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{{Short description|Psychoactive drug from the cannabis plant}} | |||
:''This is one of several related articles about cannabis. ] deals with the biology of the genus Cannabis. ] is about marijuana, hashish and related drugs. ] is about cultivation and non-drug uses. See also ].'' | |||
{{Redirect|Marijuana}} | |||
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{{Use dmy dates|date=October 2021}} | |||
{{Infobox botanical product | |||
| pronounce = Cannabis: {{IPAc-en|ˈ|k|æ|n|ə|b|ᵻ|s}}<br />Marijuana: {{IPAc-en|ˌ|m|æ|r|ə|ˈ|w|ɑː|n|ə}} | |||
| product = Cannabis | |||
| image = Cannabis Drying out the crop (16558794823).jpg | |||
| caption = Cannabis in the drying phase | |||
| plant = '']'', '']'', '']''{{efn|Pure ] of ''C. ruderalis'' are rarely used for recreational purposes.<ref>{{Cite book|title = Marijuana Horticulture: The Indoor/Outdoor Medical Grower's Bible|last = Cervantes|first = Jorge|publisher = Van Patten Publishing|year = 2006|isbn = 9781878823236|pages = |edition = 5th|url-access = registration|url = https://archive.org/details/marijuanahorticu00jorg/page/12}}</ref>}} | |||
| part = ] and ] | |||
| origin = Central or South Asia | |||
| active = ], ], ], ] | |||
| producers = Afghanistan, Canada, China, Colombia, India, Jamaica, Lebanon, Mexico, Morocco, Netherlands, Pakistan, Paraguay, Spain, Thailand, Turkey, United Kingdom, United States | |||
| legal_AU = S8 | |||
| legal_BR = E | |||
| legal_CA = Unscheduled | |||
| legal_DE = legal under the ruling of ] | |||
| legal_NZ = Class B (concentrate)<br />Class C (plant) | |||
| legal_UK = Class B | |||
| legal_US = ] | |||
| legal_UN = Narcotic Schedule I | |||
}} | |||
{{Cannabis sidebar}} | |||
'''Cannabis''' ({{IPAc-en|ˈ|k|æ|n|ə|b|ᵻ|s}}),<ref>{{cite web |title=cannabis noun – Definition, pictures, pronunciation and usage notes {{!}} Oxford Advanced Learner's Dictionary at OxfordLearnersDictionaries.com |url=https://www.oxfordlearnersdictionaries.com/definition/english/cannabis?q=cannabis |access-date=10 November 2022 |website=www.oxfordlearnersdictionaries.com}}</ref> commonly known as '''marijuana''' ({{IPAc-en|ˌ|m|æ|r|ə|ˈ|w|ɑː|n|ə}}),<ref>{{cite web |title=marijuana noun – Definition, pictures, pronunciation and usage notes {{!}} Oxford Advanced Learner's Dictionary at OxfordLearnersDictionaries.com |url=https://www.oxfordlearnersdictionaries.com/definition/english/marijuana |access-date=18 April 2019 |website=www.oxfordlearnersdictionaries.com}}</ref> '''weed''', and '''pot''', ], is a non-chemically uniform ] from the ] plant. Native to Central or South Asia, the cannabis plant has been used as a drug for both recreational and ] purposes and in various ]s for centuries. ] (THC) is the main psychoactive component of cannabis, which is one of the 483 known compounds in the plant, including at least 65 other ]s, such as ] (CBD). Cannabis can be used ], ], ], or ]. | |||
]'' plant]] | |||
<!-- Effects --> | |||
Cannabis has ], which include ], ] and ], difficulty concentrating, ], impaired ] (balance and fine psychomotor control), relaxation, and an increase in ]. Onset of effects is felt within minutes when smoked, but may take up to 90 minutes when eaten (as orally consumed drugs must be digested and absorbed). The effects last for two to six hours, depending on the amount used. At high doses, mental effects can include ], delusions (including ]), ]s, ], ], and ]. There is a strong relation between cannabis use and the risk of psychosis, though the direction of ] is debated. Physical effects include increased heart rate, difficulty breathing, nausea, and behavioral problems in children whose mothers used cannabis during pregnancy; short-term side effects may also include ] and red eyes. ] may include addiction, decreased ] in those who started regular use as adolescents,<ref>{{Cite journal |last1=Shrivastava |first1=Amresh |last2=Johnston |first2=Megan |last3=Tsuang |first3=Ming |date=2011 |title=Cannabis use and cognitive dysfunction |journal=Indian Journal of Psychiatry |volume=53 |issue=3 |pages=187–191 |doi=10.4103/0019-5545.86796 |issn=0019-5545 |pmc=3221171 |pmid=22135433 |doi-access=free }}</ref> chronic coughing, susceptibility to ], and ]. | |||
<!-- Usage --> | |||
The '''cannabis''' plant can be dried or otherwise processed to yield products containing large concentrations of ]s that have ] and ] effects when consumed, usually by smoking or eating. ] (also called '''marijuana''', or '''pot''' in slang) has been used for medical and psychoactive effects for thousands of years. Throughout the ] there was a massive upswing in the use of cannabis as a psychoactive substance, mostly for ] but to some extent for ]. The possession, use, or sale of psychoactive cannabis products became ] in many parts of the world during the early ], and remains that way today. | |||
Cannabis is mostly used recreationally or as a medicinal drug, although it may also be used for spiritual purposes. In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65). It is the most commonly used largely-illegal drug in the world, with the highest use among adults in ], the ], ], and ]. Since the 1970s, the potency of illicit cannabis has increased, with THC levels rising and CBD levels dropping. | |||
]'' plant.'']] | |||
<!-- History and legality --> | |||
Cannabis plants have been grown since at least the 3rd millennium BCE and there is evidence of it being smoked for its psychoactive effects around 500 BCE in the ], Central Asia. Since the 14th century, cannabis has been subject to legal restrictions. The possession, use, and cultivation of cannabis has been ] since the 20th century. In 2013, ] became the first country to ] recreational use of cannabis. Other countries to do so are Canada, ], ], ], ], ], and ]. In the U.S., the recreational use of cannabis is legalized in ], 3 territories, and the ], though the drug remains ]. In ], it is legalized only in the ]. | |||
] | |||
Cannabis has been known as a medicinal and psychoactive compound from very early in history, and has been used continuously throughout the world, typically without ] until the mid-20th century, when, mainly under the leadership of newspaper baron ] and the ], prohibition became increasingly global.<!-- repression in various Islamic centuries (11th, 13th, and others), early modern (ex-Ottoman) Greece, Egypt under Mehemet Ali (19th century), need sections--> | |||
==Etymology== | |||
===Ancient history=== | |||
{{main|Etymology of cannabis}} | |||
Cannabis was also known to the ]ns, as well as to the ]/]ns (ancestors of present day Eastern-Europeans), whose ] (the ''kapnobatai'' - "those who walk on smoke/clouds") used to burn cannabis flowers in order to induce trances. The cult of ], which is believed to have originated in ], has also been linked to the effects of cannabis smoke. | |||
''Cannabis'' is a ] word.<ref>{{cite book |last1=Gray |first1=Stephen |title=Cannabis and Spirituality: An Explorer's Guide to an Ancient Plant Spirit Ally |date=9 December 2016 |publisher=Simon and Schuster |isbn=978-1-62055-584-2 |page=69 |url=https://books.google.com/books?id=GmEoDwAAQBAJ&pg=PT69 |language=en |quote=Cannabis is called kaneh bosem in Hebrew, which is now recognized as the Scythian word that Herodotus wrote as kánnabis (or cannabis).}}</ref><ref name="r980">{{cite book | last1=Riegel | first1=A. | last2=Ellens | first2=J.H. | title=Seeking the Sacred with Psychoactive Substances: Chemical Paths to Spirituality and to God | publisher=Bloomsbury Publishing | series=Psychology, Religion, and Spirituality | year=2014 | isbn=979-8-216-14310-9 | url=https://books.google.com/books?id=V6nOEAAAQBAJ&pg=PT80 | access-date=2024-06-03 | page=80}}</ref><ref>{{cite book |last1=Duncan |first1=Perry M. |title=Substance Use Disorders: A Biopsychosocial Perspective |date=17 September 2020 |publisher=Cambridge University Press |isbn=978-0-521-87777-0 |page=441 |url=https://books.google.com/books?id=X7H2DwAAQBAJ&pg=PA441|language=en |quote=Cannabis is a Scythian word (Benet 1975).}}</ref> The ] learned of the use of cannabis by observing Scythian funerals, during which cannabis was consumed.<ref name="r980" /> In ], cannabis was known as ''qunubu'' ({{lang|akk|𐎯𐎫𐎠𐎭𐏂}}).<ref name="r980" /> The word was adopted in to the ] as ''qaneh bosem'' ({{lang|he|קָנֶה בֹּשׂם}}).<ref name="r980" /> | |||
==Uses== | |||
The most famous users of cannabis though were the ancient ]s. It was called 'ganjika' in ] ('ganja' in modern Indian languages). According to legend, ], the destructive aspect of the Hindu trinity, told his disciples to use the hemp plant in all ways possible. The ancient drug ], mentioned in the ]s as a sacred intoxicating hallucinogen, was sometimes identified with cannabis. However it has also been identified with a number of plants and a mushroom ]. | |||
=== |
===Medical=== | ||
{{Main|Medical cannabis}} | |||
Under the name ''cannabis'' ] medical practitioners helped to introduce the herb's drug potential (usually as a ]) to modern English-speaking consciousness. It was famously used to treat ]'s menstrual pains, and was available from shops in the US. By the end of the 19th century its medicinal use began to fall as other drugs such as ] took over. | |||
] | |||
Medical cannabis, or medical marijuana, refers to the use of cannabis to treat disease or improve symptoms; however, there is no single agreed-upon definition (e.g., ] derived from cannabis and synthetic cannabinoids are also used).<ref>{{Cite journal |vauthors=Murnion B |date=December 2015 |title=Medicinal cannabis |journal=Australian Prescriber |volume=38 |issue=6 |pages=212–15 |doi=10.18773/austprescr.2015.072 |pmc=4674028 |pmid=26843715 |issn=0312-8008}}</ref><ref>{{Cite web |date=July 2015 |title=What is medical marijuana? |url=https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine |access-date=19 April 2016 |website=National Institute of Drug Abuse |quote=The term medical marijuana refers to using the whole unprocessed marijuana plant or its basic extracts to treat a disease or symptom.}}</ref><ref name="Backes2014">{{Cite book |last=Backes |first=Michael |url=https://books.google.com/books?id=7z2FwBywoJ0C&pg=PT46 |title=Cannabis Pharmacy: The Practical Guide to Medical Marijuana |publisher=Hachette Books |date=2014 |isbn=978-1-60376-334-9 |page=46 |name-list-style=vanc}}</ref> The rigorous scientific study of cannabis as a medicine has been hampered by production restrictions and by the fact that it is classified as an illegal drug by many governments.<ref>{{Cite journal |date=September 2015 |title=Release the strains |journal=Nature Medicine |volume=21 |issue=9 |pages=963 |doi=10.1038/nm.3946 |pmid=26340110 |doi-access=free}}</ref> There is some evidence suggesting cannabis can be used to ] during ], to improve appetite in people with ], or to treat ] and ]. Evidence for its use for other medical applications is insufficient for drawing conclusions about safety or efficacy.<ref name="Borgelt2013">{{Cite journal |vauthors=Borgelt LM, Franson KL, Nussbaum AM, Wang GS |date=February 2013 |title=The pharmacologic and clinical effects of medical cannabis |journal=Pharmacotherapy |volume=33 |issue=2 |pages=195–209 |citeseerx=10.1.1.1017.1935 |doi=10.1002/phar.1187 |pmid=23386598 |s2cid=8503107}}</ref><ref name="JAMA2015">{{Cite journal |vauthors=Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S, Schmidlkofer S, Westwood M, Kleijnen J |date=23 June 2015 |title=Cannabinoids for Medical Use: A Systematic Review and Meta-analysis |journal=JAMA |volume=313 |issue=24 |pages=2456–73 |doi=10.1001/jama.2015.6358 |pmid=26103030 |doi-access=free |hdl=10757/558499|hdl-access=free }}</ref><ref>{{Cite journal |vauthors=Jensen B, Chen J, Furnish T, Wallace M |date=October 2015 |title=Medical Marijuana and Chronic Pain: a Review of Basic Science and Clinical Evidence |journal=Current Pain and Headache Reports |volume=19 |issue=10 |pages=50 |doi=10.1007/s11916-015-0524-x |pmid=26325482 |s2cid=9110606}}</ref> There is evidence supporting the use of cannabis or its derivatives in the treatment of chemotherapy-induced nausea and vomiting, neuropathic pain, and multiple sclerosis. Lower levels of evidence support its use for AIDS ], epilepsy, rheumatoid arthritis, and glaucoma.<ref name="NEJM2014" /> | |||
The name ''marijuana'' (] ''marihuana'', ''mariguana'') is associated almost exclusively with the herb’s drug potential. The term marijuana is now well known in English as a name for drug material due largely to the efforts of US drug prohibitionists during the ] and ], who deliberately used a Mexican name for cannabis in order to turn the populace against the idea that it should be legal. (''see ]'') | |||
The medical use of cannabis is legal only in a limited number of territories, including Canada,<ref name=canada2018/> ], Australia, the ], New Zealand,<ref>{{Cite news |last=Ainge Roy |first=Eleanor |date=11 December 2018 |title=New Zealand passes laws to make medical marijuana widely available |work=The Guardian |url=https://www.theguardian.com/world/2018/dec/11/new-zealand-passes-laws-to-make-medical-marijuana-widely-available |access-date=20 January 2019}}</ref><ref>{{Cite web |last=Schulz |first=Chris |date=30 June 2022 |title=You can get actual weed from the doctor now |url=https://thespinoff.co.nz/business/30-06-2022/you-can-get-actual-weed-from-the-doctor-now |website=The Spinoff}}</ref> Spain, and ]. This usage generally requires a prescription, and distribution is usually done within a framework defined by local laws.<ref name="NEJM2014" /> | |||
Although cannabis has been used for its psychoactive effects since ancient times, it first became well known in the United States during the ] music scene of the late 1920s and 1930s. ] became one of its most prominent and life-long devotees. Cannabis use was also a prominent part of ] counterculture. | |||
===Recreational=== | |||
Today in America, there are 11 states that provide some legal protection for patients who use marijuana with the consent or recommendation of a doctor. Most recently, Rhode Island became the 11th state to pass medical marijuana legislation. Tolerance for the drug appears to be growing in non-medical respects as well. For example, currently in the state of Oregon, possession of less than one ] of marijuana for personal use by an adult is considered a violation, not a crime; it is punishable by a simple fine. Various individual cities through the United States (such as ]) have similar legislation. None of these protections, however, will protect a user from federal prosecution. | |||
According to DEA Chief Administrative Law Judge, Francis Young, "cannabis is one of the safest therapeutically active substances known to man".<ref>{{Cite web |url=https://www.safeaccessnow.org/cannabis_safety |title=Information on Cannabis Safety |website=Americans for Safe Access}}</ref> Being under the effects of cannabis is usually referred to as being "high".<ref name="Small2016">{{Cite book |last=Ernest Small |url=https://books.google.com/books?id=oo2KDQAAQBAJ&pg=PT339 |title=Cannabis: A Complete Guide |publisher=CRC Press |date=2016 |isbn=978-1-315-35059-2}}</ref> Cannabis consumption has both psychoactive and physiological effects.<ref name="OnaiviSugiura2005">{{Cite book |last1=Onaivi |first1=Emmanuel S. |url=https://books.google.com/books?id=BxfLB4n3uoMC&pg=PA58 |title=Endocannabinoids: The Brain and Body's Marijuana and Beyond |last2=Sugiura |first2=Takayuki |last3=Di Marzo |first3=Vincenzo |publisher=Taylor & Francis |date=2005 |isbn=978-0-415-30008-7 |page=58 |name-list-style=vanc}}</ref> The "high" experience can vary widely, based (among other things) on the user's prior experience with cannabis, and the type of cannabis consumed.<ref name="curran2014">{{Cite encyclopedia |title=Desired and Undesired Effects of Cannabis on the Human Mind and Psychological Well-Being |encyclopedia=Handbook of Cannabis |publisher=Oxford University Press |date=2014 |editor-last=Pertwee |editor-first=Roger G. |last2=Morgan |first2=Celia J.A. |last1=Curran |first1=H. Valerie}}</ref>{{rp|p647}} When smoking cannabis, a ]nt effect can occur within minutes of smoking.<ref name="ashton2001">{{Cite journal |last=Ashton |first=C.Heather |date=2001 |title=Pharmacology and Effects of Cannabis: A Brief Review |journal=British Journal of Psychiatry |volume=178 |issue=2 |pages=101–06 |doi=10.1192/bjp.178.2.101 |pmid=11157422 |s2cid=15918781 |doi-access=free}}</ref>{{rp|p104}} Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite, impairment of short-term and working memory, and impairment of ].<ref name="Mathre1997">{{Cite book |url=https://books.google.com/books?id=1AWGDhIOvk0C&pg=PA144 |title=Cannabis in Medical Practice: A Legal, Historical, and Pharmacological Overview of the Therapeutic Use of Marijuana |publisher=University of Virginia Medical Center |date=1997 |isbn=978-0-7864-8390-7 |editor-last=Mathre |editor-first=Mary Lynn |pages=144– |name-list-style=vanc}}</ref><ref name="memoryhindered">{{Cite book |title=Cannabinoids |vauthors=Riedel G, Davies SN |date=2005 |isbn=978-3-540-22565-2 |series=Handbook of Experimental Pharmacology |volume=168 |pages=445–77 |chapter=Cannabinoid function in learning, memory and plasticity |doi=10.1007/3-540-26573-2_15 |pmid=16596784 |issue=168}}</ref> | |||
Additional desired effects from consuming cannabis include relaxation, a general ], increased awareness of sensation, increased ]<ref name="pmid18365950">{{Cite journal |vauthors=Osborne GB, Fogel C |date=2008 |title=Understanding the motivations for recreational marijuana use among adult Canadians |url=http://cannabislink.ca/info/MotivationsforCannabisUsebyCanadianAdults-2008.pdf |journal=Substance Use & Misuse |volume=43 |issue=3–4 |pages=539–72; discussion 573–79, 585–87 |doi=10.1080/10826080701884911 |pmid=18365950 |s2cid=31053594}}</ref> and ] and space. At higher doses, effects can include altered ], auditory or visual ]s, ]s and ] from selective impairment of ] ]es.{{Citation needed|date=June 2020}} In some cases, cannabis can lead to ] states such as ]<ref name="medscape1">{{Cite web |title=Medication-Associated Depersonalization Symptoms |url=http://www.medscape.com/viewarticle/468728 |website=Medscape}}</ref><ref name="pmid15889607">{{Cite journal |vauthors=Shufman E, Lerner A, Witztum E |date=April 2005 |title= |url=http://www.ima.org.il/Ima/FormStorage/Type3/05-04-07.pdf |journal=Harefuah |language=he |volume=144 |issue=4 |pages=249–51, 303 |pmid=15889607 |archive-url=https://web.archive.org/web/20050430224332/http://www.ima.org.il/Ima/FormStorage/Type3/05-04-07.pdf |archive-date=30 April 2005}}</ref> and ].<ref name="Johnson1990">{{Cite journal |vauthors=Johnson BA |date=February 1990 |title=Psychopharmacological effects of cannabis |journal=British Journal of Hospital Medicine |volume=43 |issue=2 |pages=114–16, 118–20, 122 |pmid=2178712}}</ref> | |||
On ], ], the city of ], ] passed in a 53%-46% vote to legalize the possession of up to an ounce of marijuana for adults over 21 {{ref|USAToday}}. | |||
===Spiritual=== | |||
On ], ], a broad coalition of ] in ], ], unveiled a pilot program to allow farmers to legally grow marijuana. As it stands currently, designated ] can sell cannabis, but must be supplied by underground ]s. {{ref|AP}} | |||
{{Main|Entheogenic use of cannabis}} | |||
Cannabis has held sacred status in several religions and has served as an ] – a ] used in religious, ], or ] contexts<ref>{{Cite journal |last1=Souza |first1=Rafael Sampaio Octaviano de |last2=Albuquerque |first2=Ulysses Paulino de |last3=Monteiro |first3=Júlio Marcelino |last4=de Amorim |first4=Elba Lúcia Cavalcanti |name-list-style=vanc |date=2008 |title=Brazilian Archives of Biology and Technology – Jurema-Preta (Mimosa tenuiflora Poir.): a review of its traditional use, phytochemistry and pharmacology |journal=Brazilian Archives of Biology and Technology |volume=51 |issue=5 |pages=937–47 |doi=10.1590/S1516-89132008000500010 |doi-access=free}}</ref> – in the Indian subcontinent since the ]. The earliest known reports regarding the sacred status of cannabis in the Indian subcontinent come from the ], estimated to have been composed sometime around 1400 BCE.<ref name="courtwright2001">{{Cite book |last=Courtwright |first=David |url=https://books.google.com/books?id=GHqV3elHYvMC&q=Forces+of+Habit |title=Forces of Habit: Drugs and the Making of the Modern World |publisher=Harvard University Press |date=2001 |isbn=978-0-674-00458-0 |name-list-style=vanc}}</ref> | |||
