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 Canabis (Marijuana)

Mecanism de acțiune

Canabisul este un drog care se fumează, fiind absorbit rapid la nivel pulmonar. În tractul
gastrointestinal, absorbția este mai lentă și mai puțin previzibilă în cazul ingestiei drogului. Efectele
apar la scurt timp după administrare și persistă 4-6 ore. Are un timp de înjumătățire plasmatică de 20-
30 de ore(58) și poate fi detectat în urină câteva zile după administrare la consumatorii ocazionali și
timp de câteva luni la marii consumatori.

Consecințe fiziopatologice și clinice cardiace

Canabisul are un efect bifazic asupra sistemului nervos autonom(58-61). La doze mici-moderate
determină stimularea sistemului nervos simpatic și reducerea activității parasimpatice, producând
tahicardie și creșterea debitului cardiac. La doze mari, activitatea simpatică este inhibată și cea
parasimpatică este stimulată, ducând la bradicardie și hipotensiune arterială. Apare și o creștere a
activității ectopice supraventriculare și ventriculare, fără dezvoltarea de aritmii amenințătoare de
viață. La pacienții cu boală cardiacă ischemică, canabisul crește recurența episoadelor anginoase la
prag de efort redus, din cauza creșterii necesității de oxigen la nivel miocardic prin tahicardizare și
creșterea contractilității miocardice(63).

Tratament și prognostic

Tabloul clinic în intoxicația cu canabis poate fi subtil și predomină simptomele legate de afectarea
sistemului nervos central. În absența unor boli structurale cardiace preexistente, efectele asupra
sistemului cardiovascular sunt bine tolerate. În general, hipotensiunea arterială răspunde la
administrarea parenterală de fluide. Aritmiile maligne și colapsul cardiovascular sunt rare, dar
consumul concomitent de cocaină și alte droguri recreaționale (cocaină, amfetamine, ecstasy) are
efect cumulativ, dăunător asupra sistemului nervos autonomic și asupra concentrațiilor plasmatice.

58. Olson KR, ed (1999) Poisoning and drug overdose (Appleton and Lange, Stamford, Connecticut),
3rd ed. 
59. Rinaldi L (1994) Marijuana: a research overview. Alaska Med 36:107-113.
60. Tashkin D (1978) Cannabis. Ann Intern Med 89:539-549. 
61. Kanakis C, Pouget C, Rosen KM (1976) The effects of delta 9 tetrahydrocannabinol on cardiac
performance with and without beta blockade. Circulation 53:703-707. 
62. Kochar M, Hosko MJ (1973) Electrocardiographic effects of marijuana. JAMA 225:25-27. 
63. Shapiro BJ, Reiss S, Sullivan SF, et al. (1976) Cardiopulmonary effects of marijuana smoking
during exercise. Chest 70:441. 

Marijuana este un amestec verde, maro sau gri din frunzele, tulpinile, semințele și florile uscate
ale cânepei indiene (Cannabis sativa indica) și are aspect de tutun verzui tăiat foarte fin. Fiecare tip
de marijuana conține THC (tetrahidrocanabinol), principala substanța psihoactiva a acestor produse
vegetale. Cu cât valoarea THC-ului este mai mare, cu atât mai puternice sunt efectele acestui ușor
drog.[1]
Substanțele active din cannabis au o istorie îndelungată și plină de tradiție, ca medicamente. În țările
Orientului și Americii latine, aceste substanțe sunt puternic răspândite și au indicații de consum
medicale și mai ales sociale. Din aceași plantă provine și hașișul (engl. "pot", "shit"), care este rășina
secretată de glandele situate la nivelul frunzelor de cânepă (Cannabis).

Forme de comercializare[modificare | modificare sursă]


Materialul vegetal se comercializează sub diverse forme:

 Marijuana legată în jurul unor bețe de bambus este cunoscută sub numele Buddha Sticks sau
Thai Sticks (bețisoare Thai).
 Sinsemilla, reprezintă vârfuri florale nefertilizate recoltate de pe exemplarele femele. Datorită
concentrației mari de THC și aspectului său, sinsemilla este considerată o delicatesă și este una
dintre cele mai scumpe forme de marijuana.
 Skunk, reprezintă sinsemilla obținută din varietăți afgane de cannabis, cu concentrații foarte
mari de THC.
 Bhang, este o marijuana de calitate inferioară obținută din frunze tinere uscate și care se
consumă de obicei în amestec cu opiu și specii toxice de ciumăfaie (astfel de amestecuri se
numesc poust, lutki sau mudra).
 Ganja, reprezintă vârfuri florale fertilizate comercializate sub formă de mănunchiuri sau
rulouri și are un miros fetid caracteristic. Vârfurile florale uscate mărunțite la gradul de pulbere
grosieră sunt cunoscute sub numele de takrouri, kabak, djamba sau dagga.
 Rezina, colectată de pe suprafața plantei se comercializează uscată și presată în blocuri sau
modelată în diverse forme (charas).[2]
Hașișul se comercializează în "bulgări" solizi sau plăci presate și se prezintă - în funcție de țara de
origine - în nuanțe de culoare rosie, maro, verde sau negru. Hașișul și uleiul de hașiș sunt forme mai
puternice de marijuana.

Efecte și stările psihice la om[modificare | modificare sursă]


Efectele substanțelor active din cannabis depind în mod decisiv de personalitatea și mediul social al
consumatorului. Unii oameni nu simt nimic dacă fumează marijuana, iar alții se pot relaxa și pot avea
un sentiment înălțător. Se descriu diferite faze ale stării tipice de euforie (engl. "cannabis high",
"social high"). Printre efectele inițiale se numără adesea o stare de agitație, însoțită ocazional de stare
de tensiune și anxietate, stări ce vor fi urmate în curând de o senzație plăcută de siguranță și ocrotire.
Urmează stări introspective și echilibrate, de un calm deosebit. Alteori pot apărea oscilații ale stării de
spirit, râsul nemotivat alternând cu tăcerea contemplativă. Este caracteristică intensificarea percepției
mediului extern și intern. În cazul consumului în grup, aceste modificări pot determina o trăire mai
intensă a relațiilor de grup. Pierderea aptitudinilor critice pe durata stării de stupoare poate duce la
perceperea defectuoasă a realității obiective (efectul halucinogen). Consumatorul nu face față
întotdeauna intensității trăirilor noi, ceea ce poate avea ca și consecință apariția unor stări de anxietate
severă. Amețeala după cannabis nu are aceeași evoluție în toate cazurile, existând și stări euforice
atipice. Uneori, consumul de cannabis poate simula, agrava sau declanșa psihoze
schizofreniforme. [necesită  citare]
Marijuana nu provoacă dependență fizică. Dependența psihică de substanțele active din cannabis
poate apărea în urma consumului îndelungat și depinde de doza utilizată, de regularitatea consumului,
de organismul consumatorului etc. Aparent, nu există simptome de sevraj fizic pur după oprirea
consumului. Există riscul de a dobândi dependență psihică în timp și prin consum regulat. Majoritatea
consumatorilor iau hașiș sau marijuana aproximativ o dată sau de două ori pe săptămână, de regulă
într-un "peisaj social" în care, în trecut, ar fi fost obișnuit consumul de alcool. De obicei, această
categorie de consumatori poate abandona consumul de cannabis fără a suferi de simptome de sevraj
psihic. Crește însă numărul consumatorilor care fumează zilnic și a căror ritm de viață, sentiment de
siguranță și stare generală este sensibil tulburată fără droguri. La astfel de consumatori, renunțarea
după o lungă perioadă de abuz poate duce la neliniște, alterarea stării psihice și tulburări de somn.
Boli la care ajută marijuana: scleroza multiplă, MRSA, hipertensiunea arterială, incontinență urinară,
tulburările gastro-intestinale, cancerul, durerea cronică, boala alzheimer, apneea de somn și multe
altele.[necesită  citare] printe altele și stări de vomă și insomnie.

