November 15, 2022

Marijuana Possession Discussion Topic Do you believe that prosecution for marijuana possession in your state should be more or less rigid than it currently is? Why??

Discussion- Marijuana Possession

Discussion Topic

Do you believe that prosecution for marijuana possession in your state should be more or less rigid than it currently is? Why?

Discussion Requirements:

An initial posting of at least 275 words

Chapter 11.

**LO1, LO6, LO7, LO9**

Course Materials:Required Text or E-Book: Drug Use and AbuseISBN-13:978-0-357-37595-2Authors : Stephen Maisto • Mark Galizio • Gerard Connor

https://youtu.be/Nlcr1jd_Tok

https://youtu.be/VFwYGFt5q90

https://youtu.be/CAtB0O05m3c

Maisto_DrugUse_9e_PPT_CH11.pptx

Chapter 11

Marijuana

Icebreaker

From what you have seen and heard on campus or in other settings, do you think the use of marijuana in your age group has increased, decreased, or stayed the same in the past several years? (Let students respond)

You may recall from earlier in our text that while the use of other drugs has decreased in recent years, the use of marijuana has increased, especially among teens and young adults. Why do you think that is? (Let students volunteer)

One factor influencing this increase in the United States is the legalization and decriminalization of marijuana use by some state governments.

We will be learning more about marijuana in this chapter. [5 minutes]

Chapter Objectives

After studying this chapter, you will be able to…

11-1 Discuss the historical use of cannabis and how the committee reports on marijuana shaped attitudes about its use.

11-2 Explain the factors that influence potency of cannabis.

11-3 Describe how marijuana is absorbed, distributed, metabolized, and excreted from the body.

11-4 Explain the mechanisms of action for cannabis.

11-5 Evaluate the evidence concerning whether physical or psychological dependence occurs with marijuana use.

11-6 Discuss how marijuana is used in the treatment of specific conditions.

11-7 Evaluate the physiological and psychological effects of acute and long-term use of marijuana.

Historical Overview

11.1

The Marijuana Plant

Brief History of Marijuana Use

Earliest known evidence of use :10,000 years ago in the Stone Age – pots made from cannabis plant fibers

Earliest known references to use of cannabis for its pharmacological properties: c. 2700 B.C. – Chinese emperor and pharmacist Shen Nung shared knowledge of medicinal cannabis use

Use gradually spread from China to surrounding Asian countries

India: Cannabis used in religious rites

Use did not spread to Middle East, North Africa until much later

Hashish first identified then: Use dates to c. 10th century in Middle East, 11th century in North Africa

Western world first exposed to cannabis in 19th century in medical and popular publications

Cannabis in the Americas (1 of 2)

1545: Spaniards brought cannabis to Chile

1611: Jamestown, Virginia settlers raised cannabis plants for fiber

Hemp became a staple crop, cultivated by George Washington and many others

1629: Cannabis harvested in New England

Remained core U.S. crop until after Civil War

Kentucky = center of hemp production for decades

Following European doctors, American physicians used cannabis as an all-purpose medication in the 1800s

Listed in U.S. Pharmacopeia by 1850s, until 1942

Use for recreational rather than medical purposes was limited during this time

Gautier

French writer Théophile Gautier described in detail his consumption of hashish at Le Club des Hachichins.

Cannabis in the Americas (2 of 2)

Wider recreational use in 1920s, attributed to alcohol prohibition

Early 1920s: tea-pads opened in New York City– like social clubs for smoking marijuana

Little public concern and only one law against it (1926) in Louisiana

1932: Federal Bureau of Narcotics Director Anslinger promoted anti-marijuana laws

Increased states with such laws from 16 in 1930 to nearly all states by 1937

Progressively stricter penalties thereafter

Throughout 1960s: penalties included life imprisonment and death

Since 1970s: Gradual movement toward decriminalizing marijuana for personal and medicinal use

2020: 14 states and the District of Columbia decriminalized marijuana and legalized recreational and medicinal use

30 other states allow medicinal use but vary regarding decriminalization

Use and possession remain fully illegal in six states

Committee Reports on Marijuana (1 of 2)