On ], ], the Herald News Online reported that the Joint Mental Health and Substance Abuse Committee of the ] voted 6-1 in favor of a bill that would decriminalize the possession of up to an ounce of marijuana. Rather than face criminal charges, offenders would face a civil fine of $250. {{ref|HN}} | |||
The Hindu god ] is described as a cannabis user, known as the "Lord of ]".<ref name="Iversen2000s">{{Cite book |last=Iversen |first=Leslie L. |url=https://archive.org/details/scienceofmarijua00iver |title=The Science of Marijuana |publisher=Oxford University Press |date=2000 |isbn=978-0-19-515110-7 |url-access=registration |name-list-style=vanc}}</ref>{{rp|p19}} | |||
In modern culture, the spiritual use of cannabis has been spread by the disciples of the ] who use cannabis as a ] and as an aid to meditation.<ref name=courtwright2001/> | |||
== |
==Consumption== | ||
{{Main|Cannabis consumption}} | |||
Cannabis still grows wild in many places around the world, the most prominent species being ''Cannabis sativa'' which has been found growing wild in places such as ], ], parts of ], ], ], ], ], and ]. Wild ''Cannabis indica'' is mainly confined to hash producing areas such as ], parts of the ], and in ] The wild ''C. sativa'' has a lot of genetic variation from place to place. For example the wild ''C. sativa'' in warm places can reach heights up to 20 ft (6 meters) tall, but in colder climates it can be as short as 1 ft (30 centimeters) in height. Almost every single flower bract bears a seed. The wild ''C. sativa'' has long, thin and airy buds and mostly, a Christmas tree shape structure. Wild ''C. indica'' for the most part remains compact and bushy with thick buds, and is sometimes used by the locals for hashish production. Generally, there are far fewer seeds in wild ''C. indica''. | |||
In many areas the wild population of cannabis is threatened due to government eradication and urbanization. | |||
=== Modes of consumption === | |||
==New breeding and cultivation techniques== | |||
]{{Cookbook|Cannabis}} | |||
] | |||
Many different ways to consume cannabis involve heat to ] ] into THC;<ref name="Golub2012a">{{Cite book |last=Golub |first=Andrew |url=https://books.google.com/books?id=KFMtFv2tmbYC&pg=PA82 |title=The Cultural/Subcultural Contexts of Marijuana Use at the Turn of the Twenty-First Century |publisher=Routledge |date=2012 |isbn=978-1-136-44627-6 |page=82 |name-list-style=vanc}}</ref><ref>{{Cite web |title=Why Does Cannabis Have to be Heated? |url=https://patriotcare.org/why-cannabis-heated/ |website=patriotcare.org}}</ref> common modes include: | |||
{{main_article|]}} | |||
* ], involves burning and inhaling cannabinoids ("smoke") from ], ]s (portable versions of ]s with a water chamber), paper-wrapped ], tobacco-leaf-wrapped ], or the like.<ref name="TasmanKay2011">{{Cite book |last1=Tasman |first1=Allan |url=https://books.google.com/books?id=vVG7zz7eaxcC&pg=RA9-PT2217 |title=Psychiatry |last2=Kay |first2=Jerald |last3=Lieberman |first3=Jeffrey A. |last4=First |first4=Michael B. |last5=Maj |first5=Mario |publisher=John Wiley & Sons |date=2011 |isbn=978-1-119-96540-4 |page=9 |name-list-style=vanc}}</ref> | |||
Advances in breeding and cultivation techniques have increased the diversity and potency of ] over the last 20 years, and these strains are now widely smoked all over the world. These advances—the ] of breeding - sensimilla is the dried, seedless female flowers of the cannabis plant which has been grown in the absence of males to ensure no pollination takes place. This is due to the fact that THC potency and production drops off once pollination takes place (this growing technique gives the stickiest of the icky), ], ], ], ], ]—have been in part a response to prohibition enforcement efforts which have made outdoor cultivation more risky, and so efficient indoor cultivation more common. These same advances have also resulted in the cannabis being smoked currently no longer having seeds in them as was the case 20 years ago. | |||
* ], heating various forms of cannabis to {{convert|165|–|190|°C|°F}},<ref name="Rosenthal2002b">{{Cite book |last=Rosenthal |first=Ed |url=https://books.google.com/books?id=obbSwmSB6okC&pg=PT15 |title=Ask Ed: Marijuana Gold: Trash to Stash |publisher=Perseus Books Group |date=2002 |isbn=978-1-936807-02-4 |page=15 |name-list-style=vanc}}</ref> causing the active ingredients to form ] without combustion of the plant material (the boiling point of ] is {{convert|157|°C|°F}} at atmospheric pressure).<ref>{{Cite web |title=Cannabis and Cannabis Extracts: Greater Than the Sum of Their Parts? |url=http://www.cannabis-med.org/data/pdf/2001-03-04-7.pdf |archive-url=https://web.archive.org/web/20170622203721/http://www.cannabis-med.org/data/pdf/2001-03-04-7.pdf |archive-date=22 June 2017 |access-date=7 April 2014 |publisher=Cannabis-med.org}}</ref> | |||
* ], adding cannabis as an ingredient to a wide variety of foods, including butter and baked goods. In India it is commonly consumed as the beverage ]. | |||
* ], prepared with attention to the ] quality of THC, which is only slightly water-soluble (2.8 mg per liter),<ref name="Physical Properties – Dronabinol">{{PubChem|16078|Dronabinol}}</ref> often involving cannabis in a ].<ref name="Ph.D.Rosenthal2008yt">{{Cite book |last1=Gieringer |first1=Dale |url=https://books.google.com/books?id=OuAHxDKcpS8C&pg=PA182 |title=Marijuana medical handbook: practical guide to therapeutic uses of marijuana |last2=Rosenthal |first2=Ed |publisher=QUICK AMER Publishing Company |date=2008 |isbn=978-0-932551-86-3 |page=182 |name-list-style=vanc}}</ref> | |||
* ], sometimes known as green dragon, is an ] ]. | |||
* ], typically containing ], and other ] products, for which some 220 were approved in Canada in 2018.<ref name="canada2018">{{Cite web |date=11 July 2018 |title=Health products containing cannabis or for use with cannabis: Guidance for the Cannabis Act, the Food and Drugs Act, and related regulations |url=https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/applications-submissions/guidance-documents/guidance-cannabis-act-food-and-drugs-act-related-regulations/document.html |access-date=19 October 2018 |publisher=Government of Canada}}</ref> | |||
=== Consumption by country === | |||
The increases in potency—and ramifications thereof—have been exaggerated by many opponents of cannabis use both in and out of government. In the United States, government advertisements encourage parents to disregard their own experience with cannabis when speaking to their children, on the premise that <!--don't change this, it is intentionally-->pot<!--like in the ads to which I refer--> today is significantly stronger and thus more dangerous than that which they themselves might have smoked in the past. In a general pattern of proposing reverses in ], the UK government is considering scheduling stronger cannabis (''skunk'', in local parlance) as a separate, more restricted substance. | |||
{{main|Annual cannabis use by country}} | |||
{{Global estimates of illicit drug users}} | |||
In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65).<ref name="WDR2015">{{Cite book |title=World Drug Report 2015 |page=23 |chapter=Status and Trend Analysis of {{sic|nolink=y|Illict}} Drug Markets |access-date=26 June 2015 |chapter-url=http://www.unodc.org/documents/wdr2015/WDR15_Drug_use_health_consequences.pdf}}</ref> Cannabis is by far the most widely used illicit substance,<ref name="CaulkinsHawken2012">{{Cite book |last1=Caulkins |first1=Jonathan P. |url=https://archive.org/details/marijuanalegaliz0000unse/page/16 |title=Marijuana Legalization: What Everyone Needs to Know |last2=Hawken |first2=Angela |last3=Kilmer |first3=Beau |last4=Kleiman |first4=Mark A.R. |publisher=Oxford University Press |date=2012 |isbn=978-0199913732 |page= |name-list-style=vanc}}</ref> with the highest use among adults ({{as of|2018|lc=y}}) in ], the ], ], and ].<ref>{{Cite web |title=UNODC Statistics Online |url=https://data.unodc.org/ |access-date=9 September 2018 |website=data.unodc.org}}</ref> | |||
== Immediate effects of human consumption == | |||
The nature and intensity of the immediate effects of cannabis consumption vary according to the dose, the species or hybridization of the source plant, the method of consumption, the user's mental and physical characteristics (such as possible tolerance), and the environment of consumption. This is sometimes referred to as '']''. Smoking the same marijuana either in a different frame of mind (set) or in a different location (setting) can alter the effects or perception of the effects by the individual. Effects of cannabis consumption may be loosely classified as cognitive and physical. Anecdotal evidence suggests that the '']'' species tends to produce more of the cognitive or perceptual effects, while '']'' tends to produce more of the physical effects. | |||
=== Cognitive, behavioral, or perceptual === | |||
Cannabis has a broad spectrum of possible cognitive, behavioral, or perceptual effects, the occurrence of which vary from user to user. Some of these are the intended effect desired by users, some may be considered desirable depending on the situation, and others are generally considered undesirable. Users of cannabis report that these kinds of effects are more often produced by the '']'' species of ''Cannabis''. | |||
=== |
====United States==== | ||
Between 1973 and 1978, eleven states decriminalized marijuana.<ref name="tandfonline.com">{{Cite journal |last=Joshua |first=Clark Davis |name-list-style=vanc |date=2015 |title=The business of getting high: head shops, countercultural capitalism, and the marijuana legalization movement |journal=The Sixties |volume=8 |pages=27–49 |doi=10.1080/17541328.2015.1058480 |s2cid=142795620 |hdl-access=free |hdl=11603/7422}}</ref> In 2001, ] reduced marijuana possession to a misdemeanor and since 2012, several other states have decriminalized and even legalized marijuana.<ref name="tandfonline.com" /> | |||
Cannabis also has effects that are predominantly physical or sensory, widely believed to be more common with the '']'' species. | |||
In 2018, surveys indicated that almost half of the people in the United States had tried marijuana, 16% had used it in the past year, and 11% had used it in the past month.<ref name="6 facts about marijuana">{{Cite web |date=22 November 2018 |title=6 facts about marijuana |url=https://www.pewresearch.org/fact-tank/2019/11/22/facts-about-marijuana/ |access-date=24 September 2020}}</ref> In 2014, surveys said daily marijuana use amongst US college students had reached its highest level since records began in 1980, rising from 3.5% in 2007 to 5.9% in 2014 and had surpassed daily cigarette use.<ref>{{Cite web |title=Daily marijuana use among college students highest since 1980 |url=https://record.umich.edu/articles/daily-marijuana-use-among-college-students-highest-1980 |website=The University Record}}</ref> | |||
====List of effects==== | |||
* ] properties | |||
* Modulation of ] and ] | |||
* Impairment of short-term memory | |||
* Enhancement of many other drug effects (including those of ], ], ], ], ]) | |||
* ] or visual ] at high doses in some users | |||
* ], ] and ] | |||
* Increased ] (often referred to as "the munchies"), an effect of stimulation of the ] system, which affects ], ], and ]. | |||
* Increased ] | |||
* Increased awareness of ] | |||
* Increased awareness of ]s and ]s | |||
* Increased appreciation of ] | |||
* Increased mental activity, like ] | |||
* Induced sense of ] | |||
* Initial ] followed by ] and lassitude ('burnt out') | |||
* ] or ] states of mind | |||
* Gain or loss of some ] | |||
* Mild ], feelings of general well-being | |||
* Relaxation or ] reduction | |||
* Mild ] (Increased heart rate) | |||
* Mild, temporary ] (sometimes referred to as ''cottonmouth'', ''pasties'', or ''the drys'' (NZ)) | |||
* Mild, temporary ] (sometimes referred to as ''blood-shot eyes,'' ''dry eyes'' or ''red eye''(UK)) | |||
* Mild ] and ] | |||
In the US, men are over twice as likely to use marijuana as women, and 18{{ndash}}29-year-olds are six times more likely to use as over-65-year-olds.<ref name="gallup.com">{{Cite news |last=McCarthy |first=Justin |date=22 July 2015 |title=More Than Four in 10 Americans Say They Have Tried Marijuana |work=Gallup |url=https://news.gallup.com/poll/184298/four-americans-say-tried-marijuana.aspx}}</ref> In 2015, a record 44% of the US population has tried marijuana in their lifetime, an increase from 38% in 2013 and 33% in 1985.<ref name="gallup.com" /> | |||
====List of therapeutic effects ==== | |||
* Pain relief (especially ]s, ]s, and eye pain due to lowered ]). | |||
* Increased ], food subjectively tastes better. | |||
* Reduced ], (especially from chemotherapy), though may cause or exacerbate nausea for some. | |||
* Dilation of ] (air sacs) in ], resulting in deeper respiration. | |||
* Increase in productive coughs | |||
* Dilation of ]s (]), resulting in: | |||
** Increased blood flow and heart rate | |||
** Reddening of the conjunctivae (red eye) | |||
* Lower intra-] pressure (beneficial to ] patients). | |||
* Lower ] while standing. Higher blood pressure while sitting (note that this can lead to instances of ] a.k.a. head rush). | |||
* Induces drowsiness (beneficial to sufferers of ] and ]). | |||
* Relaxation | |||
* Reduced ] | |||
* Mild ] (e.g. per ] users, more "]-Vibrations") | |||
Marijuana use in the United States is three times above the global average, but in line with other Western democracies. Forty-four percent of American 12th graders have tried the drug at least once, and the typical age of first-use is 16, similar to the typical age of first-use for alcohol but lower than the first-use age for other illicit drugs.<ref name="CaulkinsHawken2012" /> | |||
=== Active ingredients, metabolism, and method of activity === | |||
Of the approximately 400 different chemicals found in ''Cannabis'', the main active ingredient is ] (delta-9-tetrahydrocannabinol, '''THC'''). THC can degrade to CBL and CBN (other ]), which can make one feel sleepy and disoriented. Different marijuana products have different ratios of these and other cannabinoids. Depending on the ratio, the quality of the "high" will vary. | |||
A 2022 ] poll concluded Americans are smoking more marijuana than cigarettes for the first time.<ref name=":4">{{Cite news |title=For the first time, Americans are smoking more marijuana than cigarettes, poll finds |work=cbsnews.com |url=https://www.cbsnews.com/news/marijuana-more-popular-than-cigarettes-in-us-gallup-poll/}}</ref> | |||
THC has an effect on the modulation of the ] which may have an effect on malignant cells, but there is insufficient scientific study to determine whether this might promote or limit ]. Cannabinoid receptors are also present in the human ], but there is insufficient scientific study to conclusively determine the effects of cannabis on reproduction. Mild ] to cannabis may be possible in some members of the population. | |||
== Adverse effects == | |||
A study has shown that holding cannabis smoke in one's lungs for longer periods of time does not conclusively increase THC's effects{{ref|PBB}}. | |||
{{Further|Effects of cannabis}} | |||
=== |
===Short-term=== | ||
] | |||
It is generally considered to be impossible to achieve a lethal overdose by smoking cannabis. According to the ], 12th edition, the ], the lethal dose for 50% of rats tested by inhalation, is 42 ] per ] of body weight. That is equivalent of a 75 kg (165 lb) man ingesting all of the ] in 21 one-gram cigarettes of maximum-potency (15% THC) cannabis buds at once, assuming no THC was lost through burning or exhalation. For oral consumption, the LD<sub>50</sub> for rats is 1270 mg/kg and 730 mg/kg for males and females, respectively, equivalent to the THC in about a pound of 15% THC cannabis. Only with ] administration — an unheard-of method of use — may such a level be even theoretically possible. | |||
Acute negative effects may include anxiety and panic, impaired attention and memory, an increased risk of psychotic symptoms,{{efn|Psychotic episodes are well-documented and typically resolve within minutes or hours, while symptoms may last longer.<ref>{{Cite web |title=Sativex Oral Mucosal Spray Public Assessment Report. Decentralized Procedure. |url=http://www.mhra.gov.uk/home/groups/par/documents/websiteresources/con084961.pdf |access-date=7 May 2015 |publisher=United Kingdom Medicines and Healthcare Products Regulatory Agency |page=93 |quote=There is clear evidence that recreational cannabis can produce a transient toxic psychosis in larger doses or in susceptible individuals, which is said to characteristically resolve within a week or so of absence (Johns 2001). Transient psychotic episodes as a component of acute intoxication are well-documented (Hall et al 1994)}}</ref> The use of a single joint can temporarily induce some psychiatric symptoms.<ref>{{Cite news |last=Hunt |first=Katie |date=17 March 2020 |title=Single cannabis joint linked with temporary psychiatric symptoms, review finds |work=CNN |url=https://www.cnn.com/2020/03/17/health/cannabis-psychiatric-symptoms-wellness/index.html |access-date=21 March 2020}}</ref>}} the inability to think clearly, and an increased risk of accidents.<ref name="W. Hall, N. Solowij 1611–16">{{Cite journal |vauthors=Hall W, Solowij N |date=November 1998 |title=Adverse effects of cannabis |journal=Lancet |volume=352 |issue=9140 |pages=1611–16 |doi=10.1016/S0140-6736(98)05021-1 |pmid=9843121 |s2cid=16313727}}</ref><ref>{{Cite book |last1=Oltmanns |first1=Thomas |title=Abnormal Psychology |last2=Emery |first2=Robert |publisher=Pearson |date=2015 |isbn=978-0205970742 |location=New Jersey |page=294 |name-list-style=vanc}}</ref><ref name="D'Souza">{{Cite journal |vauthors=D'Souza DC, Sewell RA, Ranganathan M |date=October 2009 |title=Cannabis and psychosis/schizophrenia: human studies |journal=European Archives of Psychiatry and Clinical Neuroscience |volume=259 |issue=7 |pages=413–31 |doi=10.1007/s00406-009-0024-2 |pmc=2864503 |pmid=19609589}}</ref> Cannabis impairs a person's driving ability, and ] was the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes. Those with THC in their system are from three to seven times more likely to be the cause of the accident than those who had not used either cannabis or alcohol, although its role is not necessarily causal because THC stays in the bloodstream for days to weeks after intoxication.<ref name="NIH-2">{{Cite web |last=Abuse |first=National Institute on Drug |title=Does marijuana use affect driving? |url=https://www.drugabuse.gov/publications/research-reports/marijuana/does-marijuana-use-affect-driving |access-date=18 December 2019 |website=www.drugabuse.gov}}</ref><ref>{{Cite journal |vauthors=Li MC, Brady JE, DiMaggio CJ, Lusardi AR, Tzong KY, Li G |date=4 October 2011 |title=Marijuana use and motor vehicle crashes |journal=Epidemiologic Reviews |volume=34 |issue=1 |pages=65–72 |doi=10.1093/epirev/mxr017 |pmc=3276316 |pmid=21976636}}</ref>{{efn|A 2016 review also found a statistically significant increase in crash risk associated with marijuana use, but noted that this risk was "of low to medium magnitude."<ref>{{Cite journal |vauthors=Rogeberg O, Elvik R |date=August 2016 |title=The effects of cannabis intoxication on motor vehicle collision revisited and revised |url=https://zenodo.org/record/897625 |journal=Addiction |volume=111 |issue=8 |pages=1348–59 |doi=10.1111/add.13347 |pmid=26878835}}</ref> The increase in risk of motor vehicle crash for cannabis use is between 2 and 3 times relative to baseline, whereas that for comparable doses of alcohol is between 6 and 15 times.<ref name="hall2015">{{Cite journal |vauthors=Hall W |date=January 2015 |title=What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? |url=https://espace.library.uq.edu.au/view/UQ:346328/Hall_2014_20ycann_OA_post.pdf |journal=Addiction |volume=110 |issue=1 |pages=19–35 |doi=10.1111/add.12703 |pmid=25287883}}</ref>}} | |||