Cannabis, also known as marijuana among other names,[a] is a psychoactive drug from


the Cannabis plant used primarily for medical or recreational purposes.[18][19][20] The main psychoactive
component of cannabis is tetrahydrocannabinol (THC), which is one of the 483 known compounds in
the plant,[21] including at least 65 other cannabinoids.[22] Cannabis can be used
by smoking, vaporizing, within food, or as an extract.[23]
Cannabis has mental and physical effects. It causes a "high", or stoned feeling and other effects,
including a general change in thought and perception, difficulty concentrating, impaired short-term
memory, altered sense of time, impaired body movement,[23] relaxation,[24] and an increase in appetite,
otherwise known as "munchies".[25] Onset of effects is felt within minutes when smoked, and about 30
to 60 minutes when cooked and eaten.[23][26] The effects last for two to six hours, depending on the
amount used.[26] At high doses, mental effects sometimes include psychosis, delusions, hallucinations,
[23]
 paranoia, and ideas of reference, sometimes with anxiety and panic.[27] Its physical effects include
increased heart rate, difficulty breathing, nausea, and behavioral problems in children whose mothers
used cannabis during pregnancy.[23] Short-term side effects may include a dry mouth, red eyes, and
feelings of paranoia or anxiety.[28][29] Long-term adverse effects may include addiction,
decreased mental ability in those who started regular use as adolescents, chronic coughing, and
susceptibility to respiratory infections.[30] There is a strong relation between cannabis use and the risk
of psychosis,[31][32] though the cause and effect is debated.[33]
Cannabis is mostly used recreationally or as a medicinal drug, although it may also be used
for spiritual purposes. In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of
the global population between the ages of 15 and 65).[34] It is the most commonly used illegal
drug both in the world and the United States,[23][34] though it is also legal in some jurisdictions. The
countries with the highest use among adults as of 2018 are Zambia, the United States, Canada, and
Nigeria.[35] In 2016, 51% of people in the United States had used cannabis in their lifetimes.[36] About
12% had used it in the past year, and 7.3% had used it in the past month.[37]
While cannabis plants have been grown since at least the 3rd millennium BCE,[38] evidence suggests
that it was being smoked for psychoactive effects at least 2,500 years ago in the Pamir Mountains.
[39]
 Since the early 20th century, cannabis has been subject to legal restrictions. The possession, use,
and cultivation of cannabis is illegal in most countries of the world.[40][41] In 2013, Uruguay became
the first country to legalize recreational use of cannabis.[42] Other countries to do so are Canada,
Georgia, and South Africa, along with 11 states and the District of Columbia in the United States
(though the drug remains federally illegal).[42][43] Medical use of cannabis, requiring the approval of a
physician, has been legalized in a greater number of countries.[44]

Uses
Medical
Main article: Medical cannabis

Main short-term physical effects of cannabis

Medical cannabis, or medical marijuana, can refer to the use of cannabis and its cannabinoids to treat
disease or improve symptoms; however, there is no single agreed-upon definition.[45][46] The rigorous
scientific study of cannabis as a medicine has been hampered by production restrictions and by the
fact that it is classified as an illegal drug by many governments.[47] There is limited evidence
suggesting cannabis can be used to reduce nausea and vomiting during chemotherapy, to improve
appetite in people with HIV/AIDS, or to treat chronic pain and muscle spasms.[48][49][50] Its use for other
medical applications is insufficient for drawing conclusions about safety or efficacy.
Short-term use increases the risk of both minor and major adverse effects.[49] Common side effects
include dizziness, feeling tired and vomiting.[49] The long-term effects of cannabis are not clear.
[49]
 There are concerns surrounding memory and cognition problems, risk of addiction, risk
of schizophrenia in young people, and the risk of children taking it by accident.[48]
Recreational
Main article: Effects of cannabis

Cannabis has psychoactive and physiological effects when consumed.[51] The immediate desired
effects from consuming cannabis include relaxation and euphoria (the "high" or "stoned" feeling), a
general alteration of conscious perception, increased awareness of sensation,
increased libido[24] and distortions in the perception of time and space. At higher doses, effects can
include altered body image, auditory and/or visual illusions, pseudohallucinations and ataxia from
selective impairment of polysynaptic reflexes. In some cases, cannabis can lead to dissociative states
such as depersonalization[52][53] and derealization.[54]
Some immediate undesired side effects include a decrease in short-term memory, dry mouth, impaired
motor skills and reddening of the eyes.[55] Aside from a subjective change in perception and mood, the
most common short-term physical and neurological effects include increased heart rate, increased
appetite and consumption of food, lowered blood pressure, impairment of short-term and working
memory,[56][57] psychomotor coordination, and concentration. Some users may experience an episode
of acute psychosis, which usually abates after six hours, but in rare instances, heavy users may find
the symptoms continuing for many days.[58]
A reduced quality of life is associated with heavy cannabis use, although the relationship is
inconsistent and weaker than for tobacco and other substances.[59] The direction of cause and effect
relationship, however, is unclear.[59]
Spiritual

Main article: Entheogenic use of cannabis

Cannabis has held sacred status in several religions and has served as an entheogen – a chemical
substance used in religious, shamanic, or spiritual contexts[60] – in the Indian subcontinent since
the Vedic period dating back to approximately 1500 BCE, but perhaps as far back as 2000 BCE.
There are several references in Greek mythology to a powerful drug that eliminated anguish and
sorrow. Herodotus wrote about early ceremonial practices by the Scythians, thought to have occurred
from the 5th to 2nd century BCE. In modern culture, the spiritual use of cannabis has been spread by
the disciples of the Rastafari movement who use cannabis as a sacrament and as an aid to meditation.
The earliest known reports regarding the sacred status of cannabis in the Indian subcontinent come
from the Atharva Veda, estimated to have been composed sometime around 1400 BCE.[61]
Available forms
Main article: Cannabis consumption

A joint prior to rolling, with a paper handmade filter on the left

Cannabis is consumed in many different ways:[62]

 Smoking, which typically involves burning and inhaling vaporized cannabinoids ("smoke")
from small pipes, bongs (portable versions of hookahs with a water chamber), paper-
wrapped joints or tobacco-leaf-wrapped blunts, and other items.[63]
 Vaporizer, which heats any form of cannabis to 165–190 °C (329–374 °F),[64] causing the
active ingredients to evaporate into vapor without burning the plant material (the boiling point
of THC is 157 °C (315 °F) at atmospheric pressure).[65]
 Cannabis tea, which contains relatively small concentrations of THC because THC is an oil
(lipophilic) and is only slightly water-soluble (with a solubility of 2.8 mg per liter).[66] Cannabis
tea is made by first adding a saturated fat to hot water (e.g. cream or any milk except skim) with a
small amount of cannabis.[67]
 Edibles, where cannabis is added as an ingredient to one of a variety of foods, including
butter and baked goods. In India it is commonly made into a beverage, bhang.
 Capsules, typically containing cannabis oil, and other dietary supplement products, for which
some 220 were approved in Canada in 2018.[68]

Adverse effects
See also: Long-term effects of cannabis

Further information: Cannabis in pregnancy

Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the
police and legal services engaged in delphic analysis regarding 20 popular recreational drugs.
Cannabis was ranked 11th in dependence, 17th in physical harm, and 10th in social harm.[69]

