use : 6/22/2018 8 Cannabis-related disorders reflect the problematic use of cannabis products to varying degrees. These dis orders include:  • Cannabis dependence: The compulsive need to use the drug, coupled with problems associated with chronic drug use.  • Cannabis abuse: Periodic use that may cause legal problems, problems at work, home, or school, or danger when driving.  • Cannabis intoxication: The direct effects of acute cannabis use and reactions that accompany it such as feeling "high," euphoria, sleepiness, lethargy, impairment in short-term memory, stimulated appetite,
  9. 9. Problems related to cannabis use : 6/22/2018 9 Effect on respiratory system :regular cannabis smoking impairs the functioning of the large airways and causes symptoms of chronic bronchitis such as coughing , sputum etc. Effect on muscle spasticity :muscle spasticity is the increased resistance to passive stretching of muscles and increased deep tendon muscles. Adverse effect of cannabis use : Movement disorder : movement disorder caused by abnormalities in areas of the brain that are connected to the motor cortex , that result in abnormal skeleton muscle movement in the face ,limbs and trunk. Medical use of cannabis are dystonia ,huntington’s disease , parkinson’s disease , and Tourette’s syndrome.
  10. 10. Problems related to cannabis use : 6/22/2018 10 Epilepsy: cannabis can controle epileptic seizures , and one observational study that suggested that cannabis use was protective against seizures. Glucoma: Elevated intraocular pressure (IOP) is a chronic condition that produces blindness if untreated . IOP must be controlled by taken cannabis and THC orally or intravenously, reduce IOP by 25%.
  11. 11. Signs and Symptoms : 6/22/2018 11  central features of cannabis dependence are compulsive use, tolerance of its effects, and withdrawal symptoms. Use may interfere with family, school, and work, and may cause legal problems.  Regular cannabis smokers may show many of the same respiratory symptoms as tobacco smokers. These include daily cough and phlegm, chronic bronchitis, and more frequent chest colds. Continued use can lead to abnormal functioning of the lung tissue, which may be injured or destroyed by the cannabis smoke.  smoking marijuana has the potential to cause severe increases in heart rate and blood pressure, particularly if combined with cocaine use. Even with marijuana use alone, however, the heart rate of subjects increased an average of 29 beats per minute when smoking marijuana.  users has shown that critical skills related to attention, memory, and learning can be impaired, even after use is discontinued for at least 24 hours. Heavy users, compared to light users, made more errors on tasks and
  12. 12. Signs and Symptoms : 6/22/2018 12  Recent studies have found that babies born to mothers who used marijuana during pregnancy were smaller than those born to nonusing mothers. Smaller babies are more likely to develop health problems. Additionally, nursing mothers who use marijuana pass some of the THC to the baby in their breast milk. Research shows that use of marijuana during the first month of breastfeeding can impair an infant's motor development.
  13. 13. CAUSES : 6/22/2018 13 Cannabis-related disorders share many of the same root causes with other addictive substances. The initial desire for a "high," combined with the widely held perception that cannabis use is not dangerous, often leads to experimentation in the teen years.  Recent research challenges the notion that cannabis use is not physically addictive. According to the National Institute of Drug Abuse (NIDA), daily cannabis users experience withdrawal symptoms including irritability, stomach pain, aggression, and anxiety. Many frequent cannabis users are believed to continue using in order to avoid these unpleasant symptoms. Long-term use may lead to changes in the brain similar to those seen with long-term use of other addictive substances. It is believed that the greater availability, higher potency, and lower price for cannabis in recent years all contribute to the increase in cannabis-related disorders.  Beginning in the 1990s, researchers began to discover that cannabis-like compounds are naturally produced in various parts of the human body. These compounds, called "endocannabinoids," appear to suppress
  14. 14. PSYCHOSOCIAL REGIONS: 6/22/2018 14  The frequency of cannabis use were obtained for the period from age 14–21 years, together with measures of psychosocial outcomes including property/violent crime, depression, suicidal ideation, suicide attempt and other illicit drug use.  Particularly regular or heavy use, was associated with increased rates of a range of adjustment problems in adolescence/ young adulthood—other illicit drug use, crime, depression and suicidal behaviours—with these adverse effects being most evident for school-aged regular users. The findings reinforce public health concerns about minimizing the use of cannabis among school- aged populations.