There has only ever been one recorded verdict of fatal overdose due to cannabis. In ], ] of ], ] was found dead. The coroner's report stated "Death due to probable cannabis toxicity". It had been reported that Maisey smoked about six joints a day. Mr. Maisey's blood contained 130 ]s per ] (ng/ml) of the THC metabolite THC-COOH. | |||
Some immediate undesired side effects include a decrease in short-term memory, dry mouth, impaired motor skills, reddening of the eyes,<ref name="HallPacula2003ew">{{Cite book |last1=Hall |first1=Wayne |url=https://archive.org/details/CannabisUseAndDependence |title=Cannabis Use and Dependence: Public Health and Public Policy |last2=Pacula |first2=Rosalie Liccardo |publisher=Cambridge University Press |date=2003 |isbn=978-0-521-80024-2 |page= |url-access=registration |name-list-style=vanc}}</ref> dizziness, feeling tired and vomiting.<ref name=JAMA2015/> Some users may experience an episode of acute ], which usually abates after six hours, but in rare instances, heavy users may find the symptoms continuing for many days.<ref name="Barceloux2012" /> | |||
The validity of the finding did not stand up well under review. As reported on ] in the '']'', the Federal Health Ministry of ] asked Dr. Rudolf Brenneisen, a professor at the department for clinical research at the ], to review the data of this case. Dr. Brenneisen said that the data of the toxicological analysis and collected by autopsy were "scanty and not conclusive" and that the conclusion "death by cannabis intoxication" was "not legitimate". Additionally, Dr. Franjo Grotenhermen of the Nova-Institute in ] said: "A concentration of 130 ng/ml THC-COOH in blood is a moderate concentration, which may be observed some hours after the use of one or two joints. Heavy regular use of cannabis easily results in THC-COOH concentrations of above 500 ng/ml. Many people use much more cannabis than Mr. Maisey did, without any negative consequences." | |||
Legalization has increased the rates at which children are exposed to cannabis, particularly from edibles. While the toxicity and lethality of THC in children is not known, they are at risk for encephalopathy, hypotension, respiratory depression severe enough to require ventilation, somnolence and coma.<ref name=":13">{{Cite journal |last1=Wong |first1=Kei U. |last2=Baum |first2=Carl R. |date=November 2019 |title=Acute Cannabis Toxicity |journal=Pediatric Emergency Care |language=en-US |volume=35 |issue=11 |pages=799–804 |doi=10.1097/PEC.0000000000001970 |issn=0749-5161 |pmid=31688799 |s2cid=207897219}}</ref><ref>{{Cite journal |last1=Claudet |first1=Isabelle |last2=Le Breton |first2=Mathilde |last3=Bréhin |first3=Camille |last4=Franchitto |first4=Nicolas |date=April 2017 |title=A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach? |journal=European Journal of Pediatrics |volume=176 |issue=4 |pages=553–56 |doi=10.1007/s00431-017-2872-5 |issn=1432-1076 |pmid=28210835 |s2cid=11639790}}</ref> | |||
== Health issues and the effects of cannabis == | |||
''Main article: ]'' | |||
===Fatality=== | |||
There is little conclusive scientific evidence about the long-term effects of human cannabis consumption. The findings of earlier studies purporting to demonstrate the effects of the drug are unreliable and generally regarded as ], as the studies were flawed, with strong bias and poor methodology. The most significant confounding factor is the use of other drugs, including alcohol and tobacco, by test subjects in conjunction with cannabis. When subjects using only cannabis were combined in the same sample with subjects using other drugs as well, researchers could not reach a conclusion as to whether their findings were caused by cannabis, other drugs or the interaction between them. | |||
There is no clear evidence for a link between cannabis use and deaths from cardiovascular disease, but a 2019 review noted that it may be an under-reported, contributory factor or direct cause in cases of sudden ], due to the strain it can place on the ]. Some deaths have also been attributed to ].<ref name="drummer">{{Cite journal |vauthors=Drummer OH, Gerostamoulos D, Woodford NW |date=May 2019 |title=Cannabis as a cause of death: A review |journal=Forensic Sci Int |volume=298 |pages=298–306 |doi=10.1016/j.forsciint.2019.03.007 |pmid=30925348 |s2cid=87511682}}</ref> There is an association between cannabis use and suicide, particularly in younger users.<ref>{{cite journal |vauthors=Shamabadi A, Ahmadzade A, Pirahesh K, Hasanzadeh A, Asadigandomani H |title=Suicidality risk after using cannabis and cannabinoids: An umbrella review |journal=Dialogues Clin Neurosci |volume=25 |issue=1 |pages=50–63 |date=December 2023 |pmid=37427882 |pmc=10334849 |doi=10.1080/19585969.2023.2231466 |url=}}</ref> | |||
A 16-month survey of Oregon and Alaska emergency departments found a report of the death of an adult who had been admitted for acute cannabis toxicity.<ref>{{Cite journal |vauthors=Takakuwa KM, Schears RM |date=February 2021 |title=The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review |journal=Int J Emerg Med |type=Review |volume=14 |issue=1 |pages=10 |doi=10.1186/s12245-021-00330-3 |pmc=7874647 |pmid=33568074 |doi-access=free }}</ref> | |||
=== Reproduction === | |||
Two studies have demonstrated a causal link between marijuana and decreased sperm motility. Specifically, marijuana causes sperm to move extremely quickly during the early phase of its journey to the egg, and subsequently "burn out" before it reaches its destination. | |||
===Long-term=== | |||
=== Tolerance, withdrawal and dreams=== | |||
{{main|Long-term effects of cannabis}} | |||
Although use may become habitual, the extent of ] to cannabis is unknown (], 2004). Many animal and human studies conducted since the ] have revealed cannabis withdrawal symptoms in some people after abstinence from heavy use which is usually characterized by a period of anxiousness, ], more vivid and memorable dreams, (''] rebound''), irritability, and diminished appetite after cessation of use. Because cannabis is a ], unlike typical ] or ] drugs, these persistent effects are typically not as severe as those normally associated with physical dependence. | |||
] regarding 20 popular recreational drugs. Cannabis was ranked 11th in dependence, 17th in physical harm, and 10th in social harm.<ref>{{Cite journal |vauthors=Nutt D, King LA, Saulsbury W, Blakemore C |date=March 2007 |title=Development of a rational scale to assess the harm of drugs of potential misuse |journal=Lancet |volume=369 |issue=9566 |pages=1047–53 |doi=10.1016/s0140-6736(07)60464-4 |pmid=17382831 |s2cid=5903121}}</ref>]] | |||
THC molecules break down quickly after ingestion, although some components can be detected for a period of up to a month after use, and up to 6 weeks or more in heavy users. Although these components are not proven to have any ongoing physical or mental effects in themselves—THC undergoes ], working its way out of the body slowly over many days, thus reducing the potential to cause withdrawal symptoms. {{ref|Markel}} | |||
=== |
====Psychological effects==== | ||
A 2015 meta-analysis found that, although a longer period of abstinence was associated with smaller magnitudes of impairment, both retrospective and ] memory were impaired in cannabis users. The authors concluded that some, but not all, of the deficits associated with cannabis use were reversible.<ref>{{Cite journal |vauthors=Schoeler T, Kambeitz J, Behlke I, Murray R, Bhattacharyya S |date=January 2016 |title=The effects of cannabis on memory function in users with and without psychotic disorder: findings from a combined meta-analysis |url=https://epub.ub.uni-muenchen.de/43978/ |journal=Psychological Medicine |volume=46 |issue=1 |pages=177–88 |doi=10.1017/S0033291715001646 |pmid=26353818 |s2cid=23749219}}</ref> A 2012 meta-analysis found that deficits in most domains of cognition persisted beyond the acute period of intoxication, but was not evident in studies where subjects were abstinent for more than 25 days.<ref name="Schreiner 2012">{{Cite journal |vauthors=Schreiner AM, Dunn ME |date=October 2012 |title=Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: a meta-analysis |journal=Experimental and Clinical Psychopharmacology |volume=20 |issue=5 |pages=420–29 |doi=10.1037/a0029117 |pmid=22731735 |s2cid=207618350 |quote=Therefore, results indicate evidence for small neurocognitive effects that persist after the period of acute intoxication...As hypothesized, the meta-analysis conducted on studies eval- uating users after at least 25 days of abstention found no residual effects on cognitive performance...These results fail to support the idea that heavy cannabis use may result in long-term, persistent effects on neuropsychological functioning.}}</ref> Few high quality studies have been performed on the long-term effects of cannabis on cognition, and the results were generally inconsistent.<ref>{{Cite journal |vauthors=Gonzalez R, Carey C, Grant I |date=November 2002 |title=Nonacute (residual) neuropsychological effects of cannabis use: a qualitative analysis and systematic review |journal=Journal of Clinical Pharmacology |volume=42 |issue=S1 |pages=48S–57S |doi=10.1002/j.1552-4604.2002.tb06003.x |pmid=12412836 |s2cid=37826919}}</ref> Furthermore, ]s of significant findings were generally small.<ref name="Schreiner 2012" /> One review concluded that, although most cognitive faculties were unimpaired by cannabis use, residual deficits occurred in ]s.<ref>{{Cite journal |vauthors=Crean RD, Crane NA, Mason BJ |date=March 2011 |title=An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions |journal=Journal of Addiction Medicine |volume=5 |issue=1 |pages=1–8 |doi=10.1097/ADM.0b013e31820c23fa |pmc=3037578 |pmid=21321675 |quote=Cannabis appears to continue to exert impairing effects in executive functions even after 3 weeks of abstinence and beyond. While basic attentional and working memory abilities are largely restored, the most enduring and detectable deficits are seen in decision-making, concept formation and planning.}}</ref> Impairments in executive functioning are most consistently found in older populations, which may reflect heavier cannabis exposure, or developmental effects associated with adolescent cannabis use.<ref>{{Cite journal |vauthors=Broyd SJ, van Hell HH, Beale C, Yücel M, Solowij N |date=April 2016 |title=Acute and Chronic Effects of Cannabinoids on Human Cognition-A Systematic Review |url=http://ro.uow.edu.au/sspapers/2164 |journal=Biological Psychiatry |volume=79 |issue=7 |pages=557–67 |doi=10.1016/j.biopsych.2015.12.002 |pmid=26858214 |s2cid=9858298}}</ref> One review found three prospective cohort studies that examined the relationship between self-reported cannabis use and ] (IQ). The study following the largest number of heavy cannabis users reported that IQ declined between ages 7–13 and age 38. Poorer school performance and increased incidence of leaving school early were both associated with cannabis use, although a causal relationship was not established.<ref name="Curran2016">{{Cite journal |vauthors=Curran HV, Freeman TP, Mokrysz C, Lewis DA, Morgan CJ, Parsons LH |date=May 2016 |title=Keep off the grass? Cannabis, cognition and addiction |url=http://discovery.ucl.ac.uk/1489385/1/Curran%2520et%2520al%2520NRN-2016%2520pdf.pdf |journal=Nature Reviews. Neuroscience |volume=17 |issue=5 |pages=293–306 |doi=10.1038/nrn.2016.28 |pmid=27052382 |s2cid=1685727 |archive-url=https://web.archive.org/web/20170922191943/http://discovery.ucl.ac.uk/1489385/1/Curran%2520et%2520al%2520NRN-2016%2520pdf.pdf |archive-date=22 September 2017 |access-date=27 December 2018 |hdl-access=free |hdl=10871/24746}}</ref> Cannabis users demonstrated increased activity in task-related brain regions, consistent with reduced processing efficiency.<ref>{{Cite journal |vauthors=Ganzer F, Bröning S, Kraft S, Sack PM, Thomasius R |date=June 2016 |title=Weighing the Evidence: A Systematic Review on Long-Term Neurocognitive Effects of Cannabis Use in Abstinent Adolescents and Adults |journal=Neuropsychology Review |volume=26 |issue=2 |pages=186–222 |doi=10.1007/s11065-016-9316-2 |pmid=27125202 |s2cid=4335379}}</ref> | |||
<!-- this section needs to be synched with "Health issues and the effects of cannabis", which is more up to date --> | |||
There is a growing body of medical evidence which shows positive correlations between cannabis use and ], ], or ]. A landmark study, in 1987, of 50,000 Swedish Army conscripts, found that those who admitted at age 18 to having taken cannabis on more than 50 occasions, were six times more likely to develop schizophrenia in the following 15 years. Some believe that cannabis may trigger latent conditions or be part of a complex coordination of causes, referred to as the ] in ]. On the other hand, many people with pronounced psychological disorders, including schizophrenia, depression, bi-polar and obsessive-compulsive disorder, often ] their illness with cannabis in place of potent main-stream drugs like ]. | |||
A reduced ] is associated with heavy cannabis use, although the relationship is inconsistent and weaker than for tobacco and other substances.<ref name="Gold2017">{{Cite journal |vauthors=Goldenberg M, IsHak WW, Danovitch I |date=January 2017 |title=Quality of life and recreational cannabis use |journal=The American Journal on Addictions |volume=26 |issue=1 |pages=8–25 |doi=10.1111/ajad.12486 |pmid=28000973 |s2cid=40707053}}</ref> The direction of ], however, is unclear.<ref name=Gold2017/> | |||
One concern with research alleging a link between cannabis use and psychotic illness has been that, while a ] may be drawn, it is not possible to establish ] or causation - in other words, to establish that people who are mentally ill and have used cannabis are ill ''because'' they have used cannabis. Often, given that research is often conducted by organizations with a nonscientific ] against cannabis use, studies that show correlation between cannabis use and mental illness (or other health problems) are often incorrectly claimed to show causality as well. Recent research has attempted to address this concern by studying large groups free of mental illness, to examine the proportion of individuals that already use cannabis who go on to develop mental illnesses{{ref|UKCIA1}}. | |||
The ] are not clear.<ref name=JAMA2015/> There are concerns surrounding ], risk of addiction, and the risk of ] in young people.<ref name=Borgelt2013/> | |||
Evidence for causality was provided by a 2005 study{{ref|UKCIA2}} showing the existence of a genetic predisposition to cannabis related symptoms of psychosis, by showing correlation between presence of the ], adolescent cannabis use and symptoms of psychotic illness (though for none of these traits separately). The study demonstrates that early adolescent cannabis use is a greater predictor for symptoms of adult psychosis among carriers of the gene.<!-- | |||
====Neuroimaging==== | |||
{{ref|Times}}Newspapers usually get study results wrong, and this Times story got the maths wrong: one-in-four NOT at risk of psychosis. 25% of NZ Northern European study population carried the gene, of those who smoked cannabis heavily in adolescence 10% had incidence of later adult psychosis. This was three (3) people in the {{ref|UKCIA2}} study. I've cut the one-in-four claim and link. | |||
Although global abnormalities in ] and ] are not consistently associated with cannabis use,<ref name="Hamp2019">{{Cite journal |vauthors=Hampton WH, Hanik I, Olson IR |date=2019 |title= |journal=Drug and Alcohol Dependence |language=en |volume=197 |issue=4 |pages=288–298 |doi=10.1016/j.drugalcdep.2019.02.005 |pmc=6440853 |pmid=30875650 |quote=Given that central nervous system is an intricately balanced, complex network of billions of neurons and supporting cells, some might imagine that extrinsic substances could cause irreversible brain damage. Our review paints a less gloomy picture of the substances reviewed, however. Following prolonged abstinence, abusers of alcohol (Pfefferbaum et al., 2014) or opiates (Wang et al., 2011) have white matter microstructure that is not significantly different from nonusers. There was also no evidence that the white matter microstructural changes observed in longitudinal studies of cannabis, nicotine, or cocaine were completely irreparable. It is therefore possible that, at least to some degree, abstinence can reverse effects of substance abuse on white matter. The ability of white matter to “bounce back” very likely depends on the level and duration of abuse, as well as the substance being abused.}}</ref> reduced ] volume is consistently found.<ref>{{Cite journal |last1=Yücel |first1=M |last2=Lorenzetti |first2=V |last3=Suo |first3=C |last4=Zalesky |first4=A |last5=Fornito |first5=A |last6=Takagi |first6=M J |last7=Lubman |first7=D I |last8=Solowij |first8=N |date=January 2016 |title=Hippocampal harms, protection and recovery following regular cannabis use |journal=Translational Psychiatry |volume=6 |issue=1 |pages=e710– |doi=10.1038/tp.2015.201 |pmc=5068875 |pmid=26756903}}</ref> ] abnormalities are sometimes reported, although findings are inconsistent.<ref>{{Cite journal |vauthors=Rocchetti M, Crescini A, Borgwardt S, Caverzasi E, Politi P, Atakan Z, Fusar-Poli P |date=November 2013 |title=Is cannabis neurotoxic for the healthy brain? A meta-analytical review of structural brain alterations in non-psychotic users |journal=Psychiatry and Clinical Neurosciences |volume=67 |issue=7 |pages=483–92 |doi=10.1111/pcn.12085 |pmid=24118193 |s2cid=8245635 |doi-access=free}}</ref><ref name="Batalla2013">{{Cite journal |vauthors=Batalla A, Bhattacharyya S, Yücel M, Fusar-Poli P, Crippa JA, Nogué S, Torrens M, Pujol J, Farré M, Martin-Santos R |date=2013 |title=Structural and functional imaging studies in chronic cannabis users: a systematic review of adolescent and adult findings |journal=PLOS ONE |volume=8 |issue=2 |pages=e55821 |bibcode=2013PLoSO...855821B |doi=10.1371/journal.pone.0055821 |pmc=3563634 |pmid=23390554 |quote=The most consistently reported brain alteration was reduced hippocampal volume which was shown to persist even after several months of abstinence in one study and also to be related to the amount of cannabis use Other frequently reported morphological brain alterations related to chronic cannabis use were reported in the amygdala the cerebellum and the frontal cortex...These findings may be interpreted as reflecting neuroadaptation, perhaps indicating the recruitment of additional regions as a compensatory mechanism to maintain normal cognitive performance in response to chronic cannabis exposure, particularly within the prefrontal cortex area. |doi-access=free}}</ref><ref name="Weinstein2016">{{Cite journal |vauthors=Weinstein A, Livny A, Weizman A |date=2016 |title=Brain Imaging Studies on the Cognitive, Pharmacological and Neurobiological Effects of Cannabis in Humans: Evidence from Studies of Adult Users |journal=Current Pharmaceutical Design |volume=22 |issue=42 |pages=6366–79 |doi=10.2174/1381612822666160822151323 |pmid=27549374 |quote=1) The studies reviewed so far demonstrated that chronic cannabis use has been associated with a volume reduction of the hippocampus...3) The overall conclusion arising from these studies is that recent cannabis users may experience subtle neurophysiological deficits while performing on working memory tasks, and that they compensate for these deficits by "working harder" by using additional brain regions to meet the demands of the task.}}</ref> | |||