Short term
Acute effects may include anxiety and panic, impaired attention and memory, an increased risk of
psychotic symptoms,[b] the inability to think clearly, and an increased risk of accidents.[72][73]
[27]
 Cannabis impairs a person's driving ability, and THC was the illicit drug most frequently found in
the blood of drivers who have been involved in vehicle crashes. Those with THC in their system are
from three to seven times more likely to be the cause of the accident than those who had not used
either cannabis or alcohol, although its role is not necessarily causal because THC stays in the
bloodstream for days to weeks after intoxication.[74][75][c]
According to the United States Department of Health and Human Services, there were 455,000
emergency room visits associated with cannabis use in 2011. These statistics include visits in which
the patient was treated for a condition induced by or related to recent cannabis use. The drug use must
be "implicated" in the emergency department visit, but does not need to be the direct cause of the
visit. Most of the illicit drug emergency room visits involved multiple drugs.[78] In 129,000 cases,
cannabis was the only implicated drug.[79][80]
The short term effects of cannabis can be altered if it has been laced with opioid drugs such
as heroin or fentanyl.[81] The added drugs are meant to enhance the psychoactive properties, add to its
weight, and increase profitability, despite the increased danger of overdose.[82][83][d]
Long term
Heavy, long-term exposure to marijuana may have biologically based physical, mental, behavioral
and social health consequences and may be "associated with diseases of the liver (particularly with
co-existing hepatitis C), lungs, heart, and vasculature".[85] Mothers who used marijuana during
pregnancy have children with more depression, hyperactivity, and inattention.[86] It is recommended
that cannabis use be stopped before and during pregnancy as it can result in negative outcomes for
both the mother and baby.[87][88] However, maternal use of marijuana during pregnancy does not
appear to be associated with low birth weight or early delivery after controlling for tobacco use and
other confounding factors.[89] A 2014 review found that while cannabis use may be less harmful than
alcohol use, the recommendation to substitute it for problematic drinking was premature without
further study.[90] Various surveys conducted between 2015 and 2019 found that many users of
cannabis substitute it for prescription drugs (including opioids), alcohol, and tobacco; most of those
who used it in place of alcohol or tobacco either reduced or stopped their intake of the latter
substances.[91]
A limited number of studies have examined the effects of cannabis smoking on the respiratory system.
[92]
 Chronic heavy marijuana smoking is associated with coughing, production of sputum, wheezing,
and other symptoms of chronic bronchitis.[72] The available evidence does not support a causal
relationship between cannabis use and chronic obstructive pulmonary disease.[93] Short-term use of
cannabis is associated with bronchodilation.[94] Other side effects of cannabis use include cannabinoid
hyperemesis syndrome (CHS).[95]
Cannabis smoke contains thousands of organic and inorganic chemical compounds. This tar is
chemically similar to that found in tobacco smoke,[96] and over fifty known carcinogens have been
identified in cannabis smoke,[97] including; nitrosamines, reactive aldehydes, and polycylic
hydrocarbons, including benz[a]pyrene.[98] Cannabis smoke is also inhaled more deeply than tobacco
smoke.[99] As of 2015, there is no consensus regarding whether cannabis smoking is associated with an
increased risk of cancer.[100] Light and moderate use of cannabis is not believed to increase risk of lung
or upper airway cancer. Evidence for causing these cancers is mixed concerning heavy, long-term use.
In general there are far lower risks of pulmonary complications for regular cannabis smokers when
compared with those of tobacco.[101] A 2015 review found an association between cannabis use and the
development of testicular germ cell tumors (TGCTs), particularly non-seminoma TGCTs.[102] Another
2015 meta-analysis found no association between lifetime cannabis use and risk of head or neck
cancer.[103] Combustion products are not present when using a vaporizer, consuming THC in pill form,
or consuming cannabis foods.[104]
There is concern that cannabis may contribute to cardiovascular disease,[105] but as of 2018, evidence
of this relationship was unclear.[106] Research in these events is complicated because cannabis is often
used in conjunction with tobacco, and drugs such as alcohol and cocaine.[107] Smoking cannabis has
also been shown to increase the risk of myocardial infarction by 4.8 times for the 60 minutes after
consumption.[108]
Neuroimaging
Although global abnormalities in white matter and grey matter are not associated with cannabis abuse,
reduced hippocampal volume is consistently found. Amygdalar abnormalities are sometimes reported,
although findings are inconsistent.[109][110][111] Preliminary evidence suggests that this effect is largely
mediated by THC, and that CBD may even have a protective effect.[112]
Cannabis use is associated with increased recruitment of task-related areas, such as the dorsolateral
prefrontal cortex, which is thought to reflect compensatory activity due to reduced processing
efficiency.[111][110][113] Cannabis use is also associated with downregulation of CB1 receptors. The
magnitude of down regulation is associated with cumulative cannabis exposure, and is reversed after
one month of abstinence.[114][115][116] There is limited evidence that chronic cannabis use can reduce
levels of glutamate metabolites in the human brain.[117]
Cognition
A 2015 meta analysis found that, although a longer period of abstinence was associated with smaller
magnitudes of impairment, both retrospective and prospective memory were impaired in cannabis
users. The authors concluded that some, but not all, of the deficits associated with cannabis use were
reversible.[118] A 2012 meta analysis found that deficits in most domains of cognition persisted beyond
the acute period of intoxication, but was not evident in studies where subjects were abstinent for more
than 25 days.[119] Few high quality studies have been performed on the long-term effects of cannabis
on cognition, and the results were generally inconsistent.[120] Furthermore, effect sizes of significant
findings were generally small.[119] One review concluded that, although most cognitive faculties were
unimpaired by cannabis use, residual deficits occurred in executive functions.[121] Impairments in
executive functioning are most consistently found in older populations, which may reflect heavier
cannabis exposure, or developmental effects associated with adolescent cannabis use.[122] One review
found three prospective cohort studies that examined the relationship between self reported cannabis
use and intelligence quotient (IQ). The study following the largest number of heavy cannabis users
reported that IQ declined between ages 7–13 and age 38. Poorer school performance and increased
incidence of leaving school early were both associated with cannabis use, although a causal
relationship was not established.[114] Cannabis users demonstrated increased activity in task-related
brain regions, consistent with reduced processing efficiency.[123]
Psychiatric
See also: Cannabis and psychosis

At an epidemiological level, a dose–response relationship exists between cannabis use and increased


risk of psychosis[31][124][125][126] and earlier onset of psychosis.[127] Although the epidemiological
association is robust, evidence to prove a causal relationship is lacking.[128] But a biological causal
pathway is plausible, especially if there is a genetic predisposition to mental illness, in which case
cannabis may be a trigger.[129][better  source  needed]
It is not clear whether cannabis use affects the rate of suicide.[130][131] Cannabis may also increase the
risk of depression, but insufficient research has been performed to draw a conclusion.[132][125] Cannabis
use is associated with increased risk of anxiety disorders, although causality has not been established.
[133]

A February 2019 review found that cannabis use during adolescence was associated with an increased
risk of developing depression and suicidal behavior later in life, while finding no effect on anxiety.[134]
Reinforcement disorders
Main article: Cannabis dependence

About 9% of those who experiment with marijuana eventually become dependent according to DSM-
IV (1994) criteria.[80] A 2013 review estimates daily use is associated with a 10–20% rate of
dependence.[48] The highest risk of cannabis dependence is found in those with a history of poor
academic achievement, deviant behavior in childhood and adolescence, rebelliousness, poor parental
relationships, or a parental history of drug and alcohol problems.[135] Of daily users, about 50%
experience withdrawal upon cessation of use (i.e. are dependent), characterized by sleep problems,
irritability, dysphoria, and craving.[114] Cannabis withdrawal is less severe than withdrawal from
alcohol.[136]
According to DSM-V criteria, 9% of those who are exposed to cannabis develop cannabis use
disorder, compared to 20% for cocaine, 23% for alcohol and 68% for nicotine. Cannabis abuse
disorder in the DSM-V involves a combination of DSM-IV criteria for cannabis abuse and
dependence, plus the addition of craving, minus the criterion related to legal troubles.[114]

Overdose
THC, the principal psychoactive constituent of the cannabis plant, has low toxicity. The dose of THC
needed to kill 50% of tested rodents is extremely high. Cannabis has not been reported to cause
fatal overdose in humans.[130]

Pharmacology
Mechanism of action
See also: Effects of cannabis §  Biochemical mechanisms in the brain

The high lipid-solubility of cannabinoids results in their persisting in the body for long periods of
time.[137] Even after a single administration of THC, detectable levels of THC can be found in the body
for weeks or longer (depending on the amount administered and the sensitivity of the assessment
method).[137] A number of investigators have suggested that this is an important factor in marijuana's
effects, perhaps because cannabinoids may accumulate in the body, particularly in the lipid
membranes of neurons.[138]
Not until the end of the 20th century was the specific mechanism of action of THC at the neuronal
level studied.[citation needed] Researchers have subsequently confirmed that THC exerts its most prominent
effects via its actions on two types of cannabinoid receptors, the CB1 receptor and the CB2 receptor,
both of which are G protein-coupled receptors.[139] The CB1 receptor is found primarily in the brain as
well as in some peripheral tissues, and the CB2 receptor is found primarily in peripheral tissues, but is
also expressed in neuroglial cells.[140] THC appears to alter mood and cognition through its agonist
actions on the CB1 receptors, which inhibit a secondary messenger system (adenylate cyclase) in a
dose-dependent manner. These actions can be blocked by the selective
CB1 receptor antagonist rimonabant (SR141716), which has been shown in clinical trials to be an
effective treatment for smoking cessation, weight loss, and as a means of controlling or
reducing metabolic syndrome risk factors.[141] However, due to the dysphoric effect of CB1 receptor
antagonists, this drug is often discontinued due to these side effects.[142]
Via CB1 receptor activation, THC indirectly increases dopamine release and
produces psychotropic effects.[143] Cannabidiol (CBD) also acts as an allosteric modulator of
the μ- and δ-opioid receptors.[144] THC also potentiates the effects of the glycine receptors.[145] It is
unknown if or how these actions contribute to the effects of cannabis.[146]

Chemistry
Detection in body fluids
Main article: Cannabis drug testing

THC and its major (inactive) metabolite, THC-COOH, can be measured in blood, urine, hair, oral
fluid or sweat using chromatographic techniques as part of a drug use testing program or a forensic
investigation of a traffic or other criminal offense.[58] The concentrations obtained from such analyses
can often be helpful in distinguishing active use from passive exposure, elapsed time since use, and
extent or duration of use. These tests cannot, however, distinguish authorized cannabis smoking for
medical purposes from unauthorized recreational smoking.[147] Commercial
cannabinoid immunoassays, often employed as the initial screening method when testing
physiological specimens for marijuana presence, have different degrees of cross-reactivity with THC
and its metabolites.[148] Urine contains predominantly THC-COOH, while hair, oral fluid and sweat
contain primarily THC.[58] Blood may contain both substances, with the relative amounts dependent
on the recency and extent of usage.[58]
The Duquenois–Levine test is commonly used as a screening test in the field, but it cannot definitively
confirm the presence of cannabis, as a large range of substances have been shown to give false
positives.[149] Researchers at John Jay College of Criminal Justice reported that dietary zinc
supplements can mask the presence of THC and other drugs in urine.[150] However, a 2013 study
conducted by researchers at the University of Utah School of Medicine refute the possibility of self-
administered zinc producing false-negative urine drug tests.[151]

