CH 10 Marijuana

Identify and differentiate the primary routes of marijuana administration.

1. Inhalation Rapid and efficient Absorbed through lungs Effects felt within minutes Peak blood levels within 10 minutes Duration of action 2-3 hours 2. Oral Eaten in food (e.g., brownies) Taken in pill form (synthetic THC) Slower onset and less efficient Must pass through digestive tract, THC absorbed in small intestine Onset in 30-60 minutes Peak effects in 2-3 hours Duration of action is 4-6 hours

Summarize the stipulations of the 1937 Marijuana Tax Act and identify one of the key leaders with regard to propaganda against marijuana from the 1930s to 1960s.

1937 Marijuana tax act is a U.S. federal law that imposed tax on the sale of cannabis, hemp, or marijuana. One of the key leaders with regard to propaganda against marijuana from the 1930s to the 1960s was Harry Anslinger who served as the first commissioner of the US Federal Bureau of Narcotics. He drove a campaign against marijuana with the help of the mass media by stating that marijuana users have the ability to kill people due to an event where someone who was on marijuana killed his parents. It was later found out that the person has mental problems beforehand but Harry did not care if there was tons of evidence against his claims.

Summarize the prevalence of marijuana use among high school seniors in the U.S. and note if it has changed over the past 40 years.

36% of high school seniors reported past year use (2011). 2016 STATS: This year's Monitoring the Future (MTF) survey of drug use and attitudes among American 8th, 10th, and 12th graders is encouraging, with past-year use of illicit drugs other than marijuana continuing to decline to the lowest level in the history of the survey in all three grades—5.4 percent among 8th graders, 9.8 percent among 10th graders, and 14.3 percent among 12th graders. This is down from peak rates of 12.6 percent for 8th graders in 1995, and 18.4 percent for 10th graders in 1996, and 21.6 percent for 12th graders in 2001.

Identify the first U.S. state to legalize medicinal uses of marijuana. What states have passed legislation to allow recreational marijuana use?

California was the first state to legalize marijuana for medical use. The states that passed legislation to allow recreational use are Colorado, Washington, Oregon and Alaska.

Describe some of the early uses of the cannabis sativa in various parts of the world.

Cannabis plant is thought to be native to India. Greek physician, Galen prescribed marijuana for various medical conditions. Hemp was cultivated in Jamestown, Virginia and by presidents George Washington and Thomas Jefferson, to make clothing and rope. In the 1920's it was used by Mexican laborers in the U.S. and jazz musicians. Its use increased during prohibition.

Identify and discuss some of the potential health risks of chronic marijuana use. Critically evaluate the research evidence regarding these potential effects.

Chronic Use: Not that much research Cognitive deficits Memory problems Associated with mental health problems Difficult to establish causal effects Lung problems due to smoking Negative effects on reproductive function/fertility Negative effects on pregnancy outcomes Amotivational syndrome Shown in monkeys

How does the prevalence of marijuana use in the U.S. rank among other drugs of abuse?

Marijuana is the most widely used illicit drug in the US (Illicit drug use includes the nonmedical use of a variety of drugs that are prohibited by international law). In 2010 - 6.9% of U.S. population 12 years+ report use in the past year. Males use it more than females.

Identify and discuss the rationale for current medical uses of marijuana.

Medical Uses: Long history of use as medicine (2737 BCE) Found in medicines in the U.S until 1930's Research is ongoing Chronic pain Muscle spasticity Cachexia (wasting syndrome) Glaucoma (increased eye pressure can lead to blindness Reduces intraocular pressure Multiple sclerosis (MS) (damage to myelin, glial cells that insulate neurons) Helps with muscle spasms •Decreases nausea and vomiting

List some of the other objective acute effects of marijuana.

Objective effects: (not influenced by personal feelings or opinions in considering and representing facts.) Sedative effects Impairs cognitive and behavioral functions Decreased attention Increased errors on psychomotor tasks Driving skill impaired Memory impairments Aggression reduced Increased appetite ("munchies")

Identify two synthetic THC-based medicines and note how they are scheduled in the U.S.

