Cannabis is a plant that contains psychoactive substances (PAS). THC is the main component that produces most of the psychoactive effects of cannabis. The effects of cannabis are caused by the chemical compounds in the plant, including When ingested orally, THC can produce stronger psychotropic effects than when inhaled. .. receptors in our body interact with the cannabinoids in milk to stimulate a suckling response in newborns so as to prevent growth failure" . However, some want to avoid the “getting high” aspect of cannabis. Other people find the psychoactive effects of THC to be very beneficial, but.
Effects of THC Avoiding Psychoactive
While they are both cannabinoids the chemical category that provides most of the therapeutic effects of cannabis that have amazing therapeutic benefits, the psychoactive effects of THC can be limiting or undesirable for some people. Many patients tell me that they are interested in trying medical cannabis because nothing else has worked, or because the medications they have taken have had adverse side effects.
Other people find the psychoactive effects of THC to be very beneficial, but recognize that there are times in their life where it would be undesirable to be experiencing the mind-altering effects of THC. It is important to note that every patient is unique and there are always a number of factors that go into the recommendations I make.
Typically, mg of THC will bring a psychoactive effect for most adults. The answer lies in the fact that different cannabinoids interact with the brain in different ways. When CB1 receptors are stimulated, as happens when it binds with THC, a mood-altering or mind-altering effect can occur.
While some patients find this to be beneficial, for others it is undesirable. In fact, many of the therapeutic properties of CBD and THC occur from their stimulation of CB2 receptors, although the body utilizes these substances in other ways as well. Therefore, CBD provides at least two potential benefits.
Unless a patient has had personal experience using cannabis, I typically suggest starting on CBD only, at a low dose. It decomposes when exposed to air, heat or light 13 and readily binds to glass and plastic. Further, cannabinoids inhibit macromolecular metabolism 21 , 22 in a dose-dependent manner and have a wide range of effects on enzyme systems, hormone secretion and neurotransmitters 18 , 21 — The evidence of numerous and diffuse in vivo effects support the non-specific interaction hypothesis for THC.
Cannabinoids exert various physiological effects by interacting with specific cannabinoid receptors CB receptors present in the brain and periphery CB1 receptors in the brain 25 are particularly concentrated in anatomical regions associated with cognition, memory, reward, anxiety, pain sensory perception, motor co-ordination and endocrine function 26 , CB2 receptors are localized to the spleen and other peripheral tissues These receptors may play a role in the immune suppressive actions of cannabinoids.
The physiological ligands for these receptors appear to be a family of anandamides 29 which are derivatives of arachidonic acid, related to prostaglandins.
Although the physiological implications of these ligand-receptor interactions are not completely understood, it is suggested to be connected with opioids, GABAergic, dopaminergic, noradrenergic, serotonergic, cholinergic, glucocorticoid and prostaglandin systems 26 , 28 , 30 , The many effects of exogenous cannabinoids derived from cannabis result from perturbation of this complex system, but the exact mechanism is not clear.
Cannabis is known to have behavioral and physiological effects 27 — Behavioral effects include feeling of euphoria, relaxation, altered time perception, lack of concentration and impaired learning.
Memory and mood changes such as panic and paranoid reactions have also been reported. Physiological effects include rapid changes in heart rate and diastolic blood pressure, conjunctival suffusion, dry mouth and throat, increased appetite, vasodilatation and decreased respiratory rate 31 , Cannabis also affects the immune and endocrine system; and its abuse is associated with lung damage and EEG alterations 28 , 30 , 33 , 34 , Cannabinoids appear to affect the same reward systems as alcohol, cocaine and opioids Evidence for cannabis dependence is now available from epidemiological studies 6 , 8 of long-term users 58 , 59 , clinical populations 75 , 77 and controlled experiments on withdrawal and tolerance 35 , 36 , 37 , Tolerance to cannabis can occur in relation to mood, psychomotor performance, sleep, arterial pressure, body temperature, and antiemetic properties.
The critical elements of cannabis dependence include preoccupation with its use, compulsion to use and relapse or recurrent use of the substance In addition to producing dependence, cannabis use is associated with a wide range of psychiatric disorders While there is a clear relationship between the use of cannabis and psychosis, different hypotheses for the same have been propounded.
One such, which describes psychosis occurring exclusively with cannabis use has limited evidence. There is strong evidence that cannabis use may precipitate schizophrenia or exacerbate its symptoms. There is also reasonable evidence that cannabis use exacerbates the symptoms of psychosis Heavy cannabis mg oral and mg smoked use can specifically cause a mania-like psychosis and more generally act as a precipitant for manic relapse in bipolar patients 37 , 44 , It is possible that cannabis exposure is a contributing factor that interacts with other known and unknown genetic and environmental factors culminating in psychiatric illness It is noticed that in many developed countries, persons with severe mental disorders are more likely to use, abuse, and become dependent on psychoactive substances especially cannabis as compared to the general population 47 , The same phenomenon has not been established so far in India.
It is excreted in urine mainly as a glucuronic acid conjugate It quickly reaches high concentration in blood In some subjects, more than one plasma peak was observed 52 , This tissue distribution is followed by slow redistribution of it from the deep fat deposits back into the blood stream.
The half- life of it for an infrequent user is 1. The average plasma clearance rates have been reported to be There are eighteen acidic metabolites of cannabis identified in urine 68 and most of these metabolites form a conjugate with glucuronic acid, which increases its water solubility.
Urinary excretion half-life of THCCOOH was observed to be approximately 30 hours after seven days and hours after twelve days of monitoring 69 , Measurement of cannabinoids is necessary for pharmacokinetic studies, drug treatment, workplace drug testing and drug impaired driving investigations Because of increasing use of cannabis, developing a whole range of efficient testing methods has become essential.
