MARIJUANA – Medical Issues

THE YOUNG BRAIN
Endocabinnoids appear to play a critical role in the development of the adolescent brain. Adolescence is when the wiring and plumbing get finished. Neural networks are defined and strengthened through pruning. the strong synapses, axons and dendrites are preserved, the weak culled. At a time when the brain relies on a finely calibrated dowse of endocannabinoids, the adolescent weed smoker floods the system, overloading it and disrupting it.
Regular use in the young brain before 24 and especially 16 can produce white matter connectivity problems disrupted at a critical time in brain development. At age 13, the brain reward center is mature like adults but the prefrontal cortex is not fully developed before 24. Before 16, users are slower at tasks, have a decreased IQ, impaired impulse control, increased psychosis and increased strokes. It is a damaged brain and these form a majority of marijuana addicts. 9% of marijuana users are dependent as opposed to 23% with heroin, 17% with cocaine, and 15% with alcohol. Both psychologically and physically addictive, they often drop out of life and school. Regular marijuana use causes the brain to stop producing natural canniboids like anandamide, which when marijuana is stopped can be slow to return especially with the drug’s long half life. With its high THC content, modern marijuana is more addictive due to the high pleasure reward received. In 1972, average THC content was less than 1% and now is 13%. Withdrawal can produce irritability, nausea, and insomnia. However, it has not been shown to be a gateway drug. There are no changes in the body produced by marijuana that cause one to crave other drugs when they are exposed to them.
The first receptors stimulated by THC induce pleasure, with impaired coordination and increased appetite – a good-all-over feeling. Most become more creative due to a drug induced release of dopamine which causes one to see things differently and decrease inhibition. However too much in an inexperienced user especially in a non-supportive situation, can lead to panic and anxiety. As many as 36% have a negative high with emotional lability and paranoia. Even simple tasks can become difficult. There is slower cognitive function, and decreased memory due to prefrontal cortex involvement responsible for planning, thinking and coordinating behavior. Driving for the inexperienced user is impaired but poses little difficulty for the regular user as he will have little motor disruption. For the regular user, THC is often a stimulant and not sedative. Dreams tend to be not remembered in the chronic user.

GENES, CANNABIS AND SCHIZPRENIA. The Economist, June 28th, 2014
THAT cannabis and schizophrenia are linked is widely accepted. Several studies suggest the drug can set off short-term psychotic episodes in those already suffering from the condition. Other research, though, does more than this. It shows that people with schizophrenia are twice as likely as others to use cannabis. This leads some to argue that the drug is actually a cause of schizophrenia rather than just a trigger—a line of evidence sometimes employed by those who wish to keep it illegal.
But there is another possible explanation for the association. This is that schizophrenics are, for some reason, more drawn to the stuff in the first place. And support for this idea has just been published in Molecular Psychiatry by Robert Power of King’s College, London, and his colleagues. Their work suggests that people who have gene types associated with schizophrenia, even ones who do not have symptoms, are more likely to take cannabis.
Dr Power and his team drew their data from a study of twins in Australia which had asked relevant questions. The first part of their analysis did not depend on the participants being twins. They looked at 2,082 unrelated individuals aged between 23 and 39 who had been questioned by the study’s organizers about their alcohol and illicit-drug use, who had no symptoms of schizophrenia and who had also given blood samples. Specifically, these volunteers had been asked whether they had ever used cannabis, how old they were when they first tried it and how many times in their life they had taken it. Dr. Power and his team then analyzed the blood samples for genetic markers associated with schizophrenia.
They learned from the interview data that 1,011 members of the sample had taken cannabis, that the average age at which they had started was 20 and that the average number of times they had taken it was 63. The blood analysis let them calculate, from the number of genetic markers each participant had, and the strength of the association each marker had with the development of schizophrenia, a value called the polygenetic-risk score. This ranged from a low of -0.3 to a high of +0.3, values which correspond to a 50% lower-than-average genetic risk of developing the condition and a 50% higher-than-average risk respectively.
From this part of the study the team found two things. One was a correlation between a participant’s risk score and whether he or she had ever taken cannabis. The other was an association between the amount of someone’s cannabis use and those genetic markers most associated with schizophrenia.
The researchers then conducted a second trawl of the data, this time looking specifically at 990 pairs of twins. In this, they found that when neither of a pair had ever used cannabis, which was true of 272 of them, their average genetic risk score was -0.18. When one twin had used the drug but the other had not, which was true for 273 pairs, the genetic-risk score for both averaged -0.02 (ie, almost the same as the general population). When both members of a pair had taken cannabis, which was true for 445 of them, their average score jumped to +0.12.
Together, these findings suggest that people born with a lot of the genetic variations that seem to predispose to schizophrenia are more likely to take cannabis than those born with few of them. The study’s samples are small, so follow-up work will be needed to confirm this result. But if it is so confirmed, that will show the link between cannabis and schizophrenia to be a two-way street. It will not eliminate the possibility that taking cannabis increases someone’s chances of becoming schizophrenic. But it will mean that those predisposed to the condition are indeed more drawn to the drug.
Many genes are involved in risk for schizophrenia, but there are still a host of social or environmental influences at work. For a subset of the population, the earlier the initiation of marijuana use, the earlier the onset of psychosis. And that matters: the later schizophrenia emerges, the greater the likelihood of recovery. Schizophrenia onset in a 15-year-old is often permanently life-altering. In a 24-year-old, it can be less damaging, because the person has had the chance to accomplish more psychological social-cevelopmetnal milestones. Perhaps most people can safely use marijuana, but schizophrenics cannot.

