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Cannabis and Amphetamines
But what if you could design a drug that could interact with CB1 or CB2 receptors
in the body, but leave the brain alone? This is not as far-fetched as it sounds; the
blood-brain barrier is very effective about limiting the passage of substances to the
brain. And indeed, some companies are currently trying to do just that.
Moreover—over the past decade, evidence for CB2 receptor pathways in the brain
has been accumulating. Binding experiments—where radioactive tracers are used to
locate receptors—and immunohistological studies have been inconclusive to date,
but the signaling data is highly suggestive, indicating that CB2 receptors may pay
a bigger role in cannabinoid signaling that previously believed, and that opens up
far more questions about neuronal modulation and how it occurs.
269
The Real Deal
You might think that these new compounds could one day render marijuana, and
the dispensaries, unnecessary, that without the medical pretext there is no longer
any reason to buy the plant. But purer is not always better, and it would not be
too difficult to argue that the trace amounts of other compounds present in the
whole plant makes the experience what it is. And what if the safety profile of the
pills, pure as they may be, includes a limit at which one can overdose? It’s hard
to do that with marijuana, no matter what form it’s in. Recreational marijuana is
still safer than alcohol and just about every other drug, legal or not, out there. In
states where it has been legalized, marijuana literally saves lives as people do not
overdose on prescription narcotics as frequently. And it has been demonstrated to
be effective against pain and spasticity. Whether it helps veterans cope with PTSD
remains to be seen, but even if it’s shown not to, and the placebo effect is what’s
driving the relief, is it really ethical not to allow it?
But all this is moot if you cannot get marijuana to begin with. And while most states
have made some attempt to decriminalize marijuana, it is only readily available in
about half the country. Decriminalizing marijuana will have a far more beneficial
effect on society than all of the medicinal effects it may have, though. Yes, there
are dangers. We need to acknowledge that a sizeable minority of people can
and do become addicted to it, and all of the ensuing complications that follow
thereafter. We cannot wish away the increase in calls to the Poison Control center
for children that have accidentally eaten mom’s and dad’s pot brownies. Nothing
in life is purely good or purely bad, and it’s about time that we recognize that
things can get complicated.
Common Names
■ marijuana: lower potency dried flowering heads and leaves of the cannabis
plant
■ hash(ish): extracted resin. Also known as hash oil
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Illustrated Handbook of Drugs & Alcohol Related Health Issues
Routes of Administration
■ smoking is the most common method of ingestion — onset of effects is
more rapid and predictable. Frequently smoked with tobacco in a water
pipe (bong) or rolled as a cigarette (joint)
■ by mouth e.g. in food products or drunk in a tea
Physical and Psychosocial Complications
The effects of depression can be devastating in all areas of a person’s life. The side
effects of depression can often be seen at work, school and home as well as in the
personal relationships of the patient. Diagnosis and treatment minimizes the effects
of depression so early intervention is key. Without depression treatment, 40% of
depressed individuals will still meet a diagnosis of depression after one year.
Citation: http://blogs-images.forbes.com/kevinmurnane/files/2017/01/Smoker_Jantaaa_
Pixabay.jpg
Acute Effects
In common with other psychoactive drugs, the effects of cannabis depend on the
dose, individual and setting. Many of the following effects are perceived as positive
by users. The most common effects include:
Cannabis and Amphetamines
■ relaxation
■ sense of wellbeing (euphoria)
■ disinhibition
■ heightened visual and auditory perceptions
■ increased appetite
■ altered time perception
■ concentration:
o general difficulty
o tendency to focus awareness on a
o particular activity
Negative Acute Effects
There can also be negative acute effects such as:
■ anxiety and panic
■ paranoia
■ visual or auditory hallucinations
■ impaired coordination
■ short-term memory loss
■ tachycardia and supraventricular arrhythmias
Cannabis is not associated with fatal overdose
271
Effects of Cannabis
The primary effects of cannabis are caused by the chemical compounds in the
plant, including cannabinoids, such as tetrahydrocannabinol (THC), which is only
one of more than 100 different cannabinoids present in the plant. Cannabis has
various psychological and physiological effects on the human body.
Different plants of the genus Cannabis contain different and often unpredictable
concentrations of THC and other cannabinoids and hundreds of other molecules
that have a pharmacological effect, so that the final net effect cannot reliably be
foreseen.
Acute effects while under the influence can include euphoria and anxiety. Cannabidiol
(CBD), another cannabinoid found in cannabis in varying amounts, has been shown
to alleviate the adverse effects of THC that some consumers’ experience. With very
high doses, THC can induce auditory and visual hallucinations.
