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12. http://www.nutricia.ie/articles/what_are_gastrointestinal_problems
13. http://www.wisegeek.com/what-is-gastrointestinal-physiology.htm
14. http://www.meds.com/lung/smoking/environmental.html
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CHAPTER 4
CANNABIS AND
AMPHETAMINES
252
Illustrated Handbook of Drugs & Alcohol Related Health Issues
INTRODUCTION
Cannabis is the most commonly used
illicit drug in Australia. Cannabis is the
general name used for the products of the
plant Cannabis sativa. While most people
who use cannabis do not experience
problems, it is the most common illicit
drug dependency among adults, with
approximately 300,000 Australians
suffering from a current cannabis use
disorder. Cannabis is an illegal drug
derived from the plant cannabis sativa.
The main active ingredient in cannabis
is called delta-9 tetrahydo-cannabinol,
commonly known as THC. This is the part
of the plant that gives the ‘high’. Cannabis
is used in three main forms: marijuana,
hashish and hash oil. Marijuana is made
from dried flowers and leaves of the
cannabis plant. It is the least potent of
all the cannabis products and is usually
smoked. Hashish is made from the resin
(a secreted gum) of the cannabis plant.
It is dried and pressed into small blocks
and smoked. It can also be added to
food and eaten. Hash oil, the most potent
cannabis product, is thick oil obtained
from hashish. It is also smoked.
Amphetamines are the second most
commonly used illicit drug in Australia
after cannabis. There is evidence of
increasing use and purity, and of
serious harms associated with regular
use. Health workers can expect to see
increasing numbers of amphetamine
users. Although there are few specific
interventions or treatment options for
those experiencing problems related to
their use of amphetamines, engaging
individuals in harm reduction measures
and responding to their specific needs
can substantially reduce harms.
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Cannabis and Amphetamines
253
OVERVIEW ON CANNABIS
Cannabis is the generic term used for the psychoactive substance derived from the
three species of the Cannabis plant. The main psychoactive component in cannabis
is delta-9-tetrahydrocannabinol (THC). ‘Psychoactive’ means that it has a relatively
significant effect on the central nervous system. THC potency varies in different
cannabis products.
Cannabis is generally used in three forms: marijuana, hashish and hash oil. Marijuana
is the dried flowers and leaves of the plant. It is the least potent of all cannabis products
and is usually smoked. Hashish is made from the resin of the plant which is dried,
pressed and smoked. It can also be added to food and eaten. Hash oil, the most potent
cannabis product, is a thick oil obtained from hashish. It is also smoked.
Cannabis, also known as marijuana among several other names, is a preparation of
the Cannabis plant intended for use as a psychoactive drug or medicine. The main
psychoactive part of cannabis is tetrahydrocannabinol (THC); one of 483 known
compounds in the plant, including at least 65 other cannabinoids.Cannabis can be
used by smoking, vaporization, within food, or as an extract.
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Cannabis is often used for its mental and physical effects, such as a “high” or
“stoned” feeling, a general change in perception, euphoria (heightened mood), and
an increase in appetite. Short term side effects may include a decrease in short-term
memory, dry mouth, impaired motor skills, red eyes, and feelings of paranoia or
254
anxiety. Long term side effects may include addiction, decreased mental ability in
those who started as teenagers and behavioral problems in children whose mothers
used cannabis during pregnancy. Onset of effects is within minutes when smoked
and about 30 to 60 minutes when cooked and eaten. They last for between two
and six hours.
Cannabis is mostly used recreationally or as a medicinal drug. It may also be used
for religious or 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). In 2015, 43% of Americans had used cannabis, which increased to 51%
in 2016. About 12% have used it in the past year, and 7.3% have used it in the
past month. This makes it the most commonly used illegal drug both in the world
and the United States
The earliest recorded uses date from the 3rd millennium BC. Since the early 20th
century, cannabis has been subject to legal restrictions. The possession, use, and
sale of cannabis are illegal in most countries of the world. Medical cannabis refers
to the physician-recommended use of cannabis, which is taking place in Canada,
Belgium, Australia, the Netherlands, Spain, and 23 U.S. states. Cannabis use started
to become popular in the US in the 1970s. Support for legalization has increased in
the United States and several US states have legalized recreational or medical use.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Common questions about Cannabis
Can you become ‘addicted’ to cannabis?