Comprehensive reports on the use of marijuana and its effects published in the past century:

1894: Indian Hemp Drugs Commission Report

1933: Panama Canal Zone Military Investigations (1916-1929)

1944: LaGuardia Committee Report – one of most widely known investigations

Findings: Marijuana use not particularly harmful; no evidence of aggression, violence, or belligerence as consequences; psychoactive effects including, in extremes, “mental confusion and excitement of a delirious nature with periods of laughter and of anxiety”

1968: Baroness Wootton Report (Great Britain)

1972: Report of the Canadian Government’s LeDain Commission

1972: First Report of the National Commission on Marihuana and Drug Abuse (entitled Marihuana: A Signal of Misunderstanding)

1982: Marijuana and Health, the Ninth Report to the U.S. Congress (NIDA)

1984: Drug Abuse and Drug Abuse Research (USDHHS)

1988: Britain’s House of Lords – recommended approval of smoking marijuana for treating certain medical disorders

Committee Reports on Marijuana (2 of 2)

1999: U.S. National Academy of Sciences – Concluded there was scientific foundation for studying marijuana as a treatment vehicle in pain relief, control of nausea and vomiting, and appetite stimulation

2002: Cannabis: Our Position for a Canadian Public Policy (Senate Special Committee on Illegal Drugs) – Recommendations:

Amendments to existing law for compassionate medical access to cannabis, derivatives

A system for licensed individuals to produce and sell cannabis

Government amnesty for anyone convicted of possession under current/past legislation

2017: The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research – National Academies of Sciences, Engineering, and Medicine (NAS)

Health impacts of cannabis, derivatives

Therapeutic use

Included use to relieve multiple sclerosis spasticity as well as chronic pain and chemotherapy-induced nausea and vomiting

Psychosocial effects

Results of this report are bases for information throughout the rest of this chapter

Knowledge Check 1: Historical Overview

Question: Marijuana use increased during the _____ as a result of _______________.

1920s; alcohol prohibition

1930s; less strict statutes

1960s; decriminalizing use

Knowledge Check 1: Answer

Question: Marijuana use increased during the _____ as a result of _______________.

1920s; alcohol prohibition

1930s; less strict statutes

1960s; decriminalizing use

Answer: a. alcohol prohibition. With far less access to alcohol, people turned to recreational use of marijuana during the 1920s. Laws against marijuana became much more, not less, strict during the 1930s. They became progressively stricter during the 1960s. Decriminalizing use began in the 1970s.

Epidemiology

11.2

Marijuana Use Worldwide (1 of 2)

Marijuana = most widely used illicit drug in Western world; third most used recreational drug after alcohol and tobacco

World Health Organization (WHO): Illicit substance most widely cultivated, trafficked, misused

December 2020: United Nations reclassified cannabis to a less dangerous drug

UN Office on Drugs and Crime (2015) estimated 128.5 – 232.1 million people aged 15-64 had used cannabis in past year (= 2.7-4.9% of world population)

Highest per capita rate of use = Oceania; then Africa, then the Americas, then Europe, then Asia

2019 National Survey on Drug Use and Health (NSDUH, SAMHSA, 2020): c. 48.2 million Americans had used marijuana in past year = significant increase

Lifetime use: Prevalence rates gradually rising since mid-1990s

Marijuana Use Worldwide (2 of 2)

NSDUH: Current marijuana use has been likely to be higher for men than for women

Past-month marijuana use increased across most racial/ethnic groups (See Figure 11.2)

Marijuana use overall declined 1979-1992 and 2001-2006, increased 1992-2001 and 2006-2019

Reasons for periods of decline are likely associated with marijuana laws

Since U.S. legalization began in 1993, marijuana use has made a comeback

U.S. Trends in Prevalence of Marijuana or Hashish Use

U.S. Trends: Past-Month Marijuana Use by Race/Ethnicity

Trends in Use: High School Seniors

Knowledge Check 2: Epidemiology

Question: According to the Substance Abuse and Mental Health Services Administration (SAMHSA)’s National Survey on Drug Use and Health (NSDUH), which of the following is true of recent trends in marijuana use?