PREGNANCY
THC may have epigenetic effects (also found in heroin and cocaine): studies in rats show that exposure to marijuana’s effects in parents and grandparents is passed through DNA – it changes the way genes express themselves in the brains of offspring. This doesn’t necessarily mean that parents who smoked weed in high school will have damaged kids but there is the potential.

MEDICAL USES
In recent years, pharmaceutical companies have worked to license THC (the active ingredient in cannabis) for medical purposes. In the extensive testing required for licensing by Health Canada, virtually no serious side effects were encountered. There is addiction potential with cannabis, in fact some authorities estimate as many as 10% of regular users will develop an addiction syndrome and suffer personal, social and occupational harm as a consequence. To keep a proper perspective, the frequency and severity of cannabis addiction is on the low end of the scale compared to alcohol and tobacco. In addition, the withdrawal syndrome, if present at all, resulting from sudden cessation is relatively mild, consisting of drug craving and irritability lasting 3-7 days.
1. Protection from physical and emotional trauma. Cannabinoids and anandamide protect our brains. Our brain needs to remember things but it also needs to forget things. You need to forget what is unnecessary and what is not good for your mental health – a war, a trauma, a aversive memory of some kind. The cannabinoid system is crucial in helping us push bad memories away.
2. Cancer. Palliative role in alleviating side effects of the disease and chemotherapy especially nausea, loss of appetite, pain and sleep disorders. Nabilone is an oral medication used for nausea from cancer chemotherapy and as an appetite stimulant in the cancer setting.
The Internet has thousands of claims that it can cure cancer, most anecdotal and very weak at best and fraudulent at worst. Manuel Guzman is a biochemist from the Complutense university of Madrid, Spain, who has been studying cannabis for 20 years. Brain tumors induced in rats with human brain tumour cells and then treated with THC for one week disappeared completely in one-third and reduced in another third. But it is not known if this can be extrapolated to humans. A combination of THC, CBD and temozolomide (a moderately successful conventional chemotherapy drug) works well in treating brain tumours in mice by preventing their spread but also triggering them to commit suicide. The THC-CBD is supplied as an oral spray called Sativex developed by GW Pharmaceuticals. Many more studies are needed.
Marijuana and Lung Cancer. A 2012 US HMO Study of 61,000 insured patients showed no increased risk of lung, colorectal, melanoma, or breast cancers in current or former cannabis smokers versus those who have never smoked or experimenters when controlled for tobacco use, alcohol intake and socioeconomic status. 2012 report from the British Lung Foundation warned smoking marijuana is hazardous to the lungs and can also cause tuberculosis and Legionnaires’ disease. The study showed public awareness of the health consequences was low with almost one-third of the British population believing it is not harmful. 2011 University of Colorado Cancer Centre Study concluded that there is little direct evidence that THC or other cannabinoids are carcinogenic. A 2007 study by Harvard University researchers found that THC in marijuana cut tumor growth in half in common lung cancer tumours and significantly reduced the cancer’s ability to spread. 2005 University of California study concluded that smoking marijuana – even regularly and heavily – does not lead to lung cancer.
Studies have not demonstrated a link between lung cancer and cancers of the neck and throat despite researcher’s expectation to the contrary.
