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Marijuana Abuse and Its Harmful Der with Marijuana (Timberlake 2009)

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Marijuana Abuse and Its Harmful Der with Marijuana (Timberlake 2009) How does marijuana use affect school, work, and social life? See page 7. from the director: By the time they graduate from high school, about 42 percent of teens will have tried marijuana. Although current use among U.S. Marijuana teens has dropped dramatically in the past decade (to a prevalence of about 14 percent in 2009), this decline has stalled during the past several years. These data are from Abuse the Monitoring the Future study, which has been tracking drug use among teens since 1975. Still, the World Health Organization ranks the United States first among 17 European and North American countries for prevalence of mari- juana use. And more users start every day. In 2008, an estimated 2.2 million Americans used mari- juana for the first time; greater than half were under age 18. The use of marijuana can produce adverse physical, mental, emo- What Is tional, and behavioral effects. It can impair short-term memory Marijuana? and judgment and distort percep- tion. Because marijuana affects brain systems that are still matur- arijuana—often called pot, grass, reefer, weed, herb, ing through young adulthood, its Mary Jane, or MJ—is a greenish-gray mixture of use by teens may have a negative the dried, shredded leaves, stems, seeds, and flow- effect on their development. And M contrary to popular belief, it can ers of Cannabis sativa—the hemp plant. Most users smoke be addictive. marijuana in hand-rolled cigarettes called joints, among other names; some use pipes or water pipes called bongs. Marijuana We hope that this Research Report will help make readers aware cigars, or blunts, are also popular. To make blunts, users slice of our current knowledge of open cigars, remove some of the tobacco, and mix the remain- marijuana abuse and its harmful der with marijuana (Timberlake 2009). Marijuana also is used effects. to brew tea and sometimes is mixed into foods. Nora D. Volkow, M.D. Director continued inside National Institute on Drug Abuse Marijuana Research Report Series Abuse What Is the Long-Term Trends in Annual* Marijuana Use Scope of Among 8th, 10th, and 12th Graders Marijuana Use 40 in the United 35 12th-graders States? 30 Marijuana is the most commonly 10th-graders used illicit drug (15.2 million 25 past-month users) according to Percent the 2008 National Survey on Drug 20 Use and Health (NSDUH). That year, marijuana was used by 75.6 15 percent of current illicit drug users 8th-graders (defined as having used the drug 10 some time in the 30 days before the 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 survey) and was the only drug used *use in the past 12 months by 53.3 percent of them. Source: 2009 Monitoring the Future Survey Marijuana use is widespread among adolescents and young in the past decade among 8th-, adults. According to the Monitor- 10th-, and 12th-graders. However, How Does ing the Future Survey—an annual this decline has stalled in the past Marijuana survey of attitudes and drug use few years as attitudes have soft- Produce its among the Nation’s middle and ened about marijuana’s risks. In Effects? high school students—most mea- 2009, 11.8 percent of 8th-graders sures of marijuana use decreased reported marijuana use in the past Delta-9-tetrahydrocannabinol year, and 6.5 percent were current (THC) is the main active ingredient users. Among 10th-graders, 26.7 in marijuana, responsible for percent had used marijuana in the many of its known effects. When past year, and 15.9 percent were marijuana is smoked, its effects current users. Rates of use among begin almost immediately. THC 12th-graders were higher still: 32.8 rapidly passes from the lungs into percent had used marijuana during the bloodstream, which carries the the year prior to the survey, and chemical to organs throughout 20.6 percent were current users. the body, including the brain. The The Drug Abuse Warning Net- effects of smoked marijuana can work (DAWN), a system for moni- last from 1 to 3 hours. If marijuana toring the health impact of drugs, is consumed in foods or beverages, estimated that in 2008, marijuana the effects appear later—usually in was a contributing factor in over 30 minutes to 1 hour—but can last 374,000 emergency department up to 4 hours. Smoking marijuana (ED) visits in the United States, delivers significantly more THC with about two-thirds of patients into the bloodstream than eating being male, and 13 percent between or drinking the drug. the ages of 12 and 17. 