Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use Related Substances high-resolution scanning micrograph of cannabis Cannabis The term marijuana comes from the Spanish or Portuguese word meaning intoxicant. There is still botanical debate over whether there is 1, 3, or more species of cannabis. Cannabis Sativa Indica is grown for it PSYCHOACTIVE resins. This one may actually be a shorter, bushier version of the plant. Cannabis Sativa Sativa used primarily for its fibers from which hemp rope is made. This species grows as a weed in the US and Canada. Cannabis Ruderalis grows primarily in Russia and not at all in America. Check the species and varieties : http://en.wikipedia.org/wiki/Cannabis_sativa Primary Psychoactive Agent Delta-9 tetrahydrocannabinol (THC) is concentrated in the resin of the plant. Potency depends on the amount of psychoactive substance in the final preparation. Both male and female plants manufacture THC in usable amounts. The resin is secreted in highest quantity by the unfertilized flowers of the female plant grown in the absence of males. The leaves contain 1020% as much THC as is found in the resin. In cooler more humid climates such as North America less resin is produced but the fiber is stronger and more durable. Uses of hemp fiber are said to include: Chinese paper, the Bible, ropes and sails on Columbus’s boats, the Declaration of Independence, WWII parachutes, and the 1st Levi jeans. In hot, dry climates such as North Africa the fiber content is weak but so much resin is produced that the plant looks as if it is covered with dew. Preparations Marijuana: leafy material from cannabis indica that is generally smoked. Contains 2%-5% THC (sativa has <1% THC.) Aka: Grass, pot, weed, bud, Mary Jane, dope, indo (DEA) Sinsemilla (ganja): from the un-pollinated female plant, 4-8% THC. Hashish (charas): a dried concentrate of the resin of cannabis flowers, 8-14% THC. Hashish oil: has 15-60% THC. Marijuana is much less potent. Perhaps 1/3rd to 1/10th as potent as hashish. Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use high-resolution scanning micrograph of cannabis Related Substances An 8000-year time line of cannabis use around the world 1936 film Marihuana A good girl goes to a party, smokes marijuana, and then goes skinnydipping with her girl friends. When one of the girls drowns, the dope pushers come up with a plan to hide the body. A turn of events leads up to The girl being pregnant and unmarried. She is forced to give the child up for adoption and become a drug dealer. *Notice the Needles 1936 film Reefer Madness Tragic events follow when high school students are lured by pushers to try marihuana: a hit and run accident, manslaughter, suicide, rape, and descent into madness all ensue. Gateway Drug Marijuana has more recently been categorized as a Gateway Drug for its role in leading to the use of other illegal drugs. Very few young people use other illegal drugs without first trying marijuana. However, the majority of marijuana users (60%) do not go on to use other illicit drugs. The Terrible Truth (1951) Risk of cocaine use estimated to be >104 times greater for those who have tried marijuana than for those who never have. (DEA) One study showed that rats that had previously been administered THC consumed about 1.5 times more heroin than those that had not. Adolescent cannabis use can overstimulate and alter the pleasure and reward structures of the brain (dopaminergic system), thus increasing the risk of addiction for people who start to use heroin. (Ellgren 2006) Correlational, could be from inherent property of marijuana (ex. brain changes), characteristic of users (ex. risk-seekers), or sociocultural associations with marijuana (ex. peers who use other drugs, lowered inhibitions about drug use). Today Marijuana is a Schedule I substance (most restrictive) under the Controlled Substances Act (1970). Schedule I drugs are classified as having: • a high potential for abuse, • no currently accepted medical use in treatment in the United States • a lack of accepted safety for use of the drug or other substance under medical supervision (Office of National Drug Control Policy) 1973 Oregon became the first state to abolish criminal penalties for marijuana use, substituting civil fines up to $100. This was no different than getting a traffic ticket. By 1978, 9 other states had made possession of a small amount of marijuana only a civil offense. In 1977 President Carter sent a message to Congress in which he asked to abolish all federal criminal penalties for the possession of small amounts of marijuana. He stated: “Penalties against the possession of a drug should not be more damaging to an individual than the use of the drug itself. Therefore, I support legislation amending the federal criminal penalties for the possession of up to 1 ounce of marijuana.” Norml.org – a group working to reform marijuana laws Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use high-resolution scanning micrograph of cannabis Related Substances Classifying Marijuana • Marijuana produces some excitatory effects but it is not generally regarded as a stimulant. • Marijuana produces sedative effects, but a person faces no risk of slipping into a coma or dying. • Marijuana produces mild analgesic effects (pain relief), but it is not related pharmacologically to opiates like drugs. • Marijuana produces hallucinations at high doses, but its structure does not resemble LSD or any other drug formally categorized as hallucinogen. PRIMARY PSYCHOACTIVE AGENT? DELTA 9-TETRAHYDROCANNABINOL (THC) IS CONCENTRATED IN THE RESIN OF THE PLANT. Chemistry was established over 100 years ago by two chemists, the Smith Brothers. 