Report in Health 3Report in Health 3

WEEDWEEDMARIJUANAMARIJUANA

IntroductionIntroduction

Marijuana, common name for a drug made from the dried leaves Marijuana, common name for a drug made from the dried leaves and flowering tops of the Indian hemp plant and flowering tops of the Indian hemp plant Cannabis sativaCannabis sativa. . People smoke, chew, or eat marijuana for its hallucinogenic and People smoke, chew, or eat marijuana for its hallucinogenic and intoxicating effects. It is known by a number of slang names, intoxicating effects. It is known by a number of slang names, including “pot,” “grass,” “reefer,” “weed,” and “Mary Jane.”including “pot,” “grass,” “reefer,” “weed,” and “Mary Jane.”

The flowering tops of the The flowering tops of the CannabisCannabis plant secrete a sticky resin plant secrete a sticky resin that contains the active ingredient of marijuana, known as delta-9-that contains the active ingredient of marijuana, known as delta-9-tetrahydrocannabinol (THC). The plant has both male and female tetrahydrocannabinol (THC). The plant has both male and female forms, and the sticky flowers of the female plant are the most forms, and the sticky flowers of the female plant are the most potent. Hashish is a similar drug prepared from the same plant. It potent. Hashish is a similar drug prepared from the same plant. It differs from marijuana in that it is comprised of only the resin from differs from marijuana in that it is comprised of only the resin from the plant, whereas marijuana is made up of flowering tops and the plant, whereas marijuana is made up of flowering tops and leaves.leaves.

Known in India, Central Asia, and China as early as 3000 bc, Known in India, Central Asia, and China as early as 3000 bc, marijuana has long been used as both a medicine and an marijuana has long been used as both a medicine and an intoxicant. It gained widespread use in the United States in the intoxicant. It gained widespread use in the United States in the 1960s and 1970s, becoming the second most popular drug after 1960s and 1970s, becoming the second most popular drug after alcohol. In subsequent decades its use continued to increase, alcohol. In subsequent decades its use continued to increase, particularly among American teens. According to a survey prepared particularly among American teens. According to a survey prepared in 1998 by the United States Drug Enforcement Agency, marijuana in 1998 by the United States Drug Enforcement Agency, marijuana use among teenagers increased almost 300 percent from 1992 to use among teenagers increased almost 300 percent from 1992 to 1998.1998.

Most countries consider marijuana an illegal substance, but Most countries consider marijuana an illegal substance, but individual countries vary on how they prosecute the use and individual countries vary on how they prosecute the use and possession of marijuana. Some countries only impose small fines, possession of marijuana. Some countries only impose small fines, while others impose harsher punishment, including imprisonment.while others impose harsher punishment, including imprisonment.

In June 2005 the Supreme Court ruled 6 to 3 in In June 2005 the Supreme Court ruled 6 to 3 in Gonzales Gonzales v.v. Raich Raich that federal antidrug laws take precedence over state laws that federal antidrug laws take precedence over state laws authorizing the medical use of marijuana. Voters in 11 states had authorizing the medical use of marijuana. Voters in 11 states had approved so-called medical marijuana laws. The first was approved so-called medical marijuana laws. The first was California’s Compassionate Use Act in 1996. These laws generally California’s Compassionate Use Act in 1996. These laws generally allow patients with diseases such as cancer and acquired allow patients with diseases such as cancer and acquired immunodeficiency syndrome (AIDS) to grow and use marijuana with immunodeficiency syndrome (AIDS) to grow and use marijuana with a physician’s approval for medical purposes. a physician’s approval for medical purposes.

Although the Court’s ruling in Although the Court’s ruling in Gonzales Gonzales v.v. Raich Raich did not overturn did not overturn the state laws, it did override any provisions in those laws the state laws, it did override any provisions in those laws exempting patients in possession of medical marijuana from exempting patients in possession of medical marijuana from federal prosecution under the Controlled Substances Act (part of federal prosecution under the Controlled Substances Act (part of the Comprehensive Drug Abuse Prevention and Control Act of the Comprehensive Drug Abuse Prevention and Control Act of 1970). In its majority opinion, the Court held that the commerce 1970). In its majority opinion, the Court held that the commerce clause of the U.S. Constitution gives Congress the power to clause of the U.S. Constitution gives Congress the power to prohibit the local cultivation and use of marijuana, even if those prohibit the local cultivation and use of marijuana, even if those activities comply with state law for medical use and the drug does activities comply with state law for medical use and the drug does not cross state lines. The dissenting justices, including Chief not cross state lines. The dissenting justices, including Chief Justice Rehnquist, warned that an expansive interpretation of the Justice Rehnquist, warned that an expansive interpretation of the commerce clause would allow federal encroachment of states’ commerce clause would allow federal encroachment of states’ rights. rights.

