Marijuana — Most Widely Used Illegal Drug : Each year, two-thirds of new marijuana users are under the age of 18. One in six of these adolescents will go on to develop marijuana use or dependence. 1 More high school seniors smoke marijuana than smoke cigarettes.2
Chemical Composition: Marijuana comes from the Cannabis sativa plant. It contains over 400 different chemicals from which over 60 are identified as cannabinoids, chemicals specific to the cannabis plant. One of the cannabinoids, delta9-tetrahydrocannabinol (THC), is considered the major psychoactive ingredient. Another cannabinoid is cannabidiol, CBD, which is non-psychoactive.
Burning these chemicals in a joint can release hundreds of toxic chemicals. Marijuana smoke can contain up to 70 percent more carcinogenic materials than tobacco.3 Marijuana smoke contains carbon monoxide, acetaldehyde, phenol, creosol and naphthalene.
Marijuana plants grown outdoors can yield approximately 448 grams or 1 pound of marijuana per plant.5
Marijuana plants grown indoors are generally smaller than those grown outdoors and yield ½ pound of marijuana per plant. However, the plant produces a higher THC potency, and the plant can be harvested 4 times a year.6
Characteristics: Marijuana is much more potent today. According to the University of Mississippi’s Potency Project, the average THC content in the U.S. was: 1.37% in 1978, 3.59% in 1988, 4.43% in 1998 and 8.49% in 2008. Today, the THC content is typically between 12 to 15 percent but can reach as high as 30 percent with high-tech growing methods.7
Today, concentrated super strength marijuana can be procured through extraction by using solvents to strip the cannabinoids from the marijuana plant resulting in a THC-rich product. The THC content (THC, delta-9-tetrahydrocannabinol, is the psychoactive ingredient in marijuana.) can reach over 80%.
Within a few minutes of smoking marijuana, a person may feel intoxicated and/or euphoric lasting two to four hours. Some report feeling thirsty, hungry, sociable, relaxed and sleepy. Others experience opposite effects such as loss of memory and cognitive functions, dizziness, nausea, increased heart rate, heightened sensory perception and time distortions, panic attacks, anxiety, depression, and lack of motivation.
Marijuana is addictive, with known dependence and withdrawal symptoms. A dependent user is one who keeps using despite significant health, social or family problems.8
Research indicates 9 percent of marijuana users become addicted. Alarmingly, one in six, 17 percent, who start in their teens will become addicted, and 25-50 percent of those teens using daily will become addicted.9
The 2010 National Survey on Drug Use and Health, NSDUH, survey found 7.1 million Americans dependent on illegal drugs and 4.5 of those were dependent on marijuana.10 A 2009 survey found 18 percent those being admitted to drug treatment programs, 12-years of age and older, reported marijuana as their primary drug of choice. Of those under 15-years of age, 61 percent reported marijuana as their primary drug of choice.11
Methods of Use: The plant material is dried and then rolled into a cigarette. A cigar may be sliced open and the tobacco replaced with marijuana (blunt). Marijuana is used in edibles and brewed as tea. E-cigarettes are used to smoke marijuana while concealing its use. Vaporization allows for inhaling the psychoactive ingredients through vapor without the chemicals resulting from combustion.
Hashish is made from the sticky resin of the female plant flowers; the resin is rich in THC. The resin is collected, dried, and compressed into shapes and then pieces are broken off and put in pipes to be smoked. The THC level can range as high as 60 percent.
Hash oil is distilled from plant material using a solvent such as butane to extract resin, butane hash oil (BHO). A drop or two of the dark liquid on a cigarette is comparable to a “hard drug.” The THC level can reach over 80 percent. “Dabbing” or “dabs” use originated with butane hash oil. Hash oil is heated and smoke is emitted. The smoke is inhaled. 12
Eating Marijuana: Marijuana-infused food products can cause marijuana poisoning. These products contain concentrated super strength marijuana with THC levels much higher than contained in the marijuana plant. The THC potency can reach over 80%.
