Cannabinoids

Other Names: Cannabis, Dagga, Dope, Ganja, Grass, Hash, Hashish, Hemp, Herb, Pot, Reefer, Weed

Although the term marijuana is often used interchangeably with “cannabis,” the latter usually refers to cannabis products in general while “marijuana,” the Mexican term, is usually used to refer to dried cannabis leaves or other crude materials from the plant, like its flowers, seeds, and stems.

Marijuana contains chemicals that alter a person’s mood or consciousness. The cannabis plant is known to have over 480 different constituents, with THC  (delta9-tetrahydrocannabinol) being the main ingredient that is known to be responsible for the psychoactive effect the drug produces.

CBD or cannabidiol is the second most prevalent active ingredient in marijuana. It doesn’t cause a “high” that is usually associated with THC use, and it has been touted to be effective at treating a variety of health issues, including Dravet syndrome (a type of epilepsy syndrome), anxiety, insomnia, and chronic pain. The potential benefits of this cannabinoid is still being investigated by researchers.

Why Do People Use Marijuana?

Typically sold illegally on the streets or in legal dispensaries, marijuana is used mainly for the following purposes:

• As a recreational psychoactive drug
• For relieving the symptoms of certain ailments, e.g. pain, anxiety, nausea, seizures, etc.
• For religious and spiritual ceremonies and other such purposes

Under the federal drug scheduling system, marijuana is classified as a Schedule I substance, which means it has a high potential for abuse and dependence. Moreover, the drug has no currently accepted medical use in the United States, although state-level laws concerning the medical and recreational use of the drug vary. In many cases, state laws concerning the legality of marijuana are in conflict with federal law.

It is the U.S. Food and Drug Administration that has the federal authority to approve substances for medical use in the country.  Presently, the agency has only approved the use of certain cannabinoid drugs for medical use. These include dronabinol (a synthetic version of THC), nabilone (another synthetic cannabinoid), and the CBD drug Epidiolex, an oral solution that has no more than 0.1% THC.

How Is Marijuana Abused?

Marijuana typically appears as a dry mixture of green, brown, and gray plant shreddings since it is usually composed of flowers, leaves, stems, and seeds from the Cannabis sativa plant. It can appear very similar to tobacco.

This “herb” mixture is usually used in several ways:

• By rolling it up in a piece of lightweight paper and smoking it like a cigarette (a “joint”)
• By rolling it up in a piece of tobacco paper and smoking it like a cigar (a “blunt”)
• By emptying a cigar, filling it up with marijuana, and smoking it (also called a “blunt”)
• By mixing marijuana shreddings with tobacco shreddings and rolling it up in a piece of lightweight paper like a joint (a “spiff”)
• By brewing the shreddings like tea
• By mixing the shreddings with food and then eating it
• By using electronic vaporizers to heat up the herb and then “vaping” it

There have been reports of marijuana being tainted with other substances like fentanyl, which can unknowingly lead to an overdose. Furthermore, there are also products that are known as “marijuana concentrates,” which are highly potent concentrated forms of THC. The substance is usually brown or gold in color, and it can either have a solid consistency like butter or a liquidy one like honey. The THC in such substances can be very high, ranging from a minimum of around 40% to upwards of 80%.

Marijuana concentrates are used in the following ways:

• By taking a small amount of the concentrate (called a “dab”), heating it using an e-cigarette or vaporizer, and finally, inhaling the resulting vapor (“dabbing” or “vaping”)
• Mixing the concentrate into food and beverages

Marijuana Drug Interactions

Marijuana has the potential to interact with the following substances:

• CYP3A4 inhibitors: Substances that are known CYP3A4 inhibitors can slightly increase THC levels in the body.
• CYP3A4 inducers: Conversely, CYP3A4 inducers can decrease THC and CBD levels in the body.
• Central Nervous System (CNS) Depressants: Marijuana can magnify the CNS depressant effects of barbiturates, benzodiazepines, and alcohol.
• Alcohol: Taking alcohol with marijuana may also increase THC levels in the body.
• Warfarin: THC and CBD may increase warfarin levels in the body.
• Theophylline: Smoked cannabis can decrease theophylline levels in the body.
• Clobazam: Among children treated with CBD for epilepsy, it was observed that CBD increased clobazam levels in their body.