EffectsEffects

Many users describe two phases of marijuana intoxication: initial Many users describe two phases of marijuana intoxication: initial stimulation, which includes giddiness and euphoria, followed by stimulation, which includes giddiness and euphoria, followed by sedation and pleasant tranquility. Mood changes are often sedation and pleasant tranquility. Mood changes are often accompanied by altered perceptions of time and space. Thinking accompanied by altered perceptions of time and space. Thinking processes become disrupted by fragmentary ideas and memories. processes become disrupted by fragmentary ideas and memories. Many users report increased appetite, heightened sensory Many users report increased appetite, heightened sensory awareness, and general feelings of pleasure.awareness, and general feelings of pleasure.

Negative effects of marijuana use can include confusion, acute Negative effects of marijuana use can include confusion, acute panic reactions, anxiety attacks, fear, a sense of helplessness, panic reactions, anxiety attacks, fear, a sense of helplessness, and loss of self-control. Chronic marijuana users may develop and loss of self-control. Chronic marijuana users may develop amotivational syndrome characterized by passivity, decreased amotivational syndrome characterized by passivity, decreased motivation, and preoccupation with taking drugs. Like alcohol motivation, and preoccupation with taking drugs. Like alcohol intoxication, marijuana intoxication impairs judgment, intoxication, marijuana intoxication impairs judgment, comprehension, memory, speech, problem-solving ability, reaction comprehension, memory, speech, problem-solving ability, reaction time, and driving skills. time, and driving skills.

The effects of long-term marijuana use on the intellect have not The effects of long-term marijuana use on the intellect have not been established, and there is no evidence that marijuana causes been established, and there is no evidence that marijuana causes brain damage. Smoking marijuana can damage the lungs, brain damage. Smoking marijuana can damage the lungs, however, and long-term use may increase the risk of lung cancer. however, and long-term use may increase the risk of lung cancer. Although marijuana is not physically addicting and no physical Although marijuana is not physically addicting and no physical withdrawal symptoms occur when use is discontinued, withdrawal symptoms occur when use is discontinued, psychological dependence develops in some 10 to 20 percent of psychological dependence develops in some 10 to 20 percent of long-term regular users.long-term regular users.

Abnormal ovulation can be caused by a number of disorders of Abnormal ovulation can be caused by a number of disorders of the endocrine system, including thyroid disease, diabetes mellitus, the endocrine system, including thyroid disease, diabetes mellitus, and polycystic ovarian syndrome. Certain chemicals can affect and polycystic ovarian syndrome. Certain chemicals can affect hormonal levels and adversely affect fertility. For instance, hormonal levels and adversely affect fertility. For instance, marijuana use can shorten the menstrual cycle. Cigarette smoking marijuana use can shorten the menstrual cycle. Cigarette smoking reduces some types of hormone production and may deplete egg reduces some types of hormone production and may deplete egg supply.supply.

Marijuana PlantMarijuana Plant

Marijuana is formed from the Marijuana is formed from the dried leaves and flowering dried leaves and flowering tops of the Indian hemp plant tops of the Indian hemp plant Cannabis sativaCannabis sativa. Popularly . Popularly known as “grass,” “pot,” known as “grass,” “pot,” “reefer,” and “Mary Jane,” “reefer,” and “Mary Jane,” marijuana is smoked or marijuana is smoked or chewed for its intoxicating chewed for its intoxicating effect, and it has also been effect, and it has also been used as a sedative and used as a sedative and analgesic. Hashish is formed analgesic. Hashish is formed from the resin of the flowering from the resin of the flowering tops of the same plant, and it tops of the same plant, and it is five to eight times more is five to eight times more potent than marijuana when potent than marijuana when smoked.smoked.

