Cannabis Related Disorders Flashcards

1
Q

where are CB1 receptors found

A

primarily in brain and spinal cord but not around respiratory centers of CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where are CB2 receptors found

A

mostly in immune system, mast cells, macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

can THC cross the BBB or placenta

A

can cross both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why does THC have such a long half life (up to several days to a week)

A

highly lipophilic, can accumulate in fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is considered a “heavy” cannabis user

A

more than 3 joints per week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how long might it take a heavy cannabis user to clear THC from fatty tissues including the brain

A

can take months, up to a year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

do more men or women have cannabis use disorder

A

2:1 men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what age group has the highest incidence of cannabis use disorder

A

18-29–> 4.4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the heritability of cannabis use disorder

A

30-80%

*common genetic basis for teen substance use + conduct problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

list psychological + environmental RFs for cannabis use disorder

A

hx conduct disorder or ASPD

externalizing and internalizing disorders during childhood/adolescence

youth with high behavioural disinhibition scores

adverse childhood

tobacco smoking

cannabis use among family

family hx SUD

ease of availability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when does cannabis withdrawal start

A

1-3 days after cessation of cannabis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when does cannabis withdrawal peak

A

within first week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how long does cannabis withdrawal last

A

1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how long might sleep difficulty due to cannabis withdrawal last

A

can last up to a month or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when is cannabis use disorder most common

A

teens/young adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

early onset (before age 14) of cannabis use disorder is a ROBUST predictor of what other disorders

A

development of CUD, SUD, AUD as young adult

likely related to externalizing problems

17
Q

list physiological signs of cannabis intoxication

A

conjunctival injection

dry mouth

tachycardia–> can do 20-50bpm above baseline!!, this is amplified with alcohol use

increased appetite

sometimes orthostatic hypotension due to lower PVR

18
Q

list subjective/psychological signs of cannabis intoxication

A

high feeling, then euphoria, inappropriate laughter, grandiosity

sedation, lethargy, impaired judgment

difficulty with complex mental processes, impaired motor performance

distorted sensory perceptions

sense of time passing slowly

can also get dysphoria, anxiety, social withdrawal

19
Q

are cannabis withdrawal symptoms usually severe enough to require clinical attention

20
Q

list symptoms of cannabis withdrarwal

A

initially decreased appetite, insomnia

fatigue, yawning, difficulty concentrating

can then have rebound hypersomnia, increased appetite

21
Q

what is the prevalence of cannabis hyperemesis syndrome

22
Q

list the major features of cannabis hyperemesis syndrome

A

severe cyclical N/V

resolution with cannabis cessation

relief of symptoms with HOT SHOWERS or baths

abdo pain

daily use of cannabis

23
Q

how do you manage cannabis hyperemesis syndrome

A

complete abstinence from cannabis combined with supportive management

standard antiemetics to resolve N/V are NOT EFFECTIVE

limited evidence indicates some relief from LORAZEPAM and HALDOL as well as TOPICAL CAPSAICIN cream

24
Q

what syndrome can accompany cannabis use disorder

A

amotivation syndrome–> can mimic PDD

25
those with a mental health disorder are how much more likely to have a cannabis use disorder than the general population
2-3x more likely
26
is cannabis a gateway drug?
it seems so--> cocaine, opioids higher rates of AUD, TUD, likely other SUDs
27
in those seeking treatment for cannabis use disorder what % have another SUD
74% --most common is alcohol, then cocaine, meth, opioids
28
what is the most commonly comorbid personality disorder with cannabis use disorder
ASPD (then OCPD, paranoid)
29
what is the most commonly comorbid psych disorder with cannabis use disorder
any anxiety disorder (24%) MDD (11%) bipolar (13%) **60% have an externalizing disorder like ADHD, conduct**
30
are there any meds approved for treatment of cannabis use disorder
no
31
what meds may be helpful in treating cannabis use disorder
gabapentin--> possibly helpful, esp with withdrawal NAC naltrexone (equivocal results) replacement theory is not great
32
list the 3 most helpful primary psychosocial interventions for cannabis use disorder
CBT motivation enhancement therapy contingency management