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Marijuana

Marijuana. Marijuana. Marijuana consists of the dried and crushed leaves, flowers, stems, and seeds of the Cannabis sativa plant. THC (delta-9-tetrahydrocannabinal) is the primary mind-altering ingredient in marijuana. Derivatives of the cannabis plant. Hashish

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Marijuana

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  1. Marijuana

  2. Marijuana Marijuana consists of the dried and crushed leaves, flowers, stems, and seeds of the Cannabis sativa plant. THC (delta-9-tetrahydrocannabinal) is the primary mind-altering ingredient in marijuana.

  3. Derivatives of the cannabis plant • Hashish • Ave. concentration of THC is 2% to 8% • Ganja • Consists of the dried tops of female plants • Sinsemilla • Ave. concentration of THC is 7.5% • Bhang • Ave. concentration of THC is 1% to 2%

  4. Drug Effects on Neurotransmission: LSD • Serotonin receptor • Stimulates some receptors (agonist) • Blocks other receptors (antagonist)

  5. ? Questions and Answers ? Q. Today marijuana is how many times more potent than the marijuana on the street in the 1960s and 1970s? A. 20 times more potent Q. How many Americans are current marijuana users? A. 20 million Americans

  6. Drug Effects on Neurotransmission: THC • Binds receptors in nucleus accumbens (and other sites in the brain such as the hippocampus– memory) and increases dopamine release

  7. THC Receptor Sites in the Brain

  8. 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 • A typical high last from 2 to 3 hours, and user experiences altered perception of pace and time, impaired memory

  9. Behavioral effects • An acute dose of cannabis can produce adverse reactions: mild anxiety to panic and paranoia • A few rare cases exhibit psychoses, delusional and bizarre behavior, and hallucinations. These reactions occur most frequently in individuals who are under stress, anxious, depressed or borderline schizophrenic

  10. Behavioral effects A subjective euphoric effect associated with marijuana use is the “ongoing social and psychological experiences incurred while intoxicated with marijuana. It includes both the user’s altered state of consciousness and his or her perceptions while intoxicated.” - “connoisseurs” - differential reinforcement

  11. Driving performance • The ability to perform complex tasks, such as driving, is strongly imparted while under the influence of marijuana • In limited surveys, from 60% to 80% of marijuana user indicate that they sometimes drive while high. • In a study conducted in the Boston area, marijuana smokers were overrepresented in fatal highway accidents

  12. Critical thinking skills • Marijuana has been found to have a negative impact on critical thinking skills • Impairment can affect: • attention, memory, learning • The unresolved question is whether these impairments are short-term or long-term

  13. Amotivational syndrome • Amotivational syndrome characterizes regular users of marijuana who experience a lack of motivation and reduced productivity. • Specifically, users show apathy, a poor short-term memory, difficulty in concentration, and a lingering disinterest in pursuing goals. • Does marijuana or other factors create this syndrome?

  14. Physiological effects Central nervous system Cardiovascular system Respiratory system Sexual performance and reproduction

  15. Therapeutic uses • Marinol - indicated for treatment of nausea and vomiting in cancer patients • Anorexia in AIDS patients • Glaucoma • Antiasthmatic drug • Muscle relaxation • Antidepressant • Analgesic

  16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cannabinoid Receptors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cannabinoid Receptors Are Located in Many Areas Throughout the Brain and Play An Important Role In Regulating: • Brain Development • Memory and Cognition • Motivational Systems • & Reward • Appetite • Immunological Function • Reproduction • Movement & Coordination • Pain Regulation • & Analgesia

  17. Basic Research Selective CB2 Cannabinoid Receptor Agonist (AM1241) Dose-Dependently Inhibits Sensory Hypersensitivity in Rats Source: Ibrahim, M.M. et al., PNAS, 100(18), pp. 10529-10533, September 2, 2003.

  18. Treatment Research 90 80 70 60 50 40 30 20 10 0 0 0.3 mg/kg 1.0 mg/kg 3.0 mg/kg SR141716 Dose Cannabinoid Antagonists Have Been Shown to Block Major Triggers of Drug Relapse Impact of SR141716 on Response to Cocaine-Related Cues Cannabinoid Antagonist Blocks Cocaine-Seeking in Response to Cocaine-Related Cues in a Dose-Dependent Manner Cocaine-Seeking Responses (per 120 min) Source: De Vries, T.J., & Shaham, Y. et al., Nature Medicine,7(10), 2002.

