Cannabis
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Cannabis Abuse and Dependence
Cannabis, known as marijuana, weed, herb, pot, grass, bud, ganja, and Mary Jane is a derivative of the plant Cannabis sativa. Cannabis can be smoked in rolled cigarettes known as joints, pipes, bongs, or blunts. Cannabis can be mixed with tea or food.
Cannabis contains many chemical compounds including the Tetrahydrocannabinol (THC), which is the main psychoactive compound responsible for the intoxicating effect it is most sought after.
THC has a chemical structure similar to a brain chemical known as anandamide. Anandamide is a neurotransmitter in the brain capable of affecting parts that influence pleasure, memory, thinking, concentration and, perception of time and space. THC, similar in structure to anandamide, activate these cannabinoid receptors, causing a similar effect. THC also affects the brain’s reward system releasing dopamine, which leads to addiction over time.
Effects of Cannabis
The compound tetrahydrocannabinol (THC) present in cannabis is responsible for its psychoactive potential. Although the effects perceived vary from person to person, the common effects THC produces are;
• Sense of happiness
• Mild hallucinations
• Reduced anxiety
• Increased appetite
Cannabis Addiction, Dependence & Withdrawal
Cannabis, like any other drug, has the potential to develop into an addiction. While some users can pick up, and put down cannabis relatively easily, that is not the case for everyone. For some, cannabis use can lead to a difficult life with addiction.
Factors that determine the risk of addiction, are not limited to the social setting of the user.
• Genetics
• Age - most likely to develop an addiction to cannabis during 18-30 years
• Mental health conditions - individuals with depression, anxiety, post-traumatic stress disorder (PTSD), or schizophrenia have a high tendency to develop an addiction, especially when cannabis is used without a prescription or illegally. Cannabis can provide quick relief from anxiety and then the tolerance sets in.
• Environment & social life - being around people who consume cannabis often can add to that peer pressure and ultimately tempt you to try the drug.
• Stress - this is a common cause of why students use cannabis. Cannabis is sought out as a stress reliever, and to get rid of anxiety.
• Family & workplace problems.
• Having a responsible life with family and occupation responsibilities, and a strong social network can be protective and reduces the risk of addiction.
Signs, Symptoms & Complications of Cannabis Addiction
The increasing THC content of cannabis products contributes to increased intoxication and related risk and dependence.
• Declining performance at work or in school, including frequent absences.
• Bloodshot eyes, dry mouth
• Changes in appetite
• Fatigue, lethargy, excessive sleepiness
• Impaired balance, lack of coordination, lack of grooming and hygiene
• Problems with concentration or focusing
• Poor judgment
• Indecisiveness, dramatic mood swings
• Agitation, irritability, and paranoia
• Withdrawal from family and friends
• Legal issues
• Family problems, problems in relationships
• Diminished self-esteem and persistent sense of hopelessness
• Although there is no risk of overdosing, marijuana comprises the second highest rates of emergency room visits caused by abusing an illicit substance. This is due to accidents that occurred during intoxication.
• A gateway to other drugs of abuse such as cocaine.
Cannabis Withdrawal
Withdrawal symptoms are felt by the user upon discontinuation of the drug. This is a major obstacle in the management of cannabis addiction. Symptoms of cannabis withdrawal can vary from person to person. Following are some of the common symptoms;
• Strong urge to use cannabis
• Insomnia or hypersomnia
• Dizziness
• Lack of concentration, agitation, and irritability
• Loss of appetite and sexual dysfunction
• Depression
Therapeutic Effects of Cannabis
Cannabis is prescribed in different parts of the world for its therapeutic effects. THC containing products such as Dronabinol and nabilone are used in the palliative treatment of advanced stages of cancer to relieve nausea and vomiting.
Spasticity and neuropathic pain associated with multiple sclerosis are treated with Nabiximols which is a THC containing product.
Childhood seizures are treated with Epidiolex in a controlled manner to ensure the associated benefits are achieved without risk.
There is much controversy against laws for and against the legalisation of cannabis in the international community. However, the fact remains that cannabis is addictive, and addiction to any substance can be detrimental to the health of the individual.
References
https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine
https://www.healthline.com/health/marijuana-abuse-and-addiction
https://www.drugs.com/cg/cannabis-abuse.ht
HEALTH RISKS OF PROBLEMATIC TO DEPENDENT CANNABIS USE
Cannabis is the most widely used recreational drug globally and is also one of the cheapest drugs available.
Cannabis is extracted from the Cannabaceae family of plants, the most common being Cannabis Sativa. Australia has one of the highest prevalence of cannabis use, due to which several legislations have passed.
The effects of cannabis depend on the strain of the plant and the genetics of the user. Therefore, the effects of cannabis vary widely, but some of the health risks are common. Its wide usage is associated with many problems ranging from social issues to health issues.
ACTIVE COMPONENTS IN CANNABIS
The active components in cannabis are the psychoactive components.
- Tetrahydrocannabinol (THC)
- Cannabidiol (CBD) . There are more than 65 cannabinoids know.
It is used by inhaling it, as an extract, or within the food. Users mix cannabis with tobacco, use it in a bong, or vape it.