Cannabis use is associated with increased recruitment of task-related areas, such as the ], which is thought to reflect compensatory activity due to reduced processing efficiency.<ref name="Weinstein2016" /><ref name="Batalla2013" /><ref>{{Cite journal |vauthors=Blest-Hopley G, Giampietro V, Bhattacharyya S |date=May 2018 |title=Residual effects of cannabis use in adolescent and adult brains – A meta-analysis of fMRI studies |url=https://kclpure.kcl.ac.uk/portal/files/88441182/Residual_effects_of_cannabis_BLEST_HOPLEY_Publishedonline10March2018_GREEN_AAM_CC_BY_NC_ND_.pdf |journal=Neuroscience and Biobehavioral Reviews |volume=88 |pages=26–41 |doi=10.1016/j.neubiorev.2018.03.008 |pmid=29535069 |s2cid=4402954 |quote=This may reflect the multitude of cognitive tasks employed by the various studies included in these meta-analyses, all of which involved performing a task thereby requiring the participant to reorient their attention and attempt to solve the problem at hand and suggest that greater engagement of this region indicates less efficient cognitive performance in cannabis users in general, irrespective of their age.}}</ref> Cannabis use is also associated with downregulation of ] receptors. The magnitude of down regulation is associated with cumulative cannabis exposure, and is reversed after one month of abstinence.<ref name="Curran2016" /><ref>{{Cite journal |vauthors=Parsons LH, Hurd YL |date=October 2015 |title=Endocannabinoid signalling in reward and addiction |journal=Nature Reviews. Neuroscience |volume=16 |issue=10 |pages=579–94 |doi=10.1038/nrn4004 |pmc=4652927 |pmid=26373473}}</ref><ref>{{Cite journal |vauthors=Zehra A, Burns J, Liu CK, Manza P, Wiers CE, Volkow ND, Wang GJ |date=March 2018 |title=Cannabis Addiction and the Brain: a Review |journal=Journal of Neuroimmune Pharmacology |volume=13 |issue=4 |pages=438–52 |doi=10.1007/s11481-018-9782-9 |pmc=6223748 |pmid=29556883}}</ref> There is limited evidence that chronic cannabis use can reduce levels of ] metabolites in the human brain.<ref>{{Cite journal |vauthors=Colizzi M, McGuire P, Pertwee RG, Bhattacharyya S |date=May 2016 |title=Effect of cannabis on glutamate signalling in the brain: A systematic review of human and animal evidence |url=https://kclpure.kcl.ac.uk/portal/en/publications/effect-of-cannabis-on-glutamate-signalling-in-the-brain-a-systematic-review-of-human-and-animal-evidence(9b3d72d2-d3ae-44a6-b9a5-4c13e9690b9d).html |journal=Neuroscience and Biobehavioral Reviews |volume=64 |pages=359–81 |doi=10.1016/j.neubiorev.2016.03.010 |pmid=26987641 |s2cid=24043856}}</ref> | |||
--> The study attempted to control for prior mental illness and other alternative explanations, thereby establishing causality. However, the small sample size, symptom screening prior to likely age of symptom onset, and the cohort nature of the study, all call the result into question. This theory is still hotly disputed {{ref|Alternet}}, and further research is ongoing. | |||
===Cannabis dependence=== | |||
Some claim that extended use of cannabis may help the user reach a higher level of mental consciousness and clarity, expanding the mind and helping individuals become more aware, insightful and intelligent. These claims seem contradictory to the common view of the long-term effects of marijuana use. Some of this contradiction is sure to be indicative of differing interpretations of a common effect; consider the inherent subjectivity of identifying addiction, abuse, and ambition, for example. | |||
{{Main|Cannabis dependence}} | |||
About 9% of those who experiment with marijuana eventually become dependent according to ] criteria.<ref name="NEJM2014" /> A 2013 review estimates daily use is associated with a 10–20% rate of dependence.<ref name="Borgelt2013" /> The highest risk of cannabis dependence is found in those with a history of poor academic achievement, ] in childhood and adolescence, rebelliousness, poor parental relationships, or a parental history of drug and alcohol problems.<ref>{{Cite journal |vauthors=Hall W, Degenhardt L |date=October 2009 |title=Adverse health effects of non-medical cannabis use |journal=Lancet |volume=374 |issue=9698 |pages=1383–91 |doi=10.1016/s0140-6736(09)61037-0 |pmid=19837255 |s2cid=31616272}}</ref> Of daily users, about 50% experience withdrawal upon cessation of use (i.e. are dependent), characterized by sleep problems, irritability, dysphoria, and craving.<ref name="Curran2016" /> Cannabis withdrawal is less severe than withdrawal from alcohol.<ref>{{Cite journal |vauthors=Subbaraman MS |date=2014 |title=Can cannabis be considered a substitute medication for alcohol? |journal=Alcohol and Alcoholism |volume=49 |issue=3 |pages=292–98 |doi=10.1093/alcalc/agt182 |pmc=3992908 |pmid=24402247}}</ref> | |||
=== Long-term physical effects of smoking === | |||
The combustion of any organic material creates irritants and carcinogens, and cannabis is no different. The long-term effects of smoking any substance depends on frequency of use, duration of inhalation, and composition of the smoke. This leads many to assume that the effects of cannabis can be directly compared to other well-known smoking materials such as tobacco. However, direct, volume-for-volume comparisons of the two are probably ] because the chemical composition and methods of usage are not the same. Studies on the subject are inconclusive and have not isolated all the possible factors exacerbating or ameliorating the effects of cannabis user. Here are some of these factors: | |||
According to ] criteria, 9% of those who are exposed to cannabis develop cannabis use disorder, compared to 20% for ], 23% for ] and 68% for ]. Cannabis use disorder in the DSM-V involves a combination of DSM-IV criteria for cannabis abuse and dependence, plus the addition of craving, without the criterion related to legal troubles.<ref name="Curran2016" /> | |||
====Possibly exacerbating factors:==== | |||
*Studies have pointed out that cannabis produces more tar and burns at a higher temperature than ]. | |||
*Many cannabis smokers inhale the smoke more deeply and hold it in their lungs for a longer period of time. | |||
==== |
====Psychiatric==== | ||
{{See also|Long-term effects of cannabis#Mental health}} | |||
* Generally, even a chronic cannabis user does not inhale a daily volume of smoke equal to a significant portion of that of a tobacco smoker. | |||
* Cannabis smoke does not tend to penetrate to the smaller, peripheral passageways of the lungs, concentrating rather on the larger, central passageways. | |||
* Industrialized cultivation and preparation of tobacco introduces a variety of ] and ] additives and ]s such as ], ], ]-226, and ]-210. This problem does not pertain to cannabis, the vast majority of which is grown in ]. | |||
* There is evidence to suggest that cannabinoids present in cannabis may actually serve to protect against cancer. {{ref|NIH}} | |||
From a clinical perspective, two significant school of thought exists for psychiatric conditions associated with cannabis (or cannabinoids) use: transient, non-persistent psychotic reactions, and longer-lasting, persistent disorders that resemble schizophrenia. The former is formally known as acute cannabis-associated psychotic symptoms (CAPS).<ref>{{Cite journal |last1=Schoeler |first1=Tabea |last2=Baldwin |first2=Jessie R. |last3=Martin |first3=Ellen |last4=Barkhuizen |first4=Wikus |last5=Pingault |first5=Jean-Baptiste |date=2024-06-03 |title=Assessing rates and predictors of cannabis-associated psychotic symptoms across observational, experimental and medical research |journal=Nature Mental Health |volume=2 |issue=7 |language=en |pages=865–876 |doi=10.1038/s44220-024-00261-x |issn=2731-6076|doi-access=free |pmid=39005547 |pmc=11236708 }}</ref> | |||
Some studies have claimed a positive correlation between cannabis use and lung cancer, however, it is possible that this may be due to correlation between cannabis and tobacco use. More study would be needed to separate tobacco use and other factors in order to better understand the potential long-term physiological effects of cannabis use itself. Some recent reports suggest that when the data is properly analyzed, the correlation may in fact be negative.{{ref|Counterpunch}} | |||
At an epidemiological level, a ] exists between cannabis use and increased risk of ] and earlier onset of psychosis.<ref name="Leweke2016rev">{{Cite journal |vauthors=Leweke FM, Mueller JK, Lange B, Rohleder C |date=April 2016 |title=Therapeutic Potential of Cannabinoids in Psychosis |journal=Biological Psychiatry |volume=79 |issue=7 |pages=604–12 |doi=10.1016/j.biopsych.2015.11.018 |pmid=26852073 |s2cid=24160677 |quote=Epidemiological data indicate a strong relationship between cannabis use and psychosis and schizophrenia beyond transient intoxication with an increased risk of any psychotic outcome in individuals who had ever used cannabis}}</ref><ref name="Marconi2016">{{Cite journal |vauthors=Marconi A, Di Forti M, Lewis CM, Murray RM, Vassos E |date=September 2016 |title=Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis |journal=Schizophrenia Bulletin |volume=42 |issue=5 |pages=1262–69 |doi=10.1093/schbul/sbw003 |pmc=4988731 |pmid=26884547}}</ref><ref name="Moore 2007">{{Cite journal |vauthors=Moore TH, Zammit S, ], Barnes TR, Jones PB, Burke M, Lewis G |date=July 2007 |title=Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review |url=http://orca.cf.ac.uk/619/1/Appendix%201%20%28search%20strategy%29%20Cannabis%20use%20and%20risk%20of%20developing%20psychotic%20or%20affective%20mental%20health%20outcomes%20a%20systematic%20review.pdf |journal=Lancet |volume=370 |issue=9584 |pages=319–28 |doi=10.1016/S0140-6736(07)61162-3 |pmid=17662880 |s2cid=41595474}}</ref><ref>{{Cite journal |vauthors=Semple DM, McIntosh AM, Lawrie SM |date=March 2005 |title=Cannabis as a risk factor for psychosis: systematic review |journal=Journal of Psychopharmacology |volume=19 |issue=2 |pages=187–94 |doi=10.1177/0269881105049040 |pmid=15871146 |s2cid=44651274}}</ref><ref>{{Cite journal |vauthors=Large M, Sharma S, Compton MT, Slade T, Nielssen O |date=June 2011 |title=Cannabis use and earlier onset of psychosis: a systematic meta-analysis |journal=Archives of General Psychiatry |volume=68 |issue=6 |pages=555–61 |doi=10.1001/archgenpsychiatry.2011.5 |pmid=21300939 |doi-access=free}}</ref> Although the epidemiological association is robust, evidence to prove a causal relationship is lacking.<ref>{{Cite journal |vauthors=McLaren JA, Silins E, Hutchinson D, Mattick RP, Hall W |date=January 2010 |title=Assessing evidence for a causal link between cannabis and psychosis: a review of cohort studies |journal=The International Journal on Drug Policy |volume=21 |issue=1 |pages=10–19 |doi=10.1016/j.drugpo.2009.09.001 |pmid=19783132 |quote=The contentious issue of whether cannabis use can cause serious psychotic disorders that would not otherwise have occurred cannot be answered based on the existing data}}</ref> | |||
== Medicinal use== | |||
{{main_article|]}} | |||
Medically, cannabis is most often used as an appetite stimulant and pain reliever for certain terminal illnesses such as ] and ]. It is used to relieve ] and certain neurological illnesses such as ], ] and ]. It has also been found to relieve nausea for ] patients. The medical use of cannabis is politically controversial, but it is sometimes recommended informally by physicians. A synthetic version of the major active chemical in cannabis, THC, is readily available in the form of a pill as the prescription drug ]. THC has also been found to reduce arterial blockages.{{ref|Nature}} A sublingual spray derived from an extract of cannabis has also been approved for treatment of ] in Canada as the prescription drug ] - this drug may now be legally imported into the UK on prescription. Eleven states in the US allow marijuana consumption for medical purposes; however, ] ruled marijuana illegal for any purpose. | |||
In the case United States v. Oakland Cannabis Buyers Cooperative, 00-151, the Supreme Court ruled against marijuana. The Supreme Court ruled 8-0 that there is no exception in federal law for people to use marijuana to ease their pain from cancer, AIDS or other illnesses. | |||
Cannabis may also increase the risk of depression, but insufficient research has been performed to draw a conclusion.<ref>{{Cite journal |vauthors=Lev-Ran S, Roerecke M, Le Foll B, George TP, McKenzie K, Rehm J |date=March 2014 |title=The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies |journal=Psychological Medicine |volume=44 |issue=4 |pages=797–810 |doi=10.1017/S0033291713001438 |pmid=23795762 |s2cid=36763290}}</ref><ref name="Moore 2007" /> Cannabis use is associated with increased risk of anxiety disorders, although causality has not been established.<ref>{{Cite journal |vauthors=Kedzior KK, Laeber LT |date=May 2014 |title=A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population – a meta-analysis of 31 studies |journal=BMC Psychiatry |volume=14 |pages=136 |doi=10.1186/1471-244X-14-136 |pmc=4032500 |pmid=24884989 |doi-access=free }}</ref> | |||
See section ''History'' for information on historic and other medical use. | |||
A review in 2019 found that research was insufficient to determine the safety and efficacy of using cannabis to treat schizophrenia, psychosis, or other ]s.<ref name="black">{{Cite journal |last1=Black |first1=Nicola |last2=Stockings |first2=Emily |last3=Campbell |first3=Gabrielle |last4=Tran |first4=Lucy T. |last5=Zagic |first5=Dino |last6=Hall |first6=Wayne D. |last7=Farrell |first7=Michael |last8=Degenhardt |first8=Louisa |date=December 2019 |title=Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis |journal=The Lancet. Psychiatry |volume=6 |issue=12 |pages=995–1010 |doi=10.1016/S2215-0366(19)30401-8 |pmc=6949116 |pmid=31672337}}</ref><ref name="mayo">{{Cite journal |last1=VanDolah |first1=Harrison J. |last2=Bauer |first2=Brent A. |last3=Mauck |first3=Karen F. |date=September 2019 |title=Clinicians' Guide to Cannabidiol and Hemp Oils |journal=Mayo Clinic Proceedings |volume=94 |issue=9 |pages=1840–51 |doi=10.1016/j.mayocp.2019.01.003 |pmid=31447137 |doi-access=free}}</ref> Another found that cannabis during adolescence was associated with an increased risk of developing depression and suicidal behavior later in life, while finding no effect on anxiety.<ref name="Gobbi">{{Cite journal |last1=Gobbi |first1=Gabriella |author-link=Gabriella Gobbi |last2=Atkin |first2=Tobias |last3=Zytynski |first3=Tomasz |last4=Wang |first4=Shouao |last5=Askari |first5=Sorayya |last6=Boruff |first6=Jill |last7=Ware |first7=Mark |last8=Marmorstein |first8=Naomi |last9=Cipriani |first9=Andrea |last10=Dendukuri |first10=Nandini |last11=Mayo |first11=Nancy |date=13 February 2019 |title=Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood |journal=JAMA Psychiatry |volume=76 |issue=4 |pages=426–34 |doi=10.1001/jamapsychiatry.2018.4500 |pmc=6450286 |pmid=30758486}}</ref> | |||
== Spiritual use == | |||
{{main_article|]}} | |||
Cannabis has a long history of ] use, especially in ], where it has been used by wandering spiritual ]s for centuries. The most famous ] group to use cannabis in a spiritual context is the ], though it is by no means the only group (e.g. ]). Some historians and etymologists have claimed that cannabis was used by ancient Jews, early Christians and Muslims of the Sufi order. ] was used by the ], a warrior ] sect. | |||
====Physical==== | |||
Heavy, long-term exposure to marijuana may have physical, mental, behavioral and social health consequences. It may be "associated with diseases of the liver (particularly with co-existing ]), lungs, heart, and vasculature".<ref name="Gordon2013">{{Cite journal |vauthors=Gordon AJ, Conley JW, Gordon JM |date=December 2013 |title=Medical consequences of marijuana use: a review of current literature |url=https://zenodo.org/record/1232874 |journal=Current Psychiatry Reports |volume=15 |issue=12 |pages=419 |doi=10.1007/s11920-013-0419-7 |pmid=24234874 |s2cid=29063282}}</ref> A 2014 review found that while cannabis use may be less harmful than alcohol use, the recommendation to substitute it for ] was premature without further study.<ref>{{Cite journal |vauthors=Subbaraman MS |date=8 January 2014 |title=Can cannabis be considered a substitute medication for alcohol? |journal=Alcohol and Alcoholism |volume=49 |issue=3 |pages=292–98 |doi=10.1093/alcalc/agt182 |pmc=3992908 |pmid=24402247}}</ref> Various surveys conducted between 2015 and 2019 found that many users of cannabis substitute it for ]s (including opioids), alcohol, and tobacco; most of those who used it in place of alcohol or tobacco either reduced or stopped their intake of the latter substances.<ref>{{Cite news |last=Armentano |first=Paul |date=5 February 2019 |title=Marijuana access is associated with decreased use of alcohol, tobacco and other prescription drugs |work=The Hill |url=https://thehill.com/opinion/healthcare/428593-marijuana-access-is-associated-with-decreased-use-of-alcohol-tobacco-and}}</ref> | |||
] (CHS) is a severe condition seen in some chronic cannabis users where they have repeated bouts of uncontrollable vomiting for 24–48 hours. | |||
Many individuals also consider their use of cannabis to be spiritual regardless of organized religion, though it is banned in many parts of the world (and in some cases 'because' it is banned). | |||
Four cases of death have been reported as a result of CHS.<ref>{{Cite journal |last1=Nourbakhsh |first1=Mahra |last2=Miller |first2=Angela |last3=Gofton |first3=Jeff |last4=Jones |first4=Graham |last5=Adeagbo |first5=Bamidele |date=2019 |title=Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases |journal=Journal of Forensic Sciences |language=en |volume=64 |issue=1 |pages=270–74 |doi=10.1111/1556-4029.13819 |issn=1556-4029 |pmid=29768651 |s2cid=21718690|doi-access=free }}</ref><ref>{{Cite web |last=Rudavsky |first=Shari |title=He loved weed. Then the vomiting began. Months later, he died |url=https://www.usatoday.com/story/news/nation/2019/09/20/indiana-boy-17-died-smoking-weed-chs-blame-what-chs/2387571001/ |access-date=2 August 2021 |website=USA Today |language=en-US}}</ref> | |||
A limited number of studies have examined the ] on the respiratory system.<ref name="MaistoGalizio2014">{{Cite book |last1=Maisto |first1=Stephen |url=https://books.google.com/books?id=5F08AwAAQBAJ&pg=PA278 |title=Drug Use and Abuse |last2=Galizio |first2=Mark |last3=Connors |first3=Gerard |publisher=Cengage Learning |date=2014 |isbn=978-1-305-17759-8 |page=278 |name-list-style=vanc}}</ref> Chronic heavy marijuana smoking is associated with ],<ref name="Abuse 2019">{{Cite web |date=22 July 2019 |title=Commonly Abused Drugs Charts: Marijuana (Cannabis) |url=https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts#marijuana-cannabis- |access-date=20 January 2020 |publisher=National Institute on Drug Abuse, US National Institutes of Health}}</ref> coughing, production of sputum, wheezing, and other symptoms of chronic bronchitis.<ref name="W. Hall, N. Solowij 1611–16" /> The available evidence does not support a causal relationship between cannabis use and ].<ref>{{Cite journal |vauthors=Owen KP, Sutter ME, Albertson TE |date=February 2014 |title=Marijuana: respiratory tract effects |journal=Clinical Reviews in Allergy & Immunology |volume=46 |issue=1 |pages=65–81 |doi=10.1007/s12016-013-8374-y |pmid=23715638 |s2cid=23823391}}</ref> Short-term use of cannabis is associated with ].<ref>{{Cite journal |vauthors=Tetrault JM, Crothers K, Moore BA, Mehra R, Concato J, Fiellin DA |date=February 2007 |title=Effects of marijuana smoking on pulmonary function and respiratory complications: a systematic review |journal=Archives of Internal Medicine |volume=167 |issue=3 |pages=221–28 |doi=10.1001/archinte.167.3.221 |pmc=2720277 |pmid=17296876}}</ref> Other side effects of cannabis use include ] (CHS), a condition which involves recurrent nausea, cramping abdominal pain, and vomiting.<ref>{{Cite journal |vauthors=Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA |date=March 2017 |title=Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review |journal=Journal of Medical Toxicology |volume=13 |issue=1 |pages=71–87 |doi=10.1007/s13181-016-0595-z |pmc=5330965 |pmid=28000146}}</ref> | |||
== Preparations for human consumption == | |||
] | |||
] (A), a cannabis ] (B), a small amount of crushed cannabis (C), and a book of cigarette ] (D).]] | |||
<!-- Image with unknown copyright status removed: ] --> | |||
] bowl or ].]] | |||
