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Cannabis: Difference between revisions
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{{SubstanceBox/Cannabis}} | {{SubstanceBox/Cannabis}} | ||
'''Cannabis''' (also known as '''THC''',<ref name="wikithc">{{Citation | title=Definition of THC| url=https://wikipedia.org/wiki/Tetrahydrocannabinol}}</ref> '''marijuana''',<ref name="wikimarijuana">{{Citation | title=Definition of Marijuana | url=https://en.wikipedia.org/w/index.php?title=Marijuana_(word)&oldid=1097216058}}</ref> '''weed''',<ref name="merriamweed">{{Citation | title=Definition of Weed | url=https://www.merriam-webster.com/dictionary/weed}}</ref> '''pot''',<ref name="merriampot">{{Citation | title=Definition of POT | url=https://www.merriam-webster.com/dictionary/pot}}</ref> '''grass''',<ref name="merriamgrass">{{Citation | title=Definition of Grass | url=https://www.merriam-webster.com/dictionary/grass}}</ref> '''hemp''',<ref name="merriamhemp">{{Citation | title=Definition of HEMP | url=https://www.merriam-webster.com/dictionary/hemp}}</ref> '''zaza''',<ref name="urbanzaza">{{Citation | title=Definition of Zaza| url=https://www.urbandictionary.com/define.php?term=Zaza}}</ref> '''kush''',<ref name="urbankush">{{Citation | title=Definition of Kush| url=https://www.urbandictionary.com/define.php?term=Kush}}</ref> and many others) is a preparation of the cannabis plant that produces psychoactive effects when consumed (via [[smoking]], [[vaporizing]], or [[oral|ingestion]]). It is the most used illicit substance in the world.<ref name="ErowidCannabisVaultLegalStatus">{{Citation | title=Erowid Cannabis Vault : Legal Status | url=https://www.erowid.org/plants/cannabis/cannabis_law.shtml}}</ref><ref name="WDR-2010">{{Citation | title=WDR-2010 | url=//www.unodc.org/unodc/en/data-and-analysis/WDR-2010.html}}</ref> The mechanism of action is [[agonist|binding activity]] at [[cannabinoid]] [[receptors]] distributed throughout the body. | '''Cannabis''' (also known as '''THC''',<ref name="wikithc">{{Citation | title=Definition of THC| url=https://wikipedia.org/wiki/Tetrahydrocannabinol}}</ref> '''marijuana''',<ref name="wikimarijuana">{{Citation | title=Definition of Marijuana | url=https://en.wikipedia.org/w/index.php?title=Marijuana_(word)&oldid=1097216058}}</ref> '''weed''',<ref name="merriamweed">{{Citation | title=Definition of Weed | url=https://www.merriam-webster.com/dictionary/weed}}</ref> '''pot''',<ref name="merriampot">{{Citation | title=Definition of POT | url=https://www.merriam-webster.com/dictionary/pot}}</ref> '''grass''',<ref name="merriamgrass">{{Citation | title=Definition of Grass | url=https://www.merriam-webster.com/dictionary/grass}}</ref> '''hemp''',<ref name="merriamhemp">{{Citation | title=Definition of HEMP | url=https://www.merriam-webster.com/dictionary/hemp}}</ref> '''zaza''',<ref name="urbanzaza">{{Citation | title=Definition of Zaza| url=https://www.urbandictionary.com/define.php?term=Zaza}}</ref> '''kush''',<ref name="urbankush">{{Citation | title=Definition of Kush| url=https://www.urbandictionary.com/define.php?term=Kush}}</ref> and many others) is a preparation of the cannabis plant that produces psychoactive effects when consumed (via [[smoking]], [[vaporizing]], or [[oral|ingestion]]). It is the most used illicit substance in the world.<ref name="ErowidCannabisVaultLegalStatus">{{Citation | title=Erowid Cannabis Vault : Legal Status | url=https://www.erowid.org/plants/cannabis/cannabis_law.shtml}}</ref><ref name="WDR-2010">{{Citation | title=WDR-2010 | url=//www.unodc.org/unodc/en/data-and-analysis/WDR-2010.html}}</ref> The mechanism of action is [[agonist|binding activity]] at [[cannabinoid]] [[receptors]] distributed throughout the body.<ref>Chayasirisobhon S. [https://pmc.ncbi.nlm.nih.gov/articles/PMC8803256/ Mechanisms of Action and Pharmacokinetics of Cannabis]. Perm J. 2020 Dec;25:1-3. doi: 10.7812/TPP/19.200. PMID: 33635755; PMCID: PMC8803256.</ref> | ||