Marijuana constituents like THC and CBD also interact with enzymes in the body and can affect the metabolism and concentration of other drugs:

• As a CYP1A2 inducer, THC can can decrease serum concentrations of various substances, including clozapine, duloxetine, naproxen, cyclobenzaprine, olanzapine, haloperidol, and chlorpromazine.
• As a CYP3A4 inhibitor, CBD may increase serum concentrations of macrolides, calcium channel blockers, benzodiazepines, cyclosporine, sildenafil (and other PDE5 inhibitors), antihistamines, haloperidol, antiretrovirals, and some statins like atorvastatin and simvastatin (but not pravastatin and rosuvastatin).
• As a CYP2D6 inhibitor, CBD may increase serum concentrations of antidepressants like selective serotonin reuptake inhibitors (SSRI), tricyclic antidepressants, antipsychotics, beta blockers and opioids (including codeine and oxycodone).

Marijuana’s Side Effects

Marijuana use can result in a number of short-term side effects, including the following:

• Altered mood (which may include dysphoria, confusion, disorganized thinking, inability to converse logically, agitation, paranoia, restlessness, anxiety, and panic attacks)
• Disinhibition
• Heightened imagination
• Enhanced sensory perception (e.g. being able to smell more acutely or seeing brighter colors)
• Distorted perception of time (e.g. feeling as if mere minutes were as long as hours)
• Problems with perception, coordination, and judgment
• Difficulty in thinking, problem solving, and remembering things
• Increased appetite
• Illusions, delusions, and hallucinations (rare, at high doses)

The physiological, psychological, and behavioral effects of marijuana may vary among individuals using the drug. Furthermore, the effects of marijuana concentrates on the user may be more psychologically and physically intense than those produced by using the plant form of the drug.

Long-Term Effects of Marijuana

Chronic use of marijuana can also cause a number of adverse effects. These include the following:

• Physical dependence on the drug and the development of withdrawal symptoms after use is abruptly discontinued
• Addiction to marijuana
• Respiratory problems if the individual smokes or inhales marijuana regularly
• Problems with development of the brain, especially among individuals who started using the substance as teenagers
• Problems with child development during and after pregnancy among women who use marijuana
• Depressed mood, which can be characterized by irritability, isolation, difficulty concentrating, apathy, lack of motivation, and loss of interest in day-to-day activities.

Can You Overdose on Marijuana?

The Drug Enforcement Administration notes that no death from overdose of marijuana has ever been reported.3 However, it is still possible to experience extremely distressing marijuana effects that may require medical attention. If you or another individual experience the following symptoms, call 911 immediately:

• Anxiety
• Panic attacks
• Rapid heartbeat
• Paranoia
• Hallucinations

Symptoms of Marijuana Addiction

How can you tell if you or another individual who is using marijuana has developed an addiction to the drug? If you’re experiencing a chronic and relapsing pattern of behavior where you continue to use marijuana despite the negative consequences in your life, then you’ve probably developed marijuana use disorder.

Substance use disorders, including addiction to marijuana, are diagnosed through these  telltale symptoms detailed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5):

• Consuming increasing amounts of marijuana or using the drug for longer than intended
• Being unable to stop using marijuana despite desiring to cut down use
• Devoting a lot of time, effort, and resources to obtain and use marijuana or to recover from using it
• Developing a strong desire or craving to use marijuana
• Having difficulty in fulfilling responsibilities or obligations due to marijuana use
• Continuing use of marijuana despite it causing relationship issues
• Giving up important activities because of marijuana use
• Continuing to use marjuana even if it puts you in danger
• Continuing to use marijuana despite it exacerbating physical or psychological problems
• Developing tolerance for marijuana, which means requiring higher doses to achieve the same effect
• Developing withdrawal symptoms after abruptly stopping use of marijuana.