Urine is the preferred sample because of higher concentration and longer detection time of metabolites in it. Moreover, urine can easily be sampled. Lower concentrations of THCA can be associated with occasional use, carry over period or probable cannabis exposure Immunoassay is adopted as a preliminary method in the drug testing program However, false negative and false positive results occur from structurally related drugs that are recognized by the antibodies or occasionally artifacts such as adulterants affecting pH, detergents and other surfactants 73 , For this reason, any positive result using immunoassay must be confirmed by chromatographic techniques 75 , Cannabis has a long half-life in humans 67 days In chronic cannabis users, it is particularly difficult to determine whether a positive result for cannabis represents a new episode of drug use or continued excretion of residual drug Algorithmic models have been devised to determine whether THC levels represent new use or the carry-over from previous use 62 , However, these models are not very accurate in discriminating new use and carry-over in chronic users Interaction of chronic marijuana with other drugs of abuse has not been studied in detail.
Studies are required to understand and compare the abuse potential of marijuana in isolation and in combination with other drugs and its adverse effects on performance 80 , A unique opportunity is available in India for studying various facts of cannabis uses since it is possible to locate people that are abusing cannabis continuously in one form or other over several years, both in isolation, or in combination with other drugs.
In such subjects, the pharmacology and the interaction of cannabis with other drugs can be studied 26 , 82 , There can be indirect exposure to cannabis through passive smoking. There is now a consensus that positive results due to passive inhalation are possible In an interesting study from Pakistan, major metabolites of cannabis were found in the milk of cows which had grazed upon naturally growing cannabis vegetation Children fed on such milk showed metabolites of cannabis in the urine, suggesting passive consumption through milk A feeding infant would ingest 0.
Another point to be considered is that cannabis has an effect on the quality and quantity of the breast milk 85 , It could inhibit lactation by inhibiting prolactin production via direct action on the mammary gland. However, this data has not been confirmed in human subjects. Clinical and pharmacokinetic data indicate that cannabis use is dangerous during breast-feeding for the child Due to the intake of cannabis or other drugs psychotropic, antiepileptic by mothers, infant children depending on breast-feeding might exhibit physiological effects such as sedation or reduced muscular tone and other adverse effects The recreational use of cannabis among youth has increased worldwide over the past few decades.
Despite the demonstration of some bio-medical applications, cannabis abuse is associated with different disease conditions including probable risk of developing psychiatric disorders.
Hence, there have been significant efforts to identify the toxic factors in cannabis and establish the role of component causes that underlie individual susceptibility to cannabinoid-related psychotic disorders.
Secondly, it has necessitated the development of efficient methods to identify and quantify various cannabis metabolites from different body fluids.
While immunoassay is adopted as a preliminary test, advanced chromatographic techniques are used for confirmation. Research in the future should focus on the molecular changes induced by acute and long-term exposure to cannabis and the contribution of individual psychoactive components. All the authors declare that they have no conflicts of interest.
PS conducted the literature searches and wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript. National Center for Biotechnology Information , U. Journal List Iran J Psychiatry v. Author information Copyright and License information Disclaimer. This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3. This article has been cited by other articles in PMC.
Abstract Cannabis is one of the most widely abused substances throughout the world. Cannabis, Cannabinoids, Mental disorders, Tetrahydrocannabinol. Table 1 Different Preparations of Cannabinoids Form Source Methods of abuse 1. Bhang Fresh leaves and stalk Mixed with food items and consumed orally 3.
Open in a separate window. Chemical Components of Cannabis The cannabis plant contains more than chemicals of which 61 are cannabinoids 9 , 10 Figure 1. Table 2 Cannabinoids and their Properties Behavioral and Physiological Effects of Cannabis Cannabis is known to have behavioral and physiological effects 27 — Cannabis Dependence and Tolerance Cannabinoids appear to affect the same reward systems as alcohol, cocaine and opioids Psychiatric Conditions Associated with Cannabis Abuse In addition to producing dependence, cannabis use is associated with a wide range of psychiatric disorders Detection and Analysis of Cannabinoids by Different Analytical Techniques Measurement of cannabinoids is necessary for pharmacokinetic studies, drug treatment, workplace drug testing and drug impaired driving investigations Interactions of Cannabis with other Drugs of Abuse Interaction of chronic marijuana with other drugs of abuse has not been studied in detail.
Effects of Indirect Cannabis Exposure There can be indirect exposure to cannabis through passive smoking. Conclusions The recreational use of cannabis among youth has increased worldwide over the past few decades.
Conflict of interest All the authors declare that they have no conflicts of interest. Contributors PS conducted the literature searches and wrote the first draft of the manuscript. First identification of drugs in Egyptian mummies.
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Cannabis Use and Performance in Adolescents. The pharmacologic effects of daily marijuana smoking in humans. Musshoff F, Madea B. Review of biologic matrices urine, blood, hair as indicators of recent or ongoing cannabis use. Skopp G, Potsch L.
An investigation of the stability of free and glucuronidated nor-delta9-tetrahydrocannabinolcarboxylic acid in authentic urine samples. Vapor phase silylation of laboratory glassware. Discovery of the presence and functional expression of cannabinoid CB2 receptors in brain.
Chemistry, Metabolism, and Toxicology of Cannabis: Clinical Implications
These psychoactive products are obtained from the plant Cannabis sativa Interestingly, the biomedical benefits of cannabis have also been recognized from in amber silicate glassware to avoid loss during analytical procedures (14 ). The long-term adverse effects of cannabis are difficult to evaluate. Since and Some traits predispose individuals to the use of psychoactive substances in general. Alcohol remains the main toxic agent that hepatitis C patients should avoid. Despite popular belief, it is possible to overdose on cannabis. Here are some ways to avoid negative side effects from a large dose of.