Cannabis

Natural cannabis Cannabis, also known as grass, pot, hash, and marijuana, is made from the dried flowers and leaves of a plant called Cannabis sativa. The Cannabis sativa plant contains cannabinoids, which are chemicals that act upon cannabinoid receptors in the body (CB 1 and CB2). The most well known and researched cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive component of cannabis and is the most effective cannabinoid for alleviating nausea and vomiting and stimulating appetite. Synthetic cannabis Cannabinoids also refer to synthetic drugs developed in pharmaceutical laboratories. These act in the same way in the body as the natural plant product. Currently the three main synthetic cannabinoids are: Dronabinol, a synthetic form of THC; Nabilone, a synthetic form of THC; and Nabiximols, a chemically pure 50:50 mixture of THC and CBD. Therapeutic benefits of cannabis use A working party on the use of cannabis for medical purposes established by the NSW Government concluded in its final report (August 2000) that medical conditions for which cannabis may be of medical benefit include: As an appetite stimulant for cancer and HIV related wasting; Pain unrelieved by conventional treatments; Neurological disorders, such as multiple sclerosis; and Nausea and vomiting in cancer patients undergoing chemotherapy which do not respond to conventional treatment. These conclusions were consistent with a report prepared in 1998 by the Drug and Alcohol Services Council of South Australia for the Ministerial Council on Drug Strategy. In 2004, researchers at the National Drug and Alcohol Research Centre of the University of New South Wales recruited Australian adults who had used cannabis for medical purposes. The Australian Medical Association also considers cannabis may be of medical benefit as an appetite stimulant and as an anti-emetic, but believes that more research is needed to determine the benefits for neurological disorders and pain relief, as well as the safe and effective routes of administration. One hundred and twenty-eight respondents completed questionnaires anonymously, and the majority (58%) were NSW residents. Participants reported the use of cannabis to relieve a number of medical conditions. Cannabis use was perceived to provide substantial relief from symptoms such as pain and nausea.

In North America and some European countries, Dronabinol, Nabilone and Nabiximols are used to treat nausea and vomiting caused by chemotherapy in people who do not respond to conventional treatment. Dronabinol and Nabiximols are also used to treat loss of appetite and weight loss in cancer patients. Additionally, Nabiximols are used as an adjunctive analgesic treatment in adult patients with advanced cancer who experience moderate to severe pain. Source: Cancer Council New South Wales. Medical use of cannabis. Updated on November 9 th 2012. Accessed from http://www.cancercouncil.com.au/wp-content/uploads/2010/09/Position-Statementon-Medical-Use-of-Cannabis-FINAL.pdf

What Are the Concerns about Adolescents Using Marijuana?

Early initiation of marijuana use can have an impact on the following: Memory, attention and learning Early and continued use of marijuana can: Affect memory, attention and ability to think clearly, making it difficult to concentrate, learn new things, and make sound decisions (Dougherty et al, 2013); Affect movement and balance while intoxicated; Be associated with a moderate decrease in IQ in heavy current marijuana users (Meier et al, 2012).

School Performance Poorer school performance; Increased absent days; Increasing the risk of dropping out without graduating.

Problematic Behaviors Higher levels of leaving the family home;Immature sexual activity, which can result in unplanned pregnancy (Bryan et al, 2012); Increased risk of driving while under the influence of marijuana; marijuana use more than doubles a drivers risk of being in an accident (Asbridge et al, 2012) Higher levels of criminal behavior such as motor vehicle theft and break-and-enter offences to pay for drug use.

Increased Risk of Mental Health Issues Impaired emotional development; Increased risk of becoming more dissatisfied with their life; Increased likelihood to suffer from depression, anxiety, psychosis, or other mental illness.

Other Concerns About Early Use of Marijuana by Adolescents Use of marijuana by adolescents is illegal in Washington State and all other states in the U.S. It is an offence to cultivate, pos- sess, use, sell or supply marijuana. Doing so could result in criminal prosecution or even incarceration, depending on the type of offence and which state it was committed in.

Marijuana can have short- and long-term consequences on health Marijuana use can increase the risk of psychotic episodes occurring or trigger a mental illness Marijuana use can lead to dependence in young people who use marijuana regularly over a period of time. Relationships with family and other friends who dont use marijuana may become problematic. Using marijuana has been associated with a decrease in motivation (although the evidence is inconclusive if an "amotivational syndrome" actually exists), which can impact on school, work, family, friends and life in general The cost of using marijuana can result in financial difficulties

Source: University of Washington Alcohol and Drug Abuse Institute. Marijuana and adolescents. Updated on June 2013. Accessed from http://adai.uw.edu/marijuana/factsheets/adolescents.pdf

Ferguson D and Boden J, University of Otago Christchurch Health and Development Study. Cannabis use in adolescence. Accessed from http://www.otago.ac.nz/christchurch/otago018744.pdf

