Cannabis, The Good, The Bad and The Ugly

Cannabis, The Good, The Bad and The Ugly

 

“The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS — or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.”

Joycelyn Elders, MD

The Good

 

On April 13, 2017, the Government of Canada introduced legislation to legalize and regulate cannabis, for recreational use.  Access to cannabis for medical use was introduced by Health Canada in 2001.  Cannabis, also known as marijuana, has been used for thousands of years as medicine in Eastern cultures.  It is listed as one of 50 essential herbs in Chinese medicine.  Cannabis comes from the plant cannabis sativa.  It is believed to have diuretic, antiemetic, antiepileptic, anti-inflammatory and antipyretic properties.  The use of cannabis as medicine was introduced to the west by an Irish physician in the 1800’s, who discovered its use in India as an analgesic and anticonvulsant.  Difficulty controlling dose and the rise in popularity of opiates and synthetic drugs led to a decline in use by the end of the 19th century.  Prohibition of cannabis in Canada was instituted by Canada’s Opium and Narcotic Drug Act, in 1923.  In 2001, Health Canada authorized the use of cannabis in the context of treating symptoms associated with end of life care and debilitating symptoms associated with medical health issues.  While research and response to date is promising, the use of cannabis has not been rigorously tested.  Evidence suggests that symptoms that can be effectively treated  by cannabis include severe pain, severe nausea, anorexia, movement disorders and muscle spasms.  Research studies also suggest cannabis can also reduce symptoms associated with ptsd and anxiety.  Advocates suggest that cannabis might play a significant role in a harm reduction approach to alcohol and opiate dependency.

 

Cannabis has more than 400 chemical compounds.  At least 80 of these are cannabinoids.  Our brains also produce their own cannabinoids.  These interact with cannabinoid receptors which are widely distributed throughout our brains.  Cannabinoids influence regulation of pleasure, memory, thinking, concentration, movement, awareness of time, appetite, pain and sensations (taste, touch, smell, hearing, sight).  

 

THC and CBD are the 2 most studied cannabinoids in cannabis.  The main active chemical is THC.  THC affect the brain the most.  It is the chemical that gives those who use cannabis a high.  Short-term effects include feeling happy, relaxation, increased socialization and heightened sensation.  THC is known to reduce pain, decrease inflammation, improve muscle control, increase appetite and reduce nausea.  CBD is known to reduce pain and inflammation, control epileptic seizures and has shown benefits in the treatment of mental illness and addictions. Recent animal studies suggest that cannabis extracts can slow and help kill certain cancer cells.

 

Adverse effects of cannabis for most individuals are generally not serious.  Common side-effects include tiredness, dizziness and increased appetite.  Impairment can cause issues with attention, concentration, memory, distorted perception, trouble with thinking and problem solving, tremors, loss of coordination and increased heart rate.  Most adults who use cannabis recreationally do not experience adverse effects.

 

The Bad

 

For some individuals, cannabis can  cause anxiety, panic and psychotic symptoms.  These usually resolve within minutes or hours. However, in some instances these symptoms can persist.  Cannabis dependence, reduced IQ and bronchitis can develop with chronic use.  Like other drugs cannabis affects the brain’s reward system and can lead to addiction.  Withdrawal symptoms can include craving, irritability, boredom and sleep disturbance.  There are at least 50 known carcinogens in cannabis smoke.  These cancer causing agents are not present when vaporizing or consuming cannabis.

 

The Ugly

 

After alcohol, cannabis is the most commonly used psychoactive substance, recreationally.  It is also commonly known as weed, ganja, bud, grass, green, herb, pot, maryjane, skunk, smoke, trees, and chronic.  It is often rolled into a cigarette, called a joint or in a cigar, called a blunt.  It can be vaporized or smoked in a pipe or bong.  Other forms of cannabis include hash, wax, shatter, and oil.  Cannabis can be brewed as a tea or made into edible candies, cookies and other foods.

 

Youth use drugs and alcohol more than any other age.  There has been a significant increase in cannabis and alcohol use in grades 7-12. Cannabis use increases with grade level.  Approximately, 37% of grade 12 students in Ontario have used cannabis in the past year. Youth are not only more likely to use but to experience greater harm because of that use. Mental illness and substance use are closely linked.  70% of mental illnesses have their onset during childhood or adolescence.  15-24 year olds have the highest prevalence of mental illness and substance use disorder. 34% of Ontario high school students report moderate to serious symptoms of anxiety and depression.  

 

Teens and young adults are particularly susceptible to brain damage as a result of cannabis exposure.  There is growing scientific evidence that starting young and using frequently, can disrupt brain development.  The prefrontal cortex, an area of the brain critical to planning, judgement, reasoning, decision making and impulse control, is one of the last areas to develop and is not fully formed until approximately age 25.  Cannabis use in youth can cause damage to this area.  Also undeveloped and potentially affected, is the endocannabinoid system.  This is the  area of the brain that directly responds to THC.  This system is important for cognition, neurodevelopment, stress response, emotional control and modulation of neurotransmitters.

 

Cannabis use can change brain structure and function in teens and young adults.  Heavy use in this population is associated with poorer school performance, higher dropout rates, greater unemployment and lower life satisfaction. Persistent use is linked to a decline in IQ. Often teens use cannabis for its mild hallucinogenic effects.  In some case though cannabis can trigger a more serious break from reality. It can contribute to the onset of psychosis in those who are vulnerable.  Psychosis can be extremely frightening and debilitating. Symptoms of psychosis can include paranoia, suspiciousness, anxiety, delusions and hallucinations.  Research has shown that using cannabis in adolescence significantly increases the risk of schizophrenia.  Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves.

 

“If people are informed they will do the right thing.  It’s when they are not informed that they become hostages to prejudice”  Charlayne Hunter Gault

 

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