2 NIDA Research Report Series Marijuana’s Effects on the Brain © Alice Y. Chen, 2004. Adapted from Scientific American. When marijuana is smoked, its active ingredient, THC, travels throughout the body, including the brain, to produce its many effects. THC attaches to sites called cannabinoid receptors on nerve cells in the brain, affecting the way those cells work. Cannabinoid receptors are abundant in parts of the brain that regulate movement, coordination, learning and memory, higher cognitive functions such as judgment, and pleasure. Scientists have learned a great function of the natural, or all the consequences to the brain deal about how THC acts in the endogenous, cannabinoids. An and body when exposed to higher brain. THC binds to specific overstimulation of these receptors concentrations of THC. sites called cannabinoid receptors in key brain areas produces the (CBRs) located on the surface of marijuana “high,” as well as other nerve cells. These receptors are effects on mental processes. Over How Does found in high-density in areas of time, this overstimulation can Marijuana Use the brain that influence pleasure, alter the function of CBRs, which, Affect Your Brain memory, thinking, concentration, along with other changes in the and Body? movement, coordination, and brain, can lead to addiction and to sensory and time perception. withdrawal symptoms when drug Effects on the Brain CBRs are part of a vast use stops. As THC enters the brain, it causes communication network known The THC content or potency the user to feel euphoric—or as the endocannabinoid system, of marijuana, as detected in high—by acting on the brain’s which plays a critical role in confiscated samples over the past reward system, which is made up normal brain development and 30+ years (Potency Monitoring of regions that govern the response function. In fact, THC effects Project, University of Mississippi), to pleasurable things like sex and are similar to those produced by has been steadily increasing. This chocolate, as well as to most drugs naturally occurring chemicals increase raises concerns that the of abuse. THC activates the reward found in the brain (and body) consequences of marijuana use system in the same way that nearly called endogenous cannabinoids. could be worse than in the past, all drugs of abuse do: by stimulat- These chemicals help control many particularly among new users, or in ing brain cells to release the chemi- of the same mental and physical young people, whose brains are still cal dopamine. functions that may be disrupted by developing. We still do not know, Along with euphoria, re- marijuana use. however, whether cannabis users laxation is another frequently When someone smokes adjust for the increase in potency reported effect in human studies. marijuana, THC stimulates the by using less or by smoking it Other effects, which vary dramati- CBRs artificially, disrupting differently. We also do not know NIDA Research Report Series 3 Marijuana users who have taken large doses of the drug may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity. cally among different users, include Marijuana users who have chronic cannabis use affects brain heightened sensory perception taken large doses of the drug may structure, for example, have been (e.g., brighter colors), laughter, experience an acute psychosis, inconsistent. It may be that the altered perception of time, and which includes hallucinations, effects are too subtle for reliable increased appetite. After a while, delusions, and a loss of the sense detection by current techniques. A the euphoria subsides, and the of personal identity. Although the similar challenge arises in studies user may feel sleepy or depressed. specific causes of these symptoms of the effects of chronic marijuana Occasionally, marijuana use may remain unknown, they appear to use on brain function. Although produce anxiety, fear, distrust, or occur more frequently when a high imaging studies (functional MRI; panic. dose of cannabis is consumed in fMRI) in chronic users do show Marijuana use impairs a per- food or drink rather than smoked. some consistent alterations, the re- son’s ability to form new memories Such short-term psychotic reac- lation of these changes to cognitive (see below, “Marijuana, Memory, tions to high concentrations of functioning is less clear. This un- and the Hippocampus”) and to shift THC are distinct from longer- certainty may stem from confound- focus. THC also disrupts coordina- lasting, schizophrenia-like disor- ing factors such as other drug use, tion and balance by binding to re- ders that have been associated with residual drug effects (which can oc- ceptors in the cerebellum and basal the use of cannabis in vulnerable cur for at least 24 hours in chronic ganglia—parts of the brain that individuals. (See section on the link users), or withdrawal symptoms in regulate balance, posture, coordi- between marijuana use and mental long-term chronic users. nation, and reaction time. There- illness, page 6.) An enduring question in the fore, learning, doing complicated Our understanding of mari- field is whether individuals who tasks, participating in athletics, and juana’s long-term brain effects is quit marijuana, even after long- driving are also affected.
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