Drug Guide

Marijuana

By Anthony McDaniel, M.D.

Cannabis, also known as marijuana (sometimes spelled "marihuana") among many other names, refers to any number of preparations of the Cannabis plant intended for use as a psychoactive drug. The word marijuana comes from the Mexican Spanish marihuana. According to the United Nations, cannabis "is the most widely used illicit substance in the world." The typical herbal form of cannabis consists of the flowers and subtending leaves and stalks of mature pistillate of female plants. The resinous form of the drug is known as hashish (or merely as 'hash'). The major psychoactive chemical compound in cannabis is Δ9-tetrahydrocannabinol (commonly abbreviated as THC). Cannabis contains more than 400 different chemical compounds, including at least 66 other cannabinoids (cannabidiol (CBD), cannabinol (CBN) and tetrahydrocannabivarin (THCV), etc.) which can result in different effects from those of THC alone.

Cannabis use has been found to have occurred as long ago as the 3rd millennium BC. In modern times, the drug has been used for recreational, religious or spiritual, and medicinal purposes. The UN estimated that in 2004 about 4% of the world's adult population (162 million people) use cannabis annually, and about 0.6% (22.5 million) use it on a daily basis. The possession, use, or sale of cannabis preparations containing psychoactive cannabinoids became illegal in most parts of the world in the early 20th century. Since then, some countries have intensified the enforcement of cannabis prohibition, while others have reduced it. Cannabis has psychoactive and physiological effects when consumed. The minimum amount of THC required to have a perceptible psychoactive effect is about 10 micrograms per kilogram of body weight. Aside from a subjective change in perception and, most notably, mood, the most common short-term physical and neurological effects include increased heart rate, lowered blood pressure, impairment of short-term and working memory, psychomotor coordination, and concentration. Long-term effects are less clear. Cannabis used medically does have several well-documented beneficial effects. Among these are: the amelioration of nausea and vomiting, stimulation of hunger in chemotherapy and AIDS patients, lowered intraocular eye pressure (shown to be effective for treating glaucoma), as well as general analgesic effects (pain reliever).

As cannabis is further legalized for medicinal use, it is possible that some of the foregoing compound medicines, whose formulas have been copied exactly as published, may be scientifically tested to determine whether they are effective medications. Less confirmed individual studies also have been conducted indicating cannabis to be beneficial to a gamut of conditions running from multiple sclerosis to depression. Synthesized cannabinoids are also sold as prescription drugs, including Marinol (dronabinol in the United States and Germany) and Cesamet (nabilone in Canada, Mexico, The United States and The United Kingdom). Currently, the U.S. Food and Drug Administration (FDA) has not approved smoked marijuana for any condition or disease in the United States, largely because good quality scientific evidence for its use from U.S. studies is lacking; however, a major barrier to acquiring the necessary evidence is the lack of federal funding for this kind of research. Regardless, fourteen states have legalized cannabis for medical use. Canada, Spain, The Netherlands and Austria have also legalized cannabis for medicinal use.

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