]s, 3/8 oz of marijuana, baggies, grinder, rolling papers. In the middle are two British pound coins for size comparison.]] | |||
] | |||
Cannabis is prepared for human consumption in several forms: | |||
* ''Marijuana'' or ''buds'', the resin gland-rich flowering tops of female plants. | |||
** ''Sinsemilla'' or ''sensemillia'', flowering tops which are free of ]s as a result of being grown in a ]-free environment. Since no plant energy can go into seed formation, this version is higher in psychoactive components. | |||
* '']'' or ''kif'', a powder containing the resin glands (glandular ]s, often incorrectly called "crystals" or "pollen"). It is produced by sifting marijuana and leaves. | |||
* '']'', a concentrated resin made from pressing ''kif'' into blocks. | |||
* ''Charas'', produced by hand-rubbing the resin from the resin gland-rich parts of the plant. Often thin dark rectangular pieces. | |||
* '']'', prepared by the wet grinding of the leaves of the plant and used as a drink. | |||
* '']'', resulting from ] or ] of THC-rich parts of the plant. | |||
* Minimally potent leaves and detritus, called ''shake, bush'' or ''leaf''. | |||
Cannabis smoke contains thousands of organic and inorganic chemical compounds. This ] is chemically similar to that found in tobacco smoke,<ref>{{Cite journal |vauthors=Hashibe M, Straif K, Tashkin DP, Morgenstern H, Greenland S, Zhang ZF |date=April 2005 |title=Epidemiologic review of marijuana use and cancer risk |journal=Alcohol |volume=35 |issue=3 |pages=265–75 |doi=10.1016/j.alcohol.2005.04.008 |pmid=16054989}}</ref> and over fifty known ]s have been identified in cannabis smoke,<ref>{{Cite web |date=20 September 2010 |title=Does smoking cannabis cause cancer? |url=http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/does-smoking-cannabis-cause-cancer |archive-url=https://web.archive.org/web/20120729115046/http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/does-smoking-cannabis-cause-cancer |archive-date=29 July 2012 |access-date=9 January 2013 |publisher=Cancer Research UK}}</ref> including; nitrosamines, reactive aldehydes, and ]s, including benzpyrene.<ref>{{Cite web |last=Tashkin |first=Donald |date=March 1997 |title=Effects of marijuana on the lung and its immune defenses |url=http://www.ukcia.org/research/EffectsOfMarijuanaOnLungAndImmuneDefenses.php |access-date=23 June 2012 |publisher=UCLA School of Medicine}}</ref> Cannabis smoke is also inhaled more deeply than tobacco smoke.<ref>{{Cite journal |vauthors=Gates P, Jaffe A, Copeland J |date=July 2014 |title=Cannabis smoking and respiratory health: consideration of the literature |journal=Respirology |volume=19 |issue=5 |pages=655–62 |doi=10.1111/resp.12298 |pmid=24831571 |s2cid=29423964|doi-access=free }}</ref> {{as of|2015}}, there is no consensus regarding whether cannabis smoking is associated with an increased risk of cancer.<ref>{{Cite journal |vauthors=Huang YH, Zhang ZF, Tashkin DP, Feng B, Straif K, Hashibe M |date=January 2015 |title=An epidemiologic review of marijuana and cancer: an update |journal=Cancer Epidemiology, Biomarkers & Prevention |volume=24 |issue=1 |pages=15–31 |doi=10.1158/1055-9965.EPI-14-1026 |pmc=4302404 |pmid=25587109}}</ref> Light and moderate use of cannabis is not believed to increase risk of lung or upper airway cancer. Evidence for causing these cancers is mixed concerning heavy, long-term use. In general there are far lower risks of pulmonary complications for regular cannabis smokers when compared with those of tobacco.<ref name="Tashkin2013">{{Cite journal |vauthors=Tashkin DP |date=June 2013 |title=Effects of marijuana smoking on the lung |journal=Annals of the American Thoracic Society |volume=10 |issue=3 |pages=239–47 |doi=10.1513/annalsats.201212-127fr |pmid=23802821 |s2cid=20615545}}</ref> A 2015 review found an association between cannabis use and the development of testicular ]s (TGCTs), particularly non-] TGCTs.<ref>{{Cite journal |vauthors=Gurney J, Shaw C, Stanley J, Signal V, Sarfati D |date=November 2015 |title=Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis |journal=BMC Cancer |volume=15 |issue=1 |pages=897 |doi=10.1186/s12885-015-1905-6 |pmc=4642772 |pmid=26560314 |doi-access=free }}</ref> Another 2015 meta-analysis found no association between lifetime cannabis use and risk of head or neck cancer.<ref>{{Cite journal |vauthors=de Carvalho MF, Dourado MR, Fernandes IB, Araújo CT, Mesquita AT, Ramos-Jorge ML |date=December 2015 |title=Head and neck cancer among marijuana users: a meta-analysis of matched case-control studies |journal=Archives of Oral Biology |volume=60 |issue=12 |pages=1750–55 |doi=10.1016/j.archoralbio.2015.09.009 |pmid=26433192}}</ref> Combustion products are not present when using a ], consuming THC in pill form, or consuming ].<ref>{{Cite journal |vauthors=Loflin M, Earleywine M |date=2015 |title=No smoke, no fire: What the initial literature suggests regarding vapourized cannabis and respiratory risk |journal=Canadian Journal of Respiratory Therapy |volume=51 |issue=1 |pages=7–9 |pmc=4456813 |pmid=26078621}}</ref> | |||
There are also three species of Cannabis. These include ''Cannabis sativa'', ''Cannabis indica'', and ''Cannabis ruderalis'', the latter containing much less THC and generally not used as a psychoactive. They differ in their appearance and the highs they produce. There have also been claims to a fourth species of cannabis, which has been nicknamed "Cannabis rasta". It is not yet a formally accepted species and similar to "Cannabis sativa" with regards to psychoactivity (ie, the development of 'Psycho Powers' see also ]). | |||
There is concern that cannabis may contribute to cardiovascular disease,<ref name="Riecher-Rössler2014a">{{Cite book |url=https://books.google.com/books?id=_pDgBQAAQBAJ&pg=PA88 |title=Comorbidity of Mental and Physical Disorders |vauthors=Riecher-Rössler A |publisher=Karger Medical and Scientific Publishers |date=2014 |isbn=978-3-318-02604-7 |page=88}}</ref> but {{as of|2018|lc=y}}, evidence of this relationship was unclear.<ref>{{Cite journal |vauthors=Ravi D, Ghasemiesfe M, Korenstein D, Cascino T, Keyhani S |date=February 2018 |title=Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes: A Systematic Review |journal=Annals of Internal Medicine |volume=168 |issue=3 |pages=187–94 |doi=10.7326/M17-1548 |pmc=6157910 |pmid=29357394}}</ref> Research in these events is complicated because cannabis is often used in conjunction with tobacco, and drugs such as alcohol and cocaine that are known to have cardiovascular risk factors.<ref>{{Cite journal |vauthors=Thomas G, Kloner RA, Rezkalla S |date=January 2014 |title=Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know |journal=The American Journal of Cardiology |volume=113 |issue=1 |pages=187–90 |doi=10.1016/j.amjcard.2013.09.042 |pmid=24176069 |doi-access=free}}</ref> Smoking cannabis has also been shown to increase the risk of ] by 4.8 times for the 60 minutes after consumption.<ref>{{Cite journal |vauthors=Franz CA, Frishman WH |date=9 February 2016 |title=Marijuana Use and Cardiovascular Disease |journal=Cardiology in Review |volume=24 |issue=4 |pages=158–62 |doi=10.1097/CRD.0000000000000103 |pmid=26886465 |s2cid=205566342}}</ref> | |||
=== Smoking === | |||
The most common method of cannabis consumption is by smoking a ''hit'' through one of several classes of devices: | |||
There is preliminary evidence that cannabis interferes with the ] properties of prescription drugs used for ].<ref name="Greger">{{Cite journal |last1=Greger |first1=Jessica |last2=Bates |first2=Vernice |last3=Mechtler |first3=Laszlo |last4=Gengo |first4=Fran |date=2020 |title=A review of cannabis and interactions with anticoagulant and antiplatelet agents |journal=The Journal of Clinical Pharmacology |volume=60 |issue=4 |pages=432–38 |doi=10.1002/jcph.1557 |pmid=31724188 |s2cid=208019237}}</ref> {{as of|2019}}, the ] for the ] and possible ] effects of cannabis were not defined, and there were no governmental regulatory approvals or clinical practices for use of cannabis as a drug.<ref name=mayo/> | |||
# By rolling it up, either manually or with a ], into a cigarette, often called a '']'' or ''joint'', with thin '']'', or into a cigar, often called a ], with wrapper either obtained by removing the tobacco from the inside of a standard cigar or purchased as a "blunt wrap". In such preparation, ] or other smokable material are sometimes combined (mulled) into a single roll. Users may also purchase flavored papers or blunt wraps which both mask the scent of the cannabis and provide for a tastier smoke. | |||
# Another obscure method of smoking a rolled ''joint'' is by using a device called: ''Oat Willie's "Power Hitter"'', marketed by "Oat Willie's Head Shop" in Austin, TX (USA) during the late 1970's. The Power Hitter was a deep blue, plastic, one-quart bottle, with a black nozzle at the lid end with a stainless steel tube flared to hold a standard sized joint. The joint was placed in the tube, lit, and then screwed into the bottle. The finger was placed over a carburetor hole and squeezed to release a 'shotgun' blast of smoke for inhalation at a velocity adjusted by the rate one squeezed. Releasing the finger refilled the bottle with air for the next toke. | |||
# By using a ], often called a ''bowl'', usually made of ], wood, or sometimes metal (nonreactive, such as brass, to avoid inhalation of undesirable metal vapours). Blown-glass pipes are usually intricately and colorfully designed, with colors becoming more vivid after repeated use. Such pipes usually have a ''rush'', ''choke'', or ''carb'', short for ''carburetor'' or ''shotgun'' hole which is covered by a finger for suction when beginning smoking, which is released to finish inhalation, thus clearing the pipe of smoke without advancing the burning any further. Tobacco pipes, pipes home-made by the user, and others, are also sometimes used. Some users prefer a vertically held ceramic or glass pipe, known as a ''chillum'', coming from India. | |||
# In a water-pipe, or '']'', by which the smoke is filtered through water into a chamber. The design originated in Vietnam, bong likely being a corruption of the Thai word "baung", and was brought back to the states by American soldiers returning from the war. It should be noted that smoking from a bong loaded with cold water, ice, or snow will greatly cool the smoke and reduce adverse effects of the heat. Bong use is common and enables smoking techniques that are not possible with a simple ]. Other designs include '']s'', a term which covers several variations, including ''waterfall bongs'' and ''bucket bongs''. The bucket bong (or bucky as it is commonly referred to in New Zealand) usually consists of the user placing the marijuana in a cone made from a socket set (13 mm) atop a plastic bottle with either a few small holes (2 cm diameter) in the bottom of the bottle, or a complete cut along the bottom of the bottle. The bottle is then lowered into a bucket of water so that only the cone is above the water level. From here, the user lights the cone and proceeds to pull the bottle upwards until the bottle is full with smoke from the marijuana. The cone is then removed by unscrewing the bottle cap, and the user then proceeds to place his/her mouth over the bottle, exhaling all air beforehand, then inhaling as they lower the bottle into the water. This method is especially efficient when marijuana supplies are scarce. | |||
# In a homemade bong (''U.S.'' ''Steamroller''), which is generally a 500 ml carbonated drinks bottle, although any bottle, even glass, can be used. A bong pipe is inserted into a small hole, usually burnt or somehow put near the bottom of the bottle, but leaving enough room to allow for approx. 75 ml of water. No rush is required so there is only '''ONE''' hole on a shottie, other than the mouth piece. | |||
# In a shottie, one smoker takes a ''hit'' of a blunt or joint, and then turns it backwards in their mouth, ember in. A second smoker places his or her mouth in front of the end of the smoking device, and the first smoker exhales through the blunt, blowing both his or her smoke as well as that produced from the blunt itself into the second smoker's mouth. Other types of ''shotties'' have developed over the years, including types such as the ''boat shottie,'' ''Lincoln shottie,'' ''nose shottie,'' ''ghost shottie'' or ''whale shottie,'' which use the hands or the nose to direct the smoke in different ways. | |||
# By smoking it with a One-hitter (also referred to as a hitter or bat), a small metal device that looks similiar to a cigarette. This is usually used in conjunction with a ]. Marijuana buds are broken up and the stems and seeds are removed, then it is deposited into a compartment in the dugout. The hitter or "bat" is held in another spring loaded compartment. You pack a small amount or marijuana into the hitter and light then inhale. The bat will need to be lit for every individual hit and, if used properly, there is usually little or no burnoff at the one hitter's tip. This is often used by marijuana users who smoke in public because the hitter resembles a ]. | |||
# By hot-knifing or ''doing blades'', in which the tips of two knives are heated to a very high temperature, often by inserting them into the heating elements of a stove. The marijuana is then pressed between the heated knife-tips, rapidly combusting it. The smoke is often funneled into the mouth of the smoker through the use of a plastic bottle-top, empty pen, or other hollow tube or funnel. In New Zealand, this is also known as 'spots', and most famously undertaken at 'Da Phlat'. A modified method of "]", uses knife blades heated to a much lower temperature, hot enough to vaporise (see Vaporising below) the active ingredients, leaving the organic material scorched, rather than burned, thus removing potential harmful consequenses of the smoke itself. | |||
# By using a ''condenser'' or "nader", the user uses one of two very close methods, both of which involve a plastic bottle. The most common method is to burn a hole in the cap of the bottle and punch through with the socket to be used,(sometimes mesh netting is placed on the back of the socket, to prevent marijuana from dropping through) and then burning or cutting two more holes, one near the bottom (for inhalation) and one near the top (used as a carburetor) in the neck of the bottle. The second method is to burn one hole and punch through with the socket in the center of the bottle, and put one hole for inhalation near the bottom of the bottle. The cap serves as a "carb" and when the condenser is full of smoke, the inhalation hole is covered and the cap removed, and now the inhalation hole is used as a carb while the cap hole is used for inhalation, providing a larger hole to "rip" (inhaling and thus clearing all the smoke in a bottle by removing whatever is covering the carb). Condensers are often used as a last resort, or when the user does not wish to smell like marijuana (odor is generally not present when a condenser is used outside, since the vast majority of the smoke is the smoke that is exhaled). | |||
=====Emergency department visits===== | |||
=== Oral consumption === | |||
Emergency room (ER) admissions associated with cannabis use rose significantly from 2012 to 2016; adolescents from age 12–17 had the highest risk.<ref>{{Cite journal |last1=Shen |first1=Jay J. |last2=Shan |first2=Guogen |last3=Kim |first3=Pearl C. |last4=Yoo |first4=Ji Won |last5=Dodge-Francis |first5=Carolee |last6=Lee |first6=Yong-Jae |date=2019 |title=Trends and Related Factors of Cannabis-Associated Emergency Department Visits in the United States: 2006–2014 |journal=Journal of Addiction Medicine |language=en-US |volume=13 |issue=3 |pages=193–200 |doi=10.1097/ADM.0000000000000479 |issn=1932-0620 |pmid=30418337 |s2cid=53286585}}</ref> At one Colorado medical center following legalization, approximately two percent of ER admissions were classified as cannabis users. The symptoms of one quarter of these users were partially attributed to cannabis (a total of 2567 out of 449,031 patients); other drugs were sometimes involved. Of these cannabis admissions, one quarter were for ], primarily ], depression, and anxiety. An additional third of the cases were for gastrointestinal issues including ].<ref>{{Cite journal |last1=Shelton |first1=Shelby K. |last2=Mills |first2=Eleanor |last3=Saben |first3=Jessica L. |last4=Devivo |first4=Michael |last5=Williamson |first5=Kayla |last6=Abbott |first6=Diana |last7=Hall |first7=Katelyn E. |last8=Monte |first8=Andrew A. |date=2020 |title=Why do patients come to the emergency department after using cannabis? |journal=Clinical Toxicology |volume=58 |issue=6 |pages=453–59 |doi=10.1080/15563650.2019.1657582 |issn=1556-9519 |pmc=7073292 |pmid=31526057}}</ref> | |||
Cannabis may be orally consumed by blending it with alcohol or fats. With this method, some claim that more cannabis must be used. The effects of the drug take longer to begin, but last longer and may be more physical rather than mental. A strong dose of oral cannabis is considered to give a stronger experience than smoked cannabis. It is thought that the active component of cannabis, delta-9 THC, is converted to the more psychoactive delta-11 THC in the liver. It takes some experience for one to regulate the dose. Common preparations involve blending with butter (to create ]) that is used in preparing brownies, fudge, cookies or ]s or "space cakes." Infusion in drinks containing milk and flavoring herbs is also possible, and more common in India. | |||
According to the United States Department of Health and Human Services, there were 455,000 emergency room visits associated with cannabis use in 2011. These statistics include visits in which the patient was treated for a condition induced by or related to recent cannabis use. The drug use must be "implicated" in the emergency department visit, but does not need to be the direct cause of the visit. Most of the illicit drug emergency room visits involved multiple drugs.<ref name="NEDREDV">{{Cite web |date=2011 |title=National Estimates of Drug-Related Emergency Department Visits |url=http://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf |access-date=8 May 2015 |website=Drug Abuse Warning Network |publisher=U.S. Department of Health and Human Services |archive-date=4 April 2015 |archive-url=https://web.archive.org/web/20150404013607/http://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf |url-status=dead }}</ref> In 129,000 cases, cannabis was the only implicated drug.<ref name=NEDREDV/><ref name="NEJM2014">{{Cite journal |vauthors=Volkow ND, Baler RD, Compton WM, Weiss SR |date=June 2014 |title=Adverse health effects of marijuana use |journal=The New England Journal of Medicine |volume=370 |issue=23 |pages=2219–27 |doi=10.1056/NEJMra1402309 |pmc=4827335 |pmid=24897085}}</ref> | |||
As with other drugs that are taken orally, it is sometimes customary to fast before taking the drug to increase the effect (possibly because an empty stomach will absorb the drug faster so it 'hits' more strongly — although some do eat before consuming the drug because eating it on an empty stomach makes them feel sick). Still, time to effect onset is usually more than an hour, as opposed to smoking, where effects can be almost immediate. | |||
====Reproductive health==== | |||
Cannabis could also be consumed as a tea. THC is lipophilic and little water soluble (few grams/litre), but enough to make a tea effective. | |||
{{excerpt|Cannabis in pregnancy|paragraph=1}} | |||
==Pharmacology== | |||
The seeds of the plant, high in protein and fatty acids, are appreciated by many species of birds. Contrary to popular belief, marijuana seeds capable of growing are illegal under U.S. law. Federal law only makes an exception in the case of sterilized seeds, incapable of growing, and the mature stalks of the plant.{{ref|DEA}} | |||
===Mechanism of action=== | |||
See ] external links below. | |||
{{see also|Effects of cannabis#Biochemical mechanisms in the brain}} | |||
