BY MUHAMMAD BELLO MUSTAPHA SHABEWA
Abstract: Marijuana refers to the dried leaves, flowers, stems and seeds from the Cannabis sativa or cannabis indica plant. The plant contains the mind-altering chemical THC and other similar compounds. Extracts can also be made from the cannabis plant. Marijuana is a green, brown or grey mixture of dried, shredded leaves, stems, seeds and flowers of the hemp or cannabis plant. It goes by many different names- pot, herb, weed, grass, devils lettuce, cannabis e.t.c. and stronger forms include sinsemilla hashish and hash oil. All forms of marijuana change how the brain works. It contains more than eighty (80) chemicals including THC (delta-9-tetrahydrocannabinol). Marijuana is the most commonly used illicit drug in the United States. Its use is widespread among young people. According to the national institute of drug abuse, www.drugabuse.gov, Cannabis remains the most commonly used and trafficked illicit drug in the world. Its use is largely concentrated among young people (15- to 45-year-olds). Men are more likely than women to report both early initiation and frequent use of cannabis. Due to the high prevalence of cannabis use, the impact of Cannabis on public health may be significant. A range of acute and chronic health problems associated with cannabis use has been identified. Cannabis can frequently have negative effects in its users, which may be amplified by certain demographic and/or psychosocial factors. Acute adverse effects include hyper emesis syndrome, impaired coordination and performance, anxiety, suicidal ideations/tendencies, and psychotic symptoms. Evidence indicates that frequent and prolonged use of cannabis can be detrimental to both mental and physical health. Chronic effects of cannabis use include mood disorders, exacerbation of psychotic disorders in vulnerable people, cannabis use disorders, withdrawal syndrome, neurocognitive impairments, cardiovascular and respiratory and other diseases.
HOW DO PEOPLE USE MARIJUANA?
People smoke marijuana in hand-rolled cigarettes (joints), in pipes or water pipes (bongs). They also smoke it in blunts-emptied cigars that have been partly or completely refilled with marijuana. To avoid inhaling smoke, some people are using vaporizers. These devices pull the active ingredients (including THC) from the marijuana and collect their vapor, not smoke. Some vaporizers use a liquid marijuana extract. People can mix marijuana with food (edibles) such as cookies, candy or brew it as a tea.
HOW DOES MARIJUANA AFFECT THE BRAIN?
Marijuana has both short and long-term effects on the brain.
When a person smokes marijuana, THC quickly passes from the lungs into the loodstream. The blood carries the chemical to the brain and other organs throughout the body. The body absorbs THC more slowly when the person eats or drinks it. In that case, they generally feel the effects after 30 minutes to 1 hour. THC acts on specific brain cell receptors that ordinarily react to natural THC-like chemicals. These natural chemicals play a role in normal brain development and function. Marijuana over activates parts of the brain that contain the highest number of these receptors. This causes the “high” that people feel. Other effects include:
• altered senses (for example, seeing brighter colors)
• Altered sense of time
• Changes in mood
• Impaired body movement
• Difficulty with thinking and problem-solving
• Impaired memory
• Hallucinations (when taken in high doses)
• Delusions (when taken in high doses)
• Psychosis (risk is highest with regular use of high potency marijuana)
Marijuana also affects brain development. When people begin using marijuana as teenagers, the drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions. Researchers are still studying how long marijuana’s effects last and whether some changes may be permanent. For example, a study from New Zealand conducted in part by researchers at Duke University showed that people who started smoking marijuana heavily in their teens and had an ongoing marijuana use disorder lost an average of 8 IQ points between ages 13 and 38. The lost mental abilities didn’t fully return in those who quit marijuana as adults. Those who started smoking marijuana as adults didn’t show notable IQ declines. In another recent study on twins, those who used marijuana showed a significant decline in general knowledge and in verbal ability (equivalent to 4 IQ points) between the preteen years and early adulthood.
