Addictions: Cannabis

Cannabis is the short name for the plant cannabis sativa. Cannabis contains a chemical called THC (Delta-9 tetrahydrocannabinol). THC is a mind altering drug. People usually take it for the effects that it has on their mood and their feelings. THC is also a depressant drug, that is, it slows the brain down, particularly if taken in high doses. It can give people hallucinations, make them feel sedated or sleepy or it can act as a stimulant.
Marijuana is the dried leaves and flowers of the cannabis plant. It may range in colour from green to grey or brown. It may be fine like dried tea, or leafy. Marijuana is usually smoked as a rolled cigarette, but it can be eaten if combined with food (for example, baked in cookies). Other names for marijuana include dope, pot, grass, spliff, dak, buds, ganga, hooch and weed.
Hashish, commonly referred to as hash, is made from the resin of the cannabis plant. Hashish is often sold in hard cubes and may be brown to black in colour. It is usually smoked with tobacco (rolled into a cigarette) but can be eaten as well. Hashish is more potent or powerful in its effects than marijuana.
Hashish oil is a concentrated form of hashish. It is very potent and small amounts can produce marked effects. Marijuana, hashish and hashish oil are often taken through a pipe or bong which cools the smoke through water. Sometimes hashish oil is taken by a process called spotting. Spotting involves heating implements to combine with hashish to produce smoke (often cutlery knives are used on a stove). Burnt tips of knives are usually a sign that they have been used for this purpose.
Improved cultivation of cannabis has produced significant increases in the amount of THC in marijuana over the past decade.
Cannabis use is illegal in New Zealand. People who use or sell it can be charged under the Misuse of Drugs Act (1975).
How cannabis works
When smoked, cannabis is rapidly absorbed through the lungs into the blood, its level peaking in the blood about 30 minutes after being taken. However, cannabis is highly lipid soluble – that means it is attracted to fat cells. It is quickly taken from the blood and stored in fat cells. The THC is then released very slowly, and unevenly, back into the blood. Different figures are sometimes quoted about how long THC can remain in the body’s fat stores. The general answer is that it stays in the body for a very long period compared with other drugs, potentially for several months.
Effects of cannabis use
It is not possible to accurately summarise or predict the immediate effects of using cannabis because each person may experience individual and different effects. These effects will depend on:
• how much cannabis is taken, the way it is taken and the form in which it is taken
• how strong it is
• how experienced the user is
• the general physical health of the user
• the mental health of the user
• the user’s mood when they start taking the drug
• the setting in which they take the drug
• whether other drugs are taken as well.
Short-term effects
Although cannabis is a depressant or brain slowing drug, people often say that being intoxicated (stoned, wasted, out of it) is a very stimulating experience. The user feels very happy or high, loose or uninhibited.
Some people find that using cannabis is a negative experience. They may feel anxious, self-conscious or have paranoid thoughts. Some experience acute anxiety and panic.
People who are intoxicated on cannabis usually feel more sensitive to things around them and sensations can seem different. For example, time can seem to slow down, colours seem brighter and richer and new details and meanings can be seen in things. People concentrate less well, often talk and laugh more than usual and can have problems with their balance. Physically the pulse rate increases (from between 20 to 50 percent above the usual heart rate), the eyes become bloodshot, appetite often increases (they get the ‘munchies’) and co-ordination can be affected, making activities such as driving a car or operating machinery difficult and dangerous.
If large doses of cannabis are taken, the resulting toxicity can cause symptoms of confusion, paranoia, panic attacks, hallucinations and feelings of unreality. New users may also experience acute paranoid experiences which usually stop after intoxication wears off.
Cannabis also often impairs short-term memory and attention and makes it harder to complete complex tasks, i.e., tasks which involve doing several things at once. There is some evidence that women who smoke cannabis during the time of conception or while pregnant may increase the risk of their child being born with birth defects. Pregnant women who continue to smoke cannabis are probably at greater risk of giving birth to low birth weight babies.
Longer-term and chronic effects
A number of longer-term effects have been seen in people who use cannabis heavily. Some New Zealand researchers define heavy use as using ten times or more in a 30 day period. Heavy cannabis use effects can include the following.
• An increased risk of developing cancer of the respiratory tract. These risks are more likely to do with smoking as the method of taking cannabis, rather than the properties of the drug itself.
• An adverse effect on people with pre-existing cardiovascular disease, since cannabis use significantly raises the heart rate. (There is no evidence that cannabis use will cause permanent damaging effects to a normal, healthy cardiovascular system).
• A risk of developing chronic bronchitis, possibly irreversible obstructive lung disease, possibly lung cancer and cancers of the aero-digestive tract.