Cannabis harms
There have been no deaths recorded as a result of cannabis intoxication. However, there is growing evidence that cannabis use has the potential to have adverse physical, psychological and social outcomes. Respiratory problems and cancer risk There is evidence that long-term cannabis smokers are more likely to suffer from respiratory problems such as chronic cough, sputum production, wheezing and bronchitis than non-users, even after controlling for tobacco use. There is mixed evidence for the relationship between cannabis smoking and cancer. Cannabis smoke contains carcinogens and it has been found that more tar is inhaled and retained when cannabis is smoked than when tobacco is smoked. However, epidemiological or case-control studies have not yielded sufficient evidence to conclude that cannabis causes cancer, and further research of this type is needed. Cardiovascular effects Cannabis increases the heart rate, and has been associated with adverse cardio- vascular events such as stroke and heart attack. However, these health complications seem to be rare, and cannabis smoking does not generally cause problems for those who have healthy cardiovascular systems. Cannabis smoking may be a risk factor for adverse outcomes for those who have existing cardiovascular problems. Reproductive effects Animal research suggests that THC exposure leads to abnormalities in reproductive functioning, birth defects, and low birth weight. However, the research assessing the effects of cannabis on human reproduction is not as clear. This is mainly due to the difficulties in assessing this relationship in humans because of under-reporting of drug use during pregnancy, and the confounding effects of tobacco and alcohol use, which are likely to operate in women who use cannabis during pregnancy. However, there are a few studies that have controlled for possible confounders and these have generally found that cannabis use causes decreases in birth weight. Immunological effects The issue of whether cannabis has an adverse effect on the immune system is significant, given the therapeutic use of cannabis in those suffering from diseases affecting the immune system, such as cancer or HIV/AIDS. Much like the literature on the reproductive effects of cannabis, the literature on the immunological effectsis inconclusive. An adverse effect of cannabis on immunity is found in animal and laboratory studies, but the research on humans is conflicting and too limited to draw any conclusions. Source: WHO, Division of Mental Health and Prevention of Substance Abuse. Cannabis: a health perspective and research agenda. Updated on 1997. Accessed from http://whqlibdoc.who.int/hq/1997/WHO_msa_PSA_97.4.pdf

McLaren J and Mattick RP, National Drug and Alcohol Research Centre University of New South Wales. Cannabis in Australia: use, supply, harms, and responses. Updated on 2009. Accessed from http://www.health.gov.au/internet/drugstrategy/publishing.nsf/Content/4FDE76ABD582C84ECA257 314000BB6EB/$File/mono-57.pdf

Marijuana as Medicine
1.Marijuana and Pain Cannabinoids have shown significant promise in basic experi- ments on pain. Peripheral nerves that detect pain sensations con- tain abundant receptors for cannabinoids, and cannabinoids ap- pear to block peripheral nerve pain in experimental animals. Even more encouraging, basic studies suggest that opiates and cannab- inoids suppress pain through different mechanisms.

2.Marijuana and AIDS Another factor also may contribute to the popularity of medicinal marijuana among people with AIDS: the drugs pur- ported ability to soothe a variety of debilitating symptoms. Many such patients echo the comments of the HIV-positive man who claimed that marijuana calmed his stomach after taking medication, stimulated his appetite, eased his pain, and lifted his mood. Marijuana and cannabinoids reduce the nausea and vomiting brought on by AIDS medications. 3.Marijuana and Cancer Researchers have tested several cannabinoids for their ability to suppress vomiting, including two forms of THC (delta-9 and the less abundant delta-8-THC). Two synthetic cannabinoids (nabilone and levonantradol) that activate the same receptors as THC have also been examined as potential antiemetics.

4.Marijuana and Muscle Spasticity Animal research, too, suggests that marijuana calms muscle spasticity.

5.Marijuana and Neurological Disorders

EPILEPSY Currently, the only biological reason to believe that cannab- inoids could suppress epileptic seizures is the abundance of CB 1 receptors in some of the regions of the brain (the hippocampus and amygdala) where partial seizures originate.

ALZHEIMERs

There are two possible applications for cannabinoid treat- ments in Alzheimers disease: to stimulate patients appetites and to improve their behavior. Treatments would also be welcome that reduced agitation or antisocial behavior in Alzheimers patientsbehaviors that are not only unsafe but that also reduce caregivers ability to help patients.

6.Marijuana and Glaucoma

Several clinical studies have found that cannabinoids or mari- juana reduce intraocular pressure (IOP) as well as do most con- ventional glaucoma medications. This is true whether the cannabinoids are administered orally, intravenously, or by inhalation but not when they are applied directly to the eye.

Source: Mack A and Joy J, Editors. Marijuana as medicine: the science beyond the controversy. Washington DC: National Academic Press; 2000. Accessed from http://www.nap.edu/catalog/9586.html

Further readings:
Marijuana and Medicine: Assessing the Science Base. Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., Editors; Institute of Medicine. 1999. Available from url http://www.nap.edu/catalog/6376.html

The health and psychological effects of cannabis use. Wayne Hall Louisa Degenhardt Michael Lynskey National Drug and Alcohol Research Centre University of New South Wales. Available from url http://www.beckleyfoundation.org/pdf/hall_HealthAndPsychologicalEffects_2001.pdf

Hall W. The Mental Health Risks of Adolescent Cannabis Use. PLoS Med. 2006 February; 3(2): e39. Published online 2006 January 24. Available from url http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351917/ CENTER FOR MEDICINAL CANNABIS RESEARCH: Report to the Legislature. Available from url http://cmcr.ucsd.edu/images/pdfs/CMCR_REPORT_FEB17.pdf