Varieties and strains

Types of cannabis

CBD is a 5-HT1A receptor agonist, which may also contribute to an anxiolytic effect.[152] This likely


means the high concentrations of CBD found in Cannabis indica mitigate the anxiogenic effect of
THC significantly.[152] It is often claimed that sativa strains provide a more stimulating psychoactive
high while indica strains are more sedating with a body high.[153] However this is disputed by
researchers.[154]
Psychoactive ingredients
According to the United Nations Office on Drugs and Crime (UNODC), "the amount of THC present
in a cannabis sample is generally used as a measure of cannabis potency."[155] The three main forms of
cannabis products are the flower/fruit, resin (hashish), and oil (hash oil). The UNODC states that
cannabis often contains 5% THC content, resin "can contain up to 20% THC content", and that
"Cannabis oil may contain more than 60% THC content."[155]
A 2012 review found that the THC content in marijuana had increased worldwide from 1970 to 2009.
[156]
 It is unclear, however, whether the increase in THC content has caused people to consume more
THC or if users adjust based on the potency of the cannabis. It is likely that the higher THC content
allows people to ingest less tar. At the same time, CBD levels in seized samples have lowered, in part
because of the desire to produce higher THC levels and because more illegal growers cultivate
indoors using artificial lights. This helps avoid detection but reduces the CBD production of the plant.
[157]

Australia's National Cannabis Prevention and Information Centre (NCPIC) states that the buds
(infructescences) of the female cannabis plant contain the highest concentration of THC, followed by
the leaves. The stalks and seeds have "much lower THC levels".[158] The UN states that the leaves can
contain ten times less THC than the buds, and the stalks one hundred times less THC.[155]
After revisions to cannabis scheduling in the UK, the government moved cannabis back from a class
C to a class B drug. A purported reason was the appearance of high potency cannabis. They
believe skunk accounts for between 70 and 80% of samples seized by police[159] (despite the fact that
skunk can sometimes be incorrectly mistaken for all types of herbal cannabis).[160][161] Extracts such
as hashish and hash oil typically contain more THC than high potency cannabis infructescences.[162]

Preparations
Marijuana
Further information: Marijuana (word)

Marijuana or marihuana (herbal cannabis)[20] consists of the dried flowers and fruits and subtending
leaves and stems of the female Cannabis plant.[163][164][165][166] This is the most widely consumed form,
[166]
 containing 3% to 20% THC,[167] with reports of up to 33% THC.[168] This is the stock material from
which all other preparations are derived. Although herbal cannabis and industrial hemp derive from
the same species and contain the psychoactive component (THC), they are distinct strains with unique
biochemical compositions and uses. Hemp has lower concentrations of THC and higher
concentrations of CBD, which gives lesser psychoactive effects.[169][170]
Kief
Main article: Kief

Kief is a powder, rich in trichomes,[171] which can be sifted from the leaves, flowers and fruits
of cannabis plants and either consumed in powder form or compressed to produce cakes of hashish.
[172]
 The word "kif" derives from colloquial Arabic ‫كيف‬ kēf/kīf, meaning pleasure.[173]
Hashish
Main article: Hashish

Hashish (also spelled hasheesh, hashisha, or simply hash) is a concentrated resin cake or ball


produced from pressed kief, the detached trichomes and fine material that falls off cannabis fruits,
flowers and leaves.[174] or from scraping the resin from the surface of the plants and rolling it into
balls. It varies in color from black to golden brown depending upon purity and variety of cultivar it
was obtained from.[175] It can be consumed orally or smoked, and is also vaporized, or 'vaped'.[176] The
term "rosin hash" refers to a high quality solventless product obtained through heat and pressure.[177]
Tincture
Main article: Tincture of cannabis

Cannabinoids can be extracted from cannabis plant matter using high-proof spirits (often grain


alcohol) to create a tincture, often referred to as "green dragon".[178] Nabiximols is a branded product
name from a tincture manufacturing pharmaceutical company.[179]
Hash oil
Main article: Hash oil
Hash oil is a resinous matrix of cannabinoids obtained from the Cannabis plant by solvent extraction,
[180]
 formed into a hardened or viscous mass.[181] Hash oil can be the most potent of the main cannabis
products because of its high level of psychoactive compound per its volume, which can vary
depending on the plant's mix of essential oils and psychoactive compounds.
[182]
 Butane and supercritical carbon dioxide hash oil have become popular in recent years.[183]
Infusions
There are many varieties of cannabis infusions owing to the variety of non-volatile solvents used.
[184]
 The plant material is mixed with the solvent and then pressed and filtered to express the oils of the
plant into the solvent. Examples of solvents used in this process are cocoa butter, dairy butter, cooking
oil, glycerine, and skin moisturizers. Depending on the solvent, these may be used in cannabis
foods or applied topically.[185]
Medical use
Further information: Medical cannabis

Medical marijuana refers to the use of the Cannabis plant as a physician-recommended herbal


therapy as well as synthetic[186] THC and cannabinoids. So far, the medical use of cannabis is legal
only in a limited number of territories, including Canada,[68] Belgium, Australia, the Netherlands,
Spain, and many U.S. states. This usage generally requires a prescription, and distribution is usually
done within a framework defined by local laws. There is evidence supporting the use of cannabis or
its derivatives in the treatment of chemotherapy-induced nausea and vomiting, neuropathic pain, and
multiple sclerosis. Lower levels of evidence support its use for AIDS wasting syndrome, epilepsy,
rheumatoid arthritis, and glaucoma.[80]

Everything you need to know about marijuana (cannabis)

 What is marijuana?
 Effects
 Risks
 Addiction
 Medical use
Globally, marijuana is the most commonly used illicit drug. Classified as a Schedule 1 controlled
substance, marijuana is a mood-altering drug that affects almost every organ in the body.

In 2017, 6 percent or about 1 in 16 high school seniors in the United States reported using marijuana
(cannabis) every day. The number of 12th graders who think marijuana use is risky has halved in the
last 20 years.

According to the 2013 National Survey on Drug Use and Health (NSDUH), 19.8 million, or 80.6
percent of people who used illicit drugs in the U.S. used marijuana in the month before being
surveyed.
People can smoke marijuana, inhale it through vapor, brew it as a tea, apply it as a balm, or eat it in
products, such as brownies or chocolate bars.

Some people use medical marijuana to treat chronic pain, muscle spasticity, anorexia, nausea, and
sleep disturbances.

Medical marijuana refers to either whole marijuana or its ingredients, such as cannabidiol (CBD),
which forms the base of a limited number of approved medications.

Medical marijuana is not subject to governmental standardization, making its ingredients and potency
unknown. It is not legal in all states.

Fast facts on marijuana:

 The primary psychoactive ingredient in marijuana is delta-9-tetrahydro-cannabidinol (THC).


 Marijuana contains more than 120 compounds, which are likely to have different properties.
 The effects of recreational marijuana use include lightheadedness, a feeling of relaxation,
increased appetite, and reduced blood pressure.

What is marijuana?

Share on PinterestMarijuana comes from the Cannabis sativa plant.

Marijuana comes from the dried flowering tops, leaves, stems, and seeds of the Cannabis
sativa (hemp) plant.

Humans have used marijuana for hundreds of years for fiber (hemp), seed oils, seed, medical
treatment, and recreationally.

There is some evidence that marijuana or some of its components — such as CBD — may be useful
for relieving severe pain, inflammation, nausea, and chronic conditions.

However, CBD is just one of at least 120 substances (cannabinoids) found in marijuana. People have
many health concerns about the use of the drug.

Another primary component of marijuana is delta-9-tetrahydrocannabinol (THC).

THC is the key mind-altering (psychoactive) substance in marijuana. It acts on specific brain
receptors, causing possible mood changes, depression, suicidal thinking, memory issues, and
disruption to normal learning abilities. It may also produce dependency.
The compound is also known to stimulate appetite (informally known as “the munchies”) and induce
a relaxed state, as well as other effects on sense of smell, hearing, and eyesight. THC can also
cause fatigue. In some people, THC may reduce aggression.

Effects

Share on PinterestMarijuana has many effects on the mind and body.

The effects of the 120-plus cannabinoids present in cannabis are mostly unknown, but the most potent
psychoactive agent identified to date is THC.

When a person smokes cannabis, THC is quickly absorbed into the bloodstream, reaching the brain
within minutes.

The body absorbs THC more slowly when it is eaten, delaying the onset of action for up to 2 hours
and prolonging the duration of the effect.

THC and other cannabinoids in marijuana are similar to cannabinoids produced by the body. These
natural cannabinoids act like neurotransmitters that send chemical messages between nerve cells
(neurons) throughout the nervous system.

These neurotransmitters affect brain areas involved in memory, thinking, concentration, movement,
coordination, sensory and time perception, as well as pleasure. The receptors that respond to these
cannabinoids also react to THC, which can alter and disrupt normal brain function.

Some studies have shown that THC affects areas of the brain that control memory creation and
attention.

It also disrupts other parts of the brain, adversely affecting balance, posture, coordination, and
reaction time. This can make it unsafe for a person using marijuana to drive a car, operate heavy
machinery, or engage in sports or other potentially dangerous physical activities.

