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Marijuana: dependence, symptoms and treatment
Last reviewed: 18.10.2021
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Marijuana is the most commonly used illegal substance. With prolonged use of marijuana, a psychic dependence can develop, physical dependence is expressed very insignificantly.
Like any substance that causes euphoria and reduces anxiety, marijuana can cause addiction. However, there are usually no reports of heavy use and the inability to stop it. As a rule, marijuana is used sporadically, without leading to social or psychological dysfunction. When discontinuing use, there may be a mild withdrawal syndrome similar to the abolition of benzodia-zepines, but some patients with prolonged use talk about disturbed sleep and nervousness when discontinuing use.
In the US, marijuana, as a rule, is smoked in the form of cigarettes made from the tips of flowers and leaves of a dried plant or in the form of hash-pressed resin from a plant. Dronabinol, the synthetic form of -9-tetrahydrocannabinol (the main active principle of marijuana), is used to treat nausea and vomiting associated with chemotherapy in oncology and to increase appetite in patients with AIDS. This form is not sold on the streets.
[Symptoms of dependence on marijuana
Smoking marijuana causes a special state of consciousness in which thoughts are scattered, unpredictable and freely changing. The perception of time, color and space can change. In general, there is a sense of well-being and relaxation (drug intoxication). These effects persist 2-3 hours after inhalation. There is no conclusive evidence of a prolonged or residual effect. Tachycardia, injection of the conjunctiva and dry mouth are constantly observed. Many of the psychological effects are probably related to the environment in which the drug is taken. There are panic reactions and paranoia, especially among inexperienced consumers, but such reactions become unusual when for the culture medium the use of this substance became quite familiar. Communication and motor skills decrease, perception of depth and tracking are disturbed, the sense of time changes - all this is dangerous in certain situations (for example, driving, working with complex equipment). Appetite often rises. With the use of marijuana, psychotic symptoms can worsen and even provoke in patients with schizophrenia, even if patients are treated with antipsychotics.
Critics of marijuana refer to numerous scientific data on side effects, but most claims for severe biological disorders are not justified. The information obtained is heterogeneous even among relatively many users in intensively studied areas, such as immunological and reproductive functions. However, smoking marijuana in large doses develop bronchopulmonary symptoms (episodes of acute bronchitis, wheezing, cough, sputum), pulmonary function is disrupted. These disorders are manifested by changes in large airways, the clinical significance of which has not been proven. Even in daily marijuana smokers do not develop obstructive pulmonary disease. There are no descriptions of lung cancer in people who smoke only marijuana, perhaps because less smoke is inhaled than when smoking tobacco, and smoke contains fewer carcinogens. However, bronchial tissue biopsy sometimes reveals precancerous changes, so there can be cancer. Several controlled studies have shown a decrease in cognitive function in small groups for a long time and in large doses of marijuana users; these data need confirmation.
The effect of prenatal use of marijuana on newborns is not clear enough. A decrease in fetal body mass is described, but when all factors are taken into account (for example, the use of alcohol and tobacco by the mother), the effect on the fetal body weight decreases. N-9-Tetrahydrocannabinol is excreted in the mother's milk. Although the harm to breast-fed infants is not proven, lactating mothers, as well as pregnant women, should avoid the use of marijuana.
Since cannabinoid metabolites persist for a long time, urine analysis after each use remains positive for days or weeks after discontinuation of use. Tests that detect inactive metabolites determine only use, not dysfunction; The smoker may not have the effects of the drug at the time that his urine is being examined. The test can determine extremely small quantities and therefore has little significance in determining the characteristics of consumption.