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Sunday, December 17, 2017

Marijuana

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Overview

Marijuana is undoubtedly the most popular and well-recognized illicit substance in use today. Marijuana use is extremely common in the U.S and abroad and with all age groups, with over 11 million Americans between the ages of 18 to 25 using marijuana in 2015 alone.1 While marijuana is more benign than most illegal drugs, marijuana still carries both negative physical and mental side effects. Marijuana’s primary danger comes from its damage to neurological functioning over prolonged use, as it has been found to impair neurological development in adolescents by reducing white matter in the brain, as well as impairing memory and IQ over prolonged use. Marijuana also maintains some danger due to its damage to the lungs, its effect as a gateway drug, and how easy it is to build a tolerance to it. Despite marijuana’s status as a schedule I drug, marijuana has been shown to have a positive effect when used as a pain relief drug for many medical conditions including cancer, arthritis, epilepsy, glaucoma, multiple sclerosis, Alzheimer’s, and many others. Marijuana exhibits relatively mild short-term effects including euphoria, increased appetite, slowed movement, confusion, and dry mouth. Long term abuse of marijuana can lead to a variety of physiological and mental ailments including depression, anxiety, lung damage, memory problems, and insomnia. There are currently no effective pharmaceutical treatments for marijuana abuse, but there are many therapeutic options available to help manage dangerous and addictive behaviors, and rehabilitation facilities offer extensive resources for recovering from drug abuse in a safe, stable, and comfortable manner. What is Marijuana? Marijuana is the most commonly used illicit substance in the world. Marijuana holds a reputation for its mild pleasurable effects, relatively low danger, and commonality across nearly all age groups. Marijuana, a type of cannabis plant, has been cultivated for its pleasurable effects from as far back as 2700 BC, originating in China and the Indian subcontinent before spreading through Africa and Europe throughout the antiquity. Although death from marijuana alone has never been recorded due to the inability to overdose on marijuana, as well as it’s comparatively mild effect on the body, marijuana is still responsible for a number of deaths from causes such as inebriated driving and lung cancer, and with marijuana increasing in legality, emergency rooms are beginning to discover new illnesses linked with marijuana use that have not previously been researched. Marijuana is the second most common substance found ingested in victims of fatal automobile accidents behind alcohol, and in places where marijuana is illegal, such as Colorado, there are many debates about making driving while high on marijuana as illegal as drunk driving. The real danger of marijuana comes from its use as a gateway drug. While many now dismiss this claim as outdated rhetoric, statistics still strongly support the notion that marijuana usage leads to a higher risk of abusing other more dangerous drugs. Statistics show that 62% of adults who used marijuana under the age of fifteen went on to try cocaine, a highly dangerous and addictive drug in itself. Marijuana is classified as a Schedule I drug by the Controlled Substances Act (CSA), meaning that marijuana has no accepted medical usage and is not considered safe for use either in clinical or personal settings due to its high potential for abuse. Despite marijuana’s CSA scheduling, marijuana has been shown to have a positive effect when used as a pain relief drug for many medical conditions including epilepsy, cancer, epilepsy, glaucoma, arthritis, multiple sclerosis, and Alzheimer’s. How Does Marijuana Work? Marijuana’s effect on the brain can primarily be attributed to its ability to increase the production and release of dopamine. When marijuana is ingested, the chemical tetrahydrocannabinol (THC), along with other chemicals called cannabinoids, enter into the brain. Once in the brain, THC mimics the brain’s natural cannabinoid called anadamide, which works to block inhibitory neurotransmitters from entering the cell and prevents dopamine from being released, which results in dopamine being allowed to freely enter the cell and bind with dopamine receptors. Dopamine is a neurotransmitter that is colloquially known as the ‘happiness drug’ due to its purpose in producing feelings of well-being and pleasure when released into the brain. When the body is hurt, the brain produces natural opiates that allow dopamine to be released in the areas of the brain commonly responsible for feelings of pain and stress, which works to reduce overall feelings of pain. This is the reason why marijuana results in feelings of wellbeing and a generally pleasant mood, as it allows dopamine to work freely and in abundance. Marijuana functions in areas of the brain that work with the formation and organization of short term memories and body function, which explains why a marijuana high is often accompanied by poor short term memory, confusion, and slowed movements.

