Chapter 11: Marijuana Study Notes

Marijuana: Dried leaves, flowers, and stems of the cannabis plant.
Hashish: Derived from the dried resin of cannabis flowers, it can be up to 3 times more potent than marijuana.
Hemp: An agricultural product of cannabis used for producing textiles.

1914: Introduction of the Harrison Act to regulate drugs in the US.
1937: The Marihuana Tax Act was enacted, imposing tax on marijuana and leading to heavy legislative penalties.
1970: Marijuana classified as a Schedule I drug, indicating high potential for abuse and no currently accepted medical use.
1988: Discovery of cannabinoid receptors (CBD1 and CBD2) furthered understanding of cannabis.

1500 BC: Cannabis was introduced as a psychoactive substance during the Spanish Conquest.
1798: William O'Shaughnessy’s introduction of cannabis to Western medicine for medical use, including treatment for various ailments.
2000-2018: Increasing research and recognition of the medical efficacy of cannabis.
2737 BC: The Chinese emperor Shen Nung used cannabis for treating ailments like gout and poor memory.
Significant historical texts:
- Ebers Papyrus (1550 BC): Contains references to cannabis used in ancient Egypt.
- Ayurvedic Medicine: Describes the use of cannabis as a source of joy and spiritual relief.

Hemp constituted a cash crop in early America.
Initially, marijuana was rarely used recreationally until the prohibition era, which increased its social stigma.
The 1937 Marijuana Tax Act catalyzed a landscape of legislative penalties against marijuana use.
Post-1970: A movement began leading towards the legalization of marijuana in various states.
Terms relevant to marijuana culture: Apothecaries (pharmacists) and tea pads (communal smoking spaces).

Ranked as the 3rd most used psychoactive drug globally, following alcohol and tobacco.
Most cultivated, trafficked, and abused illicit substance worldwide.
In 2013, approximately 5% of individuals aged 15-64 globally reported marijuana use, with usage on the rise in the United States.

Oral: Ingestion through food or drink containing marijuana.
Inhalation: Several methods include:
- Joint: A rolled cannabis cigarette.
- Blunt: A cigar shell filled with marijuana instead of tobacco.
- Dab: A method of heating and inhaling vapor from concentrated hash oil.
- Vaporization (Vape): Inhaling oil that contains active cannabis ingredients.

Cannabinoids: Over 60 unique chemicals found in cannabis. Two main active compounds include:
- Δ9-THC: Primarily responsible for the psychoactive effects of cannabis.
- Cannabidiol (CBD): Non-psychoactive component that can modify the overall effects of cannabis and is also used to treat various medical conditions (pain, anxiety, depression).
Varietal differences in cannabis can alter potency and effects.
Recent trends: The potency of street-seized marijuana in the US has notably increased.

Absorption:
- Inhalation is the most efficient method, with effects beginning within minutes, peaking at 30-60 minutes, and lasting 2-4 hours.
- Holding the smoke in the lungs increases absorption.
- Oral ingestion can take up to 1 hour for onset, peaking at 2-3 hours, and lasting 4-6 hours, requiring a higher dose to achieve similar effects compared to inhalation.
Distribution: THC is highly fat-soluble, leading to widespread distribution throughout the body.
Metabolism: Primarily occurs in the liver but also in the brain, kidneys, and lungs.
Excretion: THC metabolites can be detected in urine and feces, with slow excretion rates; THC can stay in the body for up to 7 days with metabolites detectable for up to 30 days.

Cannabinoid Receptors:
- CB1: Found in brain regions responsible for motor function, memory, cognition, and mood.
- CB2: Located in the immune system.
Discovery of these receptors led to the understanding of an endogenous cannabinoid system identified in the late 1990s.
Anandamide: An endogenous cannabinoid neurotransmitter involved in functions like immune response and fetal development, associated with the feeling of a "runner's high."

Tolerance development is not well-defined but is more likely with chronic, high-dose use.
Dependence: Characterized by consistent withdrawal symptoms alleviated by the return to use. Evidence shows:
- Symptoms may include sleep disturbances, nausea, irritability, and restlessness.

Long-standing history of medical use dating back to ancient civilizations.
Introduced to the US in the 1800s, heavily utilized in patent medicines until the 1930s due to prohibition.
Current medical applications include:
- Chronic pain relief
- Decrease in chemotherapy-associated nausea
- Alleviation of muscle spasms (MS)
- Sleep aid and appetite stimulant
- Treatment for Tourette’s syndrome, anxiety, and PTSD.
Research on medical cannabis is limited due to its classification as a Schedule I substance.

Cardiovascular:
- Engorgement of conjunctiva (red eyes)
- Vasodilation and increased heart rate
- Decreased motor activity

Respiratory System:
- Increased risk of bronchitis; inconclusive evidence on long-term lung impairment due to confounding variables like concurrent cigarette smoking.
Cardiovascular System:
- Elevated heart rate can pose risks for individuals with pre-existing heart conditions.
Immune System:
- Generally no significant risks, though cannabis may diminish immune function in some users.

Potential reduction in fertility:
- In men: Decreased sperm count and motility.
- In women: Disruption of ovulation cycles.
Risks associated with pregnancy include premature birth, lower birth weight, attention deficits in children, and potential for increased later-life substance use.

Inducing relaxation, reduced motor activity, and altered speech patterns (e.g., increased loquacity).
Decreased responsiveness to external stimuli.

Impairment of short-term memory with slowed time perception. Chronic effects on cognition are less studied.

Induction of a relaxed, carefree state; some negative effects include:
- Occasional anxiety, paranoia, or dysphoria.

Reports suggest enhanced social skills due to reduced anxiety; however, links to enhanced violence are disputed and not tied to reality.
Amotivational Syndrome: Suggests that chronic marijuana use may lead to diminished accomplishment toward conventional goals, potentially characterized by apathy, decreased ambition, and difficulty concentrating. However, scientific evidence disputes the existence of this syndrome.