THC also stimulates specific cannabinoid receptors that increase the release of dopamine, a
neurotransmitter related to feelings of pleasure.

People use marijuana to achieve a feeling of elation (a high), giddiness, and relaxation. Marijuana also
produces sensory perception changes; colors may seem brighter, music more vivid, and emotions
more profound. Some people experience feelings of paranoia.

When people consume cannabis for recreational purposes, they might experience the following
effects:
 changes in perception, due to a slight hallucinogenic effect that can create a distorted illusion
of time and space
 mood changes, leading to euphoria, feelings of energy, or a state of relaxation
 higher heart rate
 reduction in blood pressure
 impairment of concentration and memory
 reduced psychomotor coordination
 nausea, even though some cannabinoids may help reduce nausea
 increase in appetite
 faster breathing

Depending on the length and amount of use, some traces of THC might still be present in a person’s
urine for several months after they last used marijuana.

Risks

Below are some examples of findings that suggest or demonstrate some of the negative consequences
of consuming cannabis:

 Impairment of judgment: A study in the BMJ found that a person is significantly more


likely to crash their car if they drive within 3 hours of smoking marijuana.
 Reproductive issues: According to a review of animal studies, cannabis use might lead to
sexual dysfunction.
 Immune response: According to one study, smoking marijuana could eventually suppress the
body’s immune system, making the user more susceptible to certain types of cancer and
infections.
 Psychosis: Research carried out on siblings suggested that long-term marijuana use could
increase the risk of developing psychosis in young adults.
 Gum disease risk: One study indicated that smoking cannabis increases the risk of
developing gum disease, regardless of whether the user smokes tobacco.
 Reduced brain function: Researchers found that regular cannabis users who started before
they were 15 years old did not score as well on brain tests as their counterparts who began
using cannabis later in life.
 Acute memory loss: A British study suggests that smokers of potent cannabis strains (skunk,
for instance) may have a higher risk of acute memory loss.
 Changes in human DNA: A British study found compelling evidence that cannabis smoke
damages human DNA in such a way that the user could become more susceptible to
developing cancer.
 Testicular cancer: A 2015 review and meta-analysis of three earlier studies found that
frequent or long-term marijuana use may increase the risk of developing testicular cancer, but
more evidence is needed to confirm this.

Addiction

Share on PinterestMarijuana may be addictive, and long-term use may cause various health problems.

Cannabis, like other pain relievers, can lead to dependence and addiction.

Over time, the severe, persistent overstimulation of the neurotransmitters that bind to cannabinoid
receptors can cause changes in the brain that result in a marijuana use disorder or addiction.

According to the National Institute on Drug Abuse (NIDA), people who start using marijuana at a
young age, and who are heavy users are more likely to develop a marijuana use disorder than some
other users.

Cannabis withdrawal

Abrupt withdrawal from cannabis can be uncomfortable but not life-threatening.

Withdrawal begins on the second day after stopping and may persist for up to weeks.

Withdrawal symptoms include:

 anxiety
 irritability
 insomnia
 stomach pain
 decreased appetite

Sleep problems can potentially persist beyond that time frame.

The full extent of the long-term health risks of chronic cannabis use is currently unknown. There is no
way to determine who will develop severe physical, psychological, or other unwanted reactions.

Synthetic marijuana

Drugs that do not have legal status, do not have FDA approval, or both cannot be guaranteed safe.
So-called synthetic marijuana, such as K2 or Spice, is not marijuana, although it contains some of the
compounds found in marijuana.

Some people may try untested and illegal synthetic cannabinoids in the belief that they are legal. This
can be dangerous and possibly fatal.

Legality

Cannabis and related products, such as CBD, are legal in some states but not in others. It is important
to check your state laws before purchasing marijuana, cannabis, or their derivatives.

Medical use

Researchers have been looking into the possible benefits of cannabinoids for treating different health
conditions.

These include autoimmune disease, inflammation, pain, seizure disorders, psychiatric disorders and
substance use disorders, withdrawal, and dependence.

CBD in medicine

Many researchers are investigating the medicinal potential of cannabidiol (CBD), a cannabinoid found
in marijuana that does not have psychoactive effects.

In June 2018, following a lengthy process of research and clinical trials, the FDA approved the use of
CBD to treat two rare and severe types of epilepsy that do not respond well to other treatments.

The drug is called Epidiolex, and it is a medication that derives from marijuana. It is a purified
cannabidiol that does not contain THC.

Some people believe that CBD might help relieve the pain and inflammation that occurs
with fibromyalgia and arthritis, for example, and possibly for treating anxiety and addiction.

THC in medication

Some studies have demonstrated that THC shows some promise for the treatment of nausea and
vomiting, but its adverse effects may limit its use.

It may have antiemetic qualities that make it helpful for people undergoing chemotherapy or other
treatment where nausea can be a side effect.
THC may also decrease pain, inflammation, nausea, and muscle control problems, but as yet, no
medications for these conditions have approval, and more evidence is necessary to confirm their
safety and effectiveness.

Some clinical trials have shown that THC has mild-to-moderate pain-relieving effects, and might be
useful for the treatment of headache pain.

Studies suggest that there are specific benefits of certain types of marijuana use, and the FDA will
likely approve more types of marijuana for medical applications over time.

In addition to Epidiolex, three other drugs have received FDA approval: Marinol, Syndros, and
Cesamet. These medications contain synthetic substances with a similar structure to THC. They are
treatment options for some kinds of anorexia.

Other researchers are looking at the potential for marijuana extracts to target and kill cancer cells, in
particular as a treatment alongside radiation therapy.

Results of a study published in July 2018 found no evidence that cannabis use can reduce pain or
reduce the need for opioids in pain related to cancer. However, the use of cannabis was mostly illicit
and did not focus on the use of specific cannabinoids.

How do people use marijuana?

People smoke marijuana in hand-rolled cigarettes (joints) or in pipes or water pipes (bongs). They
also smoke it in blunts—emptied cigars that have been partly or completely refilled with marijuana.
To avoid inhaling smoke, some people are using vaporizers. These devices pull the active ingredients
(including THC) from the marijuana and collect their vapor in a storage unit. A person then inhales
the vapor, not the smoke. Some vaporizers use a liquid marijuana extract.

People can mix marijuana in food (edibles), such as brownies, cookies, or candy, or brew it as a tea. A
newly popular method of use is smoking or eating different forms of THC-rich resins (see "Marijuana
Extracts").
Marijuana Extracts
Smoking THC-rich resins extracted from the marijuana plant is on the rise. People call this
practice dabbing. These extracts come in various forms, such as:

 hash oil or honey oil—a gooey liquid


 wax or budder—a soft solid with a texture like lip balm
 shatter—a hard, amber-colored solid
These extracts can deliver extremely large amounts of THC to the body, and their use has sent some
people to the emergency room. Another danger is in preparing these extracts, which usually involves
butane (lighter fluid). A number of people have caused fires and explosions and have been seriously
burned from using butane to make extracts at home.3,4
How does marijuana affect the brain?

Marijuana has both short-and long-term effects on the brain.

Image by NIDATHC acts on numerous areas in the brain (in


yellow).

Short-Term Effects

When a person smokes marijuana, THC quickly passes from the lungs into the bloodstream. The
blood carries the chemical to the brain and other organs throughout the body. The body absorbs THC
more slowly when the person eats or drinks it. In that case, they generally feel the effects after 30
minutes to 1 hour.

THC acts on specific brain cell receptors that ordinarily react to natural THC-like chemicals. These
natural chemicals play a role in normal brain development and function.

Marijuana over activates parts of the brain that contain the highest number of these receptors. This
causes the "high" that people feel. Other effects include:

 altered senses (for example, seeing brighter colors)


 altered sense of time
 changes in mood
 impaired body movement
 difficulty with thinking and problem-solving
 impaired memory
 hallucinations (when taken in high doses)
 delusions (when taken in high doses)
 psychosis (risk is highest with regular use of high potency marijuana)
Long-Term Effects

Marijuana also affects brain development. When people begin using marijuana as teenagers, the drug
may impair thinking, memory, and learning functions and affect how the brain builds connections
between the areas necessary for these functions. Researchers are still studying how long marijuana's
effects last and whether some changes may be permanent.