  15. 15. TREATMENT : 6/22/2018 15  Diagnosis  Diagnosis of cannabis-related disorders is made in a number of ways. Intoxication is easiest to diagnose because of clinically observable signs, including reddened eye membranes, increased appetite, dry mouth, and increased heart rate. It is also diagnosed by the presence of problematic behavioral or psychological changes such as impaired motor coordination, judgment, anxiety, euphoria, and social withdrawal. Occasionally, panic attacks may occur, and there may be impairment of short-term memory. Lowered immune system resistance, lowered testosterone levels in males, and chromosomal damage may also occur. Psychologically, chronic use of marijuana has been associated with a loss of ambition known as the “amotivational syndrome."  Cannabis use is often paired with the use of other addictive substances, especially nicotine, alcohol, and cocaine. Marijuana may be mixed and smoked with opiates, phencyclidine ("PCP" or "angel dust"), or hallucinogenic drugs. Individuals who regularly use cannabis often report physical and mental lethargy and an inability to experience pleasure when not intoxicated (known as "anhedonia"). If taken in sufficiently high dosages, cannabinoids have psychoactive effects similar to hallucinogens such as lysergic acid diethylamide (LSD), and individuals using high doses may experience adverse effects that resemble hallucinogen-induced "bad trips." Paranoid ideation is another possible effect of heavy use, and, occasionally, hallucinations and delusions occur. Highly intoxicated individuals may feel as if they are out-side their body ("depersonalization") or as if what they are experiencing isn't real ("derealization"). Fatal traffic accidents are more common
  16. 16. TREATMENT : 6/22/2018 16  Urine tests can usually identify metabolites of cannabinoids. Because cannabinoids are fat soluble, they remain in the body for extended periods. Individuals who have used cannabis may show positive urine tests for as long as two to four weeks after using.  Examination of the nasopharynx and bronchial lining may also show clinical changes due to cannabis use. Marijuana smoke is known to contain even larger amounts of carcinogens than tobacco smoke. Sometimes cannabis use is associated with weight gain.
  17. 17. TREATMENT : 6/22/2018 17  Treatment options for individuals with cannabis- related disorders are identical to those available for people with alcohol and other substance abuse disorders. The goal of treatment is abstinence. Treatment approaches range from in- patient hospitalization , drug and alcohol rehabilitation facilities, and various outpatient programs. Twelve-step programs such as Narcotics Anonymous are also treatment options. For heavy users suffering from withdrawal symptoms, treatment with anti-anxiety and/or antidepressant medication may assist in the treatment process.
  18. 18. 6/22/2018 18 Prognosis  According to the DSM-IV-TR , cannabis dependence and abuse tend to develop over a period of time. It may, however, develop more rapidly among young people with other emotional problems. Most people who become dependent begin using regularly. Gradually, over time, both frequency and amount increase. With chronic use, there can sometimes be a decrease in or loss of the pleasurable effects of the substance, along with increased feelings of anxiety and/or depression. As with alcohol and nicotine, cannabis use tends to begin early in the course of substance abuse and many people later go on to develop dependence on other illicit substances. Because of this, cannabis has been referred to as a "gateway" drug, although this view remains highly controversial. There is much that remains unknown about the social, psychological, and neurochemical basis of drug use progression, and it is unclear whether marijuana use actually causes individuals to go on to use other illicit substances.  One long-term effect of chronic use has been termed the "amotivational syndrome." This refers to the observation that many heavy, chronic users seem unambitious in relation to school and/or career.
  19. 19. TREATMENT : 6/22/2018 19  Prevention  Many drug education programs focus strongly on discouraging marijuana experimentation among young teenagers. Recent research reported by the NIDA indicates that high-sensation-seekers—that is, individuals who seek out new, emotionally intense experiences and are willing to take risks to obtain these experiences— are at greater risk for using marijuana and other drugs, and for using them at an earlier age. As a result, the NIDA developed a series of public service announcements (PSAs) for national television. These PSAs were dramatic and attention getting, and were aired during programs that would appeal to high sensation-seekers, such as action-oriented television shows. These PSAs were aired in a limited television area and the results monitored. Marijuana use declined substantially among teens during the PSA campaigns, and long-term effects were shown for several months afterwards. In one county, marijuana use decreased by 38%, and in another, by 26.7%.  Drug education programs such as the "DARE" (Drug Awareness and Resistance Education) programs target fifth graders. These and other antidrug programs focus on peer pressure resistance and the use of older teens who oppose drug use as models of a drug-free lifestyle. These programs show mixed results.
  20. 20. REFERENCES : 6/22/2018 20  ANTHONY JC,WARNER,KESSLER R: COMPARATIVE EPIDEMOLOGY OF DEPENDENCE ON TOBACCO,ALCOHOL,CONTROLLED SUBSTANCES AND INHALANTS.  CASTLE DJ,MURRAY RM,EDS : MARIJUANA AND MADNESS : PSYCHIATRY AND EUROBILOGY,CAMBRIDGE,UK.  HALL WD,PACULA RL : CANNABIS USE AND DEPENDENCE.  KALANT H,CORRIGAL W, HALL WD, SMART R , ENDS : HEALTH EFFECTS OF CANNABIS : CENTER OF ADDICTION AND MENTAL HEALTH.  INSTITUTE OF MEDICINE : MARIJUANA AND MEDICINE : ASSESSING THE SCIENCE BASE,WASHINGTON DC: NATIONAL ACADEMY PRESS.  ROFFMAN RA,STEPHENS RS ; CANNABIS DEPENDENCE : ITS NATURE , CONSEQUENSES AND TREAT MENT.  THANK YOU

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