It is known that one out of every three people in the US tries to use cannabis. Cannabis is generally smoked like a cigarette. It is an illegal substance that is easy to reach, relatively widespread and easily grows. In addition to being enjoyable, there are symptoms of cannabis use such as distress, anxiety, skepticism, unnecessary laughter, deterioration of the concept of time, social withdrawal, increased appetite, dry mouth, palpitations, and intoxication. Depending on the dose taken, body temperature decreases and the person calms down. They are often used in combination with alcohol, cocaine and other drugs. In further use, depersonalization and hallucinations may be experienced and it can lead to delusions of evil (“they follow me, they will kill me”). In high doses, delirium, cannabis psychosis may develop. These are severe psychiatric disorders.
Some sources claim that marijuana is not a drug, but its use should be released. It is argued that there are no signs of discontinuation as evidence of this claim. However, the above-mentioned severe psychiatric disorders caused by cannabis use are well known. In addition, it develops respiratory system diseases because it is drawn to the lungs such as cigarettes and breaks the body’s resistance against infections. Compared to other drugs, the greatest risk is that although addiction development is relatively mild, it is very likely that the cannabis user today will become heroin, opium users tomorrow. In this sense, cannabis is a jumping board for sharper drugs. The real risk here is this. In this respect, the allegations that cannabis is not a drug and that it should be freed may seem innocent at first glance.
Abusing Cannabis: More Info About the Herb
Cannabis (Marijuana) is a drug obtained by drying the flowers and leaves of Cannabis Sativa, a cannabis plant. The main factor in cannabis is the drug substance called THC, which causes a person to experience psychotic experiences. It is important to know the name of this substance because there has been a significant increase in this main substance in cannabis in recent years. Therefore, the harmful effect on young brains is also increased.
Cannabis or weed, with widespread use in folk language, is often used by wrapping it into cigarettes. It has a pungent smell of grass, not like a cigarette. It is also used in a method called bucket or bong where its steam is inhaled. Consumption of cannabis in cakes, sugar, lollipops or other foods is also common. Cannabis, whose use among young people has been increasing in recent years, has a lot of harm especially when it is used in youth years. Adolescence years are the years when the growth is the fastest, the person is researching to form himself, he wants to try different things while he is in this research, he takes risks and needs to discover. Research on the brain shows that the development of the human brain does not stop suddenly at the age of 18, it continues to develop.
As the technologies that enable brain research is developing, it is now known that the development of the front region of our brain, which performs tasks such as decision-making, reasoning, and organizing tasks continues until the mid-20s, and in the same period, the hormones get in order as well. It is known. So this discovery, curiosity, and desire to experiment can lead to risky behavior, such as cannabis use, that can cause permanent harm. At this age, the idea of ”nothing happens to me” is quite common. For this reason, it is very important that we talk to our young people frequently and tell them about the scientific findings of cannabis.
As I said before, the brain of young people continues to develop actively until the age of about 26 years. The marijuana used in this period harms the developing brain of the young person due to the direct effect of the additive on the brain:
- The results of brain MRI studies show that young people using cannabis have permanent damage to the brain structure.
- Difficulties in thinking and problem-solving.
- Memory functions such as remembering experiences serious distortions.
- Learning problems are observed, they complain that they can not learn as easily as before.
- Coordination deteriorates.
- They’re having trouble maintaining concentration.
- Some studies have found a decrease in IQ scores of young people who use cannabis for a long time.
The Psychology is Adversely Affected As Well
Cannabis use at a young age has a negative impact on a person’s physical health, psychology, social life, and school success. Here are the main negative effects:
- It can have psychological consequences such as panic attacks and confusion, and these psychological problems can be permanent after long use.
- With the effect of cannabis, the heart may beat more than normal. Therefore, people who use it frequently have a higher risk of heart and circulatory disorders, rhythm disorders, heart attacks.
- Cannabis using men have more risks in having testicular cancer, decreased sperm count, and erection problems than others.
- Young people using cannabis have lower grades, failing classes or being expelled from school.
