Cannabis misuse Flashcards
Cannabis sativa/indica plant
->400 compunds
-entourage effect
-delta-9 HTC
-cannabidiol
Marijuana vs hash
-MJ: dried leaves/flowers
-Hash: compressed stalked resin glands from cannabis flower blossoms
Hemp vs MJ
-Hemp 0.3% or less THC, grown for agricultural products such as textiles, seeds, oils
-MJ: 15-20% THC
-federal law chill w hemp
Cannabis classification
-schedule I under fed controlled substance act
Cannabis use in US
Acute cannabis intoxication
-Perceptual: temporal slowing, audio/vis illusions, depersonalization
-Physical: tachycardia, hypotension, conjunctival ink, dry mouth, inc appetite
-Affective: euphoria, disinhibition, anxiety, emotional lability
-Cognitive: paranoia, impaired judgement, reaction time, attention
Endocannbinoid System (ECS)
-CNS
-receptors, ligands, transport, enzymes
-receptors CB1 and CB2
-Ligands (Anandamide (AEA and 2-AG)
-transporter (EMT)
-enzymes (fatty acid amide hydrolase, FAAH, monoglycerol lipase, MAGL, diacyl glycerol lipase (DAG))
Endo and phytocannabinoids (synthetics?)
-retrograde regulators of NT, inhibit GABA and glutamine
-full agonists
THC MAO
-partial agonist at CB1R
CB1 expression
-higher than CB2 expression in brain
-low levels of respiratory centers of brain stem
-<resp depression/coma
-CB2 on glia
-CB1 in liver (inc lipogenesis, upregulated in liver fibrosis)
CB2 expression
-higher than CB1 in periphery
-lymphocytes (B and T cells)
-CB2 on glia (brain)
FDA approved cannabinoid drugs
-Marinol
-Nabilone
Marinol (Dronabinol)
-synthtic delta 9 in sesame oil
-schedule OOO
-counter loss of appetite
-tachycardia, red eyes
Nabilone (Cesamet)
-THC mimetic
-schedule II
-anti-emetic
-chronic pain off-label (fibromyalgia, MS)
Challenges w med marijuana use
-lack of product quality control
-no ADR studies
-politicalization over rationality
-growing influence of big tobacco and big alcohol in weed industry
CBD pharma
-low affinity for CB receptors
-may antagonize THC at CB1
-promiscousous effects on ECS
-lacks euphoria
CBD use
-oil w <0.3% THC legal in IN
-use for pain
-oral, topical, cosmetic, edibles, vapes
-FDA for sz disorder
-unregulated, unknown quality
CBD for sz disorders
-Dravet Syndrome
-Lennox-Gastaut syndrome
-epidiolex
Cannabis use disorder
-taken in larger amts
-desire to quit
-time
-craving
-recurrent use block social obligations
-tolerance/withdrawal
-etc
-2+
THC use and mental health
-growing evidence
Risk factors and pathways to psychosis
-age of use onset and potenccy
Cannabinoid hyperemesis syndrome tx
-cannabis cessation
-benzos
-haloperidol
-capsaicin cream on abdomen