• Heavy use of cannabis is sometimes associated with a reduction in energy and drive. This has been referred to as amotivation (not having any motivation). This problem is more likely to be an acute effect which will go away if cannabis use stops. There is poor evidence of this syndrome existing even among heavy, long-term cannabis users.
• Heavy cannabis use affects the ability to learn. This is related to decreased concentration levels, reduced short-term memory and difficulties with thinking. These problems go away if cannabis use stops.
• Chronic heavy cannabis use can reduce sex drive in some people. It can lower sperm count in males and lead to irregular periods in females. This problem goes away if cannabis use stops.
• People can become dependent on cannabis (see section below on ‘Problematic Use of Cannabis’).
Many people with mental health problems also use cannabis. Generally, it is not a good drug for such people to use. People with mental health problems need to try and keep their brain level or stable. Cannabis excites and then slows the brain down. In particular, it can make anyone who has ever been paranoid, more paranoid.
Cannabis use
People who use cannabis include those:
• who have experimented once or twice, usually out of curiosity about the effects
• who use it occasionally or in a social situation
• whose use is problematic
• who experience serious cannabis and cannabis-related problems.
Experimental use
In a 1990 study of drug use in New Zealand, researchers surveyed about 5,000 people aged 15 to 45 years. Forty three percent of those sampled said that they had used cannabis at some time, but 23 percent said they had not used it more than five times. Only 12 percent of the group said they were currently using cannabis, with three percent saying they had used cannabis more than ten times in the past 30 days.
The study showed that a lot of this group of New Zealanders had tried cannabis but that, for about half, their use was experimental. They would be unlikely to develop problems with cannabis.
Social use
People who use cannabis socially do not feel a compulsion to use it, but rather choose to use it for its effects, which they enjoy. This use is generally relatively light and usually does not lead to health or social problems for the user. However, cannabis use is illegal in New Zealand, and people who use it socially may be charged with possession for personal use of a class B or class C drug under the Misuse of Drugs Act (1975).
Problem use of cannabis
Cannabis use can be considered a problem when people start to see cannabis use as more important than other activities, or if problems related to cannabis use arise. Indicators of problematic use include hassles with friends or family, health effects, financial pressure or using cannabis as a way to manage difficult feelings, stresses or situations.
Dependent use of cannabis
Relative to other drugs, cannabis is considered less addictive than opiates (heroin, opium, etc) cocaine or nicotine. It is thought to be more like alcohol in terms of risk of dependence.
Dependence on cannabis is the most common dependence on an illegal drug in New Zealand and Australia. When a person is dependent on cannabis he/she experiences problems controlling use, and continues to use it despite negative consequences. Cannabis use may assume more importance than other activities. Signs of dependence include the following.
Increased tolerance, which means that larger amounts of the drug are needed to get the same effect that was obtained previously from smaller amounts. If a person smokes regularly they will need more cannabis to get the same effect
Psychological dependence, which means that cannabis can become central to a person’s thoughts and actions. They may spend large amounts of time thinking about cannabis, about how they are going to get their cannabis and about when they are next going to use it. Features of psychological dependence include craving cannabis; using more cannabis than was originally intended; being unable to control how much is taken and needing cannabis to feel normal, happy or good.
Physical dependence, which means both that tolerance can occur, as above, and that a person can go into physical withdrawal if they stop using cannabis. Withdrawal is often associated with flu-like feelings, irritability, mood swings, finding it difficult to sleep and headaches. Withdrawal from cannabis can take two weeks or longer for heavy, long-term users.
Reducing risks from cannabis use
Sometimes people feel a pressure to try cannabis if friends are doing it or talking about it. It is important that you do what is right for you rather than what you feel pressured to do when it comes to any risky behaviour. It is much better to say no or just ignore people’s invitation to use cannabis if you’re not entirely comfortable with going ahead. If you are in two minds about trying the drug it is probably more likely that you won’t enjoy the experience anyway. If you have decided to experiment with using cannabis, consider these suggestions.
• Be with friends you trust and feel safe with. Before you use, acknowledge to those you are with that it is your first time and ask them to agree that if you or anyone wants comforting or other help that it is okay to ask for it.
• Use marijuana leaf rather than hashish or hashish oil since these products are much more potent. If you don’t know what it is, ask. Also ask how strong it is. If you are told that it is strong, use very small amounts. Remember it takes a while to kick in so you may not feel any effect for three to five minutes.
• If you have a mental health problem or have a family with a history of mental health problems you may experience very nasty effects such as severe confusion, paranoia or panic. It is better that you don’t use the drug at all if you are in this category. If you insist on using it, do so in very small doses (for example, try one or two puffs and leave it for another half hour or so) so that you can recover quickly if the experience is unpleasant. Some people panic because they cannot escape from the anxiety and fear they experience.