The psychoactive effects of cannabis are subjective and vary among persons and method of use. No fatal overdose with cannabis use have been reported, (death by indirect means, such as dehydration from cannibanoid hyper emesis syndrome, have been reported), the principal psychoactive constituent of a cannabis plant has an extremely low toxicity and the amount that can enter the body through the consumption of cannabis plant poses no threat of death. Anxiety is the most commonly side effect of smoking marijuana. 20-30% of recreational users experience intense anxiety and/or panic attacks after smoking cannabis for a prolonged period of time. Cannabidol (CBD), another cannabinoid found in cannabis in varying amounts has been shown to ameliorate the adverse effects of THC, including anxiety that many consumers experience. Cannabis compounds contain thousands of organic and inorganic chemicals. Psychoactive drugs are typically categorized as stimulants, depressants or hallucinogens. Cannabis alone exhibits all these effects. THC is considered the primary active compound of the cannabis plant. Other cannibanoid like CBD may also play a significant role in psychoactive effects of cannabis.
CANNABIS, CANNABINOIDS, CANNABIS-USE DISORDERS
CANNABIS: A generic term used to denote the several psychoactive preparations of the cannabis plant. Cannabis is the preferred designation of the plant cannabis sativa, cannabis indica and, of minor significance, cannabis ruderalis (gloss, 2015). Cannabis resin means “separated resin”, whether crude or purified, obtained from the cannabis plant. In this report the term “cannabis” will be used instead of marijuana or other names indigenous to local cultures. The discussion of the health and social consequences of cannabis use is limited to the nonmedical use of the Cannabis plant.
CANNABINOIDS: Cannabinoids are a class of diverse chemical compounds that act on cannabinoid receptors in Cells that modulate neurotransmitter release in the brain. The composition, bioavailability, pharmacokinetics And pharmacodynamics of botanical cannabis differ from those of extracts of purified individual cannabinoids. Cannabinoids are basically derived from three sources:
(a) Phytocannabinoids are cannabinoid compounds Produced by plants cannabis sativa or cannabis indica.
(b) Endocannabinoids are neurotransmitters produced in the brain or in peripheral tissues, and act on cannabinoid receptors.
(c) Synthetic cannabinoids, synthesized in the laboratory, are structurally analogous to phytocannabinoids or endocannabinoids and act by similar
Cannabinoids are sometimes used therapeutically (e.g. for management of spasticity in multiple sclerosis or nausea in the process of cancer chemotherapy). Discussion of the health impact of the illicit use of synthetic cannabinoids is beyond the scope of this document.
Cannabis-use disorders refer to a spectrum of clinically relevant conditions and are defined via psychological, social and physiological criteria to document adverse consequences, loss of control over use, and withdrawal symptoms. Cannabis-use disorders are defined in the diagnostic and statistical manual of mental disorders (dsm-5; apa, 2013) and in the international statistical classification of diseases and related. Health problems (icd-10; who, 1992). Icd-10 distinguishes between harmful and dependent use of cannabis, while in dsm-5 cannabis-use disorders are classified by the severity of health impairments into mild, moderate and severe disorders. Both classifications also describe a specific cannabis withdrawal syndrome which can occur within 24 hours of consumption. For cannabis withdrawal syndrome to be diagnosed, the person must Report at least two mental symptoms (e.g. Irritability, restlessness, anxiety, depression, aggressiveness, loss Of appetite, sleep disturbances) and at least one physical symptom (e.g. Pain, shivering, sweating, elevated Body temperature, chills). These symptoms are most intense in the first week of abstinence but can persist
For as long as a month (hoch et al., 2015; budney & hughes, 2006).
Cannabis is globally the most commonly used psychoactive substance under international control. In 2013, an Estimated 181.8 million people aged 15−64 years used cannabis for nonmedical purposes globally (uncertainty Estimates 128.5–232.1 million) (unodc, 2015). There is a worrying increasing demand for treatment for Cannabis use disorders and associated health conditions in high- and middle-income countries, and there has been increased attention to the public health impacts of cannabis use and related disorders in international Policy dialogues. All this added up to the decision to publish this update report on the health and social affects of nonmedical use of cannabis especially the psychoactive effects and their consequences.
