Cannabis, also known as marijuana, is derived from the hemp plant Cannabis sativa. It produces over 400 chemicals, the most active being tetrahydrocannabinol (THC). In India, common forms of cannabis include bhang and ganja, which are often consumed in drinks, smoked, or mixed with tobacco. Psychological effects include feelings of well-being, euphoria, and impaired memory and motor skills. Physical effects include increased heart rate, dry mouth, and appetite. Long-term use can lead to dependence and withdrawal symptoms like irritability, insomnia, and appetite changes. Diagnosis involves a medical history, exam, and urine test to detect cannabis metabolites. Treatment focuses on symptom relief

1. Mr.Visanth V S
Asso.Professor
IGSCON, Amethi

2. CANABINOIDS ABUSE
• Cannabis is derived from the hemp plant,
Cannabis sativa.
• The dried leaves and flowers are used for abuse.
• These products often referred as Ganja or
Marijuana.
• Other name are hash, hashish, charas, grass, pot,
weed, dagga, sinsemilla, herb, reefer, dope, boom,
gangster, kif.

3. • Cannabis produces more than 400 identifiable chemicals
of which about 50 are cannabinoids, the most active being
Δ-9- tetrahydrocannabinol .
• In India bhang, ganja is a common form , that is use
frequently at various occasions like (Holi, Shivratri ) in
which use like milk based drink called THANDAI or
typically smoked (ganja / charas) in CHILAM or mixed
with tobacco of cigarettes.
• MANOKA a dry slightly sweetish preparation consisting
of bhang paste.
Contd……..

4. Preparations

5. • The features are as follows;
• Psychological
– Person experience a feeling of
wellbeing
– Mild elevation of mood
(euphoria)
– A sense of floating in the air, a
euphoric dream-like state
– Impaired memory
– Impaired psychomotor activity
– Dream like state
– Flash back phenomena
• Physical
– Tachycardia
– Reddening of the
conjunctiva
– Dry mouth
– Respiratory tract irritation
– Increased appetite
– Tolerance can be
developed with high doses
for a long term use.
– Long-term use can give
rise to dependence.
Acute Intoxication

6. • Perceptual disturbances are common and can include
depersonalisation, derealisation, synaesthesias and
increased sensitivity to sound.
• However, hallucinations are seen only in marked to
severe intoxication.
• These are often visual, ranging from elementary
flashes of lights and geometrical figures to complex
human faces and pictures.

7. Withdrawal from cannabis appear within 24 hours , most
marked within 10 days and may persist up to 28 days.
Irritability, anger, or aggression.
Nervousness or anxiety.
Sleep difficulty (e.g., insomnia, disturbing dreams).
Decreased appetite or weight loss.
Restlessness.
Depressed mood.
Physical symptoms like abdominal pain, tremors,
sweating, fever, chills, or headache.
Fatigue ,yawning, difficulty in concentration etc..
Withdrawal Symptoms

8. • Transient or short-lasting psychiatric disorders:
• Acute Anxiety
• Paranoid Psychosis
• Hysterical Fugue-like States
• Suicidal Ideation
• Hypomania
• Schizophrenia-like State
• Acute Organic Psychosis
• Very Rarely Depression.
Complications

9. • Motivational Syndrome: Chronic cannabis use is postulated to
cause lethargy, apathy, loss of interest, anergia, reduced drive and
lack of ambition.
• ‘ Hemp Insanity’ or Cannabis Psychosis
• Other complications:
– Chronic cannabis use sometimes leads to memory impairment,
– Chronic obstructive air way disease, pulmonary malignancies,
– Alteration in both the humoral and cell-mediated immunity,
– Decreased testosterone levels,
– Anovulatory cycles,
– Reversible inhibition of spermatogenesis,
– Increased risk for the developing foetus (if taken during
pregnancy).
Contd……..

10. • History Collection
• MSE & Physical Examination
• Urine test can usually identified metabolite of
cannabinoids.
• It can also detect in head hair , pubic hair, urine,
sweat, saliva and blood of users.
Diagnosis

11. • Symptomatic treatment
• The psychiatric symptoms may require
appropriate psychotropic medication and
sometimes hospitalization.
• Total abstinence form cannabis
• Psychological measures like support, counseling
• Psychotherapy and psycho-education
• Follow-up and monitoring
Treatment