Chapter 14: Cannabis Flashcards
What plant is cannabis taken from?
- Cannabis sativa
Where is it presumed to have originated ?
- Central Asia
The plant Cannabis sativa has been used for many purposes for thousands of years. Give four examples!
- Fiber —-> hemp
- seeds —-> staple grain
- intoxicating effects
- medical effects
When did the West recognize the medicinal effects of Cannabis?
- late 1800’s when it became used for many ailments
In the late 1800’s what were some medicinal uses for Cannabis ?(9)
(8 physical and 3 mental)
- anticonvulsant
- appetite stimulant
- tetanus
- neuralgia
- dysmenorrhea
- asthma
- gonorrhoea
- migraines
- addiction to opium, alcohol and chloral hydrate (claims)
What did J.J. Moreau de tours use Cannabis to treat?
- melancholia
- hypomania
When and who caused people to notice the intoxicating effects of Cannabis?
- Theophile Gautier - Le Club des Hachichins (book) on Hashish
What was hemp widely grown in American colonies for ?
- making rope
L> Hashish = hemp boiled in butter
Who introduced smoking Cannabis to the US in the early 20th century ? Who mostly used it?They introduced what term?
- Mexican Labourers
- racial minorities and musicians
- marijuana
Anti- marijuana legislation became widespread in the 1920’s because of what?Why was it unchallenged?
- association with smoking it and racial minorities / musicians
- shaped perception of white legislators to motivate opponents. Attracting police and public attention universally condemning it .
- went unchallenged due to lack of scientific info ..
In 190 the American Medical Association declared what about Cannabis?
- it had no medical use but a high potential for abuse..
- Resulting in the Controlled Substances Act ignoring previous century of medical evidence.
In 1937 what act was passed in the US? What about Canada?
- Marijuana Tax Act- making it illegal to possess it.. chargeable
- Narcotic Control Act
Have attempts to decriminalize it been successful? US? Canada? UK?
- only sometimes
US: - Oregon- up to 1 ounce - over that is finable
- California, North Carolina, Colorado, Mississippi, New York, Nebraska, Ohio, Alaska and Massachusetts.
- Canada and UK - failed attempts
What are the four active ingredients in Cannabinoids ?
- Delta-9-tetrahydrocannabinol (THC)
- cannabinol
- cannabidiol
- about 82 other terpenopheniolics
What exactly are cannabinoids?
- class of chemical compounds completely exclusive to cannabis and contribute directly or indirectly to the behavioural effects of the plant.
Cannabinoids belong to what chemical class?
- terpenophenolics
What cannabinoid is the most psychoactive?
- delta-9-THC
What effects does the Cannabidiol (CBD) cannabinoid produce?
- anxiolytic, and or antipsychotic properties
What cannabinoids were believed to be completely devoid of active properties?
- CBN - Cannabinol
- CBD- cannabidiol
Why is it difficult to estimate the effects of any cannabinoid?
- depends on preparation, route of administration and metabolism!
L> new cannabinoids are created during burning, digestion and metabolism
Can the contents of marijuana change?
- YES
- changes over time especially if left exposed to air and light ….THC can eventually turn into CBN ( cannabinol)
What are the extracted and synthetic cannabinoids?
- Sativex (Bayer)– extract
- Nabilone and Dronabinol– synthetic
Explain the extracted cannabinoid Sativex (Bayer)
- contents?
- treatment use?
- administration?
- contains THC (company calls it : tetranabinex) and cannabidiol (company calls it: nabidiolex) (CBD)
- used to treat symptoms associated with MS and cancer pain
- oral spray
Explain the Synthetic Cannabinoids Nabilone and Dronabinol!
- used to treat anorexia and weight loss in patients with AIDs
- alleviate nausea and distress in patients getting chemotherapy for cancer
Why might synthetic cannabinoids be more useful than natural extracts?
- they are more stable and effective or have greater selective effects
The synthetic cannabinoid Levonantradol, explain it!
- compared to THC
- use?
- 30 times more potent than THC
- solely used in research atm
Explain the synthetic cannabinoid WIN 55212-2
- it is a receptor ___.
- use?
- receptor agonist
- used in research
Explain the synthetic cannabinoid Rimonabant (Acomplia)
- antagonist to?meaning?
- developed originally as what? But was retracted in Europe
- antagonist to cannabinoids blocking the main cannabinoid receptors in CNS
- developed as an anti-obesity drug
What are synthetic cannabinoids used for recreational drug use called?Example? (2) As of March how many are illegal in the US?
- Designer Drugs
- sold as incense called spice and K2
- 5 are illegal
In terms of cannabis preparation explain Marijuana!
-administration as well?
- Mexican name
- dried leaves and flowers of the plant
- smoked via cigarette, cigar, pipe or sometimes baked into cookies and brownies
In terms of cannabis preparation explain Bhang !