The principal psychoactive constituent of cannabis is tetrahydrocannabinol (THC), which makes up one of 483 known compounds in the plant,<ref>{{cite book | vauthors=((Russo, E. B.)) | date=5 September 2013 | title=Cannabis and Cannabinoids: Pharmacology, Toxicology, and Therapeutic Potential | publisher=Routledge | isbn=9781136614934}}</ref> including at least 84 other [[Chemical class::cannabinoid|cannabinoids]] such as [[cannabidiol]] (CBD), cannabinol (CBN), tetrahydrocannabivarin (THCV),<ref>{{cite journal | vauthors=((El-Alfy, A. T.)), ((Ivey, K.)), ((Robinson, K.)), ((Ahmed, S.)), ((Radwan, M.)), ((Slade, D.)), ((Khan, I.)), ((ElSohly, M.)), ((Ross, S.)) | journal=Pharmacology, biochemistry, and behavior | title=Antidepressant-like effect of Δ9-tetrahydrocannabinol and other cannabinoids isolated from Cannabis sativa L | volume=95 | issue=4 | pages=434–442 | date= June 2010 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866040/ | issn=0091-3057 | doi=10.1016/j.pbb.2010.03.004}}</ref><ref>{{cite journal | vauthors=((Fusar-Poli, P.)), ((Crippa, J. A.)), ((Bhattacharyya, S.)), ((Borgwardt, S. J.)), ((Allen, P.)), ((Martin-Santos, R.)), ((Seal, M.)), ((Surguladze, S. A.)), ((O’Carrol, C.)), ((Atakan, Z.)), ((Zuardi, A. W.)), ((McGuire, P. K.)) | journal=Archives of General Psychiatry | title=Distinct Effects of Δ9-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing | volume=66 | issue=1 | pages=95 | date=1 January 2009 | url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482939 | issn=0003-990X | doi=10.1001/archgenpsychiatry.2008.519}}</ref> and cannabigerol (CBG). At least three species are recognized: ''Cannabis sativa'', ''Cannabis indica'', and ''Cannabis ruderalis''.{{citation needed}} | The principal psychoactive constituent of cannabis is tetrahydrocannabinol (THC), which makes up one of 483 known compounds in the plant,<ref>{{cite book | vauthors=((Russo, E. B.)) | date=5 September 2013 | title=Cannabis and Cannabinoids: Pharmacology, Toxicology, and Therapeutic Potential | publisher=Routledge | isbn=9781136614934}}</ref> including at least 84 other [[Chemical class::cannabinoid|cannabinoids]] such as [[cannabidiol]] (CBD), cannabinol (CBN), tetrahydrocannabivarin (THCV),<ref>{{cite journal | vauthors=((El-Alfy, A. T.)), ((Ivey, K.)), ((Robinson, K.)), ((Ahmed, S.)), ((Radwan, M.)), ((Slade, D.)), ((Khan, I.)), ((ElSohly, M.)), ((Ross, S.)) | journal=Pharmacology, biochemistry, and behavior | title=Antidepressant-like effect of Δ9-tetrahydrocannabinol and other cannabinoids isolated from Cannabis sativa L | volume=95 | issue=4 | pages=434–442 | date= June 2010 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866040/ | issn=0091-3057 | doi=10.1016/j.pbb.2010.03.004}}</ref><ref>{{cite journal | vauthors=((Fusar-Poli, P.)), ((Crippa, J. A.)), ((Bhattacharyya, S.)), ((Borgwardt, S. J.)), ((Allen, P.)), ((Martin-Santos, R.)), ((Seal, M.)), ((Surguladze, S. A.)), ((O’Carrol, C.)), ((Atakan, Z.)), ((Zuardi, A. W.)), ((McGuire, P. K.)) | journal=Archives of General Psychiatry | title=Distinct Effects of Δ9-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing | volume=66 | issue=1 | pages=95 | date=1 January 2009 | url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482939 | issn=0003-990X | doi=10.1001/archgenpsychiatry.2008.519}}</ref> and cannabigerol (CBG). At least three species are recognized: ''Cannabis sativa'', ''Cannabis indica'', and ''Cannabis ruderalis''.{{citation needed}} | ||