Cannabis Cannabis contains a coarse, tall, hairy annual herb that provides contains a coarse, tall, hairy annual herb that provides fiber from its stems, oil from its seeds, and drugs from its leaves fiber from its stems, oil from its seeds, and drugs from its leaves and flowers. The only species of and flowers. The only species of Cannabis,Cannabis, also called hemp or also called hemp or India hemp, is a native of Central Asia but is widely cultivated and India hemp, is a native of Central Asia but is widely cultivated and found as a weed throughout North America. The plant grows up to found as a weed throughout North America. The plant grows up to 1.8 m (6 ft) tall, with coarsely-toothed, palmately divided leaves 1.8 m (6 ft) tall, with coarsely-toothed, palmately divided leaves and inconspicuous clusters of flowers. Depending on the product and inconspicuous clusters of flowers. Depending on the product desired, the methods and areas of production vary. Hemp is desired, the methods and areas of production vary. Hemp is grown mainly in temperate regions. Seeds yield a drying oil used grown mainly in temperate regions. Seeds yield a drying oil used in the manufacture of varnish, paints, and soap. The seeds are in the manufacture of varnish, paints, and soap. The seeds are also used as bird feed. The fibers have a variety of uses in textiles also used as bird feed. The fibers have a variety of uses in textiles and in rope. The drugs bhang, hashish, and marijuana contain as and in rope. The drugs bhang, hashish, and marijuana contain as their principal component narcotic resins found mostly in the their principal component narcotic resins found mostly in the glandular hairs of the plants. These resins are most abundant glandular hairs of the plants. These resins are most abundant under hot, tropical conditions. In the United States, cannabis may under hot, tropical conditions. In the United States, cannabis may be grown only under government permit.be grown only under government permit.

Scientific classification:Scientific classification: The genus The genus CannabisCannabis belongs to the belongs to the family Moraceae. Hemp is classified as family Moraceae. Hemp is classified as Cannabis sativa.Cannabis sativa.

Hemp, common name for an Asian annual herb, is known for its Hemp, common name for an Asian annual herb, is known for its strong, pliable fibers. This species is often called true hemp or strong, pliable fibers. This species is often called true hemp or Indian hemp. It is cultivated in Eurasia, the United States, and Indian hemp. It is cultivated in Eurasia, the United States, and Chile. A hemp plant may be as small as 91 cm (36 in) or as high Chile. A hemp plant may be as small as 91 cm (36 in) or as high as 5 m (15 ft), depending upon the climate and soil type. The male as 5 m (15 ft), depending upon the climate and soil type. The male plants bear flowers in auxiliary racemes and die soon after plants bear flowers in auxiliary racemes and die soon after pollination. Female plants bear flowers in short, crowded spikes pollination. Female plants bear flowers in short, crowded spikes and die soon after the seed matures. Plants of both sexes are and die soon after the seed matures. Plants of both sexes are used for fiber.used for fiber.

Hemp stems are hollow and have a fibrous inner bark. The fibers Hemp stems are hollow and have a fibrous inner bark. The fibers from this bark are used to make a great variety of textile products, from this bark are used to make a great variety of textile products, including coarse fabrics, ropes, sailcloth, and packing cloth. Soft including coarse fabrics, ropes, sailcloth, and packing cloth. Soft fibers, used for making clothing fabrics in Asia, are obtained from fibers, used for making clothing fabrics in Asia, are obtained from hemp harvested at the time of pollination; strong, coarse fibers are hemp harvested at the time of pollination; strong, coarse fibers are obtained from mature plants. The fibers are removed and obtained from mature plants. The fibers are removed and processed by methods similar to those used in processing flax. processed by methods similar to those used in processing flax. Partially decomposed, the stalks are dried, broken, and shaken to Partially decomposed, the stalks are dried, broken, and shaken to separate the woody stalks from the fibers.separate the woody stalks from the fibers.

HempHemp

The annual herb The annual herb Cannabis Cannabis sativa,sativa, commonly known as commonly known as hemp, is cultivated in the hemp, is cultivated in the United States, Chile, Europe, United States, Chile, Europe, and Asia for a variety of and Asia for a variety of purposes. Manufacturers of purposes. Manufacturers of soft clothing fabrics extract soft clothing fabrics extract recently pollinated fibers from recently pollinated fibers from the inner bark of the hemp the inner bark of the hemp stem, while producers of stem, while producers of coarse fabrics, ropes, and coarse fabrics, ropes, and sailcloth utilize the strong, sailcloth utilize the strong, coarse fibers of more mature coarse fibers of more mature stems. In addition, the flowers stems. In addition, the flowers and leaves of the hemp plant and leaves of the hemp plant are used to produce narcotics are used to produce narcotics such as hashish and such as hashish and marijuana.marijuana.