Women have been more likely than men to be currently using marijuana.

People aged 35+ have had higher rates of current use than those 18-25.

Use in the past month has decreased across most racial / ethnic groups.

From 2002-2014, past-month use by people age 55+ increased the most.

Knowledge Check 2: Answer

Women have been more likely than men to be currently using marijuana.

People age 35+ have had higher rates of current use than those 18-25.

Use in the past month has decreased across most racial / ethnic groups.

From 2002-2014, past-month use by people age 55+ increased the most.

Answer: d. From 2002-214, past-month use by people age 55+ increased the most. Men have been more likely than women to be current users. People age 35+ have had lower rates of current use than those 18-25. Use in the past month has increased across most racial / ethnic groups.

Methods of Use

11.3

Methods of Using Marijuana and Hashish

Marijuana and hashish were Ingested in Indian centuries ago in liquid and food form; people have also chewed marijuana leaves

Most common way of using marijuana in the U.S. = smoking

Typically smoked in joint (cigarette) form

This is also the most efficient method for absorption

Also smoked in bongs (water pipes)

Also smoked in blunts (tobacco-leaf cigar wrappers, emptied of tobacco, refilled with marijuana)

Increases risks over smoking joints by enhancing CO exposure and raising heart rate

More recently: “vaping” (vaporization – comparable to process used with e-cigarettes)

“Dabbing” (heating hash oil, inhaling vapor)

Heating a “dab” of hash oil on the tip of a glass or titanium rod using a blowtorch; hence, has a considerable risk of serious burns

Knowledge Check 3: Methods of Use

Question: Which of the following methods of use of marijuana or hashish has the greatest risk of accidentally sustaining serious burns?

Smoking a joint

Smoking a blunt

Vaping cannabis

Dabbing cannabis

Knowledge Check 3: Answer

Question: Which of the following methods of use of marijuana or hashish has the greatest risk of accidentally sustaining serious burns?

Smoking a joint

Smoking a blunt

Vaping cannabis

Dabbing cannabis

Answer: d. Dabbing cannabis. While there is some risk of accidental burns from smoking anything that is burning, dabbing typically involves heating hash oil with a blowtorch, which carries a much greater risk of sustaining serious burns.

Active Ingredients

11.4

Cannabinoids and THC

1821: First chemical analysis of cannabis performed

More than 400 individual chemical compounds have been identified in the plant

Over 60 of these chemicals, cannabinoids, are unique to the cannabis plant

1964: Principal psychoactive agent isolated = delta-9-tetrahydrocannabinol (D-9-THC, or just THC)

The D-9-THC cannabinoid accounts for the vast majority of known specific pharmacological actions of marijuana

Other cannabinoids, like cannabidiol and cannabinol, can also be biologically active

They can modify THC effects but tend not to be psychoactive in and of themselves

Potency of Cannabis

Strength varies considerably

Most marijuana grown in the U.S. has lower THC content than that grown in other countries

Marijuana smoked in the U.S. today is considerably stronger than 3 decades ago

THC content was c. 2% in 1980, now averages 10-12%

Comparable figures reported in United Kingdom

Higher THC potency generally found in “homegrown” cannabis (grown in large-scale domestic indoor environments) – 10-30% in sinsemilla (seedless variety)

Hash oil = concentrated liquid marijuana extract derived from the cannabis plant using solvents

First appeared in the U.S. in 1971

Higher potency than marijuana leaf or resin: may contain as much as 60% THC; more generally found to be c. 20%

Knowledge Check 4: Active Ingredients

Question: Which of the following shows the correct chronological sequence of these events related to the active ingredients of cannabis?

First chemical analysis of cannabis; isolation of principal psychoactive agent in cannabis; appearance of hash oil in the United States

Isolation of principal psychoactive agent in cannabis; appearance of hash oil in the United States; first chemical analysis of cannabis

Appearance of hash oil in the United States; isolation of principal psychoactive agent in cannabis; first chemical analysis of cannabis

Knowledge Check 4: Answer

Question: Which of the following shows the correct chronological sequence of these events related to the active ingredients of cannabis?