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Illustrated Handbook of Drugs & Alcohol Related Health Issues
Citation: https://missiongalacticfreedom.files.wordpress.com/2013/12/effects-of-cannabis.jpg
What are the short-term effects of cannabis?
Cannabis affects different people in different ways. It can be influenced by many
things including how much of the drug is taken, the environment it is used in, as
well as the weight, size and mood of the person using it.
The short-term effects of using cannabis may include:
■ a feeling of well-being
■ talkativeness
■ drowsiness
■ loss of inhibitions (doing or saying things one usually wouldn’t)
■ decreased nausea
■ increased appetite
■ loss of co-ordination
■ bloodshot eyes
Cannabis and Amphetamines
■ dryness of the eyes, mouth and throat
■ anxiety and paranoia
273
What are the long-term effects of cannabis?
Like any drug, there is no way of knowing how the drug will affect the user in
the long-term. However, on the available evidence, the main probable negative
effects are:
■ increased risk of respiratory diseases associated with
■ smoking, including cancer
■ dependence
■ decreased memory and learning abilities
■ decreased motivation in areas such as study, work or concentration
Citation: https://upload.wikimedia.org/wikipedia/commons/thumb/e/ef/Bodily_effects_of_
cannabis.svg/2000px-Bodily_effects_of_cannabis.svg.png
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Illustrated Handbook of Drugs & Alcohol Related Health Issues
is cannabis stronger than it used to be?
Although the potency of cannabis overall may have increased by a small amount,
the range of THC levels is now greater than in the past. There is little evidence
to suggest, however, that it has increased as dramatically as has been reported.
Reports of increased strength could be explained by changes in the way the drug
is used and the increased availability of the stronger part of the plant, particularly
the flowering heads or buds.
Some people believe that hydroponically grown cannabis is more potent than
cannabis grown ‘naturally’. There has also been some discussion that the reported
difference could be due to cultivation techniques, chemicals and fertilizers used
by hydroponic growers. There is currently no evidence to support these theories.
What do we know about cannabis and mental health?
Some people experience unpleasant effects such as anxiety and panic when they
use cannabis. In high doses, use of the drug can cause confusion, delusions or
hallucinations. These symptoms are more likely to be felt by people who are not
used to the effects of cannabis or who have smoked more than they usually do.
Some people, particularly younger people and those with a family history of mental
health problems, are more vulnerable to the mental health effects of cannabis.
Although it is rare, some people may experience a short-term psychotic episode (a
split from reality) after a heavy session of cannabis use. This can last from several
hours up to 2-3 days, and may include delusions or hallucinations. Frequent cannabis
use has been shown to increase the risk of psychotic illness and the development
of depression.
Can you become dependent on cannabis?
Around one in ten people who ever try cannabis will become dependent on it at
some time in their lives. It has been estimated that around 200,000 Australian adults
are dependent on cannabis. People who use daily are most at risk, facing about a
one in two chance of becoming dependent. Young people are at even greater risk if
they use cannabis daily. Dependent users can experience a variety of psychological,
social and physical symptoms including withdrawal. Withdrawal symptoms include
feeling irritable, anxious and depressed, sleeping problems and decreased appetite.
Do many people need treatment for their cannabis use?
As the number of cannabis users who have problems with their use has increased,
so have the number of people seeking treatment. Cannabis continues to be the
illegal drug that most people seek treatment for in Australia. People request treatment
because of the physical, mental or social effects of cannabis use, and/or because
they feel they have become dependent on it.
Cannabis and Amphetamines
275
What treatment is available?
Compared to other drugs, there are fewer specific treatments available for cannabisrelated problems. Most involve
Counseling, although various drug treatment options are being investigated.
What are the effects of passive cannabis smoking?
Traces of cannabis can be found in body fluids as a result of passive cannabis
smoking but most testing companies report that these traces are too low to register
as a ‘positive’ test. Cannabis smoke contains many of the dangerous substances
that are found in tobacco smoke, such as tar, carbon monoxide and cancer-causing
chemicals, some in higher amounts. Therefore those who associate with cannabis
smokers can experience similar problems to those experienced by passive tobacco
smokers.
Citation: https://s-media-cache-ak0.pinimg.com/originals/0f/23/72/0f2372ff81c2fde272eb1a
ec6503da39.png
Which is worse, smoking tobacco or smoking cannabis?
Smoking anything is damaging to your health. Smoking either drug over time can
cause a range of serious respiratory and other health problems. Both tobacco and
cannabis smoke contain agents that increase the risk of cancer.
Most people who try cannabis have previously used tobacco and many current
cannabis smokers also smoke cigarettes. Smoking both cannabis and tobacco results
in a greater health risk than smoking either alone.