• Use the drug in an environment where you can relax. Don’t experiment in a situation where you are pressured to perform, such as around exam time.
• Walk, take a cab or have a non-using person take you out. Driving after cannabis use is dangerous.
• Do not take cannabis with other drugs (including alcohol) at the same time. Taking more than one drug at once can make reactions worse.
• If you are emotionally low or vulnerable, put off your experiment for another time. Sometimes cannabis makes people more distressed.
• It is better not to take cannabis in front of children or invite young adolescents to join you. Don’t tell kids afterwards what you did or what it was like, in a way that glamorises it.
Do you have a cannabis problem?
Whether or not cannabis is a good drug or a bad drug is not an issue when deciding if you have a problem with it. Here are some issues to think about in relation to your cannabis use.
• How much do you smoke?
• Does it seem that you are getting stoned too often?
• Are you using too much cannabis?
• Do you seem to be dependent on cannabis?
• Do you need to smoke more and more cannabis to get the same effect?
• Does your life, and the things that you do, seem to revolve around cannabis?
• Do you feel irritable if you do not have any cannabis?
• Is cannabis causing a problem in your life?
• Is it getting you into conflict with your family, whanau or friends, or interfering with your relationships?
• Is cannabis affecting your performance at work or at school?
• Is cannabis getting you into trouble with the law?
• Are you mixing only with people who also use cannabis?
• Is cannabis affecting your physical health?
• Is it connected to your feeling anxious, depressed, or confused?
• Are you having problems with your memory and concentration?
• If you are currently experiencing mental health problems, is your cannabis use making it harder for you?
If you answer yes to any of these questions you need to think about whether or not using cannabis is worth it. A useful thing to do is to draw up a list of the good things and the not so good things that you can think of to do with cannabis, and weigh them up. Write down all the good things you can think of, for example, that smoking dope makes you feel better, means that you have a good time with your friends or whatever. In terms of the less good things, consider any negative effects that cannabis is having on your life.
What does your family or whanau say about your drug use? Is it having any effect on them? On your relationships with others? What about your health? Playing sport? Look at the balance of the good things and the less good things. Is your drug-taking a problem for you or for other people? Do you need to change something about it? If taking marijuana or hashish is causing problems in your life are you ready to do something about it?
Treatment of Cannabis Problems
Getting help
If you are concerned about your own or another person’s cannabis use it may be useful to talk to someone who is trained to help. There are a number of alcohol and drug services to help people (and their family or whanau/partner when this is the choice of the person seeking help) to deal with their cannabis and any other drug problems. These services are free of charge and clients are entitled to confidentiality.
Help may also be available from a general practitioner, youth centre or school counsellor. Some schools have a policy of suspending pupils for using cannabis, so asking for help in this situation may not always be wise.
Making changes
If you decide that you want to do something about your cannabis use, the following things may be helpful to consider.
Reduce your use. If you think you might be dependent on cannabis, probably the best thing to do is to stop using it. If this is too hard then look at ways in which you can cut down
Get support. It is great if you have family or whanau or friends to support you when the going gets tough. You might like to spend more time with people who don’t use cannabis or don’t use heavily. You can choose to talk to someone you trust about how you are feeling when you are feeling bad. You may need someone to remind you about why you need to give up your smoking. If a lot of your family or whanau or close friends are also heavy users of cannabis it may be difficult for them to support you to stop or cut down. In this case you will probably need to look elsewhere for support
Avoid substituting other drugs. If you stop taking cannabis you may be inclined to increase other drug use, for example, alcohol or cigarettes. This is not a good idea
Manage withdrawal symptoms. You might notice that you’re starting to feel irritable, have mood swings or trouble with sleeping. These symptoms may be related to withdrawal.
If you find that there are times when giving up or cutting down is hard, remind yourself why you are doing it.
Counselling or psychological help
You might need to consider other problems or difficulties in your life which cause you worry or stress. Some people use cannabis because they have had painful or difficult experiences growing up or at an earlier time in their life. Sometimes people who have grown up with violence, verbal or other abuse use drugs as a way of coping with unpleasant memories or emotional pain. Using drugs such as cannabis can seem to help ease the memories and the pain, but usually this is not a good long-term answer. After the drug wears off the problem is still there. It may be helpful to get counselling to talk about and help resolve these past issues. Particularly consider any things which might trigger you to increase your cannabis use again.
The drug and alcohol services mentioned above or at the end of this article will direct you to an appropriate counsellor or therapist. All types of therapy/counselling should be provided in a manner which is respectful of you and with which you feel comfortable and free to ask questions. It should be consistent with and incorporate your cultural beliefs and practices.

This post is an excerpt from www.mentalhealth.org.nz

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