If you or a loved one has these symptoms, then it’s time to find help. The good news is that there are plenty of medical facilities and professionals that specialize in substance use disorders in the United States. It’s also quite easy to find resources that can connect you to suitable treatment facilities in your locality.

Marijuana Withdrawal Symptoms

If you have become dependent on marijuana, uncomfortable and even painful withdrawal symptoms could occur if you suddenly stop using the drug. These can include physical and behavioral symptoms like:

• Headaches
• Shaking
• Sweating
• Stomach pains
• Restlessness
• Irritability
• Trouble sleeping
• Anxiety
• Cravings
• Decreased appetite

Take note that becoming dependent on marijuana and developing withdrawal symptoms does not necessarily mean you’ve become addicted to the drug. It just means that you need to consult a medical professional before trying to stop using marijuana because your body has essentially become used to the drug’s presence, so you will not be able to cope without it if you just suddenly stop using it. Talk to your doctor about creating a tapering schedule that you can follow to slowly get yourself off the drug.

Marijuana Detox

Experiencing marijuana withdrawal can be very uncomfortable, distressing, and even painful, so it’s a good thing that you don’t have to go through it alone. A marijuana detox program that is overseen by a medical detox facility can help you manage the unpleasant withdrawal symptoms you could experience as you try to get yourself off the drug.

When you enter such a program, expect to be looked after round the clock by medical professionals who will monitor your condition and ensure your comfort and safety.  You may be given IV fluids and nutritional supplements to help restore your health. Furthermore, you may receive medicines to help you manage your symptoms. These can include the following:

• Sleep aid medications: Sleep-related problems feature prominently in marijuana withdrawal, so you may be given medicines that can help you sleep better.
• Anti-anxiety and anti-stress medication: You may also be given anxiolytic drugs to help you manage anxiety and panic attacks.
• Anti-epileptic medications: Some drugs that are meant to treat epilepsy may also be given to you to help you sleep while also improving your executive function.

Getting Treatment for Marijuana Addiction

Finding a rehabilitation center that offers treatment for marijuana use disorder is a solid step in helping you regain control over your life. An appropriate treatment facility will help you receive the necessary treatment, develop accountability, access professional guidance, and discover an environment that offers the right conditions to help you beat addiction. Addiction treatment typically comes in two different options:

• Inpatient marijuana addiction treatment: The more intensive option, inpatient treatment will require you to stay within the facility during the period you’re being treated. Effectively treating your marijuana addiction typically involves receiving behavioral treatments.
• Outpatient marijuana addiction treatment: Your doctor can also determine if you are a candidate for outpatient treatment, where you’ll be allowed to live in your own home and to continue doing most of your daily activities. You’ll have the freedom to go to work, attend school, and run errands, but you’ll also be asked to go to scheduled treatment sessions at a designated facility.

While the FDA hasn’t approved medications for the treatment of marijuana use disorder, behavioral treatment offers promising results, particularly if you are involved with heavy use of the drug or if you are suffering from a more chronic condition. Behavioral treatment modalities include:

• Cognitive-behavioral therapy (CBT) to help you identify and address problematic behaviors that contribute to your condition
• Contingency management training, wherein you’ll learn to associate your target behavior with positive rewards
• Motivational enhancement therapy, where you’ll undergo systematic intervention to inspire rapid, internally motivated personal change

In some cases, a combination of these programs might be implemented. At the same time, you can also undergo family or group therapies and counseling sessions where you can address the issues that contribute to—or were brought about by—your addiction.

Get the Help You Need Today

While cannabis may hold promising medicinal benefits, it’s very possible to develop an unhealthy relationship with this drug. If you or a loved one is suffering from the effects of marijuana use disorder, don’t hesitate to get the treatment you need.

Give us a call at (800) 429-7690 to speak to a recovery support advisor. They will help you verify your insurance status and find a treatment facility that’s right for you and is covered by your policy. And don’t worry if you don’t currently have insurance. There are many other ways to finance your treatment. The most important thing at the moment is for you to take the first step in your recovery journey by reaching out today.

