Marijuana (cannabis) is the most commonly used illicit drug worldwide. Some believe it is harmless, while others think it is a dangerous drug. The truth remains somewhere in the middle.
The recent legalization of marijuana for recreational use in Washington State and Colorado has inspired me to write this column with the hope of bringing some objective facts to the ongoing debate. I have written about cannabis in Harm Reduction Journal in an article entitled “Prescribing Cannabis for Harm Reduction.”
The psychoactive chemical of cannabis is delta-9-tetrahydrocannabinol or THC. THC is part of a group of compounds known as cannabinoids. Aside from THC, there have been over 100 different cannabinoids identified in cannabis.
The human body produces its own cannabinoids or endocannabinoids and has specific receptors for these substances. The endocannabinoid system is essential for our body to function normally and is involved in many of our physiological processes. However, we have yet to fully comprehend the extensive nature and function of the endocannabinoid system and more research is needed.
Growers have worked to increase THC levels, which has resulted in today’s cannabis being far more potent than ever before. This means you can smoke much less and experience the same effects as compared to your father’s cannabis.
Every person is unique and thus everyone may be affected somewhat differently by the same drug. Cannabis can be very pleasant for some while making others feel paranoid and uncomfortable. Moreover, a small segment of the population may be prone to having a psychotic episode, but this is rare. In addition, there is a lack of evidence that smoking cannabis causes lung cancer. The scientific literature provides an extensive list of potential adverse effects but that is beyond the scope of this column. Those interested can find them listed on the second page of my article in the Harm Reduction Journal.
People who smoke cannabis frequently find they need to increase the dose for the same effect. This is knows as developing tolerance. An individual who smokes daily ends up consistently flooding their system with cannabinoids, which results in the body decreasing both the receptor sites and the production of endocannabinoids.
When cannabis is decreased or stopped the body can experience withdrawal symptoms. For some, the withdrawal can be so difficult that they begin to smoke again. Daily use may be self-perpetuating in that one may feel anxiety when not smoking, but it disappears after taking a hit. The anxiety is actually a withdrawal symptom created by frequent use. Taking time off from smoking will eliminate the anxiety and infrequent use will keep it away. Using cannabis once or twice per week may manage the tolerance and withdrawal issues.
Humans have the capacity to become addicted to just about anything, including cannabis. If you find yourself smoking all the time and have difficulty taking a break you may have a problem. Seeking help from a physician or a 12-step program such as Marijuana Anonymous can be helpful.
Driving can be dangerous for some individuals who are under the influence of cannabis and should be avoided.
Although cannabis is safer than most other drugs, including alcohol, it can be problematic. People who choose to use it should take into consideration the issues of tolerance, withdrawal, addiction, and safety.
Mark Collen has had chronic pain for over 17 years and now advocates for others with pain. He is an artist and the founder of PainExhibit.com, an educational, visual arts exhibit for artists with chronic pain. Mark also serves on the editorial board of the Journal of Pain & Palliative Care Pharmacotherapy and writes on issues surrounding chronic pain.
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