Cannabis Use: Epidemiology, Pharmacology, Comorbidities, and Adverse Effects

Introduction:

Cannabis is the most common drug used by people and is mainly found in the leaves, stalks, and flowers of a plant called Cannabis sativa. Cannabis comprises almost 120 cannabinoid ingredients, the most common being delta 9- tetrahydrocannabinol (THC) and cannabidiol (CBD). It is used in various forms, such as cigarettes (joints), capsules, tablets, vaping, dapping, bongs, or sprays. Cannabis is a weed, pot, hashish, ganja, or marijuana. This drug is not only used for recreational purposes but also has some medicinal uses and thus produces dose-related effects in a person consuming them. Therapeutic uses of cannabis for advanced-stage cancer and AIDS (acquired-immuno deficiency syndrome) are effective in treating nausea and vomiting.

What Are the Uses of Cannabis?

Cannabis can be used to treat various conditions as listed below:

Pain Management: Cannabis helps in altering the perception of pain in the brain and also can be used to treat conditions that can cause chronic pain, such as:

• Migraine.

• Arthritis (inflammation of the joints).

• Endometriosis.

• Fibromyalgia (tenderness and pain in the muscles).

Neurological Disorders: Cannabis can also be used to treat mental or neurological disorders like:

• Parkinson’s disease.

• Tourette syndrome.

• Epilepsy.

• Anxiety.

• Multiple sclerosis.

• Post-traumatic stress disorder (PTSD).

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Inflammatory Conditions: Cannabis has anti-inflammatory effects also and can be used to treat inflammations in the body, such as:

• Rheumatoid arthritis.

• Crohn’s disease.

• Irritable bowel syndrome.

Sleeping Disorders: Marijuana or cannabis can also help in treating sleep disorders like insomnia, and it also improves sleep disorders by reducing or treating the pain in the body.

What Is the Epidemiology of Cannabis Use?

According to the latest research, almost 2.5 percent of the global population is engaged in cannabis consumption for recreational use. Cannabis is the third most popular psychoactive drug after alcohol and tobacco, and its prevalence has increased among young people. It is one of the most trafficked, produced, cultivated, and abused drugs nowadays, causing drug dependence in young people in developing countries. Cannabis use disorder (CUD) is more prevalent in adolescence because of early consumption and exposure to cannabinoids. Also, males are more likely to develop CUD compared to females.

What Is the Pharmacology of Cannabis Use?

Cannabinoids are available in a wide range with complex pharmacology. Cannabis at a low dose can cause sedation, drowsiness, and euphoria.THC (tetrahydrocannabinol)can be found in plasma within seconds after smoking cannabis. The maximum peak is achieved in five to seven minutes of continuous inhalation of THC. This leads to forming two active and inactive metabolites in feces and urine. The edible form of cannabis takes time to absorb and has a more prolonged effect, up to almost 24 hours. The metabolites can be found in urine culture for at least two weeks after ingestion or smoking cannabinoids.

Its dose-related effects are discussed below:

Physiological Effects

• Effects Mood: Cannabis can induce intoxication with a THC (tetrahydrocannabinol) dose of about 2.5 mg, causing less anxiety, depression, and alertness. The dose-effect usually lasts up to two hours, but it can cause psychosis, severe anxiety, and panic attacks at high levels.

• Effects Perception: Cannabis affects a person’s perception of time, place, color, and emotions, and at higher doses, it can cause hallucinations.

• Cognitive Effects: Cannabinoids disrupt a person’s cognitive performance, causing disorientation and short-term memory loss even with a small dose of about 5 to 10 mg of THC.

Systematic Effects

• Respiratory System: Cannabis smoking has carcinogenic effects on health. It can cause damage to bronchial mucosa and can also be associated with emphysema and bronchitis.

• Cardiovascular System: Cannabis use can cause dose-related tachycardia and other cardiovascular effects. It can also aggravate the existing cardiac condition.

• Other Effects: Chronic cannabis use can cause pregnancy issues and produce endocrine and immunosuppressant effects.

What Are the Comorbidities Associated With Cannabis Use?

Cannabis use disorder (CUD) is commonly related to comorbid mental health problems, including mood swings and anxiety disorders. Cannabis abusers have psychiatric comorbidities due to drug dependency causing various mental and personality disorders.

Signs and symptoms of cannabis use disorder:

• Cannabis consumption even after psychological and physical disorders.

• Cannabis drug craving.

• Inability to quit cannabis use.

• Cannabis abuse during high-risk situations.

• Taking an unintentional amount of cannabis.

• Developing tolerance against the drug.

• Withdrawal symptoms after stopping cannabis use.

What Are the Adverse Effects of Cannabis Use?

The adverse effects of cannabis include:

Short-Term Effects:

• Psychosis.

• Hallucinations.

• Disorientation.

• Headache.

• Nausea and vomiting.

• Memory issues.

• Severe anxiety.

• Drowsiness.

• Fatigue.

• Increased heart rate.

• Increased appetite.

• Dizziness.

• Dehydration.

• Sexual problems, especially in males.

• Panic attacks.

Long-Term Effects:

• Chronic users can develop cannabis dependence syndrome.

• Chronic bronchitis, epithelial damage to the trachea, and other lung diseases are also common with cannabis abuse via smoking.

• Cannabis can aggravate the schizophrenic symptoms existing in a person.

• The drug can cause complications in pregnancy, low birth weight, and fetal developmental disorders.

• Cognitive functions are also impaired selectively, involving memory loss and psychomotor dysfunction.

• Cannabis smoking can cause lung cancer and increase the risk of postnatal cancer due to prolonged smoking habits.

• Cannabis also causes altered brain development in the fetus.

• Diabetes can also occur due to cannabis consumption.

What Are the Medical Precautions for Cannabis Use?

• Risk of developing medicinal use into substance abuse.

• Pre-existing medical history of psychosis, lung disease, and cardiac disease.

• Avoid smoking medicinal cannabis to minimize addiction risk.

• Dose reduction must be made if the complete cessation of the drug is not possible while treating any medical condition.

• Cannabis must not be prescribed with other psychotropic drugs like hypnotics and sedatives.

Conclusion:

Cannabis abuse is majorly related to anxiety disorders and depression. It is the most widely used drug causing psychiatric disorders and other related health issues. The drug is readily available for recreational purposes, and youngsters are more involved in cannabis abuse. Though the drug is also used for medicinal purposes, its side effects can cause health complications if not taken as suggested. Also, the drug is contraindicated if a person already has a history of psychosis and other psychiatric issues. Therefore, the drug is unsafe for therapeutic and recreational purposes and thus should not be consumed in any way.