- It causes various psychological problems such as depression or anxiety disorder. Research shows that there is a relationship between cannabis used in youth and depression in later years.
- Increases the risk of developing similar disorders in young people with psychosis and schizophrenia.
- Young people who spend a lot of time at home and indoors, begin to experience difficulties in physical health.
- When general life satisfaction is investigated, they often give more negative feedback.
- Academic and business success is low compared to peers who do not smoke, and this affects their psychology negatively.
- It causes accidents because it negatively affects skills such as coordination, the concentration required in driving.
- Research says that 1 in 6 young people using cannabis are addictive. In other words, the idea that “cannabis doesn’t cause addiction” is not true and young people who develop addiction cannot quit even if they try to quit. Due to cannabis use, they cannot fulfill their duties and cannot participate in activities with family and friends.
- It is known to be a stepping stone to more dangerous drugs that can produce deadly consequences such as cocaine and heroin.
- It can lead to alcohol use or other risky behaviors as it weakens decision-making mechanisms.
Cannabis is the most common drug in the world today. Apart from tobacco, cannabis is the substance most commonly used by smoking. Cannabis sativa is known as Marijuana (herbal cannabis) in the world and consists of dried leaves and flowers of Cannabis sativa plant. 50% of Americans have been using marijuana at least once in their lives. The rate of cannabis use among young people is reported to reach 7% in the 13-year-old group and 40% in the 17-year-old group throughout Australia.
Although the 2003 figures in the world show that this ratio is around 4% for young people in high school and equivalent schools, this figure is estimated to increase. People who start to use cannabis initially use it to get the feeling of euphoria (joy, vitality, happiness) given by the substance. It can be said that approximately 4% of the users have met the addiction criteria in the first two years. The fact that the average income level is low, the use of different substances before cannabis and the use of cannabis in the early stages of adolescence constitute important risk factors for addiction. Showing older than age, smoking, loose contact with parents at home, absenteeism, low self-esteem, neglect or disdain for school success also put the person at risk for cannabis addiction.
Not every person who smokes cannabis will develop an addiction to the substance; in fact, the addiction rate is quite low when compared to other illegal drugs, but there is no disputing the fact that some people do depend on this drug to the point where it is having a negative impact on their life. Cannabis addiction is a very real illness and one that many are struggling with every single day (https://www.recovery.org.uk/cannabis-addiction/).
Mechanism of Action
Cannabis can also be taken by mouth sucking and chewing, but the most common use is inhalation. The main psychoactive substance is delta 9 tetrahydrocannabinol (THC). In addition to the main psychoactive component delta 9 tetrahydrocannabinol, 400 more chemicals have been reported in cannabis smoke. The effects of the central nervous system are directly related to the rate at which the substance reaches the brain, and smoking is one of the fastest ways to achieve this, while cannabis can reach the brain a few seconds after it is drawn into the lungs.
It has been claimed that Cannabis affects the brain reward and stress systems, such as opiate (heroin), cocaine and nicotine, and cannabis increases dopamine in the mesolimbic region like nicotine and cocaine. THC accumulates in the brain and adipose tissue, the fat dissolution property gives THC (cannabis) a sort of storage property, therefore, the rate of excretion from the body is low, and withdrawal symptoms are psychological rather than physiological, but dependence is a deep and severe dependence. Sometimes the cannabis removal period can be as long as 3 weeks and a month.
Following cannabis use, psychological and physiological changes begin to occur within a half-hour. The first is a feeling of euphoria and relief. Motor coordination (balance) gradually deteriorates, a perception of deceleration occurs in time. The onset of effects varies from several minutes to half an hour and may last for 3-4 hours, depending on the amount of substance taken, the route of administration (eg, effects on oral administration are delayed), the individual’s individual tolerance and the rate of absorption of the substance. Acute cannabis intoxication (cannabis poisoning) sometimes requires urgent intervention in the presence of at least two symptoms of flushing, increased appetite, dry mouth and tachycardia within two hours of use. Cannabis can trigger panic attacks, paranoia, anxiety, and even schizophrenia.
