Cannabis has been around for centuries and the plant has been used to make rope, thread, clothes and even smoked for its psychoactive properties and medicinal purposes. The drug has been widely used in America for more than 40 years.
It is estimated that close to 5 million Americans regularly use marijuana. In the last 2 decades, surveys reveal that use of marijuana among the younger population of school and college students has widely increased. Recent data indicates the average age when marijuana is used is 18 years. The majority of individuals who use marijuana are also frequent users of alcohol and other illicit drugs.
Marijuana is obtained from the dried leaves and flowers of the hemp plant. The potency of marijuana depends on the method of preparation. Ganja and hashish are both three-five times more potent than marijuana. Although marijuana is usually smoked, it can also be eaten or mixed in beverages like tea, coffee and in very rare cases, it is also injected. Analysis of marijuana has revealed that the content of delta-9-tetrahydrocannabinol (THC) is currently much higher than in the past 2 decades. THC is the primary psychoactive component of marijuana. The intoxicating effects of marijuana usually last 2-3 hours.
The majority of marijuana available in the US is smuggled in from Mexico and is a low potency, commercial grade product. The high potent marijuana is usually home grown or smuggled in from Canada. Recent seizures indicate that the content of THC has increased in the home grown product. The states which continue to cultivate large amounts of marijuana are California, Kentucky, Tennessee, Hawaii, and Washington. Law enforcement data indicate that arrests for marijuana possession are up across the nation. The Bureau of Justice Survey indicates that about 12% of prisoners in the nation are serving time for a first marijuana related offense.
Why Do People Abuse Marijuana?
Marijuana is used for several reasons including inquisitiveness, peer pressure or for fun. The majority of users claim that the drug often causes euphoria, a sense of relaxation, sexual arousal and easier socialization with other colleagues. The easy access, cheap price and minimum legal penalties has led to an increased usage of this drug in the past 2 decades.
Marijuana addiction use has been associated with numerous physical and behavioral adverse effects. The majority of users report some type of side effect. There have been numerous reports of motor vehicle accident and work related accidents which have been associated with marijuana use usually related to mental clouding and sluggishness.
The safety of marijuana during pregnancy is not in question. Continued use during pregnancy has been known to cause a small size fetus with low birth weight. Also reported is that the children of mothers who have used marijuana during pregnancy have a higher rate of a type of blood cancer
Some patients with pre-existing medical conditions who use marijuana may be at risk for developing respiratory tract infections, bronchitis, emphysema and COPD. Marijuana smoke does not contain nicotine but does have a significantly higher tar content than cigarettes and this has been associated with a higher incidence of lung cancers in these patients.
The most common side effects of marijuana are cognitive deficits. Short term use has been associated with memory defects, mental clouding and confusion.
Tolerance and Dependence
Marijuana use can lead to abuse, tolerance and dependence. After long term use, withdrawal symptoms can develop if the marijuana usage is stopped suddenly Generally the withdrawal symptoms are mild and may include nausea, tremor, sweating, weight loss, insomnia, agitation and irritability.
Does Marijuana Have Any Medical Value?
Advocates of marijuana for medical use always claim that marijuana has some medical properties in the treatment of glaucoma, nausea, vomiting and tremor. However, today there are excellent and much safer drugs used to treat these medical conditions and there is no justification for the use of marijuana. However, some states do allow legal use of marijuana for improving appetite in AIDs patient and decreasing the nausea and vomiting associated with cancer chemotherapy.
Possible Medical uses for Marijuana
- Anti emetic
- Increase appetite
- Decrease tremors
- Decrease seizures
- Decrease glaucoma
- Decrease stress
Although marijuana abuse in the younger populations is of a major concern, one needs to be aware that there are other patient groups that also abuse marijuana. Numerous individuals with certain psychiatric disorders such as stress, anxiety, post traumatic disorder and bipolar disorder have also been known to abuse marijuana. These concerns have led to many institutions obtaining direct disclosure of marijuana-related problems, usage, and a positive urine drug screen prior to undertaking any therapy.
Marijuana is a Schedule I substance under the Controlled Substances Act. Schedule I drugs are classified as having a high potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use of the drug or other substance under medical supervision.
Marijuana Dependence Treatment
Prior to any intervention, most drug treatment programs include education, monitoring of drug use, strengthening of social support, treatment of possible comorbid psychiatric disorders and referral to a pain specialist.
Withdrawal and acute panic reactions and flashbacks during marijuana intoxication are usually managed with supportive therapy. In severe cases, low-dose benzodiazepines are used. Generally the withdrawal symptoms from marijuana are mild and do not required any drug therapy.
Patients with marijuana abuse or dependence are referred to a comprehensive substance abuse treatment program. Such programs are designed to avoid relapse and include comprehensive substance abuse and psychiatric evaluations, laboratory testing, group therapy, education, social services, individual counseling, promotion of 12-step programs (such as Alcoholics Anonymous and Narcotics Anonymous) and treatment of any co-morbid psychiatric illness.
Often, these programs involve individual reflection about how problems with substance abuse develop the direct and indirect costs of substance abuse, biopsychosocial triggers for substance use, relapse prevention strategies, ways to enhance coping skills and spiritual issues.
- Losken A, Maviglia S, Friedman LS. Marijuana. In: Friedman LS, et al., eds. Source book of substance abuse and addiction. Baltimore, Md.: Williams & Wilkins, 1996:179-87.
- Cohen G, Fleming NF, Glatter KA, Haghigi DB, Halberstadt J, McHugh KB, et al. Epidemiology of substance use. In: Friedman LS, et al., eds. Source book of substance abuse and addiction. Baltimore, Md.: Williams & Wilkins, 1996:23-46.
- Schuckit MA. Cannabinols. In: Drug and alcohol abuse: a clinical guide to diagnosis and treatment. 3d ed. New York: Plenum Medical, 1989:143-57.