1. Brain Functions Treatment Options Paul Nims MA, CRADC, CCDP-D Co-Occurring Disorders Program Coordinator BJC Behavioral Health Marijuana

2.  The main intoxicating chemical in Marijuana is Tetrahydrocannabinol also known as delta-9- tetrahydrocannabinol (Δ 9 -THC) is the principal psychoactive constituent of the cannabis plant.  Among the best known of these actions is the ability of marijuana, and congeners of its active ingredient, Δ 9 -tetrahydrocannabinol (Δ 9 -THC), to disrupt sensory processing and learning and memory in animals and humans (Deadwyler et al., 1990; Hampson & Deadwyler, 1999; Sullivan, 2000).Deadwyler et al., 1990Hampson & Deadwyler, 1999Sullivan, 2000

3.  Marijuana has been altered from its original form with gene manipulation to be more potent. (Mendal and his peas)  The potency of Marijuana varies greatly.  Some samples from 2008 were as high as 37.20%

5.  Inhaled smoke is a suboptimal delivery method for any agent intended to be health- promoting in any way. (ASAM-Public Policy Statement on Marijuana)  Smoked marijuana has the potential to be as, or more, harmful than cigarettes.

6.  It contains 50 to 70 percent more carcinogenic compounds, including tar, than cigarettes (NIDA, 2005; Hubbard et al., 1999).  Marijuana also produces high levels of a particular enzyme which converts certain hydrocarbons into their carcinogenic or malignant forms (NIDA, 2005).

7.  In 1988, Allyn Howlett and William Devane used radioimmunoassay techniques to characterize the existence of a cannabinoid receptor in a rat brain. In 1990, Miles Herkenham and his team mapped the locations of a cannabinoid receptor system in several mammalian species, including man. Receptors are most dense in the basal ganglia, hippocampus, and cerebellum

8.  Pic of brain with THC Receptors

10. The Reward Pathway (ventral tegmental area)

11.  Based on this substantial body of empirical research, the American Psychiatric Association (APA) has long recognized cannabis dependence as a valid and reliable psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In a survey conducted by NIDA in 1994, epidemiologist James Anthony found that of those who tried marijuana at least once, about 9 percent eventually became addicted.NIDA

13.  8 Major Life Areas 1.Psychological 2.Physical 3.Family 4.Legal 5.Financial 6.School or Work 7.Friends 8.Interpersonal Relationships

14.  Basic guidelines ◦ Substance Abuse  Clinically Significant Impairment in Psychological plus 3 other major life areas ◦ Substance Dependence  Clinically Significant Impairment in Psychological and Physical plus 3 other major life areas

15.  Activities center around the use of substance  Occasional intoxication – increasing frequency  PSYCHOLOGICAL relief use  View drug as a friend

16.  Physical tolerance mild to moderate  Mood swings  Pre- and post- using  Fragmented Blackout Makes poor/dangerous choices around substances

17.  “must have the substance to function normally.”  Attempts to control fail  Moderate to Severe Tolerance

18.  Geographical Escapes  Significant impairment in social and School/occupational functioning  Withdrawal symptoms pronounced

19.  A physiological change resulting from repeated drug use that requires the user to take larger amounts of the drug to get the same effects initially felt from a smaller dose.

20.  When marijuana-dependent individuals stop using the drug, they experience symptoms of: ◦ irritability ◦ anger ◦ cravings ◦ decreased appetite ◦ insomnia ◦ interpersonal hypersensitivity ◦ yawning and/or fatigue (Budney et al., 2001; Preuss et al., 2010)

21.  Residential ◦ Hospital ◦ Medical Assisted Detox ◦ Inpatient Treatment  Out Patient Treatment ◦ Partial Hospitalization or Intensive Out Patient ◦ Traditional Out Patient ◦ Relapse Prevention

22.  Treatment Works  People Recover

23.  NCADA-Helpline: ◦ (314) 962-3456  MO Dept. of Mental Health ◦ (573) 751-4942 or (800) 575-7480  ACT Missouri ◦ (573)-635-6669