Short and Long Term Effects

Marijuana is most commonly smoked, and can be smoked in a variety of different forms with different instruments, including pipes, bongs, hookahs, and cigarettes, and can be smoked either in a dried or oil form. Marijuana is also frequently used in edible baked goods such as cookies and brownies, which produces a slower but much more potent high. General onset of smoked marijuana is around 10 minutes, while edibles may take up to two hours to take effect. Users report short-term mental effects such as feelings of:
  • Euphoria
  • Increased laughter
  • Stress and anxiety reduction
  • Confusion
  • Increased creativity
  • Short term memory impairment
  • Lethargy
And physical effects such as:
  • Increased appetite
  • Coughing
  • Dry mouth
  • Joint and muscle stiffness  Decreased pain sensation
  • Blood-shot eyes
  • Headache
  • Loss of coordination
Repeated long-term use of marijuana leads to physical side effects such as:
  • Lung damage – The smoke produced by smoking marijuana is toxic to the lungs, and with frequent usage can develop into irreversible damage. This damage can develop into chronic conditions such as bronchitis, as well as deadly diseases such as lung cancer
  • Damaged reproductive system – Frequent use of marijuana has been speculated to be a significant contributor to the severe drop in fertility in both men and women that has been on the rise. In studies conducted on animals, THC has been shown to decrease testosterone productive in males, and impairs sperm’s motility, leading to a gradual increase in infertility.
Long-term use of marijuana also carries several mental side effects including:
  • Permanent neurological damage – While it is common knowledge that marijuana impairs neurological functioning short-term, many underestimate the irreversible damage that can be done to the brain with frequent marijuana use. THC has been shown to permanently damage memory retention and learning capabilities, particularly in younger users, and has been shown to even lower IQ scores by up to eight points in some studies.
  • Depression – Due to overstimulation of dopamine receptors, marijuana frequently leads to depression due to the brain’s inability to utilize dopamine effectively.
  • Anxiety – Anxiety is a frequent symptom of drug abuse in general, and is common in marijuana abuse due to internal factors from the psychological and physical effect of the drug itself, as well as external factors such as pressure family, friends, and work that may all be affected by addiction. This can compound and develop into chronic paranoia. Other risks posed by marijuana abuse include:
  • Brain development – Marijuana has been shown to impair essential brain development in younger users across multiple studies, showing a change in the presence and distribution of essential white matter in the brain of chronic adolescent marijuana users.
This degradation of white matter can be linked to attention and memory problems, as well as impulse control
  • Cannabinoid Hyperemesis Syndrome – Cannabinoid Hyperemesis Syndrome (CHS) is an illness that has only recently emerged, and is little understood by medical professionals and scientists alike. Symptoms of CHS include severe nausea, vomiting, abdominal pain, and various gastrointestinal issues. Although the exact cause of CHS is undetermined, its link to marijuana use is certain.
  • Pregnancy – Cannabis use while pregnant has been shown to have a wide variety of risks in the child’s development. Both physical and neurological development can be damaged or slowed through the chronic use of marijuana while pregnant, which can stunt the child’s development later in life.
Although not life-threatening, marijuana withdrawal can be a difficult process to go through after heavy usage, and includes withdrawal symptoms such as:
  • Insomnia
  • Fatigue
  • Restlessness
  • Depression
  • Appetite loss
  • Loss of concentration
  • Joint stiffness
  • Memory problems

Methods of Treatment

Pharmacological: Because chemical dependency on marijuana is relatively infrequent, there are no pharmaceutical treatments currently available for marijuana abuse. Despite this, there is still active research in the field to find viable medications that can be used for marijuana dependency and withdrawal. Many of these medications focus primarily on sleep disorders due to marijuana withdrawal’s connection to insomnia disorders, and many traditional sleep medications such as Ambien are being tested for use in marijuana dependency treatment. Therapeutic: Other forms of treatment for marijuana addiction come in the form of psychological and behavioral therapies. These treatments focus on the behaviors and habits that led to addiction in the first place in an attempt to remove the root of addiction. Amongst these forms of treatment, Cognitive Behavioral Therapy (CBT) is one of the most common, and is growing in support from the scientific and clinical communities all the time. Cognitive Behavioral Therapy sees substance abuse such as marijuana addiction as a symptom of a greater psychological issue, and not a cause in and of itself. By utilizing reflective and analytic techniques, an addict is better able to understand what led them to addiction in the first place, change bad habits, and avoid behaviors that may trigger cravings. The twelve-step program is also available as a long-established method of treating drug and alcohol addiction. The twelve-step program works as a gradual method of guiding principles and pragmatic steps that can be taken to go from the depths of addiction and unhealthy habits to sobriety. These twelve steps are aimed at effectively recovering from compulsive and addictive behaviors, and addressing mental and behavioral problems that led to addiction in the first place. These twelve steps include both internal and external actions aimed at making amends for past mistakes, accepting responsibility for the actions that led to addiction, and moving forward to establish healthy habits and a positive mindset.

Rehabilitation

Rehabilitation for marijuana alone is generally uncommon, but may be beneficial for those who abuse marijuana frequently and have difficulty stopping dangerous behaviors that lead to its usage. There are two main types of rehabilitation: inpatient and outpatient. Inpatient rehabilitation refers to programs that require patients to check themselves into a facility where they will undergo all rehabilitation treatment. Although inpatient rehabilitation requires a greater level of commitment, the facilities, environment, and support offered by these facilities are conducive to a stable and effective recovery. Inpatient facilities generally offer services such as psychiatrists, counselors, group therapy, and all of the living facilities necessary for a comfortable stay. The extensive support offered by these facilities, combined with an environment that is focused on self-improvement and wellness is a great combination for providing the motivation to push through the difficulties of withdrawal and to establish good healthy habits to prevent relapsing once you leave. This form of rehabilitation is effective for those who would benefit from a stricter more scheduled recovery in which the outside distractions and temptations of life won’t get in the way of focusing on recovery. Outpatient rehabilitation is based on the principle of spending only part of your time in recovery programs while offering you the freedom to continue daily living on your own. Generally these programs will require ten to twelve hours of commitment per week spent in a treatment facility participating in similar activities to those done in an inpatient facility such as group therapy, counseling, and even detox. While this does offer easier access to drugs, some may find being able to maintain their normal daily schedule more beneficial. This form of rehabilitation is effective for those who require more freedom and contact with friends and family. Both forms of rehabilitation may be effective solutions at combatting marijuana abuse, and there is a variety of different types of both inpatient and outpatient rehabilitation to suit the personal needs of each individual.  

References

  1. Abuse, National Institute on Drug. “Marijuana.” NIDA, NIH, Feb. 2017, www.drugabuse.gov/publications/drugfacts/marijuana.
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