History, Treatment, Effect, and medical uses of Marijuana

Marijuana is the dried leaves and flowers of the Cannabis sativa or Cannabis indica plant. Stronger forms of the drug include high potency strains - known as sinsemilla (sin-seh-me-yah), hashish (hash for short), and extracts including hash oil, shatter, wax, and budder.  Marijuana is also known as: Boom, Bud, Chronic, Gangster, Ganja, Grass, Herb, Kif, Mary Jane, MJ, Pot, Reefer, Skunk, and Weed. Of the more than 500 chemicals in marijuana, delta-9-tetrahydrocannabinol, known as THC, is responsible for many of the drug’s psychotropic (mind-altering) effects. It’s this chemical that distorts how the mind perceives the world.

While the number of people who use marijuana at any one time does not seem to have recently increased, the number of people who have a marijuana-related disorder has risen significantly. This is more or less true depending on age and ethnic group.

How can marijuana be used?

Some people smoke marijuana in hand-rolled cigarettes called joints. Many use glass pipes, water pipes called bongs, or marijuana cigars called blunts (often made by slicing open cigars and replacing some or all of the tobacco with marijuana). To avoid inhaling smoke, some people are using vaporizers. These devices pull the active ingredients (including THC) from the marijuana into the vapor. A person then inhales the vapor, not the smoke. Some vaporizers use a marijuana liquid extract. Marijuana can also be brewed as tea or cooked into food, sometimes called edibles—such as brownies, cookies, or candy.

These concentrated extracts made from the marijuana plant should not be confused with “synthetic marijuana,” sometimes called “K2,” “Spice,” or “herbal incense.” These synthetic drugs are man-made chemicals similar to THC but often much stronger and very dangerous. Unlike marijuana, their use sometimes directly results in overdose deaths. Learn more about "synthetic marijuana”.

SHORT-TERM EFFECTS

• Short-term memory problems
• Severe anxiety, including fear that one is being watched or followed (paranoia)
• Very strange behavior, seeing, hearing or smelling things that aren’t there, not being able to tell imagination from reality (psychosis)
• Panic
• Hallucinations
• Loss of sense of personal identity
• Lowered reaction time
• Increased heart rate (risk of heart attack)
• Increased risk of stroke
• Problems with coordination (impairing safe driving or playing sports)
• Sexual problems (for males)
• Up to seven times more likely to contract sexually transmitted infections than non-users (for females)

LONG-TERM EFFECTS

• Decline in IQ (up to 8 points if prolonged use started in adolescent age)
• Poor school performance and higher chance of dropping out
• Impaired thinking and ability to learn and perform complex tasks
• Lower life satisfaction
• Addiction (about 9% of adults and 17% of people who started smoking as teens)
• Potential development of opiate abuse
• Relationship problems, intimate partner violence
• Antisocial behavior including stealing money or lying
• Financial difficulties
• Increased welfare dependence
• Greater chances of being unemployed or not getting good jobs

What is medical marijuana? How is medical marijuana prescribed?

Medical marijuana, also called marinol (Dronabinol), is a synthetic form of marijuana. It comes in 2.5 mg, 5 mg, and 10 mg capsules and is used for the treatment of poor appetite and food intake (anorexia) with weight loss in people with acquired immune deficiency syndrome (AIDS) and for the nausea and vomiting due to cancer chemotherapy in individuals who have not responded adequately to usual treatments for those symptoms. When used for appetite stimulation, marinol is usually dosed at 2.5 mg once or twice per day before lunch, dinner, and/or bedtime. When it is being prescribed to quell nausea, it is usually prescribed at 5 mg, one to three hours before a chemotherapy treatment and every two to four hours after chemotherapy, up to six doses per day.

The most common physical side effects of marinol include asthenia (lack of energy), stomach upset, nausea, vomiting, racing heart rate, facial flushing, and dizziness.