For example, a study from New Zealand conducted in part by researchers at Duke University showed
that people who started smoking marijuana heavily in their teens and had an ongoing marijuana use
disorder lost an average of 8 IQ points between ages 13 and 38. The lost mental abilities didn't fully
return in those who quit marijuana as adults. Those who started smoking marijuana as adults didn't
show notable IQ declines.5
In another recent study on twins, those who used marijuana showed a significant decline in general
knowledge and in verbal ability (equivalent to 4 IQ points) between the preteen years and early
adulthood, but no predictable difference was found between twins when one used marijuana and the
other didn't. This suggests that the IQ decline in marijuana users may be caused by something other
than marijuana, such as shared familial factors (e.g., genetics, family environment).6 NIDA’s
Adolescent Brain Cognitive Development (ABCD) study, a major longitudinal study, is tracking a
large sample of young Americans from late childhood to early adulthood to help clarify how and to
what extent marijuana and other substances, alone and in combination, affect adolescent brain
development. Read more about the ABCD study on our Longitudinal Study of Adolescent Brain and
Cognitive Development (ABCD Study) webpage.
A Rise in Marijuana’s THC Levels

The amount of THC in marijuana has been increasing steadily over the past few decades.7 For a
person who's new to marijuana use, this may mean exposure to higher THC levels with a greater
chance of a harmful reaction. Higher THC levels may explain the rise in emergency room visits
involving marijuana use.
The popularity of edibles also increases the chance of harmful reactions. Edibles take longer to digest
and produce a high. Therefore, people may consume more to feel the effects faster, leading to
dangerous results.

Higher THC levels may also mean a greater risk for addiction if people are regularly exposing
themselves to high doses.
What are the other health effects of marijuana?

Marijuana use may have a wide range of effects, both physical and mental.

Physical Effects

 Breathing problems. Marijuana smoke irritates the lungs, and people who smoke marijuana
frequently can have the same breathing problems as those who smoke tobacco. These problems
include daily cough and phlegm, more frequent lung illness, and a higher risk of lung infections.
Researchers so far haven't found a higher risk for lung cancer in people who smoke marijuana.8
 Increased heart rate. Marijuana raises heart rate for up to 3 hours after smoking. This effect
may increase the chance of heart attack. Older people and those with heart problems may be at
higher risk.
 Problems with child development during and after pregnancy. One study found that about
20% of pregnant women 24-years-old and younger screened positive for marijuana. However,
this study also found that women were about twice as likely to screen positive for marijuana use
via a drug test than they state in self-reported measures.9 This suggests that self-reported rates of
marijuana use in pregnant females is not an accurate measure of marijuana use and may be
underreporting their use. Additionally, in one study of dispensaries, nonmedical personnel at
marijuana dispensaries were recommending marijuana to pregnant women for nausea, but
medical experts warn against it. This concerns medical experts because marijuana use during
pregnancy is linked to lower birth weight10 and increased risk of both brain and behavioral
problems in babies. If a pregnant woman uses marijuana, the drug may affect certain developing
parts of the fetus's brain. Children exposed to marijuana in the womb have an increased risk of
problems with attention,11 memory, and problem-solving compared to unexposed
children.12 Some research also suggests that moderate amounts of THC are excreted into the
breast milk of nursing mothers.13 With regular use, THC can reach amounts in breast milk that
could affect the baby's developing brain. Other recent research suggests an increased risk of
preterm births.27 More research is needed. Read our Marijuana Research Report for more
information about marijuana and pregnancy.
 Intense nausea and vomiting. Regular, long-term marijuana use can lead to some people to
develop Cannabinoid Hyperemesis Syndrome. This causes users to experience regular cycles of
severe nausea, vomiting, and dehydration, sometimes requiring emergency medical attention.14
Reports of Deaths Related to Vaping

The Food and Drug Administration has alerted the public to hundreds of reports of serious lung
illnesses associated with vaping, including several deaths. They are working with the Centers for
Disease Control and Prevention (CDC) to investigate the cause of these illnesses. Many of the suspect
products tested by the states or federal health officials have been identified as vaping products
containing THC, the main psychotropic ingredient in marijuana. Some of the patients reported a
mixture of THC and nicotine; and some reported vaping nicotine alone. No one substance has been
identified in all of the samples tested, and it is unclear if the illnesses are related to one single
compound. Until more details are known, FDA officials have warned people not to use any vaping
products bought on the street, and they warn against modifying any products purchased in stores.
They are also asking people and health professionals to report any adverse effects. The CDC has
posted an information page for consumers.
Mental Effects

Long-term marijuana use has been linked to mental illness in some people, such as:

 temporary hallucinations
 temporary paranoia
 worsening symptoms in patients with schizophrenia—a severe mental disorder with
symptoms such as hallucinations, paranoia, and disorganized thinking
Marijuana use has also been linked to other mental health problems, such as depression, anxiety, and
suicidal thoughts among teens. However, study findings have been mixed.

Are there effects of inhaling secondhand marijuana smoke?

Failing a Drug Test?

While it's possible to fail a drug test after inhaling secondhand marijuana smoke, it's unlikely. Studies
show that very little THC is released in the air when a person exhales. Research findings suggest that,
unless people are in an enclosed room, breathing in lots of smoke for hours at close range, they aren't
likely to fail a drug test.15,16 Even if some THC was found in the blood, it wouldn't be enough to fail
a test.
Getting High from Passive Exposure?

Similarly, it's unlikely that secondhand marijuana smoke would give nonsmoking people in a confined
space a high from passive exposure. Studies have shown that people who don't use marijuana report
only mild effects of the drug from a nearby smoker, under extreme conditions (breathing in lots of
marijuana smoke for hours in an enclosed room).17
Other Health Effects?

More research is needed to know if secondhand marijuana smoke has similar health risks as
secondhand tobacco smoke. A recent study on rats suggests that secondhand marijuana smoke can do
as much damage to the heart and blood vessels as secondhand tobacco smoke.20But researchers
haven't fully explored the effect of secondhand marijuana smoke on humans. What they do know is
that the toxins and tar found in marijuana smoke could affect vulnerable people, such as children or
people with asthma.
How Does Marijuana Affect a Person's Life?

Compared to those who don't use marijuana, those who frequently use large amounts report the
following:

 lower life satisfaction


 poorer mental health
 poorer physical health
 more relationship problems
People also report less academic and career success. For example, marijuana use is linked to a higher
likelihood of dropping out of school.18 It's also linked to more job absences, accidents, and injuries.19
Is marijuana a gateway drug?

Use of alcohol, tobacco, and marijuana are likely to come before use of other drugs.21,22 Animal
studies have shown that early exposure to addictive substances, including THC, may change how the
brain responds to other drugs. For example, when rodents are repeatedly exposed to THC when
they're young, they later show an enhanced response to other addictive substances—such as morphine
or nicotine—in the areas of the brain that control reward, and they're more likely to show addiction-
like behaviors.23,24
Although these findings support the idea of marijuana as a "gateway drug," the majority of people
who use marijuana don't go on to use other "harder" drugs. It's also important to note that other factors
besides biological mechanisms, such as a person’s social environment, are also critical in a person’s
risk for drug use and addiction. Read more about marijuana as a gateway drug in our Marijuana
Research Report.
Can a person overdose on marijuana?

An overdose occurs when a person uses enough of the drug to produce life-threatening symptoms or
death. There are no reports of teens or adults dying from marijuana alone. However, some people who
use marijuana can feel some very uncomfortable side effects, especially when using marijuana
products with high THC levels. People have reported symptoms such as anxiety and paranoia, and in
rare cases, an extreme psychotic reaction (which can include delusions and hallucinations) that can
lead them to seek treatment in an emergency room.
While a psychotic reaction can occur following any method of use, emergency room responders have
seen an increasing number of cases involving marijuana edibles. Some people (especially preteens
and teens) who know very little about edibles don't realize that it takes longer for the body to feel
marijuana’s effects when eaten rather than smoked. So they consume more of the edible, trying to get
high faster or thinking they haven't taken enough. In addition, some babies and toddlers have been
seriously ill after ingesting marijuana or marijuana edibles left around the house.

Is marijuana addictive?

Marijuana use can lead to the development of a substance use disorder, a medical illness in which the
person is unable to stop using even though it's causing health and social problems in their life. Severe
substance use disorders are also known as addiction. Research suggests that between 9 and 30 percent
of those who use marijuana may develop some degree of marijuana use disorder.25 People who begin
using marijuana before age 18 are four to seven times more likely than adults to develop a marijuana
use disorder.26
Many people who use marijuana long term and are trying to quit report mild withdrawal symptoms
that make quitting difficult. These include:

 grouchiness
 sleeplessness
 decreased appetite
 anxiety
 cravings
What treatments are available for marijuana use disorder?