THC is a weak partial agonist at ]s, while CBD is a ] antagonist.<ref name="The Structure–Function Relationships of Classical Cannabinoids: CB1/CB2 Modulation">{{cite journal |last1=Bow |first1=Eric |title=The Structure–Function Relationships of Classical Cannabinoids: CB1/CB2 Modulation |journal=Perspectives in Medicinal Chemistry |date=2016 |volume=8 |pages=17–39 |doi=10.4137/PMC.S32171|pmid=27398024 |pmc=4927043 }}</ref><ref>{{cite journal |last1=Thomas |first1=A |title=Cannabidiol displays unexpectedly high potency as an antagonist of CB1 and CB2 receptor agonists in vitro. |journal=Br J Pharmacol |date=2007 |volume=150 |issue=5 |pages=613–623 |doi=10.1038/sj.bjp.0707133 |pmid=17245363 |url=https://doi.org/10.1038/sj.bjp.0707133|pmc=2189767 }}</ref> | |||
=== Vaporization === | |||
The CB<sub>1</sub> receptor is found primarily in the brain as well as in some peripheral tissues, and the CB<sub>2</sub> receptor is found primarily in peripheral tissues, but is also expressed in ]l cells.<ref>{{Cite journal |vauthors=Wilson RI, Nicoll RA |date=April 2002 |title=Endocannabinoid signaling in the brain |journal=Science |volume=296 |issue=5568 |pages=678–82 |bibcode=2002Sci...296..678W |doi=10.1126/science.1063545 |pmid=11976437 |s2cid=21573145}}</ref> THC appears to alter mood and cognition through its agonist actions on the CB<sub>1</sub> receptors, which inhibit a ] (]) in a dose-dependent manner. | |||
Usually with a '']'', cannabis can be heated to a temperature of about 365 °F (185 °C), at which the active ingredients are released into gaseous form with little or no burning of the plant material. With this method, the user does not inhale as many toxic chemicals per unit of mass that are byproducts of combustion. However, studies also suggest that less thc is inhaled. In fact thc/tar ratio is lower than if a regular unfiltered joint is smoked. Some users claim to experience subtly different effects when using cannabis in this way. In addition, users note an improved ability to distinguish subtle characteristics of flavor and aroma, in absence of lighter gas fumes or burnt matter. | |||
Via CB<sub>1</sub> receptor activation, THC indirectly increases ] release and produces ] effects.<ref>{{Cite journal |vauthors=Oleson EB, Cheer JF |date=August 2012 |title=A brain on cannabinoids: the role of dopamine release in reward seeking |journal=Cold Spring Harbor Perspectives in Medicine |volume=2 |issue=8 |pages=a012229 |doi=10.1101/cshperspect.a012229 |pmc=3405830 |pmid=22908200}}</ref> ] also acts as an ] of the ] and ]s.<ref name="pmid16489449">{{Cite journal |vauthors=Kathmann M, Flau K, Redmer A, Tränkle C, Schlicker E |date=February 2006 |title=Cannabidiol is an allosteric modulator at mu- and delta-opioid receptors |journal=Naunyn-Schmiedeberg's Archives of Pharmacology |volume=372 |issue=5 |pages=354–61 |doi=10.1007/s00210-006-0033-x |pmid=16489449 |s2cid=4877869}}</ref> THC also potentiates the effects of the ]s.<ref>{{Cite journal |vauthors=Hejazi N, Zhou C, Oz M, Sun H, Ye JH, Zhang L |date=March 2006 |title=Delta9-tetrahydrocannabinol and endogenous cannabinoid anandamide directly potentiate the function of glycine receptors |journal=Molecular Pharmacology |volume=69 |issue=3 |pages=991–97 |doi=10.1124/mol.105.019174 |pmid=16332990 |s2cid=21801428}}</ref> It is unknown if or how these actions contribute to the effects of cannabis.<ref>{{Cite journal |vauthors=Xiong W, Cheng K, Cui T, Godlewski G, Rice KC, Xu Y, Zhang L |date=May 2011 |title=Cannabinoid potentiation of glycine receptors contributes to cannabis-induced analgesia |journal=Nature Chemical Biology |volume=7 |issue=5 |pages=296–303 |doi=10.1038/nchembio.552 |pmc=3388539 |pmid=21460829}}</ref> | |||
== Legality == | |||
{{main_article|]}} | |||
Since the twentieth century, most countries have laws against the cultivation, use, possession, or transfer of cannabis (and, naturally, these laws impact adversely on the herb's cultivation for non-recreational purposes) but there are many regions where certain circumstances of cannabis handling are legal or licensed and others where laws against its use, possession, or sale are not enforced. Many jurisdictions have also ''decriminalized'' possession of small quantities of cannabis, so that it is punished by ] and/or a ], rather than ]. By effectively removing the user from the criminal justice system, decriminalization focuses more on those who ] and sell the drug on the ]. However this does not solve the problem of how a user will obtain the 'legal amount' of marijuana, since buying or growing marijuana is still illegal. Increasingly, many jurisdictions also permit cannabis use for medicinal purposes. However, simple possession can carry long jail terms in some countries, particularly in ], and the sale of cannabis can lead to life in prison or execution. | |||
===Pharmacokinetics=== | |||
], Canada organized by the ] and ] on April 20, 2005]] | |||
The high ] of cannabinoids results in their persisting in the body for long periods of time.<ref name="HallPacula2003hj">{{Cite book |last1=Hall |first1=Wayne |url=https://archive.org/details/CannabisUseAndDependence |title=Cannabis Use and Dependence: Public Health and Public Policy |last2=Pacula |first2=Rosalie Liccardo |publisher=Cambridge University Press |date=2003 |isbn=978-0-521-80024-2 |page= |url-access=registration |name-list-style=vanc}}</ref> Even after a single administration of THC, detectable levels of THC can be found in the body for weeks or longer (depending on the amount administered and the sensitivity of the assessment method).<ref name="HallPacula2003hj" /> Investigators have suggested that this is an important factor in marijuana's effects, perhaps because cannabinoids may accumulate in the body, particularly in the lipid membranes of neurons.<ref>{{Cite journal |last=Hollister |first=Leo E. |display-authors=etal |name-list-style=vanc |date=March 1986 |title=Health aspects of cannabis |url=http://www.lycaeum.org/drugwar/marij1.html |journal=Pharma Review |volume=38 |issue=38 |pages=1–20 |pmid=3520605 |archive-url=https://archive.today/20130415094338/http://www.lycaeum.org/drugwar/marij1.html |archive-date=15 April 2013 |access-date=17 February 2011}}</ref> | |||
=== Prohibition and criminalization in the US === | |||
Until ], consumption and sale of cannabis was legal in most American states. In some areas it could be openly purchased in bulk from grocers or in cigarette form at newsstands, though an increasing number of states had begun to outlaw it. In that year, federal law made possession or transfer of cannabis (without the purchase of a by-then-incriminating tax stamp) illegal throughout the United States. This was contrary to the advice of the ] at the time. Legal opinions of the time held that the federal government could not outlaw it entirely. The tax was $100 per pound of hemp, even for clothes or rope. The expense, extremely high for that time, was such that people stopped openly buying and making it. | |||
==Chemistry== | |||
The decision of the U.S. Congress was based in part on testimony derived from articles in the newspapers owned by ], who was heavily interested in ]. Some analysts theorize DuPont wanted to boost declining post-war textile sales, and wished to eliminate ] fiber as competition. Many argue that this seems unlikely given DuPont's lack of concern with the legal status of cotton, wool, and linen; although it should be noted that hemp's textile potential had not yet been largely exploited, while textile factories already had made large investments in equipment to handle cotton, wool, and linen. Others argue that DuPont wanted to eliminate cannabis because its high natural ] content made it a viable alternative to the company's developing innovation: modern ]. Still, others could argue that hemp could never truly compete with the high strength and elasticity of synthetics, such as ]. Furthermore, hemp would have been an easy target due to its intoxicating effect, while no rational justification could have been made for outlawing cotton, wool, or linen. | |||
===Chemical composition=== | |||
] and ].]] | |||
{{See also|Difference between C. indica and C. sativa}} | |||
The main psychoactive component of cannabis is ] (THC), which is formed via decarboxylation of ] (THCA) from the application of heat. Raw leaf is not psychoactive because the ]s are in the form of ].{{citation needed|date=December 2021}} THC is one of the 483 known compounds in the plant,<ref name="Russo2013">{{Cite book |last=Russo |first=Ethan B. |url=https://books.google.com/books?id=qH-2Lj9x7L4C&pg=PP28 |title=Cannabis and Cannabinoids: Pharmacology, Toxicology, and Therapeutic Potential |publisher=Routledge |date=2013 |isbn=978-1-136-61493-4 |page=28 |name-list-style=vanc}}</ref> including at least 65 other cannabinoids,<ref name=":3">{{Cite book |last=Newton |first=David E. |url=https://books.google.com/books?id=iWMf95ze8QEC&pg=PA7 |title=Marijuana: a reference handbook |date=2013 |publisher=ABC-CLIO |isbn=9781610691499 |location=Santa Barbara, Calif. |page=7 |name-list-style=vanc}}</ref> such as ] (CBD).<ref name="D'Souza" /> | |||
During this period, ], then-Commissioner of the Federal Bureau of Narcotics, alleged that the drug could provoke criminal behavior in previously solid citizens. Anslinger, originally against a federal law, switched his position in response to pressure from Southern and Western states seeking to outlaw the substance in connection with immigrant populations. With the aid of Hearst and other media, the Bureau of Narcotics demonized the subject in pop culture. Anslinger was a prohibitionist and believed anti-marijuana laws would help encourage a revival of alcohol's prohibition. Anslinger also popularized the word ''marihuana'' for the plant, using a ] derived word (believed to be derived from an archaic ] term for inebriation, "Maria Joana") in order to associate the plant with increasing numbers of Mexican immigrants, creating a negative stereotype which persists to this day. | |||
===Detection in body fluids=== | |||
Anslinger was successful in outlawing machine-gun sales with a trick of law that made it impossible to complete a transaction without a stamp issued by the government. Even though the government had no intentions of issuing said stamps, the Supreme Court upheld the restriction on machine gun sales. (Today these stamps are routinely issued however to qualified buyers under the rules set forth in the ].) Congress then applied the same theory to marijuana. Following passage of The 1937 federal marijuana tax act, the mayor of New York City commissioned a study that determined all of Anslinger's claims to be false. Despite the testimony of the American Medical Associations director, Congress passed the bill to curb the perceived violent spread of the drug. In fact, the legal spread of amphetamines by prescription from doctors was at this time clearly a larger problem. | |||
{{Main|Cannabis drug testing}} | |||
THC and its major (inactive) metabolite, ], can be measured in blood, urine, hair, oral fluid or sweat using ] techniques as part of a drug use testing program or a forensic investigation of a traffic or other criminal offense.<ref name="Barceloux2012">{{Cite book |last=Barceloux |first=Donald G. |title=Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants |publisher=John Wiley & Sons |date=2012 |isbn=978-1-118-10605-1 |pages=910– |chapter=Chapter 60: Marijuana (Cannabis sativa L.) and synthetic cannabinoids |access-date=14 July 2013 |chapter-url=https://books.google.com/books?id=9JLiJcjdqkcC&pg=PA910 |name-list-style=vanc}}</ref> The concentrations obtained from such analyses can often be helpful in distinguishing active use from passive exposure, elapsed time since use, and extent or duration of use. These tests cannot, however, distinguish authorized cannabis smoking for medical purposes from unauthorized recreational smoking.<ref name="Baselt2008">{{Cite book |last=Baselt |first=Randall Clint |title=Disposition of Toxic Drugs and Chemicals in Man |publisher=Biomedical Publications |date=2008 |isbn=978-0-9626523-7-0 |pages=1513–18 |name-list-style=vanc}}</ref> Commercial cannabinoid ]s, often employed as the initial screening method when testing physiological specimens for marijuana presence, have different degrees of cross-reactivity with THC and its metabolites.<ref name="ShawKwong2001">{{Cite book |last1=Shaw |first1=Leslie M. |url=https://books.google.com/books?id=pXvFGqz44pYC&pg=PA51 |title=The Clinical Toxicology Laboratory: Contemporary Practice of Poisoning Evaluation |last2=Kwong |first2=Tai C. |publisher=Amer. Assoc. for Clinical Chemistry |date=2001 |isbn=978-1-890883-53-9 |page=51 |name-list-style=vanc}}</ref> Urine contains predominantly THC-COOH, while hair, oral fluid and sweat contain primarily THC.<ref name="Barceloux2012" /> Blood may contain both substances, with the relative amounts dependent on the recency and extent of usage.<ref name="Barceloux2012" /> | |||
Anslinger's law was struck down by the ] in 1969. In a case brought by ], the Court held that the law's requirement that a would-be possessor of cannabis register with the local bureau of the ], thereby placing his name and address on a file available to local law enforcment, violated the ] privilege against self-incrimination, given the fact that at the time all 50 states had state laws on the books outlawing cannabis outright. In 1970, the ] made possession of cannabis (classified as ''Schedule I'') illegal again on a federal level, without the Fifth Amendment issues that scuttled the 1937 act, and without apparent concern for the issues which required the ] to effect the ]. Several petitions to ] under the CSA have been filed, since the Act permits the executive branch to do so, which would effectively legalize it at the federal level. | |||
The ] is commonly used as a ] in the field, but it cannot definitively confirm the presence of cannabis, as a large range of substances have been shown to give false positives.<ref>{{Cite web |title=The Non-Specificity of the Duquenois-Levine Field Test for Marijuana |url=https://www.researchgate.net/publication/266888426 |website=ResearchGate}}</ref> Researchers at John Jay College of Criminal Justice reported that dietary zinc supplements can mask the presence of THC and other drugs in urine.<ref>{{Cite journal |vauthors=Venkatratnam A, Lents NH |date=July 2011 |title=Zinc reduces the detection of cocaine, methamphetamine, and THC by ELISA urine testing |journal=Journal of Analytical Toxicology |volume=35 |issue=6 |pages=333–40 |doi=10.1093/anatox/35.6.333 |pmid=21740689 |doi-access=free}}</ref> However, a 2013 study conducted by researchers at the ] refute the possibility of self-administered zinc producing false-negative urine drug tests.<ref>{{Cite journal |vauthors=Lin CN, Strathmann FG |date=10 July 2013 |title=Elevated urine zinc concentration reduces the detection of methamphetamine, cocaine, THC and opiates in urine by EMIT |journal=Journal of Analytical Toxicology |volume=37 |issue=9 |pages=665–69 |doi=10.1093/jat/bkt056 |pmid=23843421 |doi-access=free}}</ref> | |||
== References == | |||
# {{note|USAToday}} {{citenews|url=http://www.usatoday.com/news/nation/2005-11-03-pot_x.htm|title=|org=USA Today|date=]}} | |||
# {{note|AP}}{{Web reference|URL=http://www.twincities.com/mld/twincities/news/breaking_news/13313479.htm|title=Dutch Politicians Seek Marijuana Rules|date=February 25|year=2006}} | |||
# {{note|HN}}{{Web reference|URL=http://www.heraldnews.com/site/news.cfm?newsid=16135095|title=Marijuana fight nears|date=February 17|year=2006}} | |||
# {{note|PBB}} {{cite journal|author=Block RI, Farinpour R & Braverman K.|title=Acute effects of marijuana on cognition: relationships to chronic effects and smoking techniques|journal=Pharmacology Biochemistry and Behaviour|year=1992|volume=43(3)|pages=907 – 917}} | |||
# {{note|Markel}} {{citenewsauthor|url=http:///|surname=Markel|given=Howard|title=For Addicts, Relief May Be an Office Visit Away.|org=New York Times|date=]}} WK14 | |||
# {{note|UKCIA1}} {{cite journal|url=http://www.ukcia.org/research/CannabisUseInAdolescenceAndRiskForAdultPsychosis.pdf|author=Louise Arsenault, Mary Cannon, Richie Poulton, Robin Murray, Avshalom Caspi, and Terrie E. Moffitt|title=Cannabis use in adolescence and risk for adult psychosis: longtudinal prospective study|year=2002|journal=British Medical Journal|volume=325|pages=1212 – 1213}} | |||
# {{note|UKCIA2}} {{cite journal|url=http://www.ukcia.org/research/COMTgene.pdf|Author=|title=Moderation of the effect of adult-onset cannabis use on adult psychosis by a functional polymorphism in the Catchol-O-Methyltransferase gene: Longitudinal evidence of a gene X environment interaction|author=Avshalom Caspi, Terrie E. Moffitt, Mary Cannon, Joseph McClay, Robin Murray, HonaLee Harrington, Alan Taylor, Louise Arsenault, Ben Williams, Antony Braithwaite, Richie Poulton, and Ian W. Craig|year=2005|journal=Biol Psychiatry|volume=25|pages=1117 – 1127}} | |||
# {{note|Times}} {{citenewsauthor|url=http://www.timesonline.co.uk/article/0,,3561-1565337,00.html|title=One in four at risk of cannabis psychosis|given=Mark|surname=Henderson|org=The Times|date=]}} | |||
# {{note|Alternet}} Bruce Mirken and Mitch Earleywine: {{citenews|url=http://www.alternet.org/drugreporter/21436/|date=]|title=Psychosis, Hype And Baloney|org=AlterNet}} | |||
# {{note|NIH}} {{cite journal|url=http://ehp.niehs.nih.gov/docs/2000/108-10/correspondence.html#thc|title=Antitumor Effects of THC|journal=Environmental Health Perspectives|volume=108(10)|year=October 2000|pages=Correspondence|author=James Huff and Po Chan | id=PMID 11097557}} | |||
# {{note|Counterpunch}} {{citenewsauthor|url=http://www.counterpunch.org/gardner07022005.html|org=Counterpunch|title=Study: Smoking Marijuana Does Not Cause Lung Cancer|given=Fred|surname=Gardner|date=]}} | |||
# {{note|Nature}} {{citenews|url=http://www.nature.com/news/2005/050404/full/050404-7.html|org=Nature (magazine)|title=Cannabis compound benefits blood vessels|date=]}} | |||
# {{note|DEA}} {{Web reference | url=http://www.usdoj.gov/dea/agency/csa.htm|title=Controlled Substances Act|work=21 USCS § 801|publisher=United States Drug Enforcement Agency|date=November 4|year=2005}} | |||
==Varieties and strains== | |||
== Related articles == | |||
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CBD is a ] agonist, which is under laboratory research to determine if it has an ] effect.<ref name="joy">{{Cite book |url=https://www.nap.edu/catalog/6376/marijuana-and-medicine-assessing-the-science-base |title=Marijuana and Medicine: Assessing The Science Base |vauthors=Joy JE, Watson SJ, Benson JA |publisher=] |date=1999 |isbn=978-0-585-05800-9 |location=Washington, D.C. |doi=10.17226/6376 |pmid=25101425}}</ref> It is often claimed that sativa strains provide a more stimulating psychoactive high while indica strains are more sedating with a body high.<ref>{{Cite web |last=Elliott |first=Steve |name-list-style=vanc |title=The Ultimate Guide on Indicas vs. Sativas |url=https://herb.co/marijuana/news/indica-vs-sativa-whats-the-difference |access-date=22 June 2018 |website=Herb}}</ref> However, this is disputed by researchers.<ref name="pmid28861479">{{Cite journal |vauthors=Piomelli D, Russo EB |date=2016 |title=The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD |journal=Cannabis and Cannabinoid Research |volume=1 |issue=1 |pages=44–46 |doi=10.1089/can.2015.29003.ebr |pmc=5576603 |pmid=28861479}}</ref> | |||
{{Cannabis resources}} | |||
{{Template:Cannabinoids}} | |||
A 2015 review found that the use of high CBD-to-THC strains of cannabis showed significantly fewer ], such as delusions and hallucinations, better ] and both lower risk for developing psychosis, as well as a later age of onset of the illness, compared to cannabis with low CBD-to-THC ratios.<ref>{{Cite journal |vauthors=Iseger TA, Bossong MG |date=March 2015 |title=A systematic review of the antipsychotic properties of cannabidiol in humans |journal=Schizophrenia Research |volume=162 |issue=1–3 |pages=153–61 |doi=10.1016/j.schres.2015.01.033 |pmid=25667194 |s2cid=3745655}}</ref> | |||
== External links == | |||
{{commons|Cannabis sativa}} | |||
* Forums and Information for growing medical marijuana. | |||
