Cannabis and related disorders Health Article

Definition

Cannabis, more commonly called marijuana, refers to the several varieties of Cannabis sativa, or Indian hemp plant, that contains the psychoactive drug delta-9-tetrahydrocannabinol (THC). Cannabis-related disorders refer to problems associated with the use of substances derived from this plant.

Description

Cannabis—in the form of marijuana, hashish (a dried resinous material that seeps from cannabis leaves and is more potent than marijuana), or other cannabinoids—is considered the most commonly used illegal substance in the world. Its effects have been known for thousands of years, and were described as early as the fifth century B.C., when the Greek historian Herodotus told of a tribe of nomads who, after inhaling the smoke of roasted hemp seeds, emerged from their tent excited and shouting for joy.

Cannabis is the abbreviation for the Latin name for the hemp plant—Cannabis sativa. All parts of the plant contain psychoactive substances, with THC making up the highest percentage. The most potent parts are the flowering tops and the dried, blackish-brown residue that comes from the leaves known as hashish, or "hash."

There are more than 200 slang terms for marijuana, including "pot," "herb," "weed," "Mary Jane," "grass," "tea," and "ganja." It is usually chopped and/or shredded and rolled into a cigarette, or "joint," or placed in a pipe (sometimes called a "bong") and smoked. An alternative method of using marijuana involves adding it to foods and eating it, such as baking it into brownies. It can also be brewed as a tea. Marijuana has appeared in the form of "blunts"—cigarettes emptied of their tobacco content and filled with a combination of marijuana and another drug such as crack cocaine.

Between 1840 and 1900, European and American medical journals published numerous articles on the therapeutic uses of marijuana. It was recommended as an appetite stimulant, muscle relaxant, painkiller, sedative, and anticonvulsant. As late as 1913, Sir William Osler recommended it highly for treatment of migraine. Public opinion changed, however, in the early 1900s, as alternative medications such as aspirin, opiates, and barbiturates became available. In 1937, the United States passed the Marijuana Tax Act, which made the drug essentially impossible to obtain for medical purposes.

By the year 2000, the debate over the use of marijuana as a medicine continued. THC is known to successfully treat nausea caused by cancer treatment drugs, stimulate the appetites of persons diagnosed with acquired immune deficiency syndrome (AIDS), and possibly assist in the treatment of glaucoma. Its use as a medicinal agent is still, however, highly controversial. Even although the states of Arizona and California passed laws in 1996 making it legal for physicians to prescribe marijuana in the form of cigarettes for treatment of the diseases listed above, governmental agencies continue to oppose strongly its use as a medicine, and doctors who do prescribe it may find their licenses at risk.

Cannabis-related disorders reflect the problematic use of cannabis products to varying degrees. These dis orders include:

• • Cannabis dependence: The compulsive need to use the drug, coupled with problems associated with chronic drug use.
• • Cannabis abuse: Periodic use that may cause legal problems, problems at work, home, or school, or danger when driving.
• • Cannabis intoxication: The direct effects of acute cannabis use and reactions that accompany it such as feeling "high," euphoria, sleepiness, lethargy, impairment in short-term memory, stimulated appetite, impaired judgment, distorted sensory perceptions, impaired motor performance, and other symptoms.

Causes

Cannabis-related disorders share many of the same root causes with other addictive substances. The initial desire for a "high," combined with the widely held perception that cannabis use is not dangerous, often leads to experimentation in the teen years.

Recent research challenges the notion that cannabis use is not physically addictive. According to the National Institute of Drug Abuse (NIDA), daily cannabis users experience withdrawal symptoms including irritability, stomach pain, aggression, and anxiety. Many frequent cannabis users are believed to continue using in order to avoid these unpleasant symptoms. Long-term use may lead to changes in the brain similar to those seen with long-term use of other addictive substances. It is believed that the greater availability, higher potency, and lower price for cannabis in recent years all contribute to the increase in cannabis-related disorders.

Beginning in the 1990s, researchers began to discover that cannabis-like compounds are naturally produced in various parts of the human body. These compounds, called "endocannabinoids," appear to suppress inflammation and other responses of the immune system. One of these endocannabinoids— anandamide—appears to help regulate the early stages of pregnancy.