The seed of hemp is commonly used as birdseed. Hempseed also The seed of hemp is commonly used as birdseed. Hempseed also yields an oil, called oil of hemp, used in the manufacture of soap yields an oil, called oil of hemp, used in the manufacture of soap and oil paints. A resin, called charas, produced by female flower and oil paints. A resin, called charas, produced by female flower heads and seeds of hemp, is used in narcotic smoking mixtures in heads and seeds of hemp, is used in narcotic smoking mixtures in India. Flowers and leaves of hemp are used to produce the India. Flowers and leaves of hemp are used to produce the narcotics bhang, hashish, and marijuana.narcotics bhang, hashish, and marijuana.

Unrelated plants that are commonly called hemp include Unrelated plants that are commonly called hemp include henequen, sisal, bowstring hemp, and Manila hemp. Sunn hemp henequen, sisal, bowstring hemp, and Manila hemp. Sunn hemp is obtained from a leguminous herb native to India.is obtained from a leguminous herb native to India.

Scientific classification:Scientific classification: Hemp belongs to the family Moraceae. Hemp belongs to the family Moraceae. It is classified as It is classified as Cannabis sativa.Cannabis sativa. Henequen, sisal, and bowstring Henequen, sisal, and bowstring hemp belong to the family Agavaceae. Manila hemp belongs to hemp belong to the family Agavaceae. Manila hemp belongs to the family Musaceae. Sunn hemp belongs to the subfamily the family Musaceae. Sunn hemp belongs to the subfamily Papilionoideae, in the family Fabaceae (formerly Leguminosae), Papilionoideae, in the family Fabaceae (formerly Leguminosae), and is classified as and is classified as Crotalaria junceaCrotalaria juncea

MARIJUANA AND CHEMOTHERAPHYMARIJUANA AND CHEMOTHERAPHY The federal government approved plans allowing physicians to The federal government approved plans allowing physicians to

prescribe synthetic marijuana pills for cancer patients undergoing prescribe synthetic marijuana pills for cancer patients undergoing chemotherapy. The chemical tetrahydrocannabinol, or THC, found chemotherapy. The chemical tetrahydrocannabinol, or THC, found naturally in marijuana, has been shown helpful in some cases in naturally in marijuana, has been shown helpful in some cases in relieving the often severe nausea and vomiting associated with relieving the often severe nausea and vomiting associated with such therapy.such therapy.

MARIJUANA AND HEALTHMARIJUANA AND HEALTH The long-term health effects of marijuana remain uncertain, but a panel of experts The long-term health effects of marijuana remain uncertain, but a panel of experts

convened by the Institute of Medicine of the U.S. National Academy of Sciences convened by the Institute of Medicine of the U.S. National Academy of Sciences reported this February that the drug produces a variety of short-term, reversible effects. reported this February that the drug produces a variety of short-term, reversible effects. These and other suspected effects caused the panel members to issue a strongly These and other suspected effects caused the panel members to issue a strongly worded warning about the potential dangers of marijuana. 'Our major conclusion,' they worded warning about the potential dangers of marijuana. 'Our major conclusion,' they wrote, 'is that what little we know for certain about the effects of marijuana on human wrote, 'is that what little we know for certain about the effects of marijuana on human health—and all that we have reason to suspect—justifies serious national concern.' The health—and all that we have reason to suspect—justifies serious national concern.' The panel recommended that research efforts into the health effects of the drug be greatly panel recommended that research efforts into the health effects of the drug be greatly expanded.expanded.

The effects of marijuana, currently the most commonly used illicit drug The effects of marijuana, currently the most commonly used illicit drug in the United States, are varied. It has been shown to impair physical in the United States, are varied. It has been shown to impair physical coordination, hamper short-term memory, and interfere with the ability coordination, hamper short-term memory, and interfere with the ability to follow a moving object and to detect a flash of light. The panel to follow a moving object and to detect a flash of light. The panel reported that the drug also impairs oral communication and slows reported that the drug also impairs oral communication and slows learning. The effects on memory, learning, and communication are learning. The effects on memory, learning, and communication are especially worrisome because much of the heavy use of marijuana is especially worrisome because much of the heavy use of marijuana is by adolescents during school hours.by adolescents during school hours.