50 cannabinoid-based compounds, with 4 major cannabinoids in the plant: • 2 isomers, a trans-delta-9-THC and a delta-8-THC • A cannabidiol (the 2nd most abundant psychoactive ingredient after THC) • A cannabinol a decomposition product of THC that accumulates as cannabis samples age. After ingestion, delta-9 is converted in the liver to 11-Hydroxy THC which is equally as potent and active. Endocannabinoids are the body’s endogenous cannabinoids. Anandamide (Sanskrit ananda inner bliss) is one endocannabinoid. It is found in chocolate (though there is some controversy over whether the small quantity has any effect on the body). It is about as potent as THC. Chocolate tree Chemical structures of the endocannabinoids anandamide and 2-arachidonylglycerol (2-AG) Time course of plasma THC concentrations After a 6 min smoking period, peak blood levels reached at about 7 min (100 ng/ml plasma). Most THC is absorbed from the blood within 30 min. Moves rapidly into the brain and across the blood/brain/placental barrier. Because fatty chains make it very lipid soluble. Half-life is about 19 hours. Can store in fat cells. Established physiological effects are dose related. Lethal dose for THC use has now been studied, and no human deaths have been reported due to intoxication from cannabis. Radioactively labeled delta-9-THC has been found to persist in the body as an active metabolite as long as 8 days after use. Primary metabolite has a half-life of 50 hours. The complete elimination of the drug can take as long as 6 weeks! After ingestion, delta-9 is converted in the liver to 11-Hydroxy THC which is equally as potent and active. 2/3 of metabolites are excreted in feces. 1/3 of metabolites are excreted in urine. Location of endocannabinoid receptors in a rat brain CB1 receptors (red) are widely distributed in the brain. K. MACKIE/UNIV WASHINGTON, Science, 2006 Unlike classical neurotransmitters… •Endocannabinoids are not stored in vesicles. •Endocannabinoids are retrograde transmitters. They are released from the postsynaptic cell and act on the presynaptic cell. May act presynaptically to reduce the release of glutamate and GABA Unlike classical neurotransmitters… •Endocannabinoids are not stored in vesicles. •Endocannabinoids are retrograde transmitters. They are released from the postsynaptic cell and act on the presynaptic cell. •Reduces the amount of presynaptic neurotransmitter released. May act presynaptically to reduce the release of glutamate and GABA Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use Related Substances high-resolution scanning micrograph of cannabis Dose Response Effects Threshold doses of 2 mg smoked, 5 mg orally, produce euphoria. 7 mg smoked, 17 mg orally, produces feeling enhanced perception and change in sense of time passage. 15 mg smoked, 25 mg orally, subjects report marked changes in body image, perceptual distortion, delusions, and hallucinations. Oral intake associated with nausea, physical discomfort and hangover because dose level cannot be titrated as accurately as smoking. Generally, a new user has to learn how to smoke marijuana. There are three stages: Step 1: involves deeply inhaling the smoke (breath-holding does not substantially enhance the effects of marijuana smoking – lipid solubility). Step 2: the user has to learn to identify and control the effects. Step 3: the user has to learn the label the effects as pleasant. Because of this learning process, usually first time users do not achieve the euphoric stoned or high condition of the repeat user. Also because smokers learn to enjoy marijuana: In a study comparing effects of placebos and cigarettes containing 9 mg of THC, experienced users reported moderate levels of intoxication after use of placebo cigarettes. So, save your money! Physiological Changes Tachycardia (increased heart rate) Enlarged pupils (in some users) Dryness of mouth and throat Reddening of the eyes Inconsistent blood pressure changes Eating Changes (the Munchies) The presence of the cannabinoid receptor in the ventromedial hypothalamus may explain the munchies. • Hunger may be effected by TCH concentration, as cultural differences are observed (Jamaicans think of it as appetite suppressant). • In a study, 9 male subjects were given THC-containing cigarettes either (1) before a private work period, or (2) during access to social periods with other subjects. (1) did not lead to increased food intake (2) did lead to increased food