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What are the acute effects of marijuana use?
Marijuana's effects begin
immediately after the drug enters the brain and last from 1 to 3
hours. If marijuana is consumed in food or drink, the short-term
effects begin more slowly, usually in 1/2 to 1 hour, and last
longer, for as long as 4 hours. Smoking marijuana deposits several
times more THC into the blood than does eating or drinking the
drug.30
Within a few minutes after inhaling marijuana smoke, an
individual's heart begins beating more rapidly, the bronchial
passages relax and become enlarged, and blood vessels in the eyes
expand, making the eyes look red. The heart rate, normally 70 to 80
beats per minute, may increase by 20 to 50 beats per minute or, in
some cases, even double.16
This effect can be greater if other drugs are taken with
marijuana.31
As THC enters the brain, it causes a user to feel euphoric - or
"high" - by acting in the brain's reward system, areas of the brain
that respond to stimuli such as food and drink as well as most drugs
of abuse. THC activates the reward system in the same way that
nearly all drugs of abuse do, by stimulating brain cells to release
the chemical dopamine.32,33,34
A marijuana user may experience pleasant sensations, colors and
sounds may seem more intense, and time appears to pass very slowly.
The user's mouth feels dry, and he or she may suddenly become very
hungry and thirsty. His or her hands may tremble and grow cold. The
euphoria passes after awhile, and then the user may feel sleepy or
depressed. Occasionally, marijuana use produces anxiety, fear,
distrust, or panic.
Marijuana use impairs a person's ability to form memories, recall
events (see Marijuana, Memory, and the Hippocampus), and shift
attention from one thing to another.8,35
THC also disrupts coordination and balance by binding to receptors
in the cerebellum and basal ganglia, parts of the brain that
regulate balance, posture, coordination of movement, and reaction
time.11
Through its effects on the brain and body, marijuana intoxication
can cause accidents. Studies show that approximately 6 to 11 percent
of fatal accident victims test positive for THC. In many of these
cases, alcohol is detected as well.36,
37,
38
In a study conducted by the National Highway Traffic Safety
Administration, a moderate dose of marijuana alone was shown to
impair driving performance; however, the effects of even a low dose
of marijuana combined with alcohol were markedly greater than for
either drug alone39.
Driving indices measured included reaction time, visual search
frequency (driver checking side streets), and the ability to
perceive and/or respond to changes in the relative velocity of other
vehicles.
Marijuana users who have taken high doses of the drug may
experience acute toxic psychosis, which includes hallucinations,
delusions, and depersonalization - a loss of the sense of personal
identity, or self-recognition.10,16
Although the specific causes of these symptoms remain unknown, they
appear to occur more frequently when a high dose of cannabis is
consumed in food or drink rather than smoked.
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When marijuana is smoked, its active ingredient THC
travels throughout the body, including the brain, to
produce its many effects. THC attaches to sites called
cannabinoid receptors on nerve cells in the brain,
affecting the way those cells work. Cannabinoid
receptors are abundant in parts of the brain that
regulate movement, coordination, learning and memory,
higher cognitive functions such as judgment, and
pleasure. |
Brain
Region |
Functions
Associated With Region |
Brain regions in which
cannabinoid receptors are abundant |
Cerebellum |
Body movement
coordination |
Hippocampus |
Learning and memory |
Cerebral cortex, especially
cingulate, frontal, and parietal regions |
Higher cognitive
functions |
Nucleus accumbens |
Reward |
Basal Ganglia
- Substantia nigra pars reticulata
- Entopeduncular nucleus
- Globus pallidus
- Putamen
|
Movement control |
Brain regions in which
cannabinoid receptors are moderately
concentrated |
Hypothalamus |
Body housekeeping functions
(body temperature regulation, salt and water balance,
reproductive function) |
Amygdala |
Emotional response,
fear |
Spinal cord |
Peripheral sensation,
including pain |
Brain stem |
Sleep and arousal,
temperature regulation, motor control |
Central gray |
Analgesia |
Nucleus of the solitary
tract |
Visceral sensation, nausea
and
vomiting | |
How does marijuana use affect physical health?
Marijuana use has been shown to
increase users' difficulty in trying to quit smoking tobacco40.
This was recently reported in a study comparing smoking cessation in
adults who smoked both marijuana and tobacco with those who smoked
only tobacco. The relationship between marijuana use and continued
smoking was particularly strong in those who smoked marijuana daily
at the time of the initial interview, 13 years prior to the followup
interview.
A study of 450 individuals found that people who smoke marijuana
frequently but do not smoke tobacco have more health problems and
miss more days of work than nonsmokers do.41
Many of the extra sick days used by the marijuana smokers in the
study were for respiratory illnesses.