HEALTH EFFECTS OF CANNABIS
In some people, cannabis use increases the risk of developing mental illnesses like psychosis or schizophrenia, especially in those who: start using cannabis at a young age, use cannabis frequently (daily or almost every day), have a personal or family history of psychosis and/or schizophrenia. Frequent cannabis use has also been associated with an increased risk of: suicide, depression, anxiety disorders
PSYCOSOCIAL EFFECTS OF CANNABIS
•Recent cannabis use impairs the performance in cognitive domains of learning, memory, and attention. Recent use may be defined as cannabis use within 24 hours of evaluation.
•A limited number of studies suggest that there are impairments in cognitive domains of learning, memory, and attention in individuals who have stopped smoking cannabis.
•Cannabis use during adolescence is related to impairments in subsequent academic achievement and education, employment and income, social relationships and social roles.
The effects are grouped in the stages below:
School failure, Low commitment to school, Not college bound, Deviant peer group, Peer attitudes towards drugs, Associating with drug-using peers, Aggression towards peers, Interpersonal alienation and Peer rejection.
Attending college, Substance using peers
Genetic predisposition, prenatal alcohol exposure
Poor impulse control, Low harm avoidance, Sensation seeking, Lack of behavioral self-control regulation, Aggressiveness, Antisocial behavior, Anxiety, depression, hyperactivity and Early persistent Behavioral problems.
Behavioral disengagement, coping Negative emotionality, Conduct disorder, Favorable attitudes towards drugs, antisocial behavior, and Rebelliousness.
Lack of commitment to conventional Adult roles, antisocial behavior.
Childhood/adolescence (Child-Parent relationship)
Permissive parenting, Parent-child conflict, Low parental warmth, Parental hostility, Harsh discipline, Child abuse/maltreatment, Parental/sibling modeling of drug use, Parental favorable attitudes toward drugs, Inadequate supervision and monitoring, Low parental involvement, Low parental aspirations for child, Lack of or inconsistent discipline.
Leaving home, Laws and norms favorable towards drug use, Availability, Accessibility, Extreme poverty, Anti-social behavior in childhood
MENTAL HEALTH EFFECTS
In some people, cannabis use increases the risk of developing mental illnesses like psychosis or schizophrenia, especially in those who: start using cannabis at a young age, use cannabis frequently (daily or almost every day), have a personal or family history of psychosis and/or schizophrenia. Frequent cannabis use has also been associated with an increased risk of: suicide, depression and anxiety disorders.
HEALTH EFFECTS ON YOUTH
Cannabis use that begins early in adolescence, that is frequent and that continues over time has been associated with increased risk of harms. Some of those harms may not be fully reversible. Adolescence is a critical time for brain development, as research shows the brain is not fully developed until around age 25. Youth are especially vulnerable to the effects of cannabis on brain development and function. This is because THC in cannabis affects the same biological system in the brain that directs brain development. It is important for parents, teachers, coaches and other trusted adults to be ready to talk with youth about drugs. Problematic cannabis use can include some or all of the following behaviors: failing to fulfill major duties at work, school or home, giving up important social, occupational or recreational activities, consuming it often and in larger amounts or over a longer period than they intended, being unable to cut down on or control cannabis use. People who display most or all of these behaviors over a 12-month period may have cannabis addiction.
Cannabis users exhibit deficits in prospective memory and executive Functions, which persist beyond acute intoxication. Impaired short-term memory and attention, performance of complex mental processes, judgment, motor skills, and reaction time have been reported.
DRIVING UNDER THE INFLUENCE OF CANNABIS
Cannabis impairs individuals’ performance on the cognitive and motor tasks necessary for safe driving, which, according to studies of injured and fatally injured drivers, increases the risk of collision. Rates of driving under the influence of cannabis have surpassed Rates of drinking in young people. Acute cannabis use nearly doubles the risk of a collision resulting in serious injury or death. The influence of cannabis use on the risk of minor collisions remains
IS MARIJUANA ADDICTIVE?