The drug also has effects similar to those produced by cigarette The drug also has effects similar to those produced by cigarette smoking. The panel reported that chronic heavy smoking of marijuana smoking. The panel reported that chronic heavy smoking of marijuana causes inflammation and other changes in the airways to the lungs. causes inflammation and other changes in the airways to the lungs. Moreover, there is a strong possibility that prolonged, heavy marijuana Moreover, there is a strong possibility that prolonged, heavy marijuana smoking will lead to cancer of the respiratory tract or to serious lung smoking will lead to cancer of the respiratory tract or to serious lung impairment. The effects may be exacerbated in those who smoke both impairment. The effects may be exacerbated in those who smoke both marijuana and tobacco, since the combination of the two may have marijuana and tobacco, since the combination of the two may have greater cancer-causing potential than does either substance alone.greater cancer-causing potential than does either substance alone.

Some cardiovascular effects of the drug—temporarily raising heart rate Some cardiovascular effects of the drug—temporarily raising heart rate and possibly blood pressure—are not likely to damage healthy people, and possibly blood pressure—are not likely to damage healthy people, the panel found, but they do pose a threat to those with high blood the panel found, but they do pose a threat to those with high blood pressure, cerebrovascular disease, and coronary atherosclerosis.pressure, cerebrovascular disease, and coronary atherosclerosis.

There is a possibility that marijuana affects fertility, especially in There is a possibility that marijuana affects fertility, especially in males. The number and movement of sperm decrease in males males. The number and movement of sperm decrease in males who are chronic users of marijuana. Researchers are uncertain who are chronic users of marijuana. Researchers are uncertain how this affects the users' chances of fathering children. For how this affects the users' chances of fathering children. For women of childbearing age, marijuana may also hinder fertility. women of childbearing age, marijuana may also hinder fertility. The results of animal studies show effects on ovulation and levels The results of animal studies show effects on ovulation and levels of reproductive hormones.of reproductive hormones.

The panel warned that the potential hazards of the drug may The panel warned that the potential hazards of the drug may extend beyond the short-term effects noted, since marijuana's extend beyond the short-term effects noted, since marijuana's components and their metabolic products remain in the body for a components and their metabolic products remain in the body for a long time and accumulate in the tissues. The effects of cumulative long time and accumulate in the tissues. The effects of cumulative high levels may be more serious than the effects of a single dose.high levels may be more serious than the effects of a single dose.

Estimated Numbers of Lifetime Users of Illicit Drugs, Alcohol, and Tobacco in the United StatesData are for U.S. population aged 12 and older. In thousands.

Drug 1985 1990 1995 2000

Any illicit drug 1 66,172 68,838 72,426 86,931

Marijuana and hashish 56,547 61,266 65,545 76,321

Cocaine 21,495 22,617 21,700 24,896

Crack N/A 2,967 3,895 5,307

Inhalants 15,167 11,562 12,016 16,702

Hallucinogens 13,221 15,925 20,129 26,125

PCP (phencyclidine) 3,811 4,019 6,718 5,804

LSD (lysergic acid diethylamide) 8,889 11,656 15,852 19,642

Heroin 1,826 1,517 2,451 2,779

Nonmedical use of any psychotherapeutic 2 29,386 22,731 21,446 32,443

Stimulants 14,139 11,156 10,360 14,661

Sedatives 9,260 5,609 5,760 7,142

Tranquilizers 14,692 8,020 8,251 13,007

Analgesics 14,693 12,751 12,806 19,210

Any illicit drug other than marijuana 1 43,130 39,190 40,426 52,605

1) 'Any illicit drug' indicates use at least once of marijuana or hashish, cocaine (including crack), inhalants, hallucinogens (including PCP and LSD), heroin, or any prescription-type psychotherapeutic used nonmedically. 'Any illicit drug other than marijuana' indicates use at least once of any of these listed drugs, regardless of marijuana use; marijuana users who have also used any of the other listed drugs are included.

2) Nonmedical use of any prescription-type stimulant, sedative, tranquilizer, or analgesic; does not include over-the-counter drugs.

(N/A = not available.)

Source: U.S. Substance Abuse and Mental Health Services Administration

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