1. Marijuana Chapter 13

2. What Is Marijuana?
Marijuana is a hemp plant whose biological name is cannabis sativa.
It consists of green, brown, or a grey
mixture of dried, shredded leaves, stems, seeds, and flowers.
THC (delta-9-tetrahydrocannabinol) is the primary mind-altering ingredient in marijuana.

3. Brief History and Trends
Marijuana has historically been a valued crop. The woody fibers of the stem yield a fiber that can be made into cloth and rope (hemp).
The seeds have been pressed to extract red oil used for medical purposes
The plant produces resin with active ingredients that affect the central nervous system
Botanists think that cannabis originated in Asia

4. Brief History and Trends
Early records of marijuana use:
China 2737 BC - (from Book of Drugs) Chinese Emperor prescribed marijuana for gout, malaria, and other medical conditions. The Chinese had much respect for the plant and used it for fiber for clothes and for medicine.
China 500 BC – Marijuana (Ma) was banned because of its behavioral effects. The use of Marijuana was claimed to promote disrespectful behavior. Later, because for the rampant use of Marijuana, it was legalized again.

5. Brief History and Trends
Early records of marijuana use:
India – History of cannabis cultural use for religious ceremonies.
From India, the use of marijuana spread throughout Africa, Europe, and the Americas.
Assyrians, dating back to 650 BC used it for making rope, cloth, and consumed it to experience euphoria
Ancient Greeks also knew about marijuana. Galen described the general use of hemp in Cakes, which, when eaten in excess, produced narcotic effects. The Smoke of marijuana was used for steam baths and produced euphoria.

6. Brief History and Trends
Early records of marijuana use:
In North America, in Jamestown (1611), marijuana was used to make rope and clothing
George Washington cultivated a field of hemp at Mount Vernon for medicinal purposes and for rope.
In the 1800’s through the early 1900’s in the US, Physicians used marijuana extract in tonics for medical and recreational purposes.
The 1937 Marihuana Tax Act prohibited the use of marijuana as an intoxicant, and regulated its use as medicine
Currently, marijuana grows wild in many
U.S. states

7. Brief History and Trends
Most of the abuse of Marijuana in the United States during the early part of the 20th century occurred near the Mexican Border.
Harry Anslinger, (Bureau of Narcotics) was responsible for leading an informational program to regard marijuana as a narcotic. This program of national awareness led to the federal law that banned marijuana.
A subjective conversation…..
(see “Why Marijuana is Illegal”)
See also- “Legalizing Recreational and Medicinal Marijuana Use” pp , text

8. Questions and Answers
Today marijuana is how many times more potent than the marijuana on the street in the 1960s and 1970s?
Approximately 20 times more potent as result of more efficient agriculture largely due to new methods of harvesting, new varieties, and special processing marijuana of plants

9. Questions and Answers (continued)
How many Americans are current marijuana users?
- Aged 12 or older in 2011: Out of 18.1 million illicit drug users, approximately 64.3% reported current use of only marijuana and another 16.2% used marijuana with another illicit drug. (This means that a staggering 80.5% [64.3% %] either used marijuana alone or used marijuana with another drug.) The remaining 19.5% of drug users used an illicit drug but not marijuana

10. Noteworthy Findings Regarding Marijuana Users
It is the most highly abused illicit-type of illicit drug.
The highest rate of use was found among young adults (ages 18–25) with 18.9% reporting current use (past month) and among youth (ages 12–17) with 7.6% reporting current use.
The average age of first use was 17.5 years.
There were 2.6 million new marijuana users in 2011, which averages 7,200 initiates per day.

11. Figure 13.02: Types of drugs used in the past month, illicit drug users age 12 or older in 2011.

12. Major Factors Affecting Marijuana Use
Structural factors: Age, gender, family background, lack of any religious beliefs
Social and interactional factors: Type of interpersonal relationships, friendship cliques, drug use within the peer group setting
Setting: Type of community and neighborhood (physical location of drug use)
Attitudinal factors: Personal attitudes toward the use of drugs, self esteem, maturation level

13. Major Factors Affecting Marijuana Use
Participation in after-school activities is associated with higher levels of academic achievement and self-esteem, as well as lower levels of substance use.
Religious involvement affects illicit drug use and this clearly includes marijuana use.