Marijuana use can lead to the development of problem use, known as a Marijuana use disorder, which takes the form of addiction in severe Cases. Recent data suggest that 30 percent of those who use Marijuana may have some degree of marijuana use disorder. People who begin using marijuana before the age of 18 are four to seven Times more likely to develop a marijuana use disorder than adults. Marijuana use disorders are often associated with dependence in which a person feels withdrawal symptoms when not taking the drug. People who use marijuana frequently often report irritability, mood and Sleep difficulties, decreased appetite, cravings, restlessness, and/or Various forms of physical discomfort that peak within the first week After quitting and last up to 2 weeks. Marijuana dependence occurs when the brain adapts to large amounts of the drug by reducing Production of and sensitivity to its own endocannabinoid Neurotransmitters. Marijuana use disorder becomes addiction when the person cannot stop using the drug even though it interferes with many aspects of his or her life. Estimates of the number of people addicted to marijuana are controversial, in part because epidemiological studies of substance Used often use dependence as a proxy for addiction even though it is Possible to be dependent without being addicted. Those studies Suggest that 9 percent of people who use marijuana will become Dependent on it, rising to about 17 percent in those who start Using it in their teens.
HOW DOES MARIJUANA USE AFFECT SCHOOL, WORK, AND SOCIAL LIFE?
Research has shown that marijuana’s negative effects on attention, Memory, and learning can last for days or weeks after the acute effects of the drug wear off, depending on the person’s history with the Drug. Consequently, someone who smokes marijuana daily may be functioning at a reduced intellectual level most or all of the time. Considerable evidence suggests that students who smoke marijuana Have poorer educational outcomes than their nonsmoking peers. For Example, a review of 48 relevant studies found marijuana use to be associated with reduced educational attainment (i.e., reduced chances of graduating). A recent analysis using data from three large studies In Australia and New Zealand found that adolescents who used Marijuana regularly were significantly less likely than their non-using Peers to finish high school or obtain a degree. They also had a much higher chance of developing dependence, using other drugs, and attempting suicide. Several studies have also linked heavy marijuana Use to lower income, greater welfare dependence, unemployment, Criminal behavior, and lower life satisfaction. To what degree marijuana use is directly causal in these associations Remains an open question requiring further research. Studies have also suggested specific links between marijuana use and adverse consequences in the workplace, such as increased risk for Injury or accidents. One study among postal workers found that Employees who tested positive for marijuana on a pre-employment Urine drug test had 55 percent more industrial accidents, 85 percent More injuries and 75 percent greater absenteeism compared with those who tested negative for marijuana use.
IS THERE A LINK BETWEEN MARIJUANA USE AND PSYCHIATRIC DISORDERS?
Several studies have linked marijuana use to increased risk for Psychiatric disorders, including psychosis (schizophrenia), depression, Anxiety, and substance use disorders, but whether and to what extent It actually causes these conditions is not always easy to Determine. Research using longitudinal data from the national epidemiological Survey on alcohol and related conditions examined associations between marijuana use, mood and anxiety disorders, and substance
Use disorders. After adjusting for various confounding factors, no Association between marijuana use and mood and anxiety disorders Was found. The only significant associations were increased risk of Alcohol use disorders, nicotine dependence, marijuana use disorder, And other drug use disorders. Recent research (see “akt1 gene variations and psychosis”) has found that people who use marijuana and carry a specific variant of the akt1 gene, which codes for an enzyme that affects dopamine Signaling in the striatum, are at increased risk of developing psychosis. The striatum is an area of the brain that becomes activated and Flooded with dopamine when certain stimuli are present. One study found that the risk of psychosis among those with this variant was Seven times higher for those who used marijuana daily compared with those who used it infrequently or used none at all.
SUMMARY AND CONCLUSION
Use of nonmedical marijuana is not recommended due to the fact that it is one of the known plants today that have the highest number of known and unknown chemicals which can be detrimental to health in many ways. There’s a need for further research especially on the medical use of cannabis. Development of a comprehensive, in-depth review of existing evidence regarding the health effects (both harms and benefits) of cannabis and cannabinoids use is required. All relevant authorities and stakeholders need to make a short and long-term recommendation regarding a research agenda to identify the most critical research questions and advance the cannabis and cannabinoid research agenda.
Marijuana should be legalized for medical purposes in the states.
A rehabilitation program should be introduced to enroll all addicts.
Governmental and nongovernmental organizations should embark on sensitization and orientation programs to enlighten the people on the effects and health risks of cannabis.
2012 Arizona youth survey
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