Marijuana (hemp, plan, drape), marijuana addiction: symptoms and treatment

Cannabioids (marijuana)

Hemp has long been grown both for the production of hemp twine, and for use as a medicinal and narcotic drug. The smoke produced during its combustion contains many different substances, among which 61 compounds related to cannabinoids have been identified. One of them - A-9-tetrahydrocannabinol (A-9-THC) - reproduces almost all the pharmacological properties of marijuana smoke.

According to sociological surveys, marijuana is the most common illegal substance in the US. The peak of its use fell at the end of the 1970s, when 60% of high school students had experience with marijuana, and 11% used it daily. By the mid-1990s, these indicators had declined to 40% and 2%, respectively. It should be noted that interviews with high school students could give an underestimated prevalence of drug use, since the survey was not conducted among those who dropped out of school. According to one of the latest studies, the use of marijuana among pupils of the eighth classes has again increased in the USA. Due to the fact that marijuana is perceived as a drug less dangerous than other drugs, there has been an increase in its use, especially in the age group of 10 to 15 years. In addition, the activity of marijuana preparations spreading through illegal channels has significantly increased, which is determined by a higher concentration of THC.

In recent years, the brain has been able to identify cannabinoid receptors. Later they were cloned. Although the physiological role of these receptors remains unclear, it is established that they are widely represented in the brain. Their density is especially high in the cerebral cortex, hippocampus, striatum and cerebellum. The distribution of cannabinoid receptors has similarities in several species of mammals - this indicates that these receptors are fixed in the process of evolution. Endogenous ligand of cannabinoid receptors, anandimide, arachidonic acid derivative, is isolated. Perhaps, these scientific achievements will help to better understand the mechanisms of the development of marijuana abuse and dependence on it.

[1], [2], [3], [4], [5],

Therapeutic effect of marijuana

There are reports of several useful properties of marijuana. So, it is able to reduce the nausea that occurs as a side effect of chemotherapy in the treatment of cancer, has a miorelaksiruyuschee effect, anticonvulsant effect, reduces intraocular pressure in glaucoma. Patients with AIDS report that smoking marijuana improves appetite and helps prevent weight loss, often observed with this disease. A similar effect is observed in terminal oncological patients. However, the pay for these useful properties is a psychotropic effect, which can hamper normal life activity. Thus, the question of the benefits of marijuana before the traditional methods of treating these conditions remains open. Marinol (dronabinol) is a synthetic cannabinoid that is taken orally to relieve nausea or weight loss. Adherents of smoking marijuana (which remains illegal) claim that oral intake does not allow adequate titration of the dose. Therefore, dronabinol is not as effective as smoking a plant product. With the cloning of cannabinoid receptors and the discovery of their endogenous ligand, it was hoped that preparations would be developed that would have the therapeutic effect of marijuana but lacked its psychotropic side effect.

Syndrome of dependence on cannabinoids. To the majority of effects of marijuana, both in humans and in laboratory animals tolerance develops. Tolerance can develop rapidly - after using several doses, but as quickly and disappears. However, in laboratory animals tolerance to high doses of the drug can persist for a long period after cessation of its intake. The withdrawal symptoms in patients who seek medical help are usually absent. In practice, relatively few people have ever required treatment for dependence on marijuana. Nevertheless, the person has described marijuana cancellation syndrome. In the experimental situation, the withdrawal syndrome may occur after regular ingestion of high doses of marijuana. In clinical practice, it is observed only in those who used marijuana every day, and then stopped its introduction. Compulsive or regular use of marijuana, apparently, is motivated not by fear of the withdrawal syndrome, although this issue requires systematic investigation. In 1997, according to data from staff of substance abuse programs, approximately 100,000 people were treated for dependence on marijuana.

Clinical aspects of marijuana

Pharmacological action of A-9-THC depends on the dose, route of administration, duration and frequency of use, individual susceptibility and circumstances of use. The toxic effect of marijuana is manifested by changes in mood, perception, and motivation. But the main effect, for which most people use marijuana, is a feeling of euphoria. People who use narcotic drugs claim that the "buzz", obtained from psychostimulants and opioids, varies. The effect depends on the dose, but on average the feeling of euphoria after smoking marijuana lasts about 2 hours. During this time, there are changes in cognitive functions, perception, reaction time, memory, learning ability. Violation of coordination of movements and the ability to follow moving objects remain for several hours after regression of euphoria. These violations can make it very difficult to drive a car or school.

Marijuana causes other complex phenomena, for example, a sense of an accelerated flow of thoughts or a heightened sense of hunger. Sometimes they report more vivid sexual sensations or a tendency to enlightenment against the background of "buzz" derived from marijuana. However, there are no studies that would attempt to give an objective assessment of these allegations.

There may be unpleasant reactions, such as panic attacks or hallucinations and even acute psychosis. In several surveys it was shown that 50-60% of people who used marijuana at least once experienced similar anxiety experiences. They often occur with higher doses and with oral intake, and not with the smoking of marijuana, since in the latter case it is possible to adjust the dose depending on the effect obtained. Although there is no conclusive evidence that marijuana can cause schizophreniform syndrome, there are numerous clinical reports that it can provoke a relapse in persons with a history of schizophrenia. Patients with schizophrenia in a state of remission are particularly sensitive to the negative effect of marijuana on mental status.

One of the most controversial effects attributed to marijuana is the ability to induce an "amotational syndrome". This term is not an official diagnosis; it is used to refer to the state of young people who have moved away from any social activity, do not show the slightest interest in school, work or other purposeful activity. When these manifestations occur in a person who abuses marijuana, it is the latter that is considered their cause. However, there is no evidence to demonstrate a causal relationship between marijuana use and loss of motivation. It is not proven that marijuana damages brain cells or causes any persistent functional changes. Experimental data show that a disruption of the ability to navigate in the labyrinth persists for several weeks after the administration of the last dose. This corresponds to clinical data, according to which, after long-term use of high doses of marijuana, refuse the drug, gradual normalization of mental status occurs.

Manifestations of abstinence syndrome with stopping marijuana

• Anxiety
• Irritability
• Insomnia
• EEG changes during sleep
• Nausea, muscle spasms
• Hallucinogens

[6], [7], [8], [9]

Treatment of dependence on marijuana

Specific therapy for the abuse of marijuana or dependence on it has not been developed. Persons who abuse marijuana may suffer from concomitant depression and need treatment with antidepressants, but this issue requires an individual solution. It should be borne in mind that the expressed affective symptoms can occur against the background of the disappearance of the effect of marijuana. The residual effect of the substance can persist for several weeks.