When THC is taken orally there are several significant things which happen that make it potentially unsafe and increases the chance for overdose/poisoning. (THC, delta-9-tetrahydrocannabinol, is the psychoactive ingredient in marijuana.) There is no scientific research that defines safe dosages of THC, hence the very real threat of overdose/poisoning.
Marijuana edibles are sold in medical marijuana states and in states which have legalized marijuana. A “package” which can be a bag of cookies or a single candy bar, can contain as much as 100 milligrams of active THC, which is excessive. Ten milligrams is considered by many to be a single serving. Products using infused-marijuana butter and oil, which is concentrated marijuana, have THC levels much higher than contained in the marijuana plant. Portion sizes are problematic. One cookie can have six servings, but cookies and candy bars are usually consumed in an individual serving.
Marijuana edibles have a time delay onset. The onset of action for smoking marijuana is 10-15 seconds, and the onset of action is 30-60 minutes when eating marijuana. Smoking gives the user an immediate sense of what they are taking and how it is affecting them. With the slow onset of action, oral users are prone to repeat or increase the dose and risk taking too much and accumulating lethal amounts of THC in the body.
Ingredients of marijuana suppress vomiting. When a person drinks too many alcoholic beverages, the body’s natural function is to vomit the excess alcohol to avoid alcohol poisoning. Because the onset of action when eating marijuana is 30-60 minutes, users who eat lethal amounts of marijuana may not vomit the excess marijuana, causing marijuana poisoning. It is this vomit suppression characteristic of marijuana that makes it attractive to some sick people, and makes it lethal for those who eat excessive amounts of marijuana.
High doses of THC can cause temporary symptoms of paranoia, panic, increased blood pressure, and increased heart rate. Consuming edible marijuana by individuals with underlying psychiatric or cardiac disorders can lead to overdose and serious medical harm.
Marijuana edibles pose serious dangers to children. The edibles are packaged as candy, and an unsuspecting child can pick up a piece of candy, cookie or brownie and overdose on THC. Teens can eliminate smoking a joint and having their drug use detected while still getting “high” on an edible. Read more here - Eating Marijuana and Smoking Marijuana Are Dangerously Different
“A-bomb” – marijuana and heroin cigarette, “Burn one” – smoke one, “Fly Mexican Airlines” smoke marijuana, “Love Boat” marijuana dipped in formaldehyde, “Toke” – smoke marijuana, “Up Against the Stem” – addicted to smoking marijuana, and “Zombie Weed” – marijuana with PCP.
Marijuana alone impairs driving. Research shows that a single marijuana joint with a moderate level of THC can impair a person’s ability to drive for more than 24 hours (Leirer et al, 1991). Alcohol and marijuana together produce higher intoxication than marijuana alone or alcohol alone. Studies show that low to moderate doses of alcohol and THC in combination is exceedingly dangerous and renders a driver incapable of driving safely. A person driving under the influence of alcohol and marijuana is two times more likely to risk a fatal crash than a sober person.13
Marijuana impairs cognitive and psychomotor performance. It can slow reaction time, impair motor coordination, limit short-term memory, and make it difficult to concentrate and perform complex tasks. Spatial perception is distorted and time perception is impaired so that perceived time goes faster than clock time.
In 2010, 12 percent of fatal crashes involved marijuana, compared to 4 percent in 1999. One of nine drivers involved in fatal crashes tests positive for marijuana.14
Marijuana can impair learning and motor coordination, perception, judgment, thinking, and memory. The users have difficulty sorting out information, synthesizing and classifying information correctly, and understanding subtle shades of meaning. It can take up to six weeks to regain normal functioning. Marijuana use can lead to poor attendance, dropping out of school, delinquency and behavioral problems.
Adolescents’ brains are not fully developed and don’t fully develop until the early to mid- twenties, making them vulnerable to dependence and long-term changes in the brain. Neuropsychological decline appears in adolescents after persistent marijuana use, and cessation of marijuana use did not fully restore neuropsychological functioning. Findings indicate a neurotoxic effect of marijuana on the adolescent’s brain. There is a higher risk of psychosis and schizophrenia symptoms. Teens smoking marijuana regularly (20 times a month) before age 18 show an average IQ decline of 8 points by age 38.15
Casual marijuana use by young people, ages 18 to 25, was found to produce significant abnormalities in the brain regions specific to emotion and motivation. Changes occurred in the shape, volume and density of the brain, and the more the young adults smoked the more abnormal the brain regions became.