3. AIDS. Increases appetite and decreases nausea. There is an FDA-appoved synthetic version approved.
4. Glaucoma. Decreases pressure in the eye.
5. MS. Decreases neuropathic pain, spasticity and muscle spasms. An extract has been approved for MS patients in Europe and Canada, but not the US. Sativex is an oral spray licensed for treating neuropathic pain in multiple sclerosis.
6. Post-traumatic-stress-disorder – PTSD. Decreases memory of war events, nightmares and dreams. Its use in PTSD owes its role in extinguishing unpleasant memories. Part of PTSD is due to the brains’s stress buffers being blown out by trauma. Endocabinnoids in the amygdala (the brain region important for emotional learning and memory) act as a key mechanism for memory extinction.
7. Dementia. Neuroprotectant role.
8. Parkinson’s Disease. Neuroprotectant role.
9. Strokes. Neuroprotectant role.
10. Tourettes syndrome. Decreases tics.
11. Seizure Disorders.
Widely used anti convulsants are paid for by insurance, are highly addictive, highly toxic, very sedating but legal. Marijuana should be part of the tool box of any doctor treating epilepsy.
Gervais Syndrome is a form of intractable epilepsy with ADHD features, self-destructive behavior, and very delayed development that results in death by early childhood. Charlotte Fiji was a five year old girl having 300 seizures per week and was featured on the CNN show “Weed”. No traditional therapies worked but marijuana with a high CBD content of 17% (and low THC content of .4%) reduced the seizures to one per week and the child started to develop normally. It took the family a long time to come to the decision to use marijuana and then it was very difficult to get high CBD/low THC marijuana which has minimal commercial value. The less than 2% THC content produced no high. This strain of marijuana is called Charlottes Web in honour of her.
At the time of the documentary in August, 2013, there were 41 children using marijuana for epilepsy with many more waiting. By 2015, more than a hundred families with children have moved to Colorado, especially near Colorado Springs, where there is a growing knowledge base of cannabis producers, the kinship of parents coping with similar orders, the quality of the dispensaries and the expertise of the test labs in ensuring consistent cannabis-oil formulations. Realm of Caring is a nonprofit organization in Colorado that assists families. Go to ngm.com/more to see a video on stories of families who have elected to give cannabis to their kids.
Schizencephaly is a congenital brain malformation caused by an abnormal cleft left when one of the hemispheres of the brain did not develop fully in utero. Adelyn Patrick from Maine started having a few seizures at 6 months, was having 20-30 within a few months, then 100 and then 300 per day. Anticonvulsants reduced the seizures but also put her to sleep for the most of the day. Mother quit her job and Adelyn was hospitalized 20 times in the next nine months. The family moved to Colorado Springs to obtain high-CBD oil and the seizures all but stopped – one or two per day – but even those are less intense. Her other meds were weaned and she woke up, has had no hospitalizations. She listens more, she laughs, sh’s learned how to hug and vocalize.
12. Myoclonic diaphragmatic flutter, an uncommon condition that results in intractable frequent contractions of his diaphragm that make talking and breathing difficult and is life threatening. All other treatments including many addictive medical drugs were ineffective but marijuana produced immediate relief.
13. Head injuries. It may protect the brain.
14. Amyotrophic lateral sclerosis (Lou Gehrig’s Disease).
15. Psoriasis.
16. Osteoporosis.
17. Long term effects of meth addiction. Reduces anxiety.