The main effect of cannabis is euphoria, and it lasts for a couple of hours. The primary users of cannabis in Australia are teenagers above the age of 14.
THC compound present in cannabis enters the blood through lung or GIT and then to the brain, changing dopamine and norepinephrine levels. These neurotransmitters are associated with euphoria and anxiety.
HEALTH RISK DUE TO CANNABIS
· Mental health problems
· Physical health problems
· Social health problems
MENTAL HEALTH PROBLEMS
Short term effects
The short-term effects include pleasant effects and unpleasant effects. The dominating results differ from person to person.
Pleasant effects: These occur within minutes or hours and include a person feeling happy (euphoria), talkativeness, laughter, the environment feels attractive, color appears sharp, and the music becomes comforting.
Unpleasant effects: These include anxiety, mood changes, hallucinations(sounds and images appear different), depersonalization, a person feels as if time is slowing down, increasing appetite (acute feature), lack of concentration, and difficulty in remembering information, etc.
Long term effects
Memory and attention: These are some of the main side effects of marijuana. A cannabis user struggles to focus on the given task, poor academic performance, failure to learn, and failure to remember are some of the main features. Hippocampus is one of the targets of THC. Thus, new memory formation is affected.
Addiction: Addiction will occur, but its prevalence is far less than alcohol, cocaine, etc. One in ten people will have the sign and symptoms of addiction. It is both psychological and physical. Withdrawal symptoms are present in chronic cannabis smokers.
Depression and anxiety: Anxiety is the most common side effect of cannabinoids. It is more of a reason to use marijuana than a negative impact.
Panic attack: Some of the users have severe panic attacks, second only to anxiety.
Schizophrenia: Cannabis is the leading risk factor in schizophrenia because of its dopamine increasing effects. It is apparent in those persons who are genetically susceptible. Hallucinations, delusions, and disordered thinking are the main symptoms.
Apathy and motivational syndrome: Can be seen in chronic smokers.
Suicidal: Predominantly in schizophrenic patients. Especially with teenagers.
Change in IQ: A study conducted by New Zealand showed that chronic smokers, especially young individuals, lost an average of 8 IQ. This change in mental capabilities is permanent.
PHYSICAL HEALTH PROBLEMS
Cannabis predominantly affects the respiratory system, similar to smoking tobacco and other herbs. Other systems indirectly involved one way or the other.
Bronchitis: Chronic users suffer from bronchitis characterized by cough and sputum during the night.
Excessive phlegmy cough. Common in extreme cannabis users.
Lung cancer: Mechanism is the same as that of tobacco smoking. It is more common in those who smoke cannabis by mixing it with tobacco. Research shows cannabis contains more carcinogenic factors compared to tobacco smoking. However, this varies with each strain of the cannabis plant.
Stroke: There is an increased risk of stroke.
Cardiac problems: Cannabis increases heart by 20 to 50 bpm. This increased heart rate lasts for hours. A person with risk factors for cardiovascular diseases can develop severe complications.
Red-eye: Active component of cannabis causes vasodilation and hence the red-eye.
Slowing of senses: This is an acute effect and is due to the action of THC. Hence the person is more prone to injure himself/herself.
Problems in pregnancy: The mental development of the fetus is retarded. Cannabis use in pregnancy can create problems with insufficient attention, memory, problem-solving skills, and behavior later in life.
Cannabinoid hyperemesis syndrome: Commonly seen in regular marijuana users. Cannabinoid hyperemesis syndrome causes the user to experience severe vomiting, nausea, and dehydration in cycles and may need emergency medical attention.
Immune system weakness: Chronic smokers have reduced immunity and are susceptible to various infections.
Cannabis arteritis: It is a rare disease similar to Buerger's disease.
Testicular cancer: The National Academies of Sciences has linked slow-growing testicular cancers (seminomas) to marijuana use. But convincing evidence is lacking.
SOCIAL HEALTH PROBLEMS
Social stigma: Society isn’t kind towards cannabis users. Either family isolates the addict or the addict prefers to be separated.
Poor interpersonal relationship: Like every other additive, cannabis can result in poor communication with family members, especially if someone is a heavy smoker. It can be the reason for separation and a weak bond with the children.
Economic instability: Spending a significant proportion of one’s income to buying cannabis and cigarettes. Also, decreased work capacity contributes to financial instability.
Work inefficiency: As marijuana slows one's mental activity, it directly affects working capabilities.
Crime: Tendency to commit a crime is increased mostly because of the company one keeps. Dealing with drug dealers directly impacts one’s mind.
Road traffic accidents: This is mainly because of the lethargy and numbing effects of cannabis. Marked depression in the motor activity of the body is associated as well.
REFERENCES:
- https://en.m.wikipedia.org/wiki/Effects_of_cannabis
- https://www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-conditions/cannabis-and-mental-health/
- https://www.healthline.com/health-news/cannabis-use-can-affect-your-driving-long-after-your-high-is-gone#Cannabis-use-at-a-younger-age-may-have-a-greater-impact-on-cognitive-function
- Book: Davidson’s Principles and Practice of Medicine.
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