Chapter 7 - MarijuanaChapter 7 - Marijuana

CANNABIS PRODUCTS AND CANNABIS PRODUCTS AND CONCENTRATION LEVELS OF THCCONCENTRATION LEVELS OF THC

• Marijuana --- serrated cannabis leaves, 6-8 percent Marijuana --- serrated cannabis leaves, 6-8 percent THCTHC

• Sinsemilla --- seedless portion of the Sinsemilla --- seedless portion of the cannabis cannabis plant, plant,

8-15 percent THC8-15 percent THC

• Hashish --- resin from cannabis plant, 8-14 percent Hashish --- resin from cannabis plant, 8-14 percent THCTHC

• Hashish oil, hashish oil crystals --- hashish that is Hashish oil, hashish oil crystals --- hashish that is boiled boiled in alcohol then filtered, 15-60 percent THCin alcohol then filtered, 15-60 percent THC

A movie poster of this 1942 film, A movie poster of this 1942 film, which followed the infamous which followed the infamous

Reefer MadnessReefer Madness

Such films were Such films were linked to the anti-linked to the anti-marijuana marijuana campaign led by campaign led by the FBN.the FBN.

HIGHLIGHTS FROM THE HISTORY HIGHLIGHTS FROM THE HISTORY OF MARIJUANAOF MARIJUANA

• 2737 B.C. --- First reference to a cannabis plant2737 B.C. --- First reference to a cannabis plant

• 1920s --- Recreational use of marijuana limited to 1920s --- Recreational use of marijuana limited to jazz musicians and people in show businessjazz musicians and people in show business

• 1937 --- Marijuana Tax Act virtually illegalizes 1937 --- Marijuana Tax Act virtually illegalizes marijuana in the U.S.marijuana in the U.S.

• 1960s --- Marijuana smoking becomes widespread 1960s --- Marijuana smoking becomes widespread among American youth.among American youth.

• 1990s-present --- Medical applications of marijuana 1990s-present --- Medical applications of marijuana draw increasing attention and controversy.draw increasing attention and controversy.

How THC Moves Through How THC Moves Through The BodyThe Body

Rapidly absorbed from the lungsRapidly absorbed from the lungs Much gone in a few hours-but Much gone in a few hours-but

accumulates in liver, kidneys, spleen, accumulates in liver, kidneys, spleen, and testesand testes

Joint-10-20% of THC in the joint is Joint-10-20% of THC in the joint is transferred to body; pipe-40-50%; transferred to body; pipe-40-50%; bong-most efficientbong-most efficient

About 50% still in body 24 hrs. after About 50% still in body 24 hrs. after smokingsmoking

Liver converts THC to other Liver converts THC to other compounds-may remain for several compounds-may remain for several daysdays

Effects on mental & physical Effects on mental & physical functioning can last for daysfunctioning can last for days

Very lipid soluble-remains in body Very lipid soluble-remains in body Eaten-effects occur slower and last Eaten-effects occur slower and last

longerlonger

Effects on the BrainEffects on the Brain

Cannabinoid receptorsCannabinoid receptors Anadamide-binds with cannabinoid Anadamide-binds with cannabinoid

receptorsreceptors 2-AG-also activates THC receptors-2-AG-also activates THC receptors-

170 more 2-AG than anadamide170 more 2-AG than anadamide Hippocampus-formation of new Hippocampus-formation of new

memories-high concentration of memories-high concentration of cannabinoid receptorscannabinoid receptors

Most well-established adverse effect on Most well-established adverse effect on mental functionmental function

Animals-THC-perform as poorly as those Animals-THC-perform as poorly as those with a damaged hippocampuswith a damaged hippocampus

THC-eliminated from their bodies-return to THC-eliminated from their bodies-return to normalnormal

2-AG also effects hippocampus2-AG also effects hippocampus New studies-adolescents are more likely to New studies-adolescents are more likely to

have problems with learning and memoryhave problems with learning and memory

Also-fewer unpleasant side effects in Also-fewer unpleasant side effects in adolescents-more likely to continue usingadolescents-more likely to continue using

Does marijuana kill brain cells? “At Does marijuana kill brain cells? “At present the weight of scientific evidence present the weight of scientific evidence suggests that it does”. But not for most suggests that it does”. But not for most peoplepeople

Rats-extremely high doses of THC for Rats-extremely high doses of THC for several months-cell damage in several months-cell damage in hippocampushippocampus

Other studies-realistic amounts of THC-Other studies-realistic amounts of THC-hippocampal cells didn’t survive (in a hippocampal cells didn’t survive (in a culture)culture)

Also, decreased ability of hippocampal Also, decreased ability of hippocampal cells to make connections w/other cells cells to make connections w/other cells in the culturein the culture

Rhesus monkeys-exposed to Rhesus monkeys-exposed to reasonable amount of smoke-1 year-no reasonable amount of smoke-1 year-no evidence of neuronal deathevidence of neuronal death

May be worse effects if brain is still May be worse effects if brain is still maturingmaturing