  19. Marijuana Use Disorders in the United States: 1991-1992 and 2001-2002 Wilson M. Compton, M.D., M.P.E. Director, Division of Epidemiology, Services and Prevention Research National Institute on Drug Abuse Department of Health and Human Services May 5, 2004 American Psychiatric Association Annual Meeting

  20. Background A great deal of information about trends in use of drugs is available, but no data provides reliable and valid measures of drug disorders over the past decade.

  21. Background • With data from two large household surveys of the U.S. adult population, this study seeks to answer the following questions: • What are the rates of marijuana abuse and dependence in 1991-1992 compared to 2001-2002? • Have the relationships of age, race/ethnicity or gender to marijuana abuse and dependence changed during this period?

  22. Methods Studies: • Large studies of the U.S. non-institutionalized household adult (18+) population conducted by the Census Bureau. • NLAES: National Longitudinal Alcohol Epidemiologic Study (N = 42,862) • NESARC: National Epidemiologic Study of Alcohol and Related Conditions (N = 43,093)

  23. Methods Interview: • AUDADIS: Alcohol Use Disorder and Related Disabilities Interview Schedule - DSM-IV Version • Specific measures of each criterion of abuse and dependence on marijuana • Reliability and validity well-established

  24. Methods Outcomes • Marijuana use, abuse and dependence in overall population and by age, race/ethnicity and sex • Marijuana abuse and dependence among marijuana users by age, race/ethnicity and sex

  25. =p < .05 Results: Total Population %

  26. Results: Total Population • Comparing 1991-1992 to 2001-2002: • Marijuana use rates were virtually the same: 4.0% versus 4.1% • Marijuana abuse or dependence increased from 1.2% to 1.5% (p = .014) • Marijuana abuse or dependence among users increased from 30.2% to 35.6% (p < .01) How consistent are these results across age groups, race/ethnic groups and sexes?

  27. =p < .05 Results: Marijuana Use by Sex and Race/Ethnicity %

  28. =p < .05 Results: Marijuana Use In Age Groups %

  29. =p < .05 Results: Marijuana Use in Whites %

  30. =p < .05 Results: Marijuana Use in Blacks %

  31. =p < .05 Results: Marijuana Use in Hispanics %

  32. =p < .05 Results: Marijuana Use in Men %

  33. =p < .05 Results: Marijuana Use in Women %

  34. Results: Marijuana Use in Detailed Age-Sex-Race/Ethnicity Categories • Use increased significantly for: • White males 45-64 years old • Black females overall and Black females 18-29 and 46-64 years old • Hispanic females 18-29 years old

  35. Results: Summary of Marijuana Use • Rates did not change significantly overall • Rates increased significantly for: • 18-29 and 45-64 year olds • Black and Hispanic 18-29 year olds • White and Black 45-64 years olds • Women 18-29 years old and both men and women 45-64 years old • Selected age-sex-race/ethnicity categories

  36. % =p < .05 Results: Marijuana Abuse or Dependence in Overall Population

  37. =p < .05 Results: Marijuana Abuse or Dependence by Sex and Race/Ethnicity %

  38. =p < .05 Results: Marijuana Abuse or Dependence in Whites %

  39. =p < .05 Results: Marijuana Abuse or Dependence in Blacks %

  40. =p < .05 Results: Marijuana Abuse or Dependence in Hispanics %

  41. =p < .05 Results: Marijuana Abuse or Dependence in Men %

  42. =p < .05 Results: Marijuana Abuse or Dependence in Women %

  43. Results: Summary of Marijuana Abuse or Dependence • Rates increased significantly overall • Increases in rates were significant for: • 18-29 and 45-64 year olds overall • Blacks and Hispanics overall and 18-29 years old • Women overall and 18-29 years old • Men 45-64 years old • Black and Hispanic men overall and 18-29 years old • Black women overall and 18-29 years old

  44. % =p < .05 Results: Marijuana Abuse or Dependence Among Users in Overall Population

  45. =p < .05 Results: Marijuana Abuse or Dependence among Users, by Sex and Race/Ethnicity %

  46. =p < .05 Results: Marijuana Abuse or Dependence Among Black Users %

  47. =p < .05 Results: Marijuana Abuse or Dependence Among White Users %

  48. =p < .05 Results: Marijuana Abuse or Dependence Among Hispanic Users %

  49. =p < .05 Results: Marijuana Abuse or Dependence Among Male Users %

  50. =p < .05 Results: Marijuana Abuse or Dependence Among Female Users %

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