1. Kerry Herndon, MSW, LAC-E Western Montana Addiction Services Project SUCCESS- Sentinel HS

2. THIS PRESENTATION IS ABOUT MARIJUANA AND YOUR HEALTH. Regardless of the politics and debate about legalization these are the facts about how marijuana impacts your health.

3.  Age 25: Fully Developed  Age 30: Fully Mature  Younger any chemicals are introduced, the greater the risk to brain development  Neurotransmitters  The chemical (message) being sent  Neuron  Specialized cell which sends or receives messages to other parts of our nervous system.

4. PotJoint GrassDope BushDraw Dry HighDubby GangsterGiggleweed JiveKiff Loco WeedMexican Green ResinRoach SmokeSpliff Thai SticksSkunk BammyBlanket Bo-BoBomber CrippleDinkie Dow HashCannabis AfganBlack Rock BhangWeed BroccoliBudda Grass GageGanja HempHerb JaneMary Jane Panama RedPuff ReeferSativa TeaTexas Tea ChronicCheeba BluntAshes DingGiggle Smoke

5.  Smoked  Ingested  Vaporized

6.  10-20x more potent than in 1970’s  50-70% more carcinogens than cigarettes  Type or carcinogens vary  Marijuana has over 4,000 unidentified chemicals, including more than 50 linked to cancer. (Moir et al., 2008)  Inhaled deeply and held for longer periods in the lungs, increasing tar in lungs.

7.  It is a “gateway drug” (dopamine).  Adolescents who use marijuana are more likely to use cocaine and/or heroin as adults. (SAMHSA, 2002)  Although typically not lethal, mixed with other substances (especially alcohol) it can have serious consequences.  Although it is rare, you can overdose. Some symptoms are:  acute anxiety or panic  increased heart rate  low blood pressure  psychosis or paranoia.

8.  About 9% of people become addicted  “The odds of marijuana dependence in adulthood are 6 times higher for those who started using pot before age 15 than for those who began after age 18.” (HBO Box Office, Inc, 2007)  Increases to 25 to 50% among daily users.  “While alcohol is the leading cause of emergency room admissions for adults, for adolescents, it is marijuana.” (HBO Box Office, Inc, 2007)  “Complaints include delusions, hallucinations, automobile accidents and more serious psychological and physical reactions when marijuana is combined with other addictive substances. (HBO Box Office, Inc, 2007)

9.  Bloodshot eyes  Dry mouth and throat  Decreased social inhibitions  Motivation and cognition  Learning difficulties  Difficulty speaking, listening effectively  Intense anxiety or panic attacks  Paranoia  Drops blood pressure  “Whoa, Dude, I gotta sit down”.

10.  Impacts nerve cells, hippocampus, cerebellum, basal ganglia, and cerebral cortex.  Can cause:  Hallucinations  Delusions  Impaired memory  Disorientation  Parts of Brain that Effect:  Pleasure  Memory  Thought  Concentration  Sensory and time perception  Coordinated movement

11.  Nucleus of Solitary Tract – Sensations like nausea and vomiting  Basal Ganglia – Movement Control  Cerebellum – Body Movement & Coordination  Hippocampus – Memory, Learning, Stress Control  Cerebral Cortex – Thinking, Problem Solving  Nucleus Accumbens – Reward Center  Hypothalamus – Body Functions  Amygdala – Emotional Response, Fears  Spinal Cord – Sensations  Brain Stem – Sleep, Arousal, Motor Control

12.  Heart rate (increase up to 50%)  Blood pressure drops  Heart attack 4x more likely within an hour of smoking marijuana compared to not smoking

13.  Burning and stinging of the throat  Heavy coughing/Similar to tobacco smokers  Frequent chest illnesses & lung infections  Cancer of the lung (20x greater w/ marijuana compared to tobacco per study in 2012)  Type of lung cancer maybe different that cigarette smokers due to cannabinoid carcinogens vs. tobacco carcinogens. Cannabis may kill or slow the growth of some cancer cells, but it can also been shown in other studies to increase risk or cause cancer cell growth of a different type.  Correlation to:  bullous lung disease (abnormal airspaces in lungs caused by damage to lung walls)  pneumothorax (“collapsed lung”) (http://adai.uw.edu/marijuana/factsheets/respiratoryeffects.htm)

14.  Tar similar to that of tobacco, but levels increase w/ marijuana due to inhaling it and holding it in lungs longer. “…there is a prolonged and deeper inhalation and it is smoked to a shorter butt length and at a higher combustion temperature. This results in approximately 5 times the carbon monoxide concentration, 3 times the tar, and the retention of one-third more tar in the respiratory tract. Higher levels of ammonia and hydrogen cyanide have also been found in marijuana smoke, compared to tobacco” (Moir, et al., 2008; Wu et al., 1988; Tashkin et al., 1991; Benson & Bentley, 1995).