No medications are currently available to treat marijuana use disorder, but behavioral support has
been shown to be effective. Examples include therapy and motivational incentives (providing rewards
to patients who remain drug-free). Continuing research may lead to new medications that help ease
withdrawal symptoms, block the effects of marijuana, and prevent relapse.
Points to Remember

 Marijuana refers to the dried leaves, flowers, stems, and seeds from the Cannabis
sativa or Cannabis indica plant.
 The plant contains the mind-altering chemical THC and other related compounds.
 People use marijuana by smoking, eating, drinking, or inhaling it.
 Smoking and vaping THC-rich extracts from the marijuana plant (a practice called dabbing)
is on the rise.
 THC overactivates certain brain cell receptors, resulting in effects such as:

o altered senses

o changes in mood

o impaired body movement

o difficulty with thinking and problem-solving

o impaired memory and learning

 Marijuana use can have a wide range of health effects, including:

o hallucinations and paranoia

o breathing problems

o possible harm to a fetus's brain in pregnant women

 The amount of THC in marijuana has been increasing steadily in recent decades,
creating more harmful effects in some people.
 It's unlikely that a person will fail a drug test or get high from passive exposure by
inhaling secondhand marijuana smoke.
 There aren’t any reports of teens and adults dying from using marijuana alone, but
marijuana use can cause some very uncomfortable side effects, such as anxiety and paranoia and,
in rare cases, extreme psychotic reactions.
 Marijuana use can lead to a substance use disorder, which can develop into an
addiction in severe cases.
 No medications are currently available to treat marijuana use disorder, but behavioral
support can be effective.
Learn More

For more information about marijuana and marijuana use, visit our:

 Marijuana webpage
 Drugged Driving DrugFacts
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2019322(2):145–152. doi:10.1001/jama.2019.8734

The Effects of Marijuana on Your Body

Marijuana is made from the shredded and dried parts of the cannabis plant, including the flowers,
seeds, leaves, and stems. It’s also known as pot, weed, hash, and dozens of other names. While many
people smoke or vape it, you can also consume marijuana as an ingredient in food, brewed tea, or oils.
Different methods of taking the drug may affect your body differently. When you inhale marijuana
smoke into your lungs, the drug is quickly released into your bloodstream and makes its way to your
brain and other organs. It takes a little longer to feel the effects if you eat or drink marijuana.

There is ongoing controversy around the effects of marijuana on the body. People report various
physical and psychological effects, from harm and discomfort to pain relief and relaxation.

Here’s what happens to your body when this drug enters your bloodstream.
Marijuana can be used in some states for medical reasons, and in some areas, recreational use is legal
as well. No matter how you use marijuana, the drug can cause immediate and long-term effects, such
as changes in perception and increased heart rate. Over time, smoking marijuana may cause chronic
cough and other health issues.

The effects of marijuana on the body are often immediate. Longer-term effects may depend on how
you take it, how much you use, and how often you use it. The exact effects are hard to determine
because marijuana has been illegal in the U.S., making studies difficult and expensive to conduct.

But in recent years, the medicinal properties of marijuana are gaining public acceptance. As of
2017, 29 states plus the District of Columbia have legalized medical marijuana to some extent. THC
and another ingredient called cannabidiol (CBD) are the main substances of therapeutic interest.
The National Institutes of HealthTrusted Source funded research into the possible medicinal uses of
THC and CBD, which is still ongoing.

With the potential for increased recreational use, knowing the effects that marijuana can have on your
body is as important as ever. Read on to see how it affects each system in your body.

Respiratory system

Much like tobacco smoke, marijuana smoke is made up of a variety of toxic chemicals,
including ammonia and hydrogen cyanide, which can irritate your bronchial passages and lungs. If
you’re a regular smoker, you’re more likely to wheeze, cough, and produce phlegm. You’re also at an
increased risk of bronchitis and lung infections. Marijuana may aggravate existing respiratory
illnesses, such as asthma and cystic fibrosis.

Marijuana and COPD: Is there a link? »

Marijuana smoke contains carcinogens, so it may increase your risk of lung cancer too. However,
studies on the subject have had mixed results. According to the National Institute of Drug Abuse
(NIDA), there is no conclusive evidence that marijuana smoke causes lung cancer. More research is
needed.

Circulatory system

THC moves from your lungs into your bloodstream and throughout your body. Within minutes, your
heart rate may increase by 20 to 50 beats per minute. That rapid heartbeat can continue for up to three
hours. If you have heart disease, this could raise your risk of heart attack.

One of the telltale signs of recent marijuana use is bloodshot eyes. The eyes look red because
marijuana causes blood vessels in the eyes to expand.
Central nervous system

The effects of marijuana extend throughout the central nervous system (CNS). Marijuana is thought to
ease pain and inflammation and help control spasms and seizures. Still, there are some long-term
negative effects on the CNS to consider.

THC triggers your brain to release large amounts of dopamine, a naturally occurring “feel good”
chemical. It’s what gives you a pleasant high. It may heighten your sensory perception and your
perception of time. In the hippocampus, THC changes the way you process information, so your
judgment may be impaired. The hippocampus is responsible for memory, so it may also be difficult to
form new memories when you’re high.

Changes also take place in the cerebellum and basal ganglia, brain areas that play roles in movement
and balance. Marijuana may alter your balance, coordination, and reflex response. All those changes
mean that it’s not safe to drive.

Very large doses of marijuana or high concentrations of THC can cause hallucinations or delusions.
According to the NIDA, there may be an association between marijuana use and some mental health
disorders like depression and anxiety. More research is needed to understand the connection. You
may want to avoid marijuana if you have schizophrenia, as it may make symptoms worse.

When you come down from the high, you may feel tired or a bit depressed. In some people, marijuana
can cause anxiety. About 30 percent of marijuana users develop a marijuana use disorder. Addiction is
considered rare, but very real. Symptoms of withdrawal may include irritability, insomnia, and loss of
appetite.

In people younger than 25 years, whose brains have not yet fully developed, marijuana can have a
lasting impact on thinking and memory processes. Using marijuana while pregnant can also affect the
brain of your unborn baby. Your child may have trouble with memory, concentration, and problem-
solving skills.

Digestive system

Smoking marijuana can cause some stinging or burning in your mouth and throat while you’re
inhaling.

Marijuana can cause digestive issues when taken orally. For example, oral THC can cause nausea and
vomiting because of the way it’s processed in your liver. It may also damage your liver.

Conversely, marijuana has also been used to ease symptoms of nausea or upset stomach.

An increase in your appetite is common when taking any form of marijuana, leading to what many
call “the munchies.” This is considered a benefit for people being treated with chemotherapy for
cancer. For others who are looking to lose weight, this effect could be considered a disadvantage.
Immune system

THC may adversely affect your immune system. StudiesTrusted Source involving animals showed


that THC might damage the immune system, making you more vulnerable to illnesses. Further
research is needed to fully understand the effects.

CBD vs. THC: What’s the Difference?

Overview

As the legal use of marijuana and other cannabis products grows, consumers are becoming more
curious about their options. This includes cannabidiol (CBD) and tetrahydrocannabinol (THC), two
natural compounds found in plants of the Cannabis genus.

CBD can be extracted from hemp or from marijuana. Hemp plants are cannabis plants that contain
less than 0.3 percent THC, while marijuana plants are cannabis plants that contain higher
concentrations of THC. CBD is sold in the form of gels, gummies, oils, supplements, extracts, and
more.

THC is the main psychoactive compound in marijuana that gives the high sensation. It can be
consumed by smoking marijuana. It’s also available in oils, edibles, tinctures, capsules, and more.

Both compounds interact with your body’s endocannabinoid system, but they have very different
effects.

Read on to learn more about these compounds. While they may have a lot in common, they have
some key differences that determine how they’re used.
CBD vs. THC: Chemical structure

Both CBD and THC have the exact same molecular structure: 21 carbon atoms, 30 hydrogen atoms,
and 2 oxygen atoms. A slight difference in how the atoms are arranged accounts for the differing
effects on your body.

Both CBD and THC are chemically similar to your body’s own endocannabinoids. This allows them
to interact with your cannabinoid receptors.

The interaction affects the release of neurotransmitters in your brain. Neurotransmitters are chemicals
responsible for relaying messages between cells and have roles in pain, immune function, stress,
sleep, to name a few.

CBD vs. THC: Psychoactive components

Despite their similar chemical structures, CBD and THC don’t have the same psychoactive effects. In
fact, CBD is a nonpsychoactive compound. That means it doesn’t produce the “high” associated with
THC.

THC binds with the cannabinoid 1 (CB1) receptors in the brain. It produces a high or sense of
euphoria.

CBD binds very weakly, if at all, to CB1 receptors. In fact, it can interfere with the binding of THC
and dampen the psychoactive effects.

CBD vs. THC: Legality

In the United States, cannabis-related laws are evolving regularly. Marijuana and THC are on the list
of controlled substances, so they’re prohibited under federal law.
However, many states and Washington, D.C. have passed cannabis-related laws making medical
marijuana with high levels of THC legal. The marijuana may need to be prescribed by a licensed
physician.

In addition, several states have made recreational use of marijuana and THC legal.

In states where marijuana is legal for recreational or medical purposes, you should be able to buy
CBD.

Before you try to buy products with CBD or THC, get information about your state’s laws. If you
possess cannabis-related products in a state where they’re illegal or don’t have a medical prescription
in states where the products are legal for medical treatment, you could face legal penalties.

CBD vs. THC: Medical benefits

CBD and THC have many of the same medical benefits. They can provide relief from several of the
same conditions. However, CBD doesn’t cause the euphoric effects that occur with THC. Some
people may prefer to use CBD because of the lack of this side effect.