SIDE EFFECTS
1. Respiratory. Unfiltered cannabis, inhaled deeply, has more carbon monoxide and tar than cigarettes. Cannabis has not been shown to cause chronic lung disease, although it does cause worsening of symptoms in those already suffering from cigarette induced chronic obstructive lung disease.
2. Heart. Heart rate can double which may lead to a panic attack. Shortly after use, the risk of heart attack can increase significantly.
3. Panic and anxiety. Too much in an inexperienced user, especially in a non-supportive situation, can lead to panic and anxiety. As many as 36% have a negative high with emotional lability and paranoia.
4. Impairment. Even simple tasks can become difficult. There is slower cognitive function, and decreased memory due to prefrontal cortex involvement responsible for planning, thinking and coordinating behaviour. A Canadian performed study reported in the CMAJ (Dr. Peter Fried 2002) showed that current heavy cannabis smokers demonstrated a 4% drop in measured IQ compared to pre-adolescent testing. Light smokers showed no change, and previous heavy smokers similarly showed no change. Conclusion: you are dumber while you are stoned but there does not seem to be any lasting effects on intelligence.
5. Schizophrenia. Its role in inducing psychosis in people predisposed to psychosis has been questioned. See above discussion. There is an observed statistical correlation between cannabis and the onset of schizophrenia with psychotic symptoms. However, there is no evidence that there is a causal relationship between cannabis and schizophrenia. Over the past 50 years, cannabis use in North America has increased several-fold, whereas schizophrenia rates have remained constant.
6. The young brain. Regular use in the young brain before 24 and especially 16 can produce white matter connectivity problems disrupted at a critical time in brain development. At age 13, the brain reward centre is mature like adults but the prefrontal cortex is not fully developed before 24. Before 16, users are slower at tasks, have a decreased IQ, increased psychosis and increased strokes. It is a damaged brain and these form a majority of marijuana addicts.
7. Dependency. 9% of marijuana users are dependent as opposed to 23% with heroin, 17% with cocaine, and 15% with alcohol. Both psychologically and physically addictive, they often drop out of life and school. Regular marijuana use causes the brain to stop producing natural canniboids like anandamide, which when marijuana is stopped can be slow to return especially with the drug’s long half life. With its high THC content, modern marijuana is more addictive due to the high pleasure reward received. In 1972, average THC content was less than 1% and now is 13%. Withdrawal can produce irritability, nausea, and insomnia.
8. Gateway drug? However, it has not been shown to be a gateway drug. There are no changes in the body produced by marijuana that cause one to crave other drugs when they are exposed to them.
9. Driving for the inexperienced user is impaired but poses little difficulty for the regular user as he will have little motor disruption. For the regular user, THC is often a stimulant and not sedative.
10. Dreams tend to be not remembered in the chronic user.
11. Male fertility reduction.
12. Short term memory loss, difficulty concentrating.
13. Bladder spasticity. With long term use, bladder irritability with marked urgency is not rare. Incontinence can occur. When THC consumption is stopped, this improves significantly over a few weeks.
14. Long Term Effect on Intelligence and Memory. In August 2012, Reuters reported on one of the world’s largest and longest running marijuana research studies that concluded people who wait until they are adults to take up cannabis do not show any significant mental declines in their memory and intelligence. However, the unprecedented study concluded that teenagers who become hooked on cannabis before they reach 18 may be causing lasting damage.
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Do you smoke weed recreationally? Here’s what experts want you to know.

Today’s cannabis strains are not your grandma’s weed—and they may be impacting your mental health, heart health, and more.

By Meryl Davids Landau
March 22, 2024 NATIONAL GEOGRAPHIC 

Some 23 states and the District of Columbia have legalized recreational cannabis in recent years, and others, including Florida, will vote to do so in November. This changing landscape has led to a dramatic rise in consumption, with some 62 million Americans using cannabis in 2023. But legalization of cannabis doesn’t mean that regular consumption is completely safe.

A growing body of evidence has documented an array of health concerns beyond just dry mouth and fatigue and includes both mental and physical illnesses. One recent study even links cannabis consumption to heart disease.

People think about Bob Marley when they think about cannabis. They think it’s natural, it’s Mother Nature, that it’s not going to do any harm. A review of the substance published in the BMJ found numerous potential problems.

Cannabis isn’t dangerous in the same way opioids are. People don’t die from cannabis overdose. But it can have a lot of other consequences to both physical and psychological health.

Stronger strains abound

Some of the problems can be attributed to the stronger strains now available. Today’s products are “not your grandmother’s weed”.