intake, especially between meals. The Anti-Cannabinoid Rimonabant Chronic treatment with rimonabant produces a depression-like phenotype in the brain Beyer et al., 2010, Neurobiology of Disease In contrast, stimulation of marijuana receptors in the brain partially restores neurogenesis, reduces brain inflammation and improves memory in aged rats. Marchalant et al., 2007, 2008, 2009 Effect on Memory One consistent alteration in function is on shortterm memory. The encoding and consolidation of short-term to long-term memory is impaired with marijuana intoxication. Researchers have concluded that information retrieval is intact and not altered by marijuana intoxication. The effects on memory are different from those seen with alcohol. Oral THC produces a dose-dependent impairment in explicit memory Effects of Marijuana on the Brain The hippocampus is a part of the brain’s limbic system necessary for learning and memory. The prefrontal cortex is involved in information processing and higher processes. CB1 Receptors in Hippocampus Hippocampus and prefrontal cortex both rich in CB1 receptors. Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use high-resolution scanning micrograph of cannabis Related Substances Addiction can occur to THC, but only at dose and use levels far above what is now used recreationally. 1977 Report stated that moderate marijuana smoking does not cause changes in the physical structure of the brain, at least those that can be detected. (Does not kill cells – no “dormancy”) Sensitization develops with prolonged use at recreational levels i.e. less drug being necessary with each succeeding use. This is related to its high lipid solubility. Desensitization occurs, but as more THC accumulates in the body, less is needed to reach the threshold of effect. Desensitization of cannabinoid receptors produced by chronic THC exposure 0 Days THC (Control) 3 Days THC 7 Days THC 14 Days THC 21 Days THC Psychopharmacology, 2005 Effects on Immune System? Two types of receptors are known. CB1 is in the brain and CB2 are on immune cells. Most research concludes that it does suppress some aspects of the immune system. But this is subtle. Effects on Reproduction There is not evidence of long term reproductive problems from cannabis use, yet hormonal changes do occur. Males: • Reduces level of testosterone (still within normal levels) • Reduces sperm count (10 joints/day, effect disappears when use stopped) • Changes in shape and morphology of sperm • Effects of THC can be estrogen-like producing breast development (gynecomastia). Females: • Reduction in luteinizing hormone, necessary for egg implantation into the uterus. (Not seen in regular users – implies tolerance). • Reduction of prolactin levels (associated with increased release of dopamine in the hypothalamus), effecting lactation Effects on Cognition There is evidence that long term use may lead to deficits in learning memory and attention. However, it is unknown how long these deficits may persist after abstinence from the drug. Effects of Heavy Marijuana Use on Attention, Learning, & Memory in Undergraduates Researchers compared 65 "heavy users," (smoked a median of 29 of the past 30 days), and 64 "light users," (smoked a median of 1 of the past 30 days). After 19-24 hours of abstinence from marijuana and other illicit drugs and alcohol, the undergraduates were given several standard tests measuring aspects of attention, memory, and learning. Heavy marijuana users made more errors and had more difficulty sustaining attention, shifting attention to meet the demands of changes in the environment, and in registering, processing, and using information. However, the question remains open as to whether this impairment is due to a residue of drug in the brain, a withdrawal effect from the drug, or a frank neurotoxic effect of the drug. H. G. Pope Jr and D. Yurgelun-Todd, 1996 Significant prior usage may reduce the adverse cognitive effects of acute marijuana exposure. This has led to the hypothesis that behavioral (“cognitive”) tolerance develops in heavy marijuana smokers (Hart, 2001). Does marijuana lead to psychosis? There is evidence that cannabis use is correlated with degradation in mental health, especially in those with a predisposition to mental illness. However, it is uncertain whether cannabis use is a cause, contributing factor, associated social phenomenon, or type of self-medication. (Henquet, 2004) In North Africa and India, higher incidence of psychiatric problems associated with THC are reported. The THC is usually more concentrated, used more frequently, and exposure over a lifetime is generally greater than the US. The psychosis theory was tested by Altman and Evenson: They administered questionnaires to people who were being admitted to mental institutions in Missouri. They did this until they identified 38 individuals who had used marijuana prior to having shown psychiatric symptoms. Found out what else these patients were doing prior to being admitted, and discovered 10 other events that occurred more often than marijuana use…. These included the following (in order of frequency): 10. 