Cannabis 3 Flashcards
Where do cannabinoids come from?
flowers of female Cannabis plants
What is the genetic difference between Cannabis sativa, indica, and hemp?
no genetic difference between them
-it is all Cannabis sativa
What is the effect of terpenes on the PD of cannabinoids?
probably do not affect the PD of cannabinoids
-impacts the smell
What are the side effects of acute cannabis intoxication?
clinically significant psychological changes:
-impaired motor coordination
-euphoria
-anxiety
-a sensation of slowed time
-impaired judgement
-social withdrawal
> 2:
-conjunctival injection
-increased appetite
-dry mouth
-tachycardia
perceptual disturbances:
-auditory
-visual
-tactile illusions in the absence of delirium
What is cannabis withdrawal?
cessation of cannabis use that has been heavy and prolonged (i.e. daily or almost daily > 3 months), > 3 symptoms develop ~ 1 week after cessation
What are the symptoms of cannabis withdrawal?
irritability, anger or aggression
nervousness or anxiety
sleep difficulty (most common)
decreased appetite or weight loss
restlessness
depressed mood
> 1 physical symptoms: abdominal pain, shakiness/tremors, sweating, fever, chills, or a headache
Does cannabis withdrawal occur in all heavy cannabis users?
only occurs in a subset of patients (6-12%)
When do the symptoms of cannabis withdrawal occur?
usually within 24 hours
peak by day 3
can last for up to 2 weeks
What can help to predict the severity of cannabis withdrawal?
increased use and more recent use
What do the symptoms of cannabis withdrawal represent?
the bodys developed need for a drug to maintain homeostasis
What is often seen with people who have cannabis use disorder?
susceptibility to other psychiatric disorders
What is the DSM-5 diagnostic criteria for cannabis use disorder?
- cannabis taken in large amounts or longer than intended
- persistent desire or unsuccessful efforts to cut down use
- great deal of time spent obtaining, using, and recovering
- craving or urge to use cannabis
- recurrent cannabis use results in failure to fulfill obligations
- continued use despite social or interpersonal problems
- important activities given up due to cannabis use
- using cannabis in situations that are physically hazardous
- continued use despite knowledge of a problem
- tolerance
- withdrawal
Differentiate early remission and sustained remission.
early remission:
-after full criteria for CUD was previously met, none of the criteria for CUD has been met for 3-12 months (except craving)
sustained remission:
-after full criteria for CUD was previously met, none of the criteria for CUD has been met for > 12 months (except craving)
What are the different severities of CUD?
mild: 2-3
moderate: 4-5
severe: > 6
Which substance use disorder overshadows all others?
alcohol
What is the MOA of synthetic cannabinoids?
full agonists of CB1R
What are the side effects of synthetic cannabinoids?
hypertension
tachycardia
myocardial infarction
psychoses
seizures
intoxication & death due to CNS depression and hypothermia
What were the four recommendations from the National Academics of Science regarding cannabis?
- address research gaps in clinical and observational research, health policy and economics, public health and safety
- improve research quality through creation of workshops and mechanisms for research quality standards
- improve surveillance capacity to better understand the short and long term consequences of cannabis
- address research barriers and change regulatory systems to enhance research
What is the aim of the recommendations provided by the Canadian Association for Mental Health regarding cannabis?
aimed at reducing risk, not enforcing abstinence
What are the 10 recommendations to use cannabis more safely?
- only way to avoid risks is not using cannabis
- start using cannabis later in life
- use lower strengths, lower THC to CBD ratio
- dont use synthetic cannabis products
- smoking is the most harmful way of using cannabis
- if smoking avoid inhaling deeply or holding breath
7.try limit use as much as possible - dont engage in activities while using
- people with family hx of psychosis or SUD and pregnant women should not use at all
- avoid combining any of the above
What does the current evidence suggest regarding cannabis and schizophrenia?
best evidence suggests that higher use increases risk of schizophrenia if there is a family history of schizophrenia
What is cannabis use during pregnancy associated with?
reduced body weight and foot length
reduced sociability and cognitive performance (mice)
Why does cannabis legalization varies in the USA between states?
determined by the states
Describe the legal history of cannabis in Canada.
1923: 1st banned
-regulated by HC under the Controlled Drugs and Substances Act
1972: Le Drain Commission –> cannabis should be decriminalized
2001: medical cannabis made available in “Marijuana Medical Access Regulations” (MMAR)
-single, government-sponsored commercial growth operation
2012: “Medical Marijuana Access Program” revised the MMAR to create the “Marijuana for Medical Purposes Regulations” (MMPR)
-allowed licensed applications for personal and commercial growth
2016: transition to the “Access to Cannabis for Medical Purposes Regulations” (ACMPR)
-greater freedom for personal cultivation to transition into full legalization July 2017
2017: government announced that by summer 2018 cannabis will be completely legal
What are some regulations for cannabis use in Saskatchewan?
no use in public or vehicles
may be gifted but not sold
may be transported only if sealed in original packaging, in the trunk if possible
19 yrs +
4 plants/house
Do cannabis-based medicines have a DIN or NPN?
no
-except stuff that is not plant based
What is CPhA’s stance on cannabis?
strong emphasis on education