This according to a study done by Northwestern Medicine and Massachusetts General Hospital/Harvard Medical School. The co-senior authors were Hans Breiter, M.D. and Jodi Gilman, Ph.D.
Gilman explains that, “Drugs of abuse can cause more dopamine release than natural rewards like food, sex and social interaction. In those you also get a burst of dopamine but not as much as in many drugs of abuse. That is why drugs take on so much salience, and everything else loses its importance.” 16
The heart rate can rise by 20 to 100 percent after smoking marijuana and remain high for up to three hours.17
Cannabinoid Hyperemesis Syndrome, CHS, is relatively new and coincides with the increasing use of cannabis. The symptoms are recurrent intractable nausea, vomiting and abdominal pain brought on by heavy chronic cannabis use. Frequent hot bathing brings temporary relief from the symptoms. This syndrome was first described in 2004 by JH Allen, de Moore GM, Heddle R. et al.
Cessation of the vomiting phase can occur within 48 hours by abstaining from using cannabis, and treating with fluids and anti-emetic medications.
Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS. Tetrahydrocannabinol, cannabidiol, and cannabigerol are three cannabinoids found in the cannabis plant with opposing effects on the emesis response.18
Gateway Drug: Marijuana can be a gateway drug leading to other illicit drugs. In a University of Otago study of over 1,000 young people ages 15 – 25, regular or heavy use of cannabis was associated with increased risk of using other illicit drugs, abusing or becoming dependent on other illicit drugs, using a wider variety of drugs. The odds of using other illicit drugs was 60 times greater for 15-year-olds who used weekly as compared to nonusers.19
A Yale study showed that alcohol, cigarettes, and marijuana were associated with an increased likelihood of prescription drug abuse in men 18 to 25. In women of that age, only marijuana use was linked with a higher likelihood of prescription drug abuse.20
Marijuana as Medicine: The Federal Food and Drug Administration (FDA) has concluded that marijuana has a high potential for abuse, has no accepted medical use in the United States, and lacks an acceptable level of safety for use even under medical supervision.
Since 1906, the FDA has been tasked with reviewing and approving drugs as safe and effective; manufacturers list the ingredients, directions, side effects, warnings, and date code.
The Federal Food and Drugs Act of 1906 — AN ACT For preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious food, drugs, medicines, and liquors, and for regulating traffic therein, and for other purposes.
The FDA process does not allow for a laissez-faire “buyer beware” approach to public health that “medical” marijuana requires.
Marijuana – Schedule I Substance: As a Schedule I Substance, marijuana is deemed to have a high potential for abuse, no accredited medical use, and a lack of accepted safety under medical supervision.
The Comprehensive Drug Abuse Prevention and Control Act of 1970 requires the pharmaceutical industry to maintain physical security and strict record keeping for certain types of drugs. Controlled substances are divided into five schedules (or classes) on the basis of their potential for abuse, accepted medical use, and accepted safety under medical supervision. No prescriptions may be written for Schedule I substances, and such substances are subject to production quotas by the DEA.
History of Youth Marijuana Use: Youth marijuana use peaked in 1979; 12th-graders’ lifetime marijuana use reached 51 percent. Following an aggressive educational/prevention campaign, marijuana use dropped to 21.1 percent in 1992. A year later, 1993, marijuana use began rising and peaked in 1997 at 37.8 percent.
Marijuana use then began a downward course reaching 27.9 percent in 2008. Since 2008, use has climbed to 32.0 percent in 2013.
Attitudes are an indicator of use. In 1975, 18.1 percent of 12th-graders surveyed indicated there was harm associated with smoking marijuana occasionally. In 1991, 40.6 percent and in 2013, 19.5 percent indicated there was harm associated with smoking marijuana occasionally.