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Lower doses are associated with relaxing effects similar to a [[depressant]]. Higher doses are associated with mild-to-moderate [[hallucinogenic]] effects such as [[geometry|visual hallucinations]], [[conceptual thinking]] and [[time distortion]], as well as a greater risk of [[anxiety]], [[paranoia]], and [[delusions]]. | Lower doses are associated with relaxing effects similar to a [[depressant]]. Higher doses are associated with mild-to-moderate [[hallucinogenic]] effects such as [[geometry|visual hallucinations]], [[conceptual thinking]] and [[time distortion]], as well as a greater risk of [[anxiety]], [[paranoia]], and [[delusions]]. | ||
Cannabis is considered to have low to moderate abuse potential. | Cannabis is considered to have low to moderate abuse potential.<ref name=":1" /> Chronic use is associated with escalating tolerance and psychological dependence in some individuals.{{citation needed}} It has very low physical toxicity and is essentially impossible to physically overdose on. However, it is capable of exacerbating certain mental health symptoms like [[delusions]] or [[psychosis]] in predisposed individuals (see [[cannabis#toxicity and harm potential|this section]]).{{citation needed}} | ||
Long-term cannabis use may be associated with negative cognitive effects such as brain fog, lowered motivation, difficulty learning, and inattention. These effects are typically reversible with tapered use and time off.<ref>Kevin Hill, MD, and MD Michael Hsu. “Cognitive Effects in Midlife of Long-Term Cannabis Use.” ''Harvard Health'', 14 June 2022, <nowiki>https://www.health.harvard.edu/blog/cognitive-effects-of-long-term-cannabis-use-in-midlife-202206142760</nowiki>.</ref> | Long-term cannabis use may be associated with negative cognitive effects such as brain fog, lowered motivation, difficulty learning, and inattention. These effects are typically reversible with tapered use and time off.<ref>Kevin Hill, MD, and MD Michael Hsu. “Cognitive Effects in Midlife of Long-Term Cannabis Use.” ''Harvard Health'', 14 June 2022, <nowiki>https://www.health.harvard.edu/blog/cognitive-effects-of-long-term-cannabis-use-in-midlife-202206142760</nowiki>.</ref> | ||
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===Dependence and abuse potential=== | ===Dependence and abuse potential=== | ||
Cannabis is [[Addiction potential::moderately habit-forming]]. | Cannabis is [[Addiction potential::moderately habit-forming]]. | ||
Research has shown the overall dependence potential for cannabis to be less than that for [[caffeine]], [[tobacco]], [[alcohol]], [[cocaine]] or [[heroin]], but higher than that for [[psilocybin]], [[mescaline]], or [[LSD]].<ref>{{cite journal | vauthors=((Lopez-Quintero, C.)), ((Cobos, J. P. de los)), ((Hasin, D. S.)), ((Okuda, M.)), ((Wang, S.)), ((Grant, B. F.)), ((Blanco, C.)) | journal=Drug and alcohol dependence | title=Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) | volume=115 | issue=1–2 | pages=120–130 | date=1 May 2011 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069146/ | issn=0376-8716 | doi=10.1016/j.drugalcdep.2010.11.004}}</ref> | Research has shown the overall dependence potential for cannabis to be less than that for [[caffeine]], [[tobacco]], [[alcohol]], [[cocaine]] or [[heroin]], but higher than that for [[psilocybin]], [[mescaline]], or [[LSD]].