Anxiety Disorders, Obsessive Compulsive Disorders & Trauma - & Stress-Related Disorders.
Cannabis-Related Disorders
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Transcript of Cannabis-Related Disorders
Cannabis-Related Disorders
Patty Ghazvini, PharmD. CGP.
CannabisWorld-wide, most commonly used illicit
substanceIn the United States, 42% of persons over
age 12 have used cannabis at least once in their lifetime
Between 2007 and 2010, past month use among youth aged 12 to 17 increased from 6.7 to 7.4%, corresponding with a decrease in perception of risk over that same period.
CannabisPrimary psychoactive component – ?????Potency – percentage of THC in the dry
weight of the sampleSubstantial increases in the potency of street
samples over the last few decades
Physiologic Effects of MarijuanaStimulation of the sympathetic nervous
system?????????It has been shown to increase cardiac output
by?????????????????????????????????????
HR increases start?
Causes an increase in carboxyhemoglobin levels – ??????????
Somatic ConsequencesPhysiologic effects –
Immediate pulmonary effects –
Heavy use –
Metabolites cross the placenta and are found in human milk – babies weigh less, shorter
Behavioral and Cognitive ConsequencesAcute effects – ????
Regular use –
More likely to use “harder” drugs such as cocaine
Cannabis WithdrawalDysphoric mood – ?????
Disturbed sleepGI symptomsDecreased appetiteMost symptoms begin during the first week
of abstinence and resolve after a few weeks
Treatment for WithdrawalNo medications are approvedCross-tolerant – ?
Lithium – In clinical studies, 600-600mg/day for 6 days reduced withdrawal symptoms
Depakote
CNN NEWS – Synthetic MarijuanaTeen narrowly escapes death after
smoking synthetic marijuana
One month after the life-changing night, Emily is blind. Each day since has been a fight -- a fight to move a finger, a fight to whisper something to her family, a fight for life, according to her big sister.
Amphetamine and Related Compounds
Crystal – Powder(inhaled, injected)
Crank – Tablet, Capsules
Ice and Glass - Smokeable
Meth Videoshttp://
www.youtube.com/watch?v=CfI5lCoA3b8&list=PL7307BDF42924AC44
http://www.youtube.com/watch?v=v5KL_mc1nx4
Drug and Alcohol Data Information System: 2009
Medical ComplicationsOrgan System Acute Complications Chronic Complications
CNS
Cardiovascular
Pulmonary
GI
LiverHead and Neck
Sexual Function
Reproductive System
TreatmentAmphetamines can be withdrawn abruptlyIf sedation is necessary – ???????(avoid phenothiazines, can worsen dysphoria and highten agitation)Severe hypertension –?????? for
vasodilation(avoid beta or beta-alpha blockers – worsen stimulant-induced cardiotoxicity)Most signs of intoxication clear in 2-4 days
Hallucinogen-Related
Disorders
Lysergic Acid Diethylamide
Magic Mushrooms
LSD videohttp://
www.youtube.com/watch?v=qxmqx7Ifu8s
Lysergic Acid Diethylamide (LSD)Prototype of the hallucinogen class“Psychedelic”Street names:????????????????
Stimulates both dopamine and serotonin receptorsEarly drugs effects???????????????????
No physical or psychological addiction; however, chronic use – psychosis and hallucinogenic persistent perception disorder – “flash backs”
IntoxicationSomatic symptoms:
Psychomimetic symptoms:
Treatment: Supportive care and BZDs for agitation
Psilocybin (Magic Mushrooms)Structural analogues of serotonin
In one study of 174 adolescents with a history of substance abuse, 45 (26%) reported having used hallucinogenic mushrooms at some point in their life, often combined with alcohol or marijuana.
Carter OL, Pettigrew JD, Burr DC, et al. Psilocybin impairs high-level but not low-level motion perception. Neuroreport. Aug 26 2004;15(12):1947-51.
Magic MushroomsFrom data collected from September 2008 to
December 2009, the Youth Risk Behavior Surveillance System reported that 8% of students had used an hallucinogenic drug, including LSD, PCP, angel dust, mescaline, or mushrooms, at least once in their life.
Use was more common among males and Caucasians than among females and African Americans and Hispanics.
Eaton DK, Kann L, Kinchen S, et al. Youth risk behavior surveillance - United States, 2009. MMWR Surveill Summ. Jun 4 2010;59(5):1-142.
Clinical Symptoms of IntoxicationsAlterations in perception begin within 30
minutes and subside after 6 hours.
CNS manifestations: euphoria, visual and religious hallucinations, and feeling closer to nature have been reported.
Visual hallucinations may include perceived motion of stationary objects or surfaces.
TreatmentActivated charcoal – Most useful if
administered within 2 hours of ingestionBenzodiazepines