Messages youth receive are an indicator of use. In 1975, 54.8 percent of 12th-graders disapproved of people (who are 18 or older) smoking marijuana occasionally. In 1990, 80.5 percent and in 2013, 58.9 percent disapproved of smoking marijuana occasionally.21
1 Hall and Degenhardt, 2009, SAMSHA, 2010.
2 2010 Monitoring the Future Survey, University of Michigan.
3 Cassie Shortsleeve, interview of Dr. Mahmoud ElSohly, The Truth About Medical Marijuana, Men’s Health 2013, www.menhealth.com/medical-marijuana: Mahmoud A. ElSohly, Ph.D. Director of the National Institute on Drug Abuse (NIDA) Marijuana Project at the National Center for Natural Products Research, School of Pharmacy, University of Mississippi.
4 What Americans Users Spend on Illegal Drugs 1988-2000, Office of National Drug Control Policy, December 2001.
5 University of Mississippi study, June 1992.
6 Mahmoud A. ElSohly, Ph.D. Director of the National Institute on Drug Abuse (NIDA) Marijuana Project at the National Center for Natural Products Research, School of Pharmacy, University of Mississippi.
7 National Institute on Drug Abuse (NIDA), Drug Facts—Marijuana, U.S. Department of Health and Human Services, National Institutes of Health, www.drugabuse.gov.
8 Adolescent Pot Use Leaves Lasting Mental Deficits , http://today.duke.edu/2012/08/potiq, M.H. Meier, Avshalom Caspi, et al. 2012. “Persistent cannabis users show neuropsychological decline to midlife.”
9 Budney AJ, Vandrey RG, Hughes JR, Thostenson JD, Bursac Z. Comparison of cannabis and tobacco withdrawal: Severity and contribution to relapse, Journal of Substance Abuse Treatment, e-publication, March 12, 2008.
10 Marijuana Abuse, Is Marijuana Addictive, National Institute on Drug Abuse (NIDA), www.drugabuse.gov/publications/marijuana-abuse/marijuana-addictive.
11 Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, HHS Pub. No. (SMA) 11-4658, Rockville, MD, SAMHSA, 2011.
12 Breathes, William, Crazy-High Times: The Rise of Hash Oil, Rolling Stone, June 20, 2013, http://www.rollingstone.com/culture/news/crazy-high-times-the-rise-of-hash-oil-20130610
13 Treatment Episode Data Set (Teds) Highlights-2009: National Admissions to Substance Abuse Treatment Services. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, DASIS Series: S-45, DHHS Publication No. SMA 09-4360 Rockville, MD, 2008.
14 Signs Point to Sharp Rise in Drugged Driving Fatalities , Columbia University’s Mailman School of Public Health, Journal of Epidemiology, January 29, 2014.
15 Persistent Cannabis User Show Neuropsychological Decline from Childhood to Midlife, Dunedin Multidisciplinary Health and Development, Dunedin, New Zealand 2012.
16 Hans Breiter, M.D., Jodi Gilman, Ph.D., Journal of Neuroscience, April 16, 2014, http://www.northwestern.edu/newscenter/stories/2014/04/casual-marijuana-use-linked-to-brain-abnormalities-in-students.html#sthash.BbMuPnu1.dpuf
17 Drug Facts, National Institute on Drug Abuse http://www.drugabuse.gov/publications/drugfacts/marijuana
18 Jonnathan A. Galli MD, Ronald Andari Sawaya, MD, Frank K. Friedenberg MD, et al. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis use. Gut. 2004;53:1566–1570. [PMC free article] [PubMed], https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576702/ .
19 Fergusson DM, Boden JM, Horwood LI., Cannabis use and other drug use: testing the cannabis gateway hypothesis, Christchurch Health and Development Study at the Christchurch School of Medicine and Health Sciences, Addiction 2006. http://www.scoop.co.nz/stories/GE0603/S00045.htm.
20 Fiellin, Lynn MED ’96, Yale University School of Medicine, Journal of Adolescent Health, August 20, 2012. www.thecrimereport.org/archive/2012-08-pot-as-gateway-drug.
21 Monitoring the Future National Survey Results On Drug Use, 1975 – 2013, 2013 Overview Key Findings on Adolescent Drug Use, http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2013.pdf