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13. Substance Use + Addictions > Cannabis Related Disorders > Flashcards

Cannabis Related Disorders Flashcards

1
Q

where are CB1 receptors found

A

primarily in brain and spinal cord but not around respiratory centers of CNS

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2
Q

where are CB2 receptors found

A

mostly in immune system, mast cells, macrophages

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3
Q

can THC cross the BBB or placenta

A

can cross both

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4
Q

why does THC have such a long half life (up to several days to a week)

A

highly lipophilic, can accumulate in fat

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5
Q

what is considered a “heavy” cannabis user

A

more than 3 joints per week

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6
Q

how long might it take a heavy cannabis user to clear THC from fatty tissues including the brain

A

can take months, up to a year

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7
Q

do more men or women have cannabis use disorder

A

2:1 men

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8
Q

what age group has the highest incidence of cannabis use disorder

A

18-29–> 4.4%

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9
Q

what is the heritability of cannabis use disorder

A

30-80%

*common genetic basis for teen substance use + conduct problems

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10
Q

list psychological + environmental RFs for cannabis use disorder

A

hx conduct disorder or ASPD

externalizing and internalizing disorders during childhood/adolescence

youth with high behavioural disinhibition scores

adverse childhood

tobacco smoking

cannabis use among family

family hx SUD

ease of availability

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11
Q

when does cannabis withdrawal start

A

1-3 days after cessation of cannabis

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12
Q

when does cannabis withdrawal peak

A

within first week

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13
Q

how long does cannabis withdrawal last

A

1-2 weeks

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14
Q

how long might sleep difficulty due to cannabis withdrawal last

A

can last up to a month or more

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15
Q

when is cannabis use disorder most common

A

teens/young adulthood

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16
Q

early onset (before age 14) of cannabis use disorder is a ROBUST predictor of what other disorders

A

development of CUD, SUD, AUD as young adult

likely related to externalizing problems

17
Q

list physiological signs of cannabis intoxication

A

conjunctival injection

dry mouth

tachycardia–> can do 20-50bpm above baseline!!, this is amplified with alcohol use

increased appetite

sometimes orthostatic hypotension due to lower PVR

18
Q

list subjective/psychological signs of cannabis intoxication

A

high feeling, then euphoria, inappropriate laughter, grandiosity

sedation, lethargy, impaired judgment

difficulty with complex mental processes, impaired motor performance

distorted sensory perceptions

sense of time passing slowly

can also get dysphoria, anxiety, social withdrawal

19
Q

are cannabis withdrawal symptoms usually severe enough to require clinical attention

A

no

20
Q

list symptoms of cannabis withdrarwal

A

initially decreased appetite, insomnia

fatigue, yawning, difficulty concentrating

can then have rebound hypersomnia, increased appetite

21
Q

what is the prevalence of cannabis hyperemesis syndrome

A

up to 32%

22
Q

list the major features of cannabis hyperemesis syndrome

A

severe cyclical N/V

resolution with cannabis cessation

relief of symptoms with HOT SHOWERS or baths

abdo pain

daily use of cannabis

23
Q

how do you manage cannabis hyperemesis syndrome

A

complete abstinence from cannabis combined with supportive management

standard antiemetics to resolve N/V are NOT EFFECTIVE

limited evidence indicates some relief from LORAZEPAM and HALDOL as well as TOPICAL CAPSAICIN cream

24
Q

what syndrome can accompany cannabis use disorder

A

amotivation syndrome–> can mimic PDD

25
Q

those with a mental health disorder are how much more likely to have a cannabis use disorder than the general population

A

2-3x more likely

26
Q

is cannabis a gateway drug?

A

it seems so–> cocaine, opioids

higher rates of AUD, TUD, likely other SUDs

27
Q

in those seeking treatment for cannabis use disorder what % have another SUD

A

74%

–most common is alcohol, then cocaine, meth, opioids

28
Q

what is the most commonly comorbid personality disorder with cannabis use disorder

A

ASPD (then OCPD, paranoid)

29
Q

what is the most commonly comorbid psych disorder with cannabis use disorder

A

any anxiety disorder (24%)

MDD (11%)

bipolar (13%)

60% have an externalizing disorder like ADHD, conduct

30
Q

are there any meds approved for treatment of cannabis use disorder

A

no

31
Q

what meds may be helpful in treating cannabis use disorder

A

gabapentin–> possibly helpful, esp with withdrawal

NAC

naltrexone (equivocal results)

replacement theory is not great

32
Q

list the 3 most helpful primary psychosocial interventions for cannabis use disorder

A

CBT

motivation enhancement therapy

contingency management

13. Substance Use + Addictions (13 decks)

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