<ref name=":1">{{cite journal | vauthors=((Lopez-Quintero, C.)), ((Cobos, J. P. de los)), ((Hasin, D. S.)), ((Okuda, M.)), ((Wang, S.)), ((Grant, B. F.)), ((Blanco, C.)) | journal=Drug and alcohol dependence | title=Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) | volume=115 | issue=1–2 | pages=120–130 | date=1 May 2011 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069146/ | issn=0376-8716 | doi=10.1016/j.drugalcdep.2010.11.004}}</ref> | ||
Dependence on cannabis is more common amongst heavy users. Cannabis use can lead to increased tolerance<ref name="Borgelt2013" /><ref>{{cite journal | vauthors=((Sewell, R. A.)), ((Poling, J.)), ((Sofuoglu, M.)) | journal=American Journal on Addictions | title=The Effect of Cannabis Compared with Alcohol on Driving | volume=18 | issue=3 | pages=185–193 | date= January 2009 | url=http://doi.wiley.com/10.1080/10550490902786934 | issn=1055-0496 | doi=10.1080/10550490902786934}}</ref> and [[Withdrawal#Cannabis|withdrawal symptoms]] upon stopping usage.<ref name="Gordon2013" /><ref>{{cite journal | vauthors=((Lichtman, A. H.)), ((Martin, B. R.)) | journal=Handbook of Experimental Pharmacology | title=Cannabinoid tolerance and dependence | issue=168 | pages=691–717 | date= 2005 | issn=0171-2004 | doi=10.1007/3-540-26573-2_24}}</ref> Prolonged cannabis usage requires the user to consume higher doses of the substance to achieve a common desirable effect, and reinforce the body's metabolic systems for synthesizing and eliminating it more efficiently.<ref>{{cite journal | vauthors=((Watson, S. J.)) | journal=Archives of General Psychiatry | title=Marijuana and Medicine: Assessing the Science Base: A Summary of the 1999 Institute of Medicine Report | volume=57 | issue=6 | pages=547–552 | date=1 June 2000 | url=http://archpsyc.ama-assn.org/cgi/doi/10.1001/archpsyc.57.6.547 | issn=0003990X | doi=10.1001/archpsyc.57.6.547}}</ref> | Dependence on cannabis is more common amongst heavy users. Cannabis use can lead to increased tolerance<ref name="Borgelt2013" /><ref>{{cite journal | vauthors=((Sewell, R. A.)), ((Poling, J.)), ((Sofuoglu, M.)) | journal=American Journal on Addictions | title=The Effect of Cannabis Compared with Alcohol on Driving | volume=18 | issue=3 | pages=185–193 | date= January 2009 | url=http://doi.wiley.com/10.1080/10550490902786934 | issn=1055-0496 | doi=10.1080/10550490902786934}}</ref> and [[Withdrawal#Cannabis|withdrawal symptoms]] upon stopping usage.<ref name="Gordon2013" /><ref>{{cite journal | vauthors=((Lichtman, A. H.)), ((Martin, B. R.)) | journal=Handbook of Experimental Pharmacology | title=Cannabinoid tolerance and dependence | issue=168 | pages=691–717 | date= 2005 | issn=0171-2004 | doi=10.1007/3-540-26573-2_24}}</ref> Prolonged cannabis usage requires the user to consume higher doses of the substance to achieve a common desirable effect, and reinforce the body's metabolic systems for synthesizing and eliminating it more efficiently.<ref>{{cite journal | vauthors=((Watson, S. J.)) | journal=Archives of General Psychiatry | title=Marijuana and Medicine: Assessing the Science Base: A Summary of the 1999 Institute of Medicine Report | volume=57 | issue=6 | pages=547–552 | date=1 June 2000 | url=http://archpsyc.ama-assn.org/cgi/doi/10.1001/archpsyc.57.6.547 | issn=0003990X | doi=10.1001/archpsyc.57.6.547}}</ref> | ||