9. 8. 7. 6. 5. 4. 3. 2. Growing long hair Masturbation Driving a car Taking a sex education class Having sexual intercourse Beer drinking Dancing Tobacco use Kissing And the most frequent thing they did that may have correlated best with psychosis… 1. Watching late night television!! Amotivational Syndrome. Recent studies have found that users of moderate amounts of marijuana show no personality disturbances, but heavy users were characterized as suffering from apathy, dullness, lethargy, and impairment of judgment. However, heavy users were defined as people who smoked 17-200 marijuana cigarettes per day! (1 joint ever waking 5 mins!) This is also correlational evidence. Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use Related Substances high-resolution scanning micrograph of cannabis 1949 A report fount cannabis to be effective in some cases when Phenytoin (Dilantin), anti-convulsant of choice, was found to be ineffective. Queen Victoria and Sir William Osler found it to be effective in the treatment of headaches and migraines. 1972 Report demonstrated that marijuana smoking reduces fluid pressure inside the eye, and was effective in treatment of glaucoma. (1975 1st legal use) Cannabis has some bacteriocidal characteristics and may be effective against gonorrhea. 1975 Medications containing pure THC were found to be effective in reducing severe nausea caused by anti-cancer drugs. Current Medical Use of Cannabinoids Cannabinoids have found medical use in the treatment of nausea and vomiting in chemotherapy patients and as an appetite stimulant in AIDS patients. They’ve been shown to attenuate the pathogenesis of multiple sclerosis. Cannabinoids also have potential in the treatment of degenerative diseases such as Parkinson’s Disease and Alzheimer’s by turning off overactive immune cells. Hempfest 2004 Seattle, Washington (AFP/Getty Images/Ron Wurzer) Pot use among seniors goes up as boomers age. Grayhaired tokers turn to marijuana to relieve many problems of aging. Perry Parks, 67, takes a puff of marijuana at his home in Rockingham, N.C. The retired Army pilot suffered crippling pain from degenerative disc disease and arthritis before turning to marijuana. updated 9:42 a.m. ET, Mon., Feb. 22, 2010 MIAMI, Florida - In her 88 years, Florence Siegel has learned how to relax: A glass of wine. A copy of The New York Times, if she can wrest it from her husband. Some classical music, preferably Bach. And every night, she lifts a pipe to her lips and smokes marijuana. Cannabinoids Background History & Prohibition Mechanisms of Action Acute Behavioral & Physiological Effects Abuse & Effects of Chronic Exposure Medical Use Related Substances high-resolution scanning micrograph of cannabis Terpenes Marijuana, catnip, wormwood, mints are all in the family of terpenes. Thujone (wormwood) Delta-9-THC Various uses of Catnip tea for medicinal purposes: curing chronic bronchitis, diarrhea, upset stomach, infant colic, flatulency, spasms, and “various lower type female disorders”. Catnip’s active ingredient, nepetalactone causes mood elevation and sedation in humans and euphoria in cats. The tea is said to induce perspiration and has been used to break fevers, bring on sleep, and to cool a person down on a hot summer day. Wormwood Bitter taste (due to absinthin). Has a taste threshold of one part in 70.000. The nurse in Romeo and Juliet smeared oil of wormwood on her nipples to wean Juliet. In the 1850’s it was noticed that prolonged consumption was associated with addiction, euphoria, auditory and visual hallucinations and hyperexcitability. Chronic use is associated with contractions of the face muscles and extremities, anxiety, paranoia, energy loss, numbness, headaches, delirium, paralysis and death. Thujone produces convulsions and death at high doses. Wormwood (artemisia absinthium) was used in US and Europe as a sedative. Oil of wormwood was the most active ingredient in the bright green (due to chlorophyll) alcoholic hallucinogenic drink called absinthe. The oil contains thujone. 1896 poster Thujone is described as a GABA receptor antagonist. It was thought to activate CB receptors because of similarity in structure and behavioral effects as THC, but this has come into dispute. Mixed with wine, the herb has been used since antiquity, and was very popular with European artists. VanGogh was particularly addicted. The ritual was to pour the emerald-green liquid slowly over sugar held in a perforated spoon and then diluted with water. Thujone is found in low amounts in drinks such as Vermouth (from the German wermuth for wormwood), Chartreuse, and Benedictine. In 1971 Henri-Louis Pernod bought the formula to make absinthe under his trademark. Then in 1915, his family was forced by the French government to remove wormwood from its drink. The new product is called Pernod. In 1868, the American Journal of Pharmacology wrote “It’s an ignoble poison, destroying life not until it has more or less brutalized its votaries, and made driveling idiots of them.” The End