First chemical analysis of cannabis; isolation of principal psychoactive agent in cannabis; appearance of hash oil in the United States

Isolation of principal psychoactive agent in cannabis; appearance of hash oil in the United States; first chemical analysis of cannabis

Appearance of hash oil in the United States; isolation of principal psychoactive agent in cannabis; first chemical analysis of cannabis

Answer: a. First chemical analysis of cannabis; isolation of principal psychoactive agent in cannabis; appearance of hash oil in the United States. The first known chemical analysis of cannabis was made in 1821. The principal psychoactive agent in cannabis (THC) was first isolated in 1964. Hash oil first appeared in the United States in 1971.

Pharmacokinetics

11.5

Absorption

Depends primarily on mode of consumption

Smoking = most rapid and efficient absorption – directly through lungs

Onset of THC action begins within minutes of inhaling

Peak concentrations occur 30-60 minutes later

Effects can be experienced for 2-4 hours

Several factors can influence amount of THC absorbed through smoking:

Potency of the cannabis

About ½ of the THC is in the smoke; amount absorbed by smoking is c. 20%; amount absorbed into the bloodstream is probably less

Length of time smoke is held in the lungs (longer time = more absorption)

Oral ingestion = much slower, relatively inefficient; onset of action can take an hour

Goes through GI tract and liver; liver clears much of the THC before it reaches the brain

However, effects can last longer than from smoking: generally, 4-6 hours

Dose needed for comparable high is c. 3 times greater than needed when smoking

Distribution, Metabolism, and Excretion

Plasma levels of THC decrease rapidly:

THC is deposited in tissues of various organs, especially those with fatty material

Brain, lungs, kidneys, liver

Even when blood levels of THC = 0, levels of THC in other organs can be substantial

THC is also able to cross the placenta and reach the fetus

THC is metabolized over time to products that are less active

This occurs mainly in the liver, but also can occur in other organs

THC metabolites are excreted slowly through feces and urine

About half of the THC is excreted over several days, the rest by c. a week

Some THC metabolites, some of which may still be active in the system, can still be detected in the body:

At least 30 days after ingesting a single dose

In the urine for several weeks after chronic use

Knowledge Check 5: Pharmacokinetics

Question: Some metabolites of THC, which may still be active, can be found in the body at least ________ after a single dose of cannabis.

Three days

Two weeks

Thirty days

Knowledge Check 5: Answer

Question: Some metabolites of THC, which may still be active, can be found in the body at least ________ after a single dose of cannabis.

Three days

Two weeks

Thirty days

Answer : c. Thirty days. Although half of the THC from ingested cannabis is excreted over several days and the rest over about a week, some of its metabolites, which may still be active, can still be found in the body at least 30 days after a single dose.

Mechanisms of Action

11.6

Research Findings

THC in relatively small doses decreases activity in several neurotransmitters:

Acetylcholine, L-glutamate, GABA, noradrenaline, dopamine, 5-HT

Inhibits acetylcholine, especially in the hippocampus – affects memory

THC facilitates release of the neurotransmitter serotonin:

Produces changes in the dopamine system, enhancing activation of movement

Cannabinoid receptors CB1 and CB2 have been identified

Uniquely stimulated by THC

Located mainly in brain areas controlling memory, cognition, the motor system, and mood

CB2 receptors are most prevalent in the immune system

Cannabinoid receptor research has also enabled research into endorphins, brain pathways

PET scans show THC increases blood flow in the cerebral cortex and deeper brain structures

Greatest blood flow = in frontal cortex, critical to executive functions

Cerebral cortex has greater densities of cannabinoid receptors

Marijuana Use by Young People

There has been growing concern over the use of marijuana by young people.

Tolerance and Dependence

Tolerance in humans:

Research findings are inconsistent

Some discrepancies can be due to dose and duration of use being stud

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Marijuana Possession Discussion Topic Do you believe that prosecution for marijuana possession in your state should be more or less rigid than it currently is? Why??

Discussion Topic

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