There are multiple aspects of addiction including the physical, the social and
psychological/emotional factors. Long-term marijuana abuse may eventually lead
to physical addiction. Being dependent on a drug means that you need repeated
doses of the drug to feel good or to avoid feeling bad. There is clear evidence of a
cannabis withdrawal syndrome, with symptoms including anxiety, irritability, disturbed
sleep with an increase in vivid dreams, nausea, excess salivation, tremor, weight
loss, and increased body temperature. These symptoms usually resolve themselves
overtime but this can vary from one week to two months after ceasing cannabis use.
Cannabis and Amphetamines
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255
Can cannabis cause anxiety?
Anxiety and panic attacks are among the most common negative reactions to
Cannabis reported by users. Some people, however, use the drug in a belief it will
relieve their anxiety, but find that it usually makes it worse in the long run. There
are concerns and indications that cannabis use may cause or exacerbate longer
lasting forms of anxiety disorders such as panic disorder.
Is there a link between cannabis and mental health?
There is consistent evidence which shows that cannabis use may exacerbate psychotic
symptoms in people who have a mental disorder, even if they no longer have acute
symptoms. Cannabis may also trigger a first psychotic episode in people with a
personal or family history of schizophrenia.
What are the harms associated with cannabis use?
The National Cannabis Prevention and Information Centre (NCPIC) reports that
although the short-term consequences of cannabis use are fairly well-known, the
longterm effects of regular use are less so.
Consequences
Short term cannabis-related problems include:
■ impaired attention, memory and psychomotor performance while intoxicated
256
■ cannabis-induced psychosis
■ An increased risk of motor-vehicle accident.
Determining the long-term effects of cannabis, however, is difficult. Often people
use more than one drug so consequences cannot be exclusively linked to cannabis.
Also, it can take some time for long-term effects to become apparent, making
associations between cannabis use and outcome less clear.
Long-term harms that are probably associated with cannabis use include:
■ subtle impairment in attention, memory and the ability to organise complex
information
■ risk of developing dependence on cannabis
■ respiratory problems, such as bronchitis
■ It is also possible that other long-term harms are associated with cannabis
use, such as:
■ increased possibility of heart attack in people with risk factors for heart
disease
■ increased rate of lung cancer
■ increased likelihood of pre-cancerous changes
■ oral health problems (such as tooth decay or gum disease) resulting from
dry mouth
■ some evidence that cannabis may affect human female fertility
■ Difficulties with problem-solving and attention for children exposed to
cannabis in the womb.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
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Cannabis and Amphetamines
257
Synthetic Cannabinoid Products (‘Synthetic Cannabis’)
These products are usually sold in foil sachets typically containing 1-3 grams of
dried plant matter to which one or more of the cannabinoids have been added. It
is believed that a solution of the cannabinoids is sprayed onto the herbal mixture.
A number of plantbased ingredients are often listed on the packaging but scientific
testing has found that many of these are not actually present.
Synthetic cannabis are often classified as ‘research chemicals’. Research chemicals
are experimental chemicals that are not approved for human consumption. The vast
majority of these chemicals have only been recently synthesized and little, if any,
data exists currently about their side effects, adverse reactions, long term damage
or dependence potential. Most importantly, there are no officially published safety
data and almost nothing is known about their effects on humans.
In addition to the possible legal consequences of using these products, we know
little about their ingredients and as a result the possible health consequences of
using them via any route of administration are as yet unknown.
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Cannabis and the ADF
The ADF has a zero tolerance policy on the use of illicit drugs by its members. This
means that any member found to be using illicit drugs will be required to ‘show
cause’ why they should be permitted to remain in the ADF. A request for voluntary
258
referral without any disciplinary or administrative sanction can only be made if the
Defence member has not previously reported involvement with prohibited substances,
or if the Defence member has not been identified for Prohibited Substance Testing
Program (PSTP) testing.
The ADF conducts random drug testing of ADF members. Both cannabis and its
synthetic variations are tested for the in the PSTP. Cannabis is the most commonly
detected drug in the Prohibited Substance Testing Program. Cannabis remains
detectable in uri ne for some time after use, so a person could return a positive
test up to 10 weeks after they have used cannabis
Illustrated Handbook of Drugs & Alcohol Related Health Issues
History of Cannabis
Cannabis, also known as hemp or marijuana, has been used by humans for fiber,
medicine, and as a psychoactive for at least 4,500 years. Its biological name is
Cannabis sativa, with a subspecies, Cannabis sativa indica, used most often for
recreational or medicinal purposes. The earliest milestone in the history of cannabis
are charred cannabis seeds dated to 2500 BCE found on a ritual brazier in Romania.
In 2008, nearly two pounds of cannabis was found buried in the tomb of a Gushi
shaman who lived about 700 BCE in the Gobi Desert, northern China. Genetic
analysis of the plants found they were cultivated rather than from the wild.
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