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Illustrated Handbook of Drugs & Alcohol Related Health Issues
Does cannabis use lead to the use of other drugs?
Most people who use illicit drugs first used substances like alcohol, tobacco or
cannabis. However, the vast majority of people who use cigarettes, alcohol or
cannabis never use other illegal drugs.
Nevertheless, cannabis use, particularly regular use at a younger age, increases the
risk of other drug use.
does cannabis affect driving skills?
All drugs affect the user’s perception. Altered perception can have a gravely negative
effect on driving skills. Cannabis affects a person’s ability to react and pay attention
on the road. Latest evidence reports that driving under the influence of cannabis
appears to increase the risk of motor vehicle crashes by a factor of two or three
times.
isn’t cannabis legal in some parts of Australia?
Cannabis is an illegal drug throughout Australia. Each state and territory has its own
laws for cannabis offences. Some jurisdictions have decriminalized minor cannabis
offences. This means that the offence can be dealt with by a civil penalty, such as
a fine, rather than by receiving a criminal charge. However, there is no jurisdiction
in the country where cannabis is legal.
what are the medical benefits of cannabis?
Cannabis does not ‘cure’ any illness, but it appears to relieve the symptoms of
certain medical problems. Research has indicated that cannabis may be most useful
for conditions such as pain relief, nausea and vomiting, wasting or severe weight
loss, and neurological disorders such as multiple sclerosis. Although people have
reportedly used cannabis for medical purposes, it has not been approved as a
therapeutic product anywhere in the world.
if I know someone who has a problem with cannabis, or I need help
myself, where can I go?
The Cannabis Information and Helpline provides a nationally available free call
service for people who use cannabis themselves or those concerned about the
cannabis use of a friend or family member. Callers will receive reliable evidence
based information and support and advice about how to communicate with users
and help engage them in interventions.
Cannabis and Amphetamines
Citation: http://www.desciphered.com/wp-content/uploads/2016/08/cannabis_sketch.png
Harms Associated with Chronic Use
277
There are several probable harms associated with regular (daily or near daily),
sustained use (over several years):
■ Cannabis dependence syndrome: characterized by a variety of cognitive,
physical and behavioral symptoms, such as an inability to control use,
continued use despite problems, withdrawal and tolerance
■ Subtle cognitive impairment: affecting attention, memory, and the organisation
and integration of complex information. Evidence to date suggests that these
impairments are not grossly debilitating, but their reversibility is unknown
■ Adverse respiratory effects: associated with the route of administration, such
as chronic bronchitis and mutagenic and carcinogenic histopathological
changes of the parenchyma and epithelial cells
■ An increased likelihood of carcinoma e.g. Carcinoma of the oropharynx
and bronchus
■ Reduced sperm count
■ Negative effects on the developing fetus. Avoiding cannabis is advisable
if pregnant or trying to get pregnant
High Risk Groups
Certain groups are at a higher risk of developing adverse acute and chronic effects.
These include:
■ Adolescents
278
■ Pregnant women. Continued smoking throughout pregnancy may increase
the risk of having a low birthweight baby
■ Those with respiratory or cardiovascular disease, whose conditions may
be aggravated by use
■ Those with a comorbid psychological disorder. Cannabis use is strongly
associated with other drug use disorders and psychosis. Those with
schizophrenia may be particularly susceptible to the negative effects of
cannabis. There is evidence that use may exacerbate psychotic symptoms
in those with the disorder, and longterm, heavy use may precipitate
schizophrenia in vulnerable individuals.
Illustrated Handbook of Drugs & Alcohol Related Health Issues
Management and Intervention Strategies
While many people with a substance use disorder do not seek assistance from a
health professional, there has been a substantial increase in the number of cannabis
smokers seeking professional assistance to quit, or to manage cannabis-related
problems.
There are no maintenance pharmacotherapies available for the management of
cannabis withdrawal or relapse prevention.
Assessment
Assessment should focus on:
■ level and patterns of cannabis use and dependence
■ evidence of psychiatric sequelae
■ withdrawal symptoms
■ health complications of cannabis use
■ psychosocial context of use
Respiratory Function
■ examination of respiratory function may be useful
■ spirometry may be considered to provide feedback to a user regarding the
acute consequences of smoking cannabis (alone or mixed with tobacco)
■ significant respiratory problems such as emphysema, chronic bronchitis or
exacerbation of asthma may be evident
Cardiovascular
The cardiovascular system, also known as the circulatory system, is a system of
the body comprised of the heart, the blood, and the blood vessels. This system
is responsible for transporting blood. As the cardiovascular system moves blood