In some Western European countries, cannabis tolerance is often perceived among young people as evidence that this substance is less harmful and less addictive. However, the reality is not so, because the tolerance and substance dependence can be controlled more easily. Some recent scientific studies in the Netherlands have shown that cannabis use is responsible for almost 50% of the cases of schizophrenia in the world. Due to this evidence, cannabis will likely become an increasingly controlled substance. It has also been observed that school and learning difficulties due to memory and concentration deterioration increase with the length of use. Depression and suicide attempts are eight times more common in cannabis addicts than in non-cannabis addicts.
There is no specific treatment for acute poisoning, and it is symptomatic. Benzodiazepines may be useful to reduce intense anxiety. If paranoia and psychotic symptoms do not relieve after benzodiazepine use, it may be necessary to use antipsychotics for a certain period of time.
A combination of psychotherapy to increase motivation including behavioral and cognitive approaches, and some antidepressants, divalproex sodium, and THC antagonist (effect blocker) rimonabant hydrochloride are promising for permanent maintenance after intoxication. Treatment should be continued with a combination of psychotherapy and medication for at least 6-8 months, and changes in the school, environment, and lifestyle are of great help to a permanent recovery.
Cannabis and Derivatives: The Use Disorder
Cannabis is a drug of both ancient and modern age. Cannabis is derived from the tip leaves and seeds of cannabis (cannabis Indica). Approximately 1-meter length of cannabis herb is planted in May and harvested in October. There are two different genera of this plant divided into male and female. The main active ingredient of the Cannabis plant is Delta-9 Tetrahydrocannabinol, but it also contains close to 60 cannabinoid compounds and is not evenly distributed throughout the plant, ie, the density of the leaves, resin, and the flower is different.
By the way, let’s talk about two terms that are often confused and often used interchangeably: hashish and poppy. Hashish is a name given to cannabis obtained from the flowers of cannabis and containing a high amount of Delta-9 Tetrahydrocannabinol in Europe and the USA. Poppy is a plant from which drugs such as morphine, base morphine, and codeine are obtained. When smoked, Delta-9 Tetrahydrocannabinol mixes into the blood within a few minutes, and when taken orally it may take 1-2 hours.
Effects of Cannabis Abuse
Dry mouth, hunger, flushing of the eyes, increased blood pressure and palpitations due to the amount taken are common effects of the cannabis use. The decrease in testosterone level and sperm count in chronic use, infertility in women and low birth weight of the newborn babies can be experienced as well. Cannabis, which has psychological effects such as relaxation, increased self-confidence, pleasure, and general well-being, is also known to affect time and color perception. It causes a slowdown in attention and reactions. In contrast, some people may experience anxiety, distress, intense fear, and panic attacks.
For years, it has been known that tolerance to the effects of cannabis does not develop, because people who use cannabis for a long time have stated that even after the first cigarette they get high. However, recent studies have shown that this is not the case, tolerance is improved and both biological and psychological dependence can develop. As a matter of fact, it was observed in a study that there were withdrawal symptoms such as restlessness, insomnia, decreased appetite, weight loss and intolerance in individuals who used high amounts of cannabis for several weeks.
Emotion-thought disorders related to cannabis use are a condition that psychiatrists frequently see in recent years. Especially in people who use a large amount of cannabis for a long time, hallucinations, emotional tides, blurred consciousness, and the like develops suddenly and sometimes lasts for a few hours, sometimes a few days. Sometimes it can also cause completely schizophrenia-like conditions. There are many hypotheses that try to explain this, the most important of which suggests that patients have an underlying genetic predisposition. Some studies show that cannabis use directly affects the brain and causes schizophrenia-like conditions. It has been reported that the risk of developing schizophrenia in cannabis users is almost 2 times higher than others. The effect of cannabis on the brain is not limited to this. There is also a reduction and destruction of brain volume called atrophy in the brain due to cannabis use.