These products are much more potent and come in so many different formulations, that it’s very different from those in the sixties and even the nineties.

The way people consume cannabis today increases the amount of the active ingredient, tetrahydrocannabinol (THC), they ingest. Vaping and edibles generally deliver higher quantities than rolling and smoking joints do.

Psychological distress is a significant problem

One of the lesser-known but troublesome risks of regular cannabis use is substance-abuse psychosis, where a person has delusions or paranoia, hears voices, and otherwise temporarily loses touch with reality. The psychosis generally resolves within a few days, but in some cases requires hospitalization.

This condition can occur with any psychologically altering substances, but the risk from cannabis is higher even than from cocaine.

You’re more likely to develop substance-abuse psychosis if you use cannabis daily, but I cannot tell you there’s a safe amount that would prevent this. Young adults and males are the most prone.

Especially worrisome, up to a third of people who experience substance-abuse psychosis go on to develop the more permanent condition of schizophrenia.

(Schizophrenia in women is widely misunderstood—and misdiagnosed)

Observational studies also connect other mental health conditions to frequent cannabis use. Solmi’s review found that depression increases, as does violence among dating couples. And since cannabis causes cognitive impairment—as well as visual impairment—car accidents have risen among users who drive while under the influence.

Experts especially worry about the mental health impacts for teenagers. Some 17 percent of tenth graders report using cannabis, even though no state has legalized the drug for anyone under 21.

Adolescents are 37 percent more likely to develop depression by young adulthood if they regularly use cannabis compared to non-users. Rates of suicide are also higher. Teenage brains are going through a time of maturity and pruning, so when substances are put in there, they have more of an influence than they do on adult brains.

Cannabis harms the heart

Regular use of cannabis can also lead to significant physical problems.

People who use the drug regularly have a higher risk for heart attack, stroke, and other heart disease, according to a large population-based study published in the Journal of the American Heart Association in February. Heart attack rates rose 25 percent while stroke increased 42 percent in this group, the researchers found.

This likely occurs because THC affects blood flow in the arteries and because receptors for cannabinoids exist throughout the cardiovascular system, the authors state. People who smoke their weed also boost their heart disease risk from the particulate matter they inhale alongside the THC.

Other studies have linked cannabis with improving nausea and vomiting after chemotherapy, but the BMJ review found regular users can actually suffer from an extended vomiting condition known as hyperemesis. This is rare, but it’s increasing as more people use the drug.

Pregnant women who use cannabis regularly are more likely to have preterm births and dangerously small babies. More research is needed to determine whether this results from the drug itself or from other lifestyle factors among those who choose to use cannabis while they are pregnant, Solmi says.

Cannabis addiction is a concern

Many people perceive cannabis to be safer than alcohol, but one in five cannabis users develop an addiction to the drug. Symptoms of cannabis use disorder are like those for other substances.

If people experience cravings, feel they need more and more to get the same effects, they’ve had unsuccessful attempts to quit or cut down,” or have several other symptoms “that’s a warning”.

As with alcohol, cannabis addiction can lead to personal, financial, legal, and health problems.

Certain groups are at particularly heightened risk for this addiction. Rates in veterans have increased substantially since 2005, Hasin found in her research. She attributes this to a combination of increased potency and greater acceptance of the drug from its legal status, as well as the likely use of cannabis to self-medicate chronic pain and psychiatric disorders. “The VA has done a good job of reducing unnecessary prescribing of opioids in veterans, so some of them might be turning to cannabis,” she says.

(Is pain relief from cannabis all in your head?)

Young people are also at risk for developing this disorder. Youth who begin using the drug at earlier ages or who have a family history of addiction especially heighten their odds for trouble.

People younger than 25 should avoid cannabis altogether. They have no idea how they will react to cannabis. You’re gambling with your brain and your health. For everyone else, moderation is key. This isn’t a benign substance that has no risk. Most users will be fine, but we can’t predict who will develop problems.

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I would like to think of myself as a full time traveler. I have been retired since 2006 and in that time have traveled every winter for four to seven months. The months that I am "home", are often also spent on the road, hiking or kayaking. I hope to present a website that describes my travel along with my hiking and sea kayaking experiences.
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