In June 2018, the Food and Drug Administration approvedTrusted Source Epidiolex, the first
prescription medication to contain CBD. It’s used to treat rare, difficult-to-control forms of epilepsy.

CBD is used to help with other various conditions, such as:

 seizures

 inflammation

 pain

 psychosis or mental disorders

 inflammatory bowel disease

 nausea

 migraines

 depression
 anxiety

THC is used to help with conditions such as:

 pain

 muscle spasticity

 glaucoma

 insomnia

 low appetite

 nausea

 anxiety

CBD vs. THC: Side effects

CBD is well-tolerated, even in large doses. ResearchTrusted Source suggests any side effects that
occur with CBD use are likely the result of drug-to-drug interactions between CBD and other
medications you may be taking.

THC causes temporary side effects, such as:

 increased heart rate

 coordination problems

 dry mouth

 red eyes

 slower reaction times

 memory loss

These side effects are part of the compound’s psychoactive properties.

Neither compound is fatal.


However, high THC use may be connected to long-term negative psychiatric effects. This is
especially true for adolescents who consume large amounts of THC.

The effect on the brain is more profound for teens. Using the compound increases the risk for some
psychiatric disorders, such as schizophrenia.

CBD vs. THC: Drug testing

Cannabinoids like THC and CBD are stored in the body’s fat. They can show up on drug tests for
several days or weeks after you use them.

Not every drug test will be able to detect CBD, but CBD-sensitive tests are available. Most standard
drug tests will look for chemicals related to THC, so THC or marijuana use might show up on a
screening.

Likewise, hemp can produce some THC in addition to CBD, so a test could be positive for THC even
if you’ve not used it.

Why do people talk about THC content in CBD oil if THC and CBD are two different

compounds?

CBD and THC are two of the most prominent cannabinoids found in the Cannabis plant. Both
marijuana and hemp produce CBD and THC.

However, marijuana has a higher concentration of THC. Hemp has a higher concentration of CBD.

The average marijuana strain today contains about 12 percentTrusted Source THC. CBD oil may
contain small amounts of THC because it’s present in the hemp plant. CBD can have no more than 0.3
percent THC to be legal at the federal level.

Takeaway
CBD and THC both have medical benefits. They’re also both considered safe, but consider the
possibility of side effects and interactions with other drugs you’re taking. Talk with your doctor if you
have any questions.

Want to learn more about CBD? Click here for more product reviews, recipes, and research-based
articles about CBD from Healthline.

CBD THC

Hemp-derived YES NO

Marijuana-derived YES* NO

Illegal NO (See below) YES (See below)

Produce a “high” NO YES

Interact with endocannabinoid


YES YES
system

Side effects Almost none Psychoactive side effects

Shows on drug test Possibly** YES

Pain reliever YES YES

Reduces nausea YES YES

Eases migraines YES YES

Reduces anxiety YES YES

Eases depression YES NO

Decreases seizures YES NO

Anti-inflammatory YES YES

Helps with insomnia YES YES

Helps with psychosis YES NO


Increases appetite NO YES

Used for various other conditions YES YES

* CBD can be extracted from hemp (cannabis plants that contain less than 0.3 percent THC) or from
marijuana plants (cannabis plants with higher concentrations of THC).

** CBD isn't detected in hemp products, but hemp products may contain trace amounts of THC. THC
may show up in high enough concentrations to produce a positive drug test.

Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the
federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal
on the federal level, but are legal under some state laws. Check your state’s laws and those of
anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and
may be inaccurately labeled.

Canabis (Marijuana)
Informatii generale

Canabis este denumirea generica pentru drogul psihoactiv cunoscut ca marijuana, iarba, ”dope”.
Numele stiintific al plantei canabis este canabis sativa. Potrivit unui raport al Natiunilor Unite,
canabisul a fost drogul cel mai produs, traficat si consumat in 2010. In acel an, intre 119 si 224 de
milioane de adulti din intreaga lume l-au consumat.

Cum functioneaza canabisul?

Principala substanta chimica psihoactiva (cu efecte asupra creierului) din canabis se numeste delta-9
tetrahydro-canabinol (THC). Aceasta substanta este cea care induce senzatia de ”high”. Produsele pe
baza de canabis au diverse concentratii de THC. Continutul de THC din canabisul ilegal a crescut in
mod ingrijorator in ultimii 50 de ani.

Canabisul este folosit in principal sub 3 forme: marijuana, hasis si ulei de hasis. Marijuana este
produsul rezultat din uscarea florilor si a frunzelor plantei de canabis. Este produsul cel mai putin
puternic si de obicei se fumeaza. Hasisul este obtinut din rasina. Este uscat, presat si fumat, consumat
ca atare sau adaugat in mancare.
Uleiul de hasis, cel mai puternic dintre produsele pe baza de canabis, apare sub forma unui ulei dens
obtinut din hasis. Canabisul se fumeaza in general, dar poate fi si ingerat sau adaugat in prajituri
(”hash cookies”).

Canabisul este cunoscut sub numele de: marijuana, iarba, pot, dope, Mary Jane, hooch, weed, hash,
brew, cones, smoke, mull, buddha, ganja, hydro, yarndi, heads, shit si green. Tigarile care contin
canabis sunt numite jointuri sau “reefers”.

Efecte

La fumarea canabisului, substanta THC este absorbita cu repeziciune din plamani in sange, iar apoi
transmisa catre creier si celelalte organe ale corpului. Cand canabisul este consumat ca ingredient in
alimente sau in bautura, substanta este absorbita mai incet.

In cazul consumului de canabis in scopuri recreationale, pot aparea urmatoarele efecte:

 Schimbarea perceptiei: efecte halucinogene, consumatorii vad realitatea distorsionat


 Schimbarea starii de spirit: unele persoane resimt o senzatie de euforie, altii de relaxare,
cunoscuta sub denumirea de ”high”.
 Palpitatii
 Alterarea capacitatii de memorare
 Afectarea memoriei pe termen scurt
 Dificultati de concentrare
 Respiratie accelerata
 Volubilitate
 Stare de somnolenta
 Lipsa de inhibitii
 Calmarea starilor de rau
 Apetit crescut
 Lipsa coordonarii
 Anxietate, paranoia
 Senzatie de uscaciune a ochilor, gurii, gatului
 Apetit crescut, pofta de dulciuri
 Deficiente de atentie

Semne ale abuzului de canabis

 Crize de ras in fazele de inceput ale consumului abuziv


 Somnolenta
 Lipsa de concentrare si de coordonare
 Tendinta de a uita foarte repede
 Ochi rosii
 Perceptia distorsionata a timpului
 Posesia unui ”kit”, care contine foite de hartie, pipe, “bonguri”
 Paranoia, comportament nerealist

Riscuri asupra sanatatii

Conform studiilor, canabisul afecteaza negativ capacitatea de invatare si memoria, iar daunele persista
mult timp dupa ce efectele drogului dispar. La adolescentii care consuma canabis, acestea pot persista
cativa ani, iar consecintele asupra creierului aflat in dezvoltare sunt si mai grave.
Potrivit unor studii recente, consumul de canabis favorizeaza instalarea bolilor respiratorii aparute ca
urmare a fumatului, cum ar fi cancerul pulmonar. De asemenea, consumul este asociat cu scaderea
libido-ului si a fertilitatii si cu o forma agresiva de cancer testicular la consumatorii tineri.

Dozele ridicate de canabis pot cauza stari de panica sau psihoza. Unele persoane au reactii psihotice
violente (ganduri si senzatii distorsionate, paranoia) sau sufera de atacuri de panica atunci cand sunt
sub influenta drogului.

Cei care incep sa consume canabis inainte de 16 ani sunt predispusi la schizofrenie. Folosirea
canabisului de catre cei care sufera de schizofrenie duce la inrautatirea simptomelor psihotice.

Unele studii si rapoarte arata ca utilizarea canabisului poate avea urmatoarele efecte:

 Pierderi mari de memorie


 Depresie
 Slabirea sistemului imunitar
 Stari de voma puternice
 Paranoia

Simptome de sevraj

Persoanele dependente de canabis, care incearca sa intrerupa consumul, manifesta simptome de


iritabilitate, agresivitate, insomnie, transpiratie pe timp de noapte, lipsa poftei de mancare, scadere/
crestere in greutate, tulburari de digestie, crampe, stari de rau dupa mese, agitatie, anxietate, depresie,
pofte. Toate aceste simptome ingreuneaza abstinenta.

Dependenta de canabis: tratament

Terapiile comportamentale, cum ar fi terapia cognitiv-comportamentala, terapia familiala si


stimulentele motivationale s-au dovedit a fi eficiente in tratarea dependentei de canabis.

Pentru a afla mai multe despre cum tratatam dependenta de canabis la Castle Craig Hospital in Scotia,
va rugam sa vizitati pagina dedicata tratamentului.

Surse

drugabuse.gov

nhs.uk

medicalnewstoday.com

learnaboutmarijuanawa.org

mentalhealthdaily.com