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*, website for 2006 initiative in Nevada to regulate and tax marijuana. | |||
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* (NORML) | |||
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* from the ] | |||
*Friends of cannabis, hemp heroes, pot stars, activists, pioneers celebrity stoners ect. | |||
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===Psychoactive ingredients=== | |||
According to the ] (UNODC), "the amount of THC present in a cannabis sample is generally used as a measure of cannabis potency."<ref name="Why Does Cannabis Potency Matter?">{{Cite web |date=29 June 2009 |title=Why Does Cannabis Potency Matter? |url=http://www.unodc.org/unodc/en/frontpage/2009/June/why-does-cannabis-potency-matter.html |publisher=United Nations Office on Drugs and Crime}}</ref> The three main forms of cannabis products are the flower/fruit, resin (hashish), and oil (hash oil). The UNODC states that cannabis often contains 5% THC content, resin "can contain up to 20% THC content", and that "Cannabis oil may contain more than 60% THC content."<ref name="Why Does Cannabis Potency Matter?" /> | |||
Studies have found that the potency of illicit cannabis has greatly increased since the 1970s, with THC levels rising and CBD levels dropping.<ref>{{Cite web |date=16 November 2020 |title=Cannabis strength soars over past half century |url=https://www.sciencedaily.com/releases/2020/11/201116092241.htm |website=]}}</ref><ref>{{Cite journal |vauthors=ElSohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC |date=2016 |title=Changes in Cannabis Potency Over the Last 2 Decades (1995–2014): Analysis of Current Data in the United States |journal=] |volume=79 |issue=7 |pages=613–619 |doi=10.1016/j.biopsych.2016.01.004 |pmc=4987131 |pmid=26903403}}</ref><ref>{{Cite journal |vauthors=Cascini F, Aiello C, Di Tanna G |date=March 2012 |title=Increasing delta-9-tetrahydrocannabinol (Δ-9-THC) content in herbal cannabis over time: systematic review and meta-analysis |journal=Current Drug Abuse Reviews |volume=5 |issue=1 |pages=32–40 |doi=10.2174/1874473711205010032 |pmid=22150622 |s2cid=24350419}}</ref> It is unclear, however, whether the increase in THC content has caused people to consume more THC or if users adjust based on the potency of the cannabis. It is likely that the higher THC content allows people to ingest less tar. At the same time, CBD levels in seized samples have lowered, in part because of the desire to produce higher THC levels and because more illegal growers cultivate indoors using artificial lights. This helps avoid detection but reduces the CBD production of the plant.<ref>{{Cite news |last=Smith |first=Dana |name-list-style=vanc |date=17 January 2014 |title=Cannabis and memory loss: dude, where's my CBD? |work=The Guardian |url=https://www.theguardian.com/science/blog/2014/jan/17/cannabis-memory-loss-cbd}}</ref> | |||
Australia's ] (NCPIC) states that the buds (]s) of the female cannabis plant contain the highest concentration of THC, followed by the leaves. The stalks and seeds have "much lower THC levels".<ref name="urlCannabis Potency">{{Cite web |title=Cannabis Potency |url=http://ncpic.org.au/ncpic/publications/factsheets/article/cannabis-potency |url-status=dead |archive-url=https://web.archive.org/web/20111206100249/http://ncpic.org.au/ncpic/publications/factsheets/article/cannabis-potency |archive-date=6 December 2011 |access-date=13 December 2011 |publisher=National Cannabis Prevention and Information Centre}}</ref> The UN states that the leaves can contain ten times less THC than the buds, and the stalks 100 times less THC.<ref name="Why Does Cannabis Potency Matter?" /> | |||
After revisions to ] in the UK, the government moved cannabis back from a ] to a ]. A purported reason was the appearance of high potency cannabis. They believe ] accounts for between 70% and 80% of samples seized by police<ref>{{Cite news |date=7 May 2008 |title=BBC: Cannabis laws to be strengthened. May 2008 20:55 UK |work=BBC News |url=http://news.bbc.co.uk/1/hi/uk_politics/7386889.stm |access-date=20 September 2010}}</ref> (despite the fact that skunk can sometimes be incorrectly mistaken for all types of herbal cannabis).<ref>{{Cite journal |display-authors=8 |vauthors=Di Forti M, Morgan C, Dazzan P, Pariante C, Mondelli V, Marques TR, Handley R, Luzi S, Russo M, Paparelli A, Butt A, Stilo SA, Wiffen B, Powell J, Murray RM |date=December 2009 |title=High-potency cannabis and the risk of psychosis |journal=The British Journal of Psychiatry |volume=195 |issue=6 |pages=488–91 |doi=10.1192/bjp.bp.109.064220 |pmc=2801827 |pmid=19949195}}</ref><ref>{{Cite news |last=Hope |first=Christopher |date=6 February 2008 |title=Use of extra strong 'skunk' cannabis soars |work=The Daily Telegraph |location=London |url=https://www.telegraph.co.uk/news/uknews/1577798/Use-of-extra-strong-skunk-cannabis-soars.html |url-status=live |url-access=subscription |archive-url=https://ghostarchive.org/archive/20220110/https://www.telegraph.co.uk/news/uknews/1577798/Use-of-extra-strong-skunk-cannabis-soars.html |archive-date=10 January 2022}}{{cbignore}}</ref> ]s such as ] and ] typically contain more THC than high potency cannabis infructescences.<ref name="Doweiko2011">{{Cite book |last=Doweiko |first=Harold |url=https://books.google.com/books?id=RWMIAAAAQBAJ&pg=PA124 |title=Concepts of Chemical Dependency |publisher=Cengage Learning |date=2011 |isbn=978-1-133-17081-5 |page=124 |name-list-style=vanc}}</ref> | |||
====Laced cannabis and synthetic cannabinoids==== | |||
<!-- Categories --> | |||
{{See also |Synthetic cannabinoids#Hemp (or low potent cannabis) buds}} | |||
Hemp buds (or low-potency cannabis buds) laced with ] started to be sold as cannabis street drug in 2020.<ref>{{Cite news |title=Fake Hanf: Ein Drogentrend schwappt in die Schweiz – was du darüber wissen musst |language=de |work=]|url=https://www.watson.ch/schweiz/international/986556231-fake-cannabis-ein-drogentrend-schwappt-in-die-schweiz-mit-folgen}}</ref><ref>{{Cite news |title=Fake Hanf: Tödliches Marihuana hat bereits 61 Menschen getötet |language=de |work=]|url=https://www.watson.ch/schweiz/drogen/165953741-fake-hanf-toedliches-marihuana-hat-bereits-61-menschen-getoetet}}</ref><ref>{{Cite news |title=Fake Hanf mit synthetischen Cannabinoiden besprüht |language=de |work=drugcom |url=https://www.drugcom.de/news/fake-hanf-mit-synthetischen-cannabinoiden-besprueht/}}</ref><ref>{{Cite web |date=14 August 2020 |title=Tödlicher Fake Hanf – Chemisch behandelte Hanfblüten – niemand kann sie erkennen |url=https://www.srf.ch/news/schweiz/toedlicher-fake-hanf-chemisch-behandelte-hanfblueten-niemand-kann-sie-erkennen |website=Schweizer Radio und Fernsehen (SRF) |language=de}}</ref> | |||
] | |||
] | |||
The short-term effects of cannabis can be altered if it has been laced with ] drugs such as heroin or ].<ref>, ''MedPageToday'', 17 July 2018</ref> The added drugs are meant to enhance the psychoactive properties, add to its weight, and increase profitability, despite the increased danger of overdose.<ref> {{Webarchive|url=https://web.archive.org/web/20181218145559/https://www.baltimoresun.com/news/opinion/oped/bs-ed-op-1207-fentanyl-opioid-20181206-story.html |date=18 December 2018 }}, ''The Baltimore Sun'', 7 December 2018</ref>{{efn|Advocates of legalizing marijuana for recreational use, such as former Illinois state Senator ], say that legalizing it would help reduce such hazardous added drugs: "Over 95 percent are buying it on the black market. You don't know what you're buying. It's not a safe product. We've seen it laced with rat poison, fentanyl, all sorts of things. It's funding the cartels and other criminal activity."<ref>, ''State Journal-Register'', (Springfield, IL), 15 December 2018</ref>}} | |||
] | |||
==Preparations== | |||
{{gallery |mode=packed |align=center |height=160 | |||
|File:Marijuana-Cannabis-Weed-Bud-Gram.jpg|Dried flower buds (marijuana) | |||
|File:Kief (yellow).jpg|A gram of ] | |||
|File:Hashish-2.jpg|Hashish | |||
|File:Drop of cannabis oil.jpg|Hash oil | |||
|File:Cannabis Butter.JPG|Infusion (dairy butter) | |||
}} | |||
===Marijuana=== | |||
{{further|Marijuana (word)|l1=''Marijuana'' (word)}} | |||
Marijuana or marihuana (herbal cannabis)<ref name="Dictionaries2007m">{{Cite book |url=https://archive.org/details/spanishwordhisto00houg |title=Spanish Word Histories and Mysteries: English Words That Come From Spanish |publisher=Houghton Mifflin Harcourt |date=2007 |isbn=978-0-547-35021-9 |page= |url-access=registration}}</ref> consists of the dried flowers and fruits and subtending leaves and stems of the female cannabis plant.<ref name="PotterBouchard2013">{{Cite book |last1=Potter |first1=Gary |url=https://books.google.com/books?id=ENOhAgAAQBAJ&pg=PA17 |title=World Wide Weed: Global Trends in Cannabis Cultivation and its Control |last2=Bouchard |first2=Martin |last3=Decorte |first3=Tom |publisher=Ashgate Publishing, Ltd. |date=2013 |isbn=978-1-4094-9438-6 |edition=revised |page=17 |name-list-style=vanc}}</ref><ref name="HallPacula2003">{{Cite book |last1=Hall |first1=Wayne |url=https://archive.org/details/CannabisUseAndDependence |title=Cannabis Use and Dependence: Public Health and Public Policy |last2=Pacula |first2=Rosalie Liccardo |publisher=Cambridge University Press |date=2003 |isbn=978-0-521-80024-2 |page= |url-access=registration |name-list-style=vanc}}</ref><ref>{{Cite book |last=United Nations Office on Drugs and Crime |url=https://books.google.com/books?id=4rFqzQEACAAJ&pg=PA15 |title=Recommended Methods for the Identification and Analysis of Cannabis and Cannabis Products |publisher=United Nations Publications |date=2009 |isbn=978-92-1-148242-3 |page=15}}</ref><ref name="Houck2015">{{Cite book |last=Houck |first=Max M. |url=https://books.google.com/books?id=POpDBAAAQBAJ&pg=PA131 |title=Forensic Chemistry |date=2015 |publisher=Elsevier Science |isbn=978-0-12-800624-5 |page=131 |name-list-style=vanc}}</ref> This is the most widely consumed form,<ref name="Houck2015" /> containing 3% to 20% THC,<ref name="AdlerAdler2012">{{Cite book |last1=Adler |first1=Patricia A. |url=https://books.google.com/books?id=_s_9tfNlfGkC&pg=PA330 |title=Drugs and the American Dream: An Anthology |last2=Adler |first2=Peter |last3=O'Brien |first3=Patrick K. |publisher=John Wiley & Sons |date=2012 |isbn=978-0-470-67027-9 |pages=330– |name-list-style=vanc}}</ref> with reports of up to 33% THC.<ref name="MosherAkins2013">{{Cite book |last1=Mosher |first1=Clayton J. |url=https://books.google.com/books?id=2UQXBAAAQBAJ&pg=PA17 |title=Drugs and Drug Policy: The Control of Consciousness Alteration |last2=Akins |first2=Scott M. |publisher=Sage Publications |date=2013 |isbn=978-1-4833-2188-2 |page=17 |name-list-style=vanc}}</ref> This is the stock material from which all other preparations are derived. Although herbal cannabis and ] derive from the same species and contain the psychoactive component (THC), they are distinct strains with unique biochemical compositions and uses. Hemp has lower concentrations of THC and higher concentrations of CBD, which gives lesser psychoactive effects.<ref>{{Cite web |title=Hemp Facts |url=http://www.naihc.org/hemp_information/hemp_facts.html |archive-url=https://web.archive.org/web/20121127055208/http://naihc.org/hemp_information/hemp_facts.html |archive-date=27 November 2012 |access-date=9 January 2013 |publisher=Naihc.org}}</ref><ref name="Earleywine2002">{{Cite book |last=Earleywine |first=Mitch |url=https://books.google.com/books?id=QUn92XLQqf8C&pg=PA3 |title=Understanding Marijuana: A New Look at the Scientific Evidence |date=2002 |publisher=Oxford University Press |isbn=978-0-19-988143-7 |page=3}}</ref> | |||
===Kief=== | |||
{{Main|Kief}} | |||
Kief is a powder, rich in ]s,<ref name="Rosenthal2002">{{Cite book |last=Rosenthal |first=Ed |url=https://books.google.com/books?id=H_QDJ7CWf2sC&pg=PA116 |title=Ask Ed: Marijuana Gold: Trash to Stash |publisher=QUICK AMER Publishing Company |date=2002 |isbn=978-0-932551-52-8 |page=116 |name-list-style=vanc}}</ref> which can be sifted from the leaves, flowers and fruits of ] and either ] or compressed to produce cakes of ].<ref>{{Cite web |date=9 March 2005 |title=Kief |url=http://www.cannabisculture.com/articles/4220.html |archive-url=https://web.archive.org/web/20090605025019/http://www.cannabisculture.com/articles/4220.html |archive-date=5 June 2009 |access-date=2 January 2010 |publisher=Cannabisculture.com}}</ref> The word "kif" derives from ] {{lang|ar|كيف}} ''{{transliteration|ar|2=kēf<span style="margin:1.5px">/</span>kīf}}'', meaning ''pleasure''.<ref name="Bukszpan2012">{{Cite book |last=Bukszpan |first=David |url=https://books.google.com/books?id=eA8vlPcMXTUC&pg=PA94 |title=Is That a Word?: From AA to ZZZ, the Weird and Wonderful Language of SCRABBLE |publisher=Chronicle Books |date=2012 |isbn=978-1-4521-0824-7 |page=94 |name-list-style=vanc}}</ref> | |||
===Hashish=== | |||
{{Main|Hashish}} | |||
], ] in 1973]] | |||
Hashish (also spelled hasheesh, hashisha, or simply hash) is a concentrated ] cake or ball produced from pressed kief, the detached trichomes and fine material that falls off cannabis fruits, flowers and leaves,<ref name="urlHashish - Definitions from Dictionary.com">{{Cite web |title=Hashish |url=http://dictionary.reference.com/browse/Hashish |publisher=dictionary.reference.com}}</ref> or from scraping the resin from the surface of the plants and rolling it into balls. It varies in color from black to golden brown depending upon purity and variety of cultivar it was obtained from.<ref name="slade2012">{{Cite encyclopedia |title=Is cannabis becoming more potent? |encyclopedia=Marijuana and Madness (Second Edition) |publisher=Cambridge University Press |date=2012 |editor-last=Castle |editor-first=David |page=35 |last2=Mehmedic |first2=Zlato |last3=Chandra |first3=Suman |last4=ElSohly |first4=Mahmoud |last1=Slade |first1=Desmond |editor2-last=Murray |editor2-first=Robin M. |editor3-last=Cyril D'Souza |editor3-first=Deepak}}</ref> It can be consumed orally or smoked, and is also vaporized, or 'vaped'.<ref name="Goldberg2012q">{{Cite book |last=Goldberg |first=Raymond |url=https://books.google.com/books?id=U9TjZHWVGoIC&pg=PA255 |title=Drugs Across the Spectrum |publisher=Cengage Learning |date=2012 |isbn=978-1-133-59416-1 |edition=7th |page=255 |name-list-style=vanc}}</ref> The term "rosin hash" refers to a high quality solventless product obtained through heat and pressure.<ref>Alchimia Blog, ''''</ref> | |||
===Tincture=== | |||
{{main|Tincture of cannabis}} | |||
Cannabinoids can be ] from cannabis plant matter using high-] ] (often ]) to create a ], often referred to as "green dragon".<ref name="Iversen2000s" />{{rp|p17}} ] is a branded product name from a tincture manufacturing pharmaceutical company.<ref name="CohenRudick2011">{{Cite book |last1=Cohen |first1=Jeffrey A. |url=https://books.google.com/books?id=LxQkUu2tfXcC&pg=PA670 |title=Multiple Sclerosis Therapeutics |last2=Rudick |first2=Richard A. |publisher=Cambridge University Press |date=2011 |isbn=978-1-139-50237-5 |page=670 |name-list-style=vanc}}</ref> | |||
===Hash oil=== | |||
{{Main|Hash oil}} | |||
Hash oil is a ]ous matrix of ]s obtained from the cannabis plant by ],<ref name="King2009c">{{Cite book |last=King |first=Leslie A. |url=https://books.google.com/books?id=x9Z1QZ5NIEIC&pg=PA78 |title=Forensic Chemistry of Substance Misuse: A Guide to Drug Control |publisher=Royal Society of Chemistry |date=2009 |isbn=978-0-85404-178-7 |page=78 |name-list-style=vanc}}</ref> formed into a hardened or viscous mass.<ref>{{Cite web |date=24 February 2014 |title=Dabs – marijuana's explosive secret |url=https://www.cnbc.com/2014/02/26/dabsmarijuanas-explosive-secret.html |access-date=28 February 2014 |publisher=]}}</ref> Hash oil can be the most potent of the main cannabis products because of its high level of psychoactive compound per its volume, which can vary depending on the plant's mix of essential oils and psychoactive compounds.<ref name="WD2009_98">{{Cite book |url=https://archive.org/details/worlddrugreport20000unse |title=World Drug Report |publisher=United Nations Publications |date=2009 |isbn=9789211482409 |page= |url-access=registration}}</ref> ] and ] ] hash oil have become popular in recent years.<ref>Alison Hallett for Wired. 20 February 2013 </ref> | |||
===Infusions=== | |||
There are many varieties of cannabis infusions owing to the variety of non-volatile solvents used.<ref name="Kintz2014">{{Cite book |last=Kintz |first=Pascal |url=https://books.google.com/books?id=YgnUAgAAQBAJ&pg=PA141 |title=Toxicological Aspects of Drug-Facilitated Crimes |publisher=Elsevier Science |date=2014 |isbn=978-0-12-416969-2 |page=141 |name-list-style=vanc}}</ref> The plant material is mixed with the solvent and then pressed and filtered to express the oils of the plant into the solvent. Examples of solvents used in this process are cocoa butter, dairy butter, cooking oil, ], and skin moisturizers. Depending on the solvent, these may be used in ] or applied topically.<ref name="McDonoughMagazine2012">{{Cite book |last=McDonough |first=Elise |url=https://books.google.com/books?id=W-vas6K75YYC&pg=PA17 |title=The Official High Times Cannabis Cookbook: More Than 50 Irresistible Recipes That Will Get You High |publisher=Chronicle Books |date=2012 |isbn=978-1-4521-0133-0 |page=17 |name-list-style=vanc}}</ref> | |||
===Marihuana prensada=== | |||
{{main|Marihuana prensada}} | |||
{{lang|es|Marihuana prensada}} ('pressed marijuana') is a cannabis-derived product widespread among the lower classes of South America,<ref>{{Cite book |last=Sociedad de Psiquiatría y Neurología de la infancia y la Adolescencia |url=https://books.google.com/books?id=3dViDwAAQBAJ |title=Marihuana: Consensos y evidencias sobre su impacto en la salud |publisher=Editorial Forja |date=2016 |isbn=9789563382600 |pages=35 |language=es |access-date=17 July 2021}}</ref> especially from the 90s. Locally it is known as "{{lang|es|paraguayo}}" or "{{lang|es|paragua}}", since its main producer is ].<ref name=":0">{{Cite book |last=Trejos Rosero |first=Luis Fernando |title=Fronteras: fuentes de conflicto y cooperación |date=2016 |others=Luis Fernando Trejos Rosero, Universidad del Norte. Departamento de Ciencia Política y Relaciones Internacionales |isbn=978-958-741-689-3 |location=Barranquilla, Colombia |pages= |language=es |oclc=979988717}}</ref> Marijuana is dried and mixed with ] that make it toxic and highly harmful to health.<ref name=":2">{{Cite news |last=Stuardo |first=S. |date=5 September 2015 |title=Marihuana prensada: El lado negro de la hierba canábica |language=es |work=BioBioChile |url=https://www.biobiochile.cl/noticias/2015/09/05/marihuana-prensada-el-lado-negro-de-la-hierba-canabica.shtml |access-date=17 June 2021}}</ref> It is cut into the shape of bricks (''ladrillos'') and sold for a low price in ], Brazil, Chile, ], ], and even the United States.<ref name=":12">{{Cite book |last=Wicht |first=J. J. |url=https://books.google.com/books?id=ecq-AAAAIAAJ |title=Por un Perú mejor: exposiciones y debates del Primer Programa de Alta Especialización para Parlamentarios |date=1991 |location=Universidad del Pacífico. Centro de Investigación, Asociación Acción y Pensamiento Democrático (Lima, Peru), Konrad-Adenauer-Stiftung. Internationales Institut |pages=206 |language=es |access-date=17 June 2021}}</ref> | |||
==History== | |||
{{main|History of cannabis|Timeline of cannabis law|Religion and drugs}} | |||
===Ancient history=== | |||
] | |||