Effects last after marijuana use is Effects last after marijuana use is stoppedstopped

Cerebellum and basal ganglia-rich in Cerebellum and basal ganglia-rich in cannabinoid receptorscannabinoid receptors

Brain stem-no receptors-virtually Brain stem-no receptors-virtually impossible to OD on marijuanaimpossible to OD on marijuana

No evidence it causes heart disease or No evidence it causes heart disease or heart attackheart attack

Lungs: Dies chronic marijuana use Lungs: Dies chronic marijuana use impair lung function? Yes-many impair lung function? Yes-many studiesstudies

Also, abnormal appearance and cell Also, abnormal appearance and cell organizationorganization

Is marijuana smoke 100x more toxic Is marijuana smoke 100x more toxic than tobacco smoke?than tobacco smoke?

Tar, carbon monoxide, cyanide-Tar, carbon monoxide, cyanide-comparable in bothcomparable in both

Benzopyrene-greater in marijuana Benzopyrene-greater in marijuana smokesmoke

Does marijuana smoking cause lung Does marijuana smoking cause lung cancer?cancer?

Most believe a link will be establishedMost believe a link will be established One study-DNA damage in cells-One study-DNA damage in cells-

precursor to lung cancerprecursor to lung cancer

3-4 joints a day-chronic bronchitis as often as 3-4 joints a day-chronic bronchitis as often as cigarette smokers who smoke 1 pack a daycigarette smokers who smoke 1 pack a day

Reproductive system: doesn’t make you Reproductive system: doesn’t make you sterilesterile

Decreases probability of conceptionDecreases probability of conception Men: reduces testosterone levels & sperm Men: reduces testosterone levels & sperm

count; increases abnormally formed spermcount; increases abnormally formed sperm Women: irregular periods; reduction in Women: irregular periods; reduction in

leutenizing hormone (LH)-necessary for egg leutenizing hormone (LH)-necessary for egg to implant in uterusto implant in uterus

Copyright (c) Pearson Education Copyright (c) Pearson Education 20102010

MARIJUANA EFFECTS ON DRIVINGMARIJUANA EFFECTS ON DRIVING

• Driving ability is impaired while Driving ability is impaired while under the influence of marijuana.under the influence of marijuana.

• Not a matter of reaction timeNot a matter of reaction time• Difficulty lies in the ability to attend Difficulty lies in the ability to attend

to peripheral information and in to peripheral information and in making an appropriate response making an appropriate response while driving.while driving.

Psychological EffectsPsychological Effects

High-intellectually interesting and High-intellectually interesting and emotionally pleasingemotionally pleasing

Improvement in sense perceptionsImprovement in sense perceptions Sense of euphoria and well-beingSense of euphoria and well-being Sharpened sense of sight and soundSharpened sense of sight and sound May feel creativity is increasedMay feel creativity is increased Time passes slowlyTime passes slowly Sometimes sleepy and dreamySometimes sleepy and dreamy

Tolerance, Dependence, Tolerance, Dependence, and Withdrawaland Withdrawal

Tolerance: less a feeling of being Tolerance: less a feeling of being high; placebos; significant learning high; placebos; significant learning effect; reverse tolerance? No-efficient effect; reverse tolerance? No-efficient smoking and buildup of THC in systemsmoking and buildup of THC in system

Psychological Dependence: not many Psychological Dependence: not many experience loss of controlexperience loss of control

Physical Dependence: marijuana Physical Dependence: marijuana withdrawal is usually mildwithdrawal is usually mild

Copyright (c) Pearson Education Copyright (c) Pearson Education 20102010

One study: 10 or 30 mg oral doses One study: 10 or 30 mg oral doses every 3-4 hrs for 21 days-irritability, every 3-4 hrs for 21 days-irritability, restlessness, insomnia, sweating, restlessness, insomnia, sweating, mild nausea; symptoms went away mild nausea; symptoms went away when THC was readministeredwhen THC was readministered

Nucleus accumbensNucleus accumbens

Copyright (c) Pearson Education Copyright (c) Pearson Education 20102010

Effects on MemoryEffects on Memory

Long term memory and cognitive Long term memory and cognitive functioning?functioning?

Appears to have effects for 48 hrs Appears to have effects for 48 hrs after smokingafter smoking

Study-day after last use, daily Study-day after last use, daily smokers had significant impairment smokers had significant impairment on memory for words and pictureson memory for words and pictures

Also-more errors on problem-solving Also-more errors on problem-solving tasks requiring mental flexibilitytasks requiring mental flexibility

Other studies – p. 160Other studies – p. 160

Other Reported ProblemsOther Reported Problems

Psychoses? : most smokers, modest Psychoses? : most smokers, modest riskrisk

Some predisposed; geneticsSome predisposed; genetics Using during adolescence-relatively Using during adolescence-relatively

high risk of developing psychological high risk of developing psychological disordersdisorders

Another reason why adolescents Another reason why adolescents shouldn’t useshouldn’t use

Aggression?Aggression?