14. Cannabis Use Disorder Defined by DSM-V*
Cannabis is often taken in larger amounts than was intended
There are persistent desires or unsuccessful efforts to cut down or control cannabis use
Much time is spent securing the drug, using the drug and/or recovering from its effects
Craving the euphoric effects of the drug
Failure to fulfill major role obligations at work, school, or home
Continued use of cannabis despite persistent or recurrent social and interpersonal problems cased by the effect of cannabis

15. Cannabis Use Disorder Defined by DSM-V*
Important social, occupational or recreational activities are given up or reduced because of cannabis use
Recurrent cannabis usage in situations in which it is physically hazardous
Cannabis use is continued despite persistent or recurrent physical or psychological problems stemming from usage
Tolerance develops to offset the diminishing effects of cannabis resulting in more use of cannabis
Withdrawal symptoms lead to increased use of cannabis

16. Marijuana
Gateway drugs are drugs that often lead to the use of more addictive types of drugs (gateway to the use and abuse of other more potent drugs).
Alcohol, tobacco, and marijuana are the drugs most commonly believed to be gateway drugs.
Other common gateway drugs include inhalants and anabolic steroids. Just recently, the abuse of prescription drugs (mainly painkillers) is also included.

17. Marijuana
Gateway drugs – The claim that marijuana most often leads to the use of other more serious drugs is controversial.
Likely Factors include the age at which teens have opportunities to use drugs and the willingness, mindset, or predisposition to use drugs
Youths who use drugs are usually alienated, and the progression from marijuana to other drugs is likely to depend on peer group composition, family relationships, social class, and the age at which drug use begins.

18. Two Major Types of Marijuana
Cannabis Sativa:
Originates from Colombia, Mexico, Jamaica, South Africa, Thailand, and Southeast Asia.
Causes uplifting and energetic feelings, appetite stimulant, and provides pain relief.
Cannabis Indica:
Originates from hash producing with very warm climates in such countries Afghanistan, Pakistan, India, Turkey, Morocco, and Tibet.
Causes body relaxation, stress relief, and calmness and serenity and has lower THC content than Sativa

19. Varieties of Marijuana from the Cannabis Sativa Plant
Hashish (resin): Average concentration of THC is 12.1% for domestic, 7.03% for non-domestic, and for samples seized by law enforcement officials
Ganja: Consists of the dried tops of female plants. The term is also used as a slang term for marijuana (pot, weed, reefer)
Sinsemilla (without seeds), “hydro” (grown in water), kind bud, dro, 30s, AK-47, and blueberry (more recent names of popular types of marijuana). The average concentration of THC is 7.5% and higher

20. Behavioral Effects
Low to moderate doses produce euphoria and a pleasant state of relaxation.
Common effects: dry mouth, elevated heartbeat, some loss of coordination and balance, slower reaction times, reddening of the eyes, elevated blood pressure, some mental confusion (short-term memory loss).
A typical high lasts from 2 to 3 hours (length of effect depends on amount of THC), and the user experiences altered perception of space and time as well as impaired memory.

21. Behavioral Effects (continued)
An acute dose of cannabis can produce adverse reactions: mild anxiety to panic and paranoia.
In a minority of cases users can exhibit psychoses, delusional and bizarre behavior, and hallucinations. These reactions occur most frequently in individuals who are under stress, anxious, depressed, or borderline schizophrenic, and are using the more potent types of marijuana.
See also “Signs and Symptoms” p 422.
Next Slide

22. Signs & Symptoms: Specific Indicators of Marijuana Use

23. Behavioral Effects (continued)
Subjective euphoric effect: Refers to the ongoing social and psychological experiences incurred while intoxicated with marijuana. These include both the user’s altered state of consciousness and their perceptions while intoxicated. Subjective effects in experienced users include a general sense of relaxation, coupled with heightened sense of sound, taste and emotion. For inexperienced user, there may be more anxiety from the anticipation of the effects. Greater concentrations of THC produce more hallucinogenic effects

24. Behavioral Effects (continued)
Differential association: Behavioral satisfaction derived from friends who use marijuana (“fun-times when high with friends”). The conversation and banter that occur among drug user friends is perceived as a way to relieve stress, boredom and any behavioral satisfaction derived from friends who use marijuana. In this situation, getting high with others is the positive reward that solidifies the user to their friends and the drug use.