- dried leaves of uncultivated cannabis plants or female plants from which the resin has been removed.
- not very potent
In terms of cannabis preparation explain Ganja ?
- made up from the tops of females that the resin was not removed
- 3 to 4 times more potent than bhang
In terms of cannabis preparation explain Hashish?
- what part of plant?
- pre harvested description, post?
- use?
- dried resin from the top of the female plant
- pale yellow sap - when harvested turns black when dried
- smoked alone
- or in a mixture of tobacco …or baked into cookies
In terms of cannabis preparation explain Hash oil?
- process?
- contents?
- usage?
- hashish is boiled in a solvent (alcohol), filter the residue, than allow the alcohol to evaporate…since cannabinoids are highly soluble in alcohol they will be left after the alcohol dissipates.
- pure form of hash
- contains 60% THC …easier to smuggle than hashish
- placed on the paper of a normal tobacco cig, hot tinfoil and inhaling smoke
Has the concentration of THC in marijuana increased since the 1960’s?
- yes dramatically
- 1960 (1.5%) - 2008 ( >10%)
What could the increase in THC in marijuana since the 1960’s be due to ?
- improved cultivation methods
- increased frequency of sinsemilla and high potency marijuana found in police seizures
- sinsemilla is a crossbred and hydroponically grown…..THC= >30%
Absorption :
Oral?
- not very effective
- THC is a weak acid (10.6) not ionizing in ph of body fluids.
In terms of lipid solubility how do cannabinoids stand?Issues with oral consumption?
- extremely high lipid solubility
- must be taken with an oil…
ex: Marinol - pill
In terms of speed of absorption in the digestive system how do cannabinoids stand?
- very slow absorption
- considerable first pass metabolism
- dose must be doubled or tripled to get an effect similar to inhalation
What is the peak effect after oral administration?
- 1 to 3 hours following ingestion and may last 5 hours or longer
Side effects mostly likely to occur after oral administration?
- nausea or vomiting
Solution to slow effects of oral administration?
- inhalers
- sprays
Smoking Cannabis?
- blood levels peak?
- effects peak?
- duration of inhalation vs depth
- 15 mins
- effects within 30-60 mins
- duration is not as important as depth of inhalation in determining THC absorption
What is a joint?
- cannabis rolled into paper …smoked
What is a bong?
- cools the smoke and prevents loss of the drug through side stream smoke
What does vaporization of cannabis avoid?
- inhalation of tars and carcinogens
How does one vaporize cannabis?
- heat the plant to a point where active compounds reach their boiling point and can be inhaled as a vapour
- these cannabinoids vaporize at a lower temp than tars or carcinogens! (avoidance of them)
What beneficial use does going the vaporization method produce?
- increases pulmonary function without reduction in drug use
- avoids many respiratory disadvantages experienced from older methods of smoking associated with the burning of organic materials
What is delta-9-THC converted to during metabolism in the liver?
- 11-hydroxy-delta-9-THC which is actually believed to be more active and penetrates
Describe metabolism of cannabis in general…like where it occurs?
- lungs (if inhaled )
- intestine ( if taken orally)
- Liver - most metabolism occurs here
What is Phase 1 excretion?
- rapid fall in blood levels due to redistribution in fat therefore rate of metabolism is determined by the rate THC is released from body fat
Explain Phase 2 Excretion!
- slow due to release from fat
L> THC leaves fat very slowly - trace amounts can be present 30 days after use
What is it thought about CBD in relation to its effect on the metabolism of THC in the liver?
- direct effect
- blocks enzyme that metabolizes TCH, slowing it down and prolonging the duration of action
What effect does CBN have on metabolism of THC?
-speeds up metabolism
When CBN and CBD interact with THC what can they do?
- alter distribution of THC by displacing it from binding sites in the blood increasing the amount of THC available to go to the brain.
Describe the two cannabinoid receptors where are the found!
- CB1 : found in many regions (mostly CNS)
2. CB2: mainly but not exclusively outside of the CNS, in the immune system and spleen
What is Anandamide?
- first endocannabinoid identified (naturally occurring cannabinoids )
Cannabinoid receptors and ligands seem to function as what?
- neuromodulators of many other NT systems than as NTs themselves
Retrograde transmission?
- the postsynaptic cell releases an endocannbinoid that blocks further NT release from the presynaptic cell (inhibitory effect)
- act on CB1 opening ion channels…stoping action
In the nucleus accumbens the cannabinoid receptors do what?
- potentiate the effects of opiate receptor ligands which in turn affects DA transmission.
- THC increases DA via potentiation of endogenous opiates which are neruomodulators of DA..