Even infrequent marijuana use can cause burning and stinging of
the mouth and throat, often accompanied by a heavy cough. Someone
who smokes marijuana regularly may have many of the same respiratory
problems that tobacco smokers do, such as daily cough and phlegm
production, more frequent acute chest illnesses, a heightened risk
of lung infections, and a greater tendency toward obstructed
airways.4
Cancer of the respiratory tract and lungs may also be promoted by
marijuana smoke.4
A study comparing 173 cancer patients and 176 healthy individuals
produced strong evidence that smoking marijuana increases the
likelihood of developing cancer of the head or neck, and that the
more marijuana smoked, the greater the increase.18
A statistical analysis of the data suggested that marijuana smoking
doubled or tripled the risk of these cancers.
Marijuana has the potential to promote cancer of the lungs and
other parts of the respiratory tract because it contains irritants
and carcinogens.42
In fact, marijuana smoke contains 50 percent to 70 percent more
carcinogenic hydrocarbons than does tobacco smoke.43
It also produces high levels of an enzyme that converts certain
hydrocarbons into their carcinogenic form, levels that may
accelerate the changes that ultimately produce malignant cells.44
Marijuana users usually inhale more deeply and hold their breath
longer than tobacco smokers do, which increases the lungs' exposure
to carcinogenic smoke. These facts suggest that, puff for puff,
smoking marijuana may increase the risk of cancer more than smoking
tobacco does.
Some adverse health effects caused by marijuana may occur because
THC impairs the immune system's ability to fight off infectious
diseases and cancer. In laboratory experiments that exposed animal
and human cells to THC or other marijuana ingredients, the normal
disease-preventing reactions of many of the key types of immune
cells were inhibited.17
In other studies, mice exposed to THC or related substances were
more likely than unexposed mice to develop bacterial infections and
tumors.15,45
One study has indicated that a person's risk of heart attack
during the first hour after smoking marijuana is four times his or
her usual risk.46
The researchers suggest that a heart attack might occur, in part,
because marijuana raises blood pressure and heart rate and reduces
the oxygen-carrying capacity of blood.
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Marijuana's damage to short-term memory seems to
occur because THC alters the way in which information is
processed by the hippocampus, a brain area responsible
for memory formation. Laboratory rats treated with THC
displayed the same reduced ability to perform tasks
requiring short-term memory as other rats showed after
nerve cells in their hippocampus were destroyed.65
In addition, the THC-treated rats had the greatest
difficulty with the tasks precisely during the time when
the drug was interfering most with the normal
functioning of cells in the hippocampus.
As people age, they normally lose neurons in the
hippocampus, which decreases their ability to remember
events. Chronic THC exposure may hasten the age-related
loss of hippocampal neurons. In one series of studies,
rats exposed to THC every day for 8 months
(approximately 30 percent of their lifespan), when
examined at 11 to 12 months of age, showed nerve cell
loss equivalent to that of unexposed animals twice their
age.66 | |
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THC owes many of its effects to its similarity to a
family of chemicals called the endogenous
cannabinoids, which are natural Cannabis-like
chemicals. Because a THC molecule is shaped like these
endogenous cannabinoids, it interacts with the same
receptors on nerve cells, the cannabinoid receptors,
that endogenous cannabinoids do, and it influences many
of the same processes. Research has shown that the
endogenous cannabinoids help control a wide array of
mental and physical processes in the brain and
throughout the body, including memory and perception,
fine motor coordination, pain sensations,67
immunity to disease, and reproduction.68
When someone smokes marijuana, THC overstimulates the
cannabinoid receptors, leading to a disruption of the
endogenous cannabinoids' normal control. This
overstimulation produces the intoxication experienced by
marijuana smokers. Over time, it may degrade some
cannabinoid receptors, possibly producing permanent
adverse effects and contributing to addiction and risk
for a withdrawal syndrome.69,70
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THC, the main active ingredient in marijuana,
produces effects that potentially can be useful for
treating a variety of medical conditions. It is the main
ingredient in a medication that is currently used to
treat nausea and increase appetite in patients with
wasting due to cancer chemotherapy or AIDS, to relieve
pain, and to treat glaucoma. Scientists are
investigating other potential medical uses for
cannabinoids, including treating brain damage due to
stroke and neurological disorders such as Parkinson's
disease and Tourette's syndrome.71
Some clinical trials of smoked marijuana for therapy
are underway, but the inconsistency of THC dosage in
different marijuana samples poses a major hindrance to
valid trials and to the safe and effective use of the
drug. Moreover, the adverse effects of marijuana smoke
on the respiratory system will offset the helpfulness of
smoked marijuana for some patients. Finally, little is
known about the many chemicals besides THC that are in
marijuana, or their possible deleterious impact on
patients with medical
conditions. | | |
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