Motor Performance and Motor Performance and DrivingDriving

Impairs ability to concentrate and Impairs ability to concentrate and make corrections; not necessarily make corrections; not necessarily reaction timereaction time

Lose ability to attend to peripheral Lose ability to attend to peripheral informationinformation

Acute Physiological EffectsAcute Physiological Effects

Increased heart rateIncreased heart rate Blood pressure-may increase, Blood pressure-may increase,

decrease, or stay the same decrease, or stay the same (standing, sitting, lying down)(standing, sitting, lying down)

Bloodshot eyesBloodshot eyes Dry mouthDry mouth ““munchies”-true of North Americans; munchies”-true of North Americans;

not Jamaicansnot Jamaicans

Enhanced sexual response; India-Enhanced sexual response; India-considered a sexual depressantconsidered a sexual depressant

2006-291,000 ED visits involved 2006-291,000 ED visits involved marijuana; 2marijuana; 2ndnd only to coke; most had only to coke; most had other drugs in systemother drugs in system

Medical UsesMedical Uses

Nausea, glaucoma, MS, seizures, Nausea, glaucoma, MS, seizures, chronic pain, migraine headacheschronic pain, migraine headaches

Since 1996 – 13 states passes Since 1996 – 13 states passes medical marijuana initiatives or medical marijuana initiatives or legislation favoring medical uselegislation favoring medical use

STATEMENT FROM THE INSTITUTE STATEMENT FROM THE INSTITUTE OF MEDICINE REPORT ON OF MEDICINE REPORT ON

MARIJUANA (1999)MARIJUANA (1999)

““Until a nonsmoked, rapid-onset Until a nonsmoked, rapid-onset cannabinoid drug delivery system cannabinoid drug delivery system becomes available, we acknowledge becomes available, we acknowledge that there is no clear alternative for that there is no clear alternative for people suffering from people suffering from chronic chronic conditions that might be relieved by conditions that might be relieved by smoking marijuana, such as pain and smoking marijuana, such as pain and AIDS wasting.”AIDS wasting.”

STATUS OF MEDICAL MARIJAUANASTATUS OF MEDICAL MARIJAUANA

• Eleven U.S. states (Alaska, Arizona, Eleven U.S. states (Alaska, Arizona, California, Colorado, Hawaii, Maine, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Washington, and Montana, Nevada, Oregon, Washington, and Vermont) as well as the District of Columbia Vermont) as well as the District of Columbia allow marijuana smoking for relief of pain allow marijuana smoking for relief of pain and discomfort, when prescribed by a and discomfort, when prescribed by a physicianphysician

• Canada permits patients to grow and smoke Canada permits patients to grow and smoke marijuana if their symptoms have been marijuana if their symptoms have been certified by a physician as warranting this certified by a physician as warranting this treatmenttreatment

U.S. SUPREME COURT 2005U.S. SUPREME COURT 2005GONZALES v. RAICHGONZALES v. RAICH

• Overturned 2003 ruling by a federal Overturned 2003 ruling by a federal appeals court that shield California’s appeals court that shield California’s Compassionate Use Act from federal Compassionate Use Act from federal drug enforcementdrug enforcement

• Upheld “Congress’s power to Upheld “Congress’s power to regulate purely local activities that regulate purely local activities that are part of an economic ‘class of are part of an economic ‘class of activities’ that have a substantial activities’ that have a substantial effect on interstate commerce”effect on interstate commerce”

CONSEQUENCES OF CONSEQUENCES OF GONZALES v. RAICH (2005)GONZALES v. RAICH (2005)

• A restriction of medical marijuana to A restriction of medical marijuana to intrastate (within a state) commerce could intrastate (within a state) commerce could not be guaranteed.not be guaranteed.

• Therefore, federal jurisdiction takes over.Therefore, federal jurisdiction takes over.

• The federal prohibition of possession and The federal prohibition of possession and use of marijuana for medical purposes use of marijuana for medical purposes remains in force, even in those states that remains in force, even in those states that permit it.permit it.

Legalization/Legalization/DecriminalizationDecriminalization

Pharmacological, social, and economic Pharmacological, social, and economic viewpointsviewpoints

2 principal factors that change 2 principal factors that change attitudes and laws=culture and timeattitudes and laws=culture and time

1930s-marijuana led to violent 1930s-marijuana led to violent behaviorbehavior

1940s-studies indicated marijuana was 1940s-studies indicated marijuana was relatively harmless; didn’t change relatively harmless; didn’t change personality of userpersonality of user

1950s & 1960s-few scientific studies1950s & 1960s-few scientific studies 1970s-AMA and ABA-suggested reducing 1970s-AMA and ABA-suggested reducing

or even eliminating criminal penalties for or even eliminating criminal penalties for possession of small amountpossession of small amount

1980s (Reagan)-”War on Drugs”1980s (Reagan)-”War on Drugs” 1990s-marijuana use increased; 1990s-marijuana use increased;

between 1992-1994, used by 12-17 yr between 1992-1994, used by 12-17 yr olds doubledolds doubled

Future?Future?