- responsible for the reinforcing effects of cannabis
Effects on the body: - Cause \_\_\_\_ eyes. - Cause \_\_ mouth and compulsion to\_\_\_ - They increase \_\_\_ - They increase \_\_\_\_ -They cause \_\_\_\_\_\_\_ relaxation -They have various psychoactive effects such as: L>alterations of \_\_\_ L> causing \_\_\_\_. L> feelings of \_\_\_\_. L>increased appreciation of \_\_\_\_.
- bloodshot
- dry mouth and compulsion to drink
- appetite
- heart rate
- muscle relaxation
- alterations of perception
- euphoria
- feelings of well being
- appreciation of humour
Effects on sleep:
- Causes ____ and ____ in sleeping time
- At higher doses it can cause what?
- drowsiness and increased sleeping time
- restlessness and insomnia
Medically useful effects?? (5)
- treatment of glaucoma
- as an antiemetic
- treatment of muscular spasticity (Parkinson’s)
- anaglesia
- appetite stimulation
What mood changes can it have?
- mostly positive, but not always ( anxiety and foreboding)
- the mood of others is an important variable
- euphoria - placid dreams
Changes in Perception?
2
- perceived increase in sensitivity of sensory systems, but objective research does not report this
- Time distortion..via decrease in cerebral blood flow since the cerebellum is associated with timing systems. (time feels like it is moving slower)
Memory Changes?
Temporal Disintegration
L> disrupts what?
- loss of the ability to retain and coordinate information for a purpose
- disrupts working memory and impairs long term storage.
Creativity?
L> level
L> art?
- users report that it improves appreciation of art
- enhance creativity but there is little objective evidence of this
Performance
- hand eye coordination impairment
- accuracy but not speed is affected in complex and choice reaction time tests
- affect psychomotor and memory
- amount of THC consumed is directly related to the level of impairment
Driving effects? (3)
- impairment is present
- little effect on the ability to control a car, but impaired attention to stimuli in peripheral vision
- alcohol consumption greatly increases impairment by THC
Performance screening tests?(3)
- blood tests are not accurate since it remains in the system for long periods of time
-breathalyzer type tests do not exist yet - Standardized Field Sobriety Test
L> tests of gaze nystagmus (involuntary eye movements), walk and turn test, one legged stand.( this is adapted for the alcohol test)
Dissociation:
- Asymmetrical
- Symmetrical
- info acquired during the drug state was remembered after smoking but not remembered while sober.
- difficulty transferring acquired information given in one state to another…but it could be overcome by cues reminding them.
There is ____ tolerance to several affects of THC in animals but not tolerance to ______ or the _____ effects.
- rapid
- anorexic
- discriminative stimulus effects
In humans, tolerance to the _____ have been shown in laboratory.
- subjective effects
Though claimed by users _____ has never been demonstrated in the laboratory with animals or humans.
- sensitization
Withdrawal can occur after prolonged use of ___ doses. It is ___ severe the symptoms include what three things ?
- high doses
- not
- appetite change
- restlessness
- cravings for cannibas
Titration of the dose means what?
- there is a desired high the user wants but once reached they stop.
In a self administration experiment with humans (casual users and heavy users) what are the changes in use over the time of the exp?
- amount consumed over time was generally what?
- are cyclic patterns or abstinence periods present?
- casual: started at two increased to three a day (joints)
- heavy: started at four a day and increased to 7
- amount consumed was fairly stable, no cyclic patterns or periods of abstinence
In NA cannabis is primarily a ___ drug
- social
What is the ranking of long term drug use ?
- Cannabis, binge drinking, cocaine and ecstasy
- Binge Drinking > cannabis> cocaine= ecstasy
In terms of violence and aggression how does cannabis effect this?
- little effect or decrease!
Mental disturbances?
at high doses
causation of mental illness?
- can cause paranoia, panic attacks and hallucinations
- doubtful
Permanent Intellectual impairment and brain damage?
- Irreversible damage evidence?
- Cognitive deficits?
- no evidence
2. heavy users show short term cog deficits but this disappears after drug use stops
Amotivational Syndrome?
- does it exist?
- causation?
- correlation?
- yes it does but it is not clear that THC is the cause
- THC dose disrupt attention and memory, these are important in academic and workplace environments
- there is a correlation between cannabis and reduced educational achievement
Progression to other drugs?
- relevant?
- not really
- marijuana users are more likely to come into contact with harder drugs and their sources
Reproduction effects?
- males
- females
- lowers testosterone levels, unclear if there is a bio sig..maybe aggression, increases sexual desire but impairs performance
- increases desire, pleasure, satisfaction and orgasm quality
Immunity effects?
- suppresses immune function, but this has not been related to an increase in any diseases
Cancer relation?
- contains many more carcinogens than tobacco, but this has not been related to a specific type of cancer or increase