25. Driving Performance
The ability to perform complex tasks, such as driving, is often impaired while under the influence of marijuana.
In limited surveys, from 70% to 80% of marijuana users indicate that they sometimes drive while being high.
Research reveals that approximately 600,000 high school seniors drive after smoking marijuana (DEA, 2006) and 41% of teens were notconcerned about driving after taking drugs. (Driving while under the influence of a drug termed drugged driving.)
Habitual cannabis users were 9.5 times more likely to be involved in crashes.

26. Critical Thinking Skills
Marijuana has been found to have a negative impact on critical thinking skills.
Specifically, heavy
marijuana use impairs attention, memory and learning.
Marijuana alters brain activity because residues of this drug persist in the brain.
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27. Amotivational Syndrome or Anti-motivational Syndrome
Amotivational syndrome refers to a belief that heavy use of marijuana causes a lack of motivation or impaired desire and reduced productivity.
Specifically, users show:
Apathy
Poor short-term memory
Difficulty with concentration
A lingering lack of interest in pursuing goals

28. Amotivational Syndrome or Anti-motivational Syndrome
Amotivational syndrome - it is difficult to determine if the lack of motivation is caused by the use of marijuana or if poorly motivated people begin using marijuana.
Because a sizeable number of user are alienated from society, they may select to use not conformist behavior rather than goal-oriented behavior.
Contrary to this belief are the “highly productive” Jamaican culture, where there is much habitual marijuana use (the work; however is not complex cognitive activity, but mostly a monotony of physical labor)

29. Therapeutic Uses of Marijuana
Medical marijuana use: Involves using the THC derived from smoking marijuana or using Marinol as a drug to calm or relieve symptoms of an illness. (Marinol is an FDA-approved THC in capsule form.)
Some research shows that THC can be used for treating:
Glaucoma: potentially blinding eye disease causing continual and increasing intraocular pressure

30. Therapeutic Uses of Marijuana (continued)
Appetite stimulant: Patients experiencing anorexia, AIDS, chemotherapy and radiation therapy
Antiseizure: Aids in the prevention of seizures (epilepsy)
Antiasthmatic effect: Short-term smoking of marijuana improves breathing for asthma patients
Antidepressant effect: Used in Great Britain as a euphoriant for treating depression
Muscle relaxation: Aids in muscle spasms relief in patients with muscular disorders
Analgesic effect: In patients experiencing frequent migraines and chronic headaches or inflammation
Antinauseant: Relieves nausea that accompanies chemotherapy in cancer treatment.

31. Arguments Against Marijuana Use
It contains 421 chemicals.
It is stronger than it was 20 years ago.
Smoking this drug is worse for the lungs than tobacco.
Impairs short-term memory and may cause “amotivational syndrome.”
U.S. federal law continues to legally prohibit the possession, the sale, and use of marijuana. (The federal government believes marijuana has no medically proven use.)

32. Physiological Effects
The brain: THC activates the reward system in the brain by stimulating brain cells to release the chemical dopamine
Central nervous system: Alters mood, coordination, memory, and self-perception
Respiratory system: Damage to the lungs
Cardiovascular system: Marijuana products limit the amount of oxygen that can be carried to the heart
Sexual performance and reproduction: Affects the sympathetic nervous system, increasing vasodilation in the genital and delaying ejaculation; high doses can decrease sexual desire

33. Effects of Marijuana on the Central Nervous System
Altered perceptions
Changes in the interpretation of stimuli resulting from marijuana use
“Munchies”
Hunger experienced while under the effects of marijuana
Anandamide
Possible neurotransmitter acting at the marijuana (cannabinoid) receptor site

34. Effects on Other Systems
Alveolar Macrophages (respiratory system)
Special white blood cells that play a role in cleaning lung tissue are less able to remove debris when exposed to smoke
Vasodilation (cardiovascular system)
Enlarged blood vessels
Aphrodisiac (sexual performance and reproduction)
In lower doses of marijuana, THC is believed to cause sexual arousal

35. This is the end of the presentation, Dude