Cannabis Abuse Treatment
The common misconception that cannabis addiction is less important than other addictions is common among the public. But, like other substances, cannabis causes a person to experience social, behavioral and psychological problems. Cannabis use leads to greater problems, especially in the presence of another comorbid psychiatric disorder. Cannabis use can trigger the development of psychosis in predisposed individuals and may cause the first episode of schizophrenic patients to occur at an early age. It is also a fact that individuals using cannabis frequently abuse or addict other substances.
There is no specific treatment to reduce the withdrawal symptoms of cannabis as a drug treatment. Drugs such as bupropion, Divalproex, naltrexone, and nefazodone have been tested, but no positive response has been obtained. Therefore, the treatment of cannabis withdrawal is symptomatic. Psychotherapeutic approaches are predominantly used in the treatment of cannabis use disorder. Of these, short motivational approaches, skill gaining therapies and relapse prevention therapies are the most commonly used methods.
Harms of Cannabis Abuse
- Amotivational Syndrome
When a young person starts to abuse cannabis and its derivatives, he starts to experience some problems in his lifestyle, thinking, relationships with other people and motivational features. These problems are apathy, loss of functionality in daily routine tasks, inability to plan long term. It is characterized by symptoms such as not being able to concentrate on a long-term job, disruption of speaking and writing skills. These cancers occurring in cannabis abusers are called amotivational syndrome.
- Orientation to Other Substances
The use of cannabis products often leads to heavy use. It has been found that the majority of heroin users use cannabis derivatives before using this substance. In addition, it has been reported that marijuana users often use other addictive substances and drugs together. However, in cannabis addicts and other addicts, it is not possible to establish a clear cause-effect relationship between multiple substance use and the fact that one substance causes another substance use. That is, soda cannot be caused by alcohol intake in a person who drinks alcohol in soda or other harmless beverages, but it cannot be said that the use of cannabis causes a person to start using cocaine or amphetamine after some time. However, it can be thought that the amotivational syndrome and personality changes that occur in those who constantly abuse marijuana-like cannabis products increase the tendency to use other substances and prepare the ground by creating a personality structure suitable for using them.
- Effects on Immunity
It is well known that continuous cannabis abuse weakens the body’s immune system. Although it has been suggested that THC use prevents rejection reactions after organ transplants, this is a very speculative view and THC is not used for this purpose. There is evidence that marijuana users are more prone to infections than non-marijuana users.
- Effects on Respiration
Marijuana has both positive and negative effects on respiration. THC has some positive effects on asthma treatment with its bronchodilator feature. However, long-term cannabis smoking adversely affects oxygen transport in the lungs, causing asthma-like symptoms. Long-term use of marijuana also causes a decrease in macrophage activity in the lungs. Inadequate macrophages make the lungs vulnerable to infections and increase the risk of lung infection.
- Cancer and Cannabis Use
There is a serious relationship between tobacco use and cancer. The same relationship is expected to be found in consumers who smoke cannabis products. Because cannabis products contain 50-70% more carcinogenic substances than tobacco. However, we do not have sufficient studies and scientific data to investigate the relationship between cannabis use and cancer. Although we do not have sufficient research results on this subject, we can foresee that the cancer risk will increase in long-term inhalation users using cannabis products similar to tobacco.
- Cannabis Intoxication
THC has a wider safety dose range compared to other psychoactive substances. Cannabis intoxication is rarely fatal. In fatal cases, there is usually another substance besides cannabis. The lethal dose of marijuana in humans is unknown. If cannabis products are taken in high doses at one time and THC reaches excessive blood concentrations, symptoms such as excessive comfort, thirst, hypersensitivity to touch sensation, excessive metaphysical and anger thought, loss of time-space perception, excessive dry mouth (feeling like mouth cotton), very vivid and moving vision, laughing crises and complete loss of short-term memory can be experienced. In the meantime, blood pressure follows a different course; falls when the person stands up from the lying position. If tachycardia and blood pressure are not controlled, it can lead to serious cardiovascular problems such as arrhythmia and heart attack in risky individuals. The severity of symptoms varies according to the dose taken and the individual’s ability to metabolize. Although cannabis intoxication is rarely lethal, intervention should be performed in well-equipped health centers and by experienced medical personnel.