15.  Smoking devices that use water filters (bongs, e.g.) have been shown to involve equivalent amounts of tar and do not reduce risks of marijuana smoke inhalation (Gieringer, 1996; Bloor et al, 2008).  Vaporizers, which heat marijuana below combustion point, have been theorized to be a safer method of administration, producing lower levels of tar than cigarettes (Grotenhermen, 2001) and fewer respiratory symptoms reported by users (Earleywine & Smucker Barnwell, 2007). However, these devices have also been shown to release ammonia which, when inhaled, can cause irritation and central nervous system effects, as well as asthma and bronchial spasms (Bloor et al, 2008). More research on the potential use of vaporizers as a harm reduction technique is needed. http://adai.uw.edu/marijuana/factsheets/respiratoryeffects.htm

16.  Eating marijuana ("edibles") is perhaps a more obvious means to reduce the respiratory effects when using the drug. Oral administration carries its own challenges, however, as it typically takes longer for the effects of the drug to appear (30–60 minutes compared to seconds), making it more difficult to monitor dose and increasing the risk of overdose. Additionally, the effects last longer than some users prefer (Grotenhermen, 2001). That said, overdosing on marijuana is rare and most likely to happen to naïve users. A marijuana overdose can trigger acute anxiety or panic, increased heart rate, low blood pressure, and additional problems.  Other alternative forms of marijuana delivery, including sublingual, rectal, and transdermal delivery have not been appropriately investigated but may also further reduce the possible risks associated with the administration of cannabis (Grotenhermen, 2001).  http://adai.uw.edu/marijuana/factsheets/respiratoryeffects.htm

17.  Can induce psychosis  Anxiety  Depression  Schizophrenia  Bipolar Disorder  Panic attacks  Learning difficulties/disabilities  Emotional development Which comes first? Mental health or triggered symptoms as a result of marijuana.

18.  Adolescents 6x more likely to develop psychotic symptoms  10% of adolescents who use before age 15 will develop psychotic symptoms by age 26 compared to 3% who never used.  Genetically predisposed people are likely to see symptoms of mental health disorders earlier if they use marijuana.  Young men who use are more likely to experience suicidal thoughts if they use marijuana.

19.  Burning and stinging of mouth/throat  Changes in potassium levels  Changes in amount of protein and Ph of urine  Some renal problems reported as a result having to digest the marijuana  UA’s ▪ Occasional Use -10 to 14 days ▪ Regular Use -45 days ▪ Heavy Use – 90 days

20.  Lowered immune system  Cancer patients in treatment may be impacted differently by the effect of marijuana on the immune system.  Suppress auto-immune system  Reduces white cell production

21.  Slows muscle growth  Decreases muscle mass  Lowers testosterone needed for muscle growth  Used as a muscle relaxant  Increased muscle spasms  Absorption of calcium reduced  Weakened bones (especially in adolescent women)

22.  Recreational use linked to testicular cancer  Cannabis receptors in the testacies  Female infertility issues  THC can be found in vaginal fluids  Interference with menstrual and ovulation cycles  Male infertility issues  Lower sperm count/mobility of sperm impacted  Lower volume of seminal fluid  Reduced testosterone

23.  Effects different people in a different way  BHA: Food additive ingested while using marijuana can promote health effects in lungs.  Males more likely to develop dependency  Higher risk taking behaviors  Denial of organ transplants

24.  Most pronounced 10- 18 days after last use  Peaking at day 2 or 3  Tremors  Fever like feeling  Nausea  Muscle spasms  Loose stools  Abdominal distress  Hiccups  Anxiety  Muscle tension  Mood swings  Appetite changes  Insomnia  Nightmares/terrors  Depressed mood  Anger/Aggression  Agitation  Irritable

27. Resources had varying information about marijuana. Unless a resource is directly cited, the information came by reading multiple articles, professional resources, etc. Every article, book or resource on marijuana ever encountered would need to be listed to capture the host of information obtained for this presentation.  http://adai.uw.edu/marijuana/factsheets/respiratoryeffects.htm http://adai.uw.edu/marijuana/factsheets/respiratoryeffects.htm