Marijuana: Its Origins and History

The cannabis plant is native to Central Asia, and its fiber has been used to make fabric and ropes in China and Japan during the Neolithic period. It’s not known exactly when people started using marijuana for its psychoactive effects, but there’s evidence that as early as 3500 BC, people were burning marijuana as part of spiritual or religious ceremonies.

Marijuana was introduced to the West in the mid-1800s by physicians who found the plant during their travels, and the drug was also mentioned in several literary works of the period. By this point, authorities had noted the drug’s effects on those who regularly used it. Soon, many jurisdictions around the world have started criminalizing the cultivation, sale, and use of marijuana outside of medical and scientific research and industrial purposes, such as the manufacture of rope and fabrics. In the US, the passing of the Marihuana Tax Act in 1937 prohibited the growing of cannabis and hemp.

In the last 10 years, many national and local governments have taken steps to ease the restrictions surrounding the use of cannabis, though laws vary greatly depending on location. Many institutions have also started to treat excessive cannabis use as a health issue more than an indicator of criminal behavior. Within the same period, the number of people who use marijuana has increased by an estimated 130%. As of 2019, it is estimated that more than 200 million people use marijuana regularly, making the substance the most popular recreational drug in the world. Additionally, the legalization of marijuana has also paved the way for the founding of robust cannabis-based industries in more permitting locations.

The Legal Status of Medical and Recreational Marijuana in the U.S.

As mentioned, marijuana is classified as a Schedule I drug at the federal level as per the Controlled Substances Act of 1970. This prohibits the use of marijuana for any medical purpose. But while most Schedule I drugs are deemed to have no medical value, some U.S. states and territories have legalized the medical or non-medical use of marijuana in recent years.

The Legal Status of Medical Marijuana

There’s been a significant push to acknowledge the medicinal properties of the cannabis plant in recent years, and this has led to a noticeable shift in the public’s attitude towards marijuana use. Many researchers are currently looking into the beneficial properties of CBD, and many states have legalized and decriminalized the medical use of marijuana. In 1996, California was the first state to legalize marijuana for medical purposes.

Presently, in addition to the District of Columbia, the following states have also legalized marijuana for medical use:

• Alaska
• Alabama
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• Florida
• Hawaii
• Illinois
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Missouri
• Montana
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Dakota
• Utah
• Vermont
• Virginia
• Washington
• West Virginia

As of June 2021, four out of five U.S. territories have also legalized the drug for medical use. These are:

• Guam
• Northern Mariana Islands
• Puerto Rico
• S. Virgin Islands

Meanwhile, the following states permit limited access to medical products that contain cannabidiol:

• Georgia
• Indiana
• Iowa
• Kansas
• Kentucky
• Mississippi
• North Carolina
• South Carolina
• Tennessee
• Texas
• Wisconsin
• Wyoming

The Legal Status of Recreational Marijuana

The U.S. remains divided regarding the legalization of cannabis for non-medical use. In the past decade, however, more and more states have begun exploring the idea, with several having already legalized it. The first states to do so were Colorado and Washington in 2012, with Connecticut being the latest as of June 2021.

In addition to the Northern Mariana Islands, Guam, and the District of Columbia, these 18 states have legalized the use of marijuana for adult recreational purposes as of June 2021:

• Alaska
• Arizona
• California
• Colorado
• Connecticut
• Illinois
• Maine
• Massachusetts
• Michigan
• Montana
• New Jersey
• New Mexico
• New York
• Nevada
• Oregon
• Vermont
• Virginia
• Washington

Unlike with medical marijuana, many critics oppose the legalization of marijuana for recreational purposes, believing it to be a gateway drug whose use could result in subsequent addiction to harder substances. But while some studies do suggest that marijuana use can cause people to develop other substance use disorders, most people who use marijuana do not start using other substances afterward.

Supporters of marijuana legalization point to how prohibition has not led to a significant reduction in the use of and access to the substance, and has instead encouraged more sales in the black market. They also note that legalization will allow the federal government to impose taxes on marijuana sales. These taxes can help fund new initiatives such as treatment programs for people with substance use disorder.