The most common psychological side effects of marinol include anxiety, sleepiness, confusion, hallucinations, and paranoia.

This medication should, therefore, be used with caution in persons who have a mental health diagnosis, particularly depression, mood swings, schizophrenia, or substance abuse. When prescribed for those people, the individual is usually under the care of a psychiatrist.

History and Types of Marijuana

The history of marijuana goes back for thousands of years. It was only made illegal in many countries during the 20th century. In the past 20 years in the United States, the legalization pros and cons of medical marijuana have been intensely debated as it has become legal to use it in 20 states and the District of Columbia. In those jurisdictions, people for whom medical marijuana has been specifically recommended by a physician must carry a (medical) marijuana card that indicates their use of the substance for a clear medical purpose. Individuals who do not carry such a card risk prosecution for marijuana possession. Different states that allow for legal use of marijuana have different guidelines for the legality of possessing and using medical marijuana. For example, at least one bans home cultivation, and there are regulations concerning the operations of dispensaries in some states.

Treatments for Marijuana Abuse and Addiction

Most individuals with marijuana abuse or dependence are treated on an outpatient basis. Admission to outpatient and inpatient treatment programs for marijuana addiction has increased over the years to the point that the addiction to this substance is nearly as high as dependence on other illegal drugs, like cocaine or heroin.

Behavioral treatments, like motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), and contingency management (CM), as well as family-based treatments have been found to be effective treatments for marijuana abuse and addiction.

MET is designed to lessen the resistance a person who abuses marijuana may have to abstain from using it. This intervention is also designed to motivate the individual to change.

CBT teaches people who abuse marijuana skills to help them stop using the drug and to ways to avoid or manage other problems that might prevent them from marijuana use recovery.

CM usually provides marijuana users with vouchers of increasing value as a reward for repeatedly testing negative for (the absence of) drugs over time. Those vouchers are then exchanged for positive items or services that promote the person's participation in more positive (pro-social) activities, like securing employment or advancing their education or health.

In addition to the individual therapies just described, adolescents who abuse or are addicted to marijuana are often treated using one or more family therapies. These include multidimensional therapy, multisystemic therapy, family support network intervention, and brief strategic family therapy. Each of these interventions uses techniques that are designed to enhance the skills of the addicted individual and his or her family members as a way of discouraging marijuana use.

Although there is no medication that has yet been shown to be a clearly effective treatment of marijuana-use disorders, research shows that antidepressant medications like nefazodone (Serzone) and fluoxetine (Prozac) may help some individuals manage marijuana withdrawal and to avoid relapse, respectively. Oral THC (Dronabinol) may also help alleviate symptoms of marijuana withdrawal. Successful psychotherapeutic approaches to the treatment of marijuana abuse or addiction include motivational approaches to coping skills development.

Federal laws continue to deem marijuana possession, as well as its distribution, as illegal, whether it is used for medicinal purposes or not. While the prosecution rates of individuals who carry small amounts of the substance along with a medical marijuana card tend to be low, dispensaries in states that have legalized medical marijuana remain criminalized and are therefore often raided by law-enforcement agencies.

Attempts to completely legalize the use of marijuana, whether for medicinal purposes or not, remain strongly contested in most jurisdictions. For example, in 2010, Proposition 19, a measure that would have completely legalized possession and growing marijuana then taxed and regulated its use was defeated in the state of California. However, California already reduced legal sanctions for possessing small amounts of marijuana to the level comparable to the penalty for speeding on a freeway.

There are a variety of marijuana types, also called strains. Strains tend to be based on leaf color as indicated in pictures, as well as the strains' potency and medical purpose. Medical strains of marijuana are specifically grown for a particular health benefit, like pain management or reduction of nausea. Some states place restrictions on the strains of marijuana that may be legally used and sold. Marijuana dispensaries often sell hydroponic marijuana seeds through mail order, which can be grown in nutrient solution, with or without soil.