One THC based medicine is Sativex which is used to treat spasticity (muscle spasms and stiffness) and it is approved in 25 countries but is not available in the US yet. In the US, Phase III clinical trials started in late 2006 for treatment of pain in cancer patients and were in recruitment in 2013. On Apr. 20, 2011, a US patent was granted for Sativex in cancer pain. As of Apr. 28, 2014, Sativex was still in Phase 3 clinical development to treat pain in cancer patients, and the company expects to see results from the program at the end of 2014. The second THC- based medicine is Marinol and Cesamet which is is FDA-approved for the treatment of nausea in patients undergoing chemotherapy and is also prescribed to AIDS patients suffering from loss of appetite. The drug is made of a synthetic form of THC and is delivered as an oral capsule. Marinol and Cesamet, however, are listed as Schedule III and Schedule II drugs, respectively, meaning the FDA recognizes their clinical benefits and their abuse potentials are believed to be lower.

Contrast marijuana with alcohol and opiates regarding their effects on the brain stem mechanisms that regulate heart rate and respiration.

People who use marijuana have been subject to have an Increased heart rate and blood pressure.

Explain why THC remains in the body for a long time after marijuana use.

Pharmacokinetics: Distributed throughout the body and brain Metabolism is slow THC can be stored in fatty deposits of the body Metabolites can be detected for up to 3 weeks in a chronic user

Summarize the pharmacological actions of THC in the brain.

Sites of Action: THC binds to cannabinoid receptors (two types CB1 and CB2) Cannabinoid receptors found throughout the brain (except brain stem) Anandamide (first isolated in 1992) Endogenous fatty acid that binds to cannabinoid receptors Plays a role in appetite, sleep, memory, concentration, time perception, pleasure, and pain perception Cannabinoid receptors also alter activity of endorphins and GABA

Summarize the acute effects of marijuana on psychomotor performance. Include research findings regarding its effects on driving performance.

Subjective Effects (based on or influenced by personal feelings, tastes, or opinions) Effects are variable Sometimes feel nothing at all Feel high Euphoria Mellow, drowsy, relaxed, carefree Laughter and talkativeness Perception of time is altered Sometimes anxiety, panic attacks, paranoid thoughts and other negative effects Effects on the Body Bloodshot eyes (vasodilation) Increased heart rate and blood pressure Dry mouth, thirst, hunger, headache, nausea, dizziness Effects not fatal (essentially impossible to overdose)

Identify the two cannabinoid receptor subtypes and a naturally occurring substance that binds to these receptors. Which of these receptor subtypes is found predominantly in the brain and what brain regions are these cannabinoid receptors most densely distributed?

THC binds to cannabinoid receptors (two types CB1 and CB2).

Summarize the evidence that marijuana can produce physical dependence and describe the withdrawal symptoms associated with dependence.

The Risk of dependence estimated to be 9% which is Lower than other drugs Treatment: Few patients seek treatment for marijuana dependence Cessation may result in depression and craving No direct pharmacological treatments Antidepressant medication Psychological therapies Cognitive-behavioral therapy Motivational incentives Withdrawal symptoms: Variable among users Limited physical symptoms Not as aversive as other drug withdrawal symptoms Irritability, depression, restlessness, and agitation Onset after 1-3 days of abstinence Last up to 2 weeks

Name the chemical identified as primarily responsible for most of marijuana's psychoactive effects.

The main psychoactive chemical is known as delta-9-tetrahydrocannabinol (THC).

Discuss how the Marijuana Tax Act and subsequent federal drug laws in the United States impact public views of marijuana.

The marijuana tax act and subsequent federal drug laws in the US greatly impacted the public's views on marijuana. Marijuana was made to seem more dangerous than it actually is comparing to the many other dangerous drugs out there. Marijuana is labeled as a schedule 1 drug under a category where no prescriptions are given for these drugs and they are not readily available for clinical use. Doing this makes people think that marijuana is far worse than other drugs.

What name is given to chemicals specifically found in cannabis and approximately how many have been identified?

The name of the chemicals found in cannabis are cannabinoids and there are 60.

Briefly summarize what is known regarding cannabis and the risks for various forms of cancer and lung diseases.

There is not that much data that shows a 100% correlation between smoking cannabis and risk of forming cancer or lung disease. (maybe smokers cough). However there have been studies. An example is a cannabis and case control study that was done which concluded that Long term cannabis use increases the risk of lung cancer in young adults. (The risk of lung cancer increased 8%) In another study that was done. ( https://www.ncbi.nlm.nih.gov/pubmed/24384575) Smoking marijuana is associated with chronic bronchitis symptoms and large airway inflammation. SUMMARY: There is unequivocal evidence that habitual or regular marijuana smoking is not harmless. A caution against regular heavy marijuana usage is prudent. The medicinal use of marijuana is likely not harmful to lungs in low cumulative doses, but the dose limit needs to be defined. Recreational use is not the same as medicinal use and should be discouraged.