Cannabis is ] to Central or South Asia<ref>{{Cite book |last=ElSohly |first=Mahmoud A. |url=https://books.google.com/books?id=fxoJPVNKYUgC&pg=PA8 |title=Marijuana and the Cannabinoids |publisher=Springer |date=2007 |isbn=978-1-59259-947-9 |page=19 |name-list-style=vanc}}</ref> and its uses for fabric and rope dates back to the ] in China and Japan.<ref name="StaffordBigwood1992">{{Cite book |last1=Stafford |first1=Peter G. |url=https://books.google.com/books?id=o4_pLqCOyDsC&pg=PA157 |title=Psychedelics Encyclopedia |last2=Bigwood |first2=Jeremy |publisher=Ronin Publishing |date=1992 |isbn=978-0-914171-51-5 |page=157 |name-list-style=vanc}}</ref><ref>{{Cite book |title=Prehistoric Textiles: The Development of Cloth in the Neolithic and Bronze Ages with Special Reference to the Aegean |vauthors=Barber EJ |publisher=Princeton University Press |date=1992 |pages=17}}</ref> It is unclear when cannabis first became known for its psychoactive properties. The oldest archeological evidence for the burning of cannabis was found in Romanian ]s dated 3,500 BC, and scholars suggest that the drug was first used in ritual ceremonies by ] tribes living in the ] during the ] period, a custom they eventually spread throughout Western Eurasia during the ].<ref>{{Cite book |last=Anthony |first=David W. |url=https://books.google.com/books?id=mTxQmQEACAAJ |title=The Horse, the Wheel, and Language: How Bronze-Age Riders from the Eurasian Steppes Shaped the Modern World |date=2007 |publisher=Princeton University Press |isbn=978-0-691-05887-0 |pages=362 |language=en}}</ref><ref>{{Cite book |last=Ellens |first=J. Harold |url=https://books.google.com/books?id=nBvFBAAAQBAJ |title=Seeking the Sacred with Psychoactive Substances: Chemical Paths to Spirituality and to God |date=2014 |publisher=ABC-CLIO |isbn=978-1440830884 |pages=24, 31 |language=en}}</ref> Some research suggests that the ancient ] drug ], mentioned in the ]s, sometimes contained cannabis. This is based on the discovery of a basin containing cannabis in a shrine of the ] in Turkmenistan.<ref name="Rudgley-Encyclopedia">{{Cite book |last=Rudgley |first=Richard |title=The Encyclopedia of Psychoactive Substances |publisher=Little, Brown and Company |date=1998 |isbn=978-0-349-11127-8 |chapter=Soma |chapter-url=http://www.huxley.net/soma/index.html |name-list-style=vanc}}</ref> | |||
Cannabis was known to the ], who discovered its psychoactive properties through the Iranians.<ref>{{Cite book |last=Franck |first=Mel |title=Marijuana Grower's Guide |publisher=Red Eye Press |date=1997 |isbn=978-0-929349-03-9 |page=3 |name-list-style=vanc}}</ref> Using it in some religious ceremonies, they called it ''qunubu'' (meaning "way to produce smoke"), a probable origin of the modern word ''cannabis''.<ref>{{Cite book |last=Rubin |first=Vera D. |title=Cannabis and Culture |publisher=Campus Verlag |date=1976 |isbn=978-3-593-37442-0 |page=305 |name-list-style=vanc}}</ref> The Iranians also introduced cannabis to the Scythians, ] and ]ns, whose shamans (the '']''{{snd}}"those who walk on smoke/clouds") burned cannabis infructescences to induce ].<ref>{{Cite book |last=Cunliffe |first=Barry W. |title=The Oxford Illustrated History of Prehistoric Europe |publisher=Oxford University Press |date=2001 |isbn=978-0-19-285441-4 |page=405 |name-list-style=vanc}}</ref> The plant was used in China before 2800 BC, and found therapeutic use in India by 1000 BC, where it was used ], including '']''.<ref>{{Cite book |last=Schultes |first=Richard Evans |url=https://archive.org/details/hallucinogenicpl00schu_0/page/34 |title=Hallucinogenic Plants |publisher=Golden Press |others=Illustrated by Elmer W. Smith |date=1976 |isbn=978-0-307-24362-1 |location=New York |page=}}</ref><ref name="vice">{{Cite web |last=Staelens, Stefanie |date=10 March 2015 |title=The Bhang Lassi Is How Hindus Drink Themselves High for Shiva |url=https://munchies.vice.com/en_us/article/kbx94a/httpmunchies-vice-comarticlesthe-bhang-lassi-is-how-hindus-drink-themselves-high-for-shiva |access-date=10 August 2017 |website=Vice.com}}</ref> | |||
], {{circa}} 512 CE]] | |||
Cannabis has an ancient history of ritual use and has been used by religions around the world. It has been used as a drug for both ] and ] purposes and in various ]s for centuries.<ref>{{Cite book |last=Vij |url=https://books.google.com/books?id=Vp8FAsnfGF4C&pg=PT672 |title=Textbook Of Forensic Medicine And Toxicology: Principles And Practice |publisher=Elsevier India |date=2012 |isbn=978-81-312-1129-8 |page=672}}See also article on ].</ref><ref>{{ShorterOxfordEnglishDictionary}}</ref><ref name="Dictionaries2007m" /> The earliest evidence of cannabis smoking has been found in the 2,500-year-old tombs of Jirzankal Cemetery in the ] in Western China, where cannabis residue were found in burners with charred pebbles possibly used during funeral rituals.<ref>{{Cite journal |vauthors=Ren M, Tang Z, Wu X, Spengler R, Jiang H, Yang Y, Boivin N |date=June 2019 |title=The origins of cannabis smoking: Chemical residue evidence from the first millennium BCE in the Pamirs |journal=Science Advances |volume=5 |issue=6 |pages=eaaw1391 |bibcode=2019SciA....5.1391R |doi=10.1126/sciadv.aaw1391 |pmc=6561734 |pmid=31206023}}</ref><ref name="NatGeo2019Jun">{{Cite web |last=Donahue |first=Michelle |date=12 June 2019 |title=Earliest evidence for cannabis smoking discovered in ancient tombs |url=https://www.nationalgeographic.com/culture/2019/06/earliest-evidence-cannabis-marijuana-smoking-china-tombs/ |archive-url=https://web.archive.org/web/20190613054237/https://www.nationalgeographic.com/culture/2019/06/earliest-evidence-cannabis-marijuana-smoking-china-tombs/ |url-status=dead |archive-date=13 June 2019 |website=National Geographic}}</ref> Hemp seeds discovered by archaeologists at ] suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century BC, confirming previous historical reports by Herodotus.<ref>{{Cite book |last=Walton |first=Robert P. |title=Marijuana, America's New Drug Problem |publisher=JB Lippincott |date=1938 |page=6 |name-list-style=vanc}}</ref> It was used by Muslims in various ] orders as early as the ] period, for example by the ].<ref>{{Cite book |last=Taymiyya |first=Ibn |title=Le haschich et l'extase |publisher=Albouraq |date=2001 |isbn=978-2-84161-174-4 |location=Beyrouth |language=FR |author-link=Ibn Taymiyya |name-list-style=vanc}}</ref> Smoking pipes uncovered in Ethiopia and carbon-dated to around {{circa}} AD 1320 were found to have traces of cannabis.<ref name="Rubin1975">{{Cite book |last=Rubin |first=Vera |url=https://books.google.com/books?id=gCRNRGOhNA4C&pg=PA77 |title=Cannabis and Culture |publisher=Walter de Gruyter |date=1975 |isbn=978-3-11-081206-0 |pages=77– |quote=Cannabis Smoking in 13th-14th Century Ethiopia: Chemical Evidence |name-list-style=vanc}}</ref> | |||
===Modern history=== | |||
Cannabis was introduced to the ] by the Spaniards in 1530–1545.<ref>{{Cite book |last=Booth |first=Martin |title=Cannabis: A History |publisher=Picador |date=2004 |pages=38}}</ref><ref>{{Cite book |last=David E. Newton |title=Marijuana: A Reference Handbook, 2nd Edition |date=2017 |page=325}}</ref><ref>{{Cite book |last=Eileen Konieczny, Lauren Wilson |title=Healing with CBD |date=2018}}</ref> Following an 1836–1840 travel in North Africa and the Middle East, French physician ] wrote on the psychological effects of cannabis use; he founded the Paris' ] in 1844.<ref>{{Cite web |last=Pilkington |first=Mark |date=2005-07-27 |title=Clouds of smoke |url=http://www.theguardian.com/science/2005/jul/28/farout |access-date=2022-11-10 |website=] |language=en}}</ref> In 1842, Irish physician ], who had studied the drug while working as a medical officer in Bengal with the ], brought a quantity of cannabis with him on his return to ], provoking renewed interest in the West.<ref name="Iversen2007">{{Cite book |last=Iversen |first=Leslie L. |url=https://books.google.com/books?id=sshsCAAAQBAJ&pg=PT110 |title=The Science of Marijuana |publisher=Oxford University Press |date=2007 |isbn=978-0-19-988693-7 |pages=110– |name-list-style=vanc}}</ref> Examples of classic literature of the period featuring cannabis include '']'' (1860) by ] and '']'' (1857) by ]. | |||
] | |||
Cannabis was criminalized in some countries beginning in the 14th century and was illegal in most countries by the middle of the 20th century. The colonial government of Mauritius banned cannabis in 1840 over concerns on its effect on Indian indentured workers;<ref>{{Cite book |url=https://books.google.com/books?id=0ktHAQAAMAAJ&pg=PA541 |title=A Collection of the Laws of Mauritius and Its Dependencies |publisher=By the authority of the Government |date=1867 |pages=541–}}</ref> the same occurred in Singapore in 1870.<ref name="Bunyapraphatsōn_1999">{{Cite book |last=Bunyapraphatsōn |first=Nanthawan |url=https://books.google.com/books?id=ifDwAAAAMAAJ |title=Medicinal and poisonous plants |publisher=Backhuys Publishers |date=1999 |isbn=978-90-5782-042-7 |page=169 |name-list-style=vanc}}</ref> In the United States, the first restrictions on sale of cannabis came in 1906 (in the ]).<ref>{{Cite web |title=Statement of Dr. William C. Woodward |url=http://www.druglibrary.org/schaffer/hemp/taxact/woodward.htm |access-date=20 September 2010 |publisher=Drug library |quote=The District of Columbia law, insofar as it relates to Cannabis, is a part of an act passed by Congress in 1906 entitled "An act to regulate the practice of pharmacy and the sale of poisons in the District of Columbia, and for other purposes", approved May 17, 1906, and originally published as 34 Statutes, 175, which is now to be found in the District Code, section 191 and following. It limits the sale of Cannabis, its derivatives and its preparations to pharmacists and persons who are authorized assistants to pharmacists.}}</ref> Canada criminalized cannabis in ''The Opium and Narcotic Drug Act, 1923'',<ref>{{Cite canlaw |short title=The Opium and Narcotic Drug Act, 1923 |abbr=S.C. |year=1923 |chapter=22 |link=https://archive.org/stream/actsofparl1923v01cana#page/134/mode/2up}}</ref> before any reports of the use of the drug in Canada, but eventually legalized its consumption for recreational and medicinal purposes in 2018.<ref name=canada2018/> | |||
In 1925, a compromise was made at an international conference in ] about the ] that banned exportation of "Indian hemp" to countries that had prohibited its use, and requiring importing countries to issue certificates approving the importation and stating that the shipment was required "exclusively for medical or scientific purposes". It also required parties to "exercise an effective control of such a nature as to prevent the illicit international traffic in Indian hemp and especially in the resin".<ref>{{Cite web |date=1925 |title=Opium as an international problem |url=http://www.druglibrary.org/schaffer/history/e1920/willoughby.htm |access-date=20 September 2010 |publisher=The Johns Hopkins Press |vauthors=Willoughby WW |location=Baltimore}}</ref><ref>{{Google books|GJm-XDLJe1QC|Opium as an international problem: the Geneva conferences – Westel Woodbury Willoughby}}</ref> In the United States in 1937, the ] was passed,<ref>{{USStatute|75|238|50|551|1937|8|2}}</ref> and prohibited the production of hemp in addition to cannabis. | |||
] | |||
In 1972, the Dutch government divided drugs into more- and less-dangerous categories, with cannabis being in the lesser category. Accordingly, possession of {{convert|30|g}} or less was made a misdemeanor.<ref>{{Cite book |last=Booth |first=Martin |url=https://books.google.com/books?id=O7AoY6ljSygC&pg=PA338 |title=Cannabis: A History |date=2004 |publisher=Picador |isbn=978-0-312-42494-7 |pages=338 |name-list-style=vanc}}</ref> Cannabis has been available for recreational use in ] since 1976.<ref name="Tonry2015">{{Cite book |last=Michael Tonry |url=https://books.google.com/books?id=TMauCgAAQBAJ&pg=PT261 |title=Crime and Justice |publisher=University of Chicago Press |date=2015 |isbn=978-0-226-34102-6 |series=A Review of Research |volume=44 |pages=261–}}</ref> Cannabis products are only sold openly in certain local "coffeeshops" and possession of up to {{convert|5|g}} for personal use is decriminalized, however: the police may still confiscate it, which often happens in car checks near the border. Other types of sales and transportation are not permitted, although the general approach toward cannabis was lenient even before official ].<ref>{{Citation |title=Use drop-down menu on site to view Netherlands entry.) |url=http://eldd.emcdda.europa.eu/html.cfm/index5174EN.html |access-date=17 February 2011 |archive-url=https://web.archive.org/web/20100507181022/http://eldd.emcdda.europa.eu/html.cfm/index5174EN.html |publisher=Eldd.emcdda.europa.eu |archive-date=7 May 2010}}</ref><ref>{{Citation |title=Drugs Policy in the Netherlands |url=http://www.ukcia.org/research/dutch.php |access-date=17 February 2011 |archive-url=https://web.archive.org/web/20170802141845/http://www.ukcia.org/research/dutch.php |publisher=Ukcia.org |archive-date=2 August 2017}}</ref><ref>{{Cite news |date=27 May 2011 |title=Amsterdam Will Ban Tourists from Pot Coffee Shops |work=Atlantic Wire |url=http://www.theatlanticwire.com/global/2011/05/amsterdam-ban-pot-sales-tourists/38248/ |access-date=23 June 2011 |archive-url=https://web.archive.org/web/20110528221704/http://www.theatlanticwire.com/global/2011/05/amsterdam-ban-pot-sales-tourists/38248/ |archive-date=28 May 2011}}</ref> | |||
In Uruguay, President ] signed legislation to ] in December 2013, making Uruguay the first country in the modern era to legalize cannabis. In August 2014, Uruguay legalized growing up to six plants at home, as well as the formation of growing clubs (]), and a state-controlled ] regime. | |||
{{as of|2018|October|17}}, when recreational use of cannabis was legalized in Canada, ]s for human use and ] containing not more than 10 parts per million of THC extract were approved for marketing; ] (as Sativex) is used as a prescription drug in Canada.<ref name=canada2018/> | |||
The United Nations' '']'' stated that cannabis "was the world's most widely produced, trafficked, and consumed drug in the world in 2010", and estimated between 128 million and 238 million users globally in 2015.<ref>{{Cite news |last=Dockterman |first=Eliana |name-list-style=vanc |date=29 June 2012 |title=Marijuana Now the Most Popular Drug in the World |work=Time NewsFeed |publisher=Time Inc |url=https://newsfeed.time.com/2012/06/29/marijuana-now-the-most-popular-drug-in-the-world/ |access-date=16 March 2013}}</ref><ref>{{Cite book |title=World Drug Report 2017 |publisher=United Nation Office on Drugs and Crime (UNODC) |chapter=Factsheet |chapter-url=https://www.unodc.org/wdr2017/index.html}}</ref> | |||
==Culture, legality and economics== | |||
=== Culture === | |||
{{main|Cannabis culture}} | |||
{{see also|Drug culture|420 (cannabis culture)}} | |||
] in a village in ]. On the Indian festival of colors, ], it is a customary addition to some intoxicating drinks.<ref>{{Cite journal |last=Ayyagari |first=Shalini |name-list-style=vanc |date=2007 |title="Hori Hai": A Festival of Colours!! (review) |journal=Asian Music |publisher=Johns Hopkins University Press |volume=38 |issue=2 |pages=151–53 |doi=10.1353/amu.2007.0029 |s2cid=192201145}}</ref>]] | |||
Cannabis has been one of the most used ]s in the world since the late 20th century, following only ] and ] in popularity.<ref name="Rubin1">Rubin, 1975. p. 1</ref> According to Vera Rubin, the use of cannabis has been encompassed by two major cultural complexes over time: a continuous, traditional ] stream, and a more circumscribed, contemporary configuration.<ref name="Rubin3">Rubin, 1975. p. 3</ref> The former involves both sacred and secular use, and is usually based on small-scale cultivation: the use of the plant for ], clothing, medicine, food, and a "general use as an ] and symbol of fellowship."<ref name="Rubin3" /><ref name="Rubin4">Rubin, 1975. p. 4</ref> The second stream of expansion of cannabis use encompasses "the use of hemp for commercial manufacturers utilizing large-scale cultivation primarily as a fiber for mercantile purposes"; but it is also linked to the search for ]s (which can be traced back to the formation of the Parisian ]).<ref name="Rubin4" /> | |||
===Legality=== | |||
{{Main|Legality of cannabis}} | |||
{{See also|Prohibition of drugs|Drug liberalization}} | |||
[[File:Map-of-world-cannabis-laws.svg|thumb|upright=1.5|alt=Map of world cannabis laws| | |||
'''Legal status of cannabis possession for non-medical use''' | |||
---- | |||
{{legend|#0d00f2|Legal}} | |||
{{legend|#ffb700|Illegal but decriminalized}} | |||
{{legend|#ff9e9e|Illegal but often unenforced}} | |||
{{legend|#ff3c3c|Illegal}} | |||
---- | |||
<small>See also ].</small>]] | |||
<!-- PLEASE, keep this section relatively compact, contributions are more than welcome at ]. THANKS. --> | |||
Since the beginning of the 20th century, most countries have enacted ] against the cultivation, possession or transfer of cannabis.<ref name="Levinson2002">{{Cite book |last=Levinson |first=David |url=https://books.google.com/books?id=aiQ09D7nWxYC&pg=PA572 |title=Encyclopedia of Crime and Punishment |publisher=Sage Publications |date=2002 |isbn=978-0-7619-2258-2 |page=572 |name-list-style=vanc}}</ref> These laws have had an adverse effect on cannabis cultivation for non-recreational purposes, but there are many regions where handling of cannabis is legal or licensed. Many jurisdictions have lessened the penalties for possession of small quantities of cannabis so that it is punished by confiscation and sometimes a fine, rather than imprisonment, focusing more on those who traffic the drug on the ]. | |||
In some areas where cannabis use had been historically tolerated, new restrictions were instituted, such as the closing of cannabis coffee shops near the borders of the Netherlands,<ref>{{Cite web |date=27 November 2007 |title=Many Dutch coffee shops close as liberal policies change, Exaptica |url=http://www.expatica.com/nl/leisure/arts_culture/many-dutch-coffee-shops-close-as-liberal-policies-change-46376.html |archive-url=https://web.archive.org/web/20110429192229/http://www.expatica.com/nl/leisure/arts_culture/many-dutch-coffee-shops-close-as-liberal-policies-change-46376.html |archive-date=29 April 2011 |access-date=20 September 2010 |publisher=Expatica.com}}</ref> and closing of coffee shops near secondary schools in the Netherlands.<ref>, Radio Netherlands, Friday 21 November 2008 {{webarchive |url=https://web.archive.org/web/20081202130012/http://www.rnw.nl/internationaljustice/news/international/6061587/43-Amsterdam-coffee-shops-to-close-doors |date=2 December 2008 }}</ref> In ], Denmark in 2014, mayor ] discussed possibilities for the city to legalize cannabis production and commerce.<ref>{{Cite news |last=O'Sullivan |first=Feargus |name-list-style=vanc |date=3 March 2014 |title=Why the Mayor of Copenhagen Wants to Get Into the Marijuana Business |work=Bloomberg.com |url=https://www.citylab.com/equity/2014/03/why-mayor-copenhagen-wants-get-marijuana-business/8527/ |access-date=23 January 2018}}</ref> | |||
Some jurisdictions use free voluntary or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution. Political parties, non-profit organizations, and causes based on the legalization of medical cannabis or legalizing the plant entirely (with some restrictions) have emerged in such countries as China and Thailand.<ref>{{Cite web |last=Johnston |first=Ian |name-list-style=vanc |date=5 January 2014 |title=As cannabis is widely legalised, China cashes in on an unprecedented boom |url=https://www.independent.co.uk/news/world/asia/as-cannabis-is-widely-legalised-china-cashes-in-on-an-unprecedented-boom-9039191.html |access-date=23 January 2018 |publisher=Independent}}</ref><ref>{{Cite web |last=Liljas |first=Per |name-list-style=vanc |date=3 June 2017 |title=Could Thailand, which gave world the bong, legalise cannabis for medicinal use? After failed war on drugs, attitudes have softened |url=http://www.scmp.com/magazines/post-magazine/long-reads/article/2097464/could-thailand-which-gave-world-bong-legalise |access-date=23 January 2018 |publisher=Post Magazine}}</ref> | |||
In December 2012, the U.S. state of ] became the first state to officially legalize cannabis in a state law (]) (but still illegal by ]),<ref>{{Cite news |date=7 December 2012 |title=Marijuana goes legal in Washington state amid mixed messages |work=Reuters |url=https://www.reuters.com/article/uk-usa-marijuana-washington-idUSLNE8B502120121207 |url-status=live |access-date=14 December 2012 |archive-url=https://web.archive.org/web/20150924172450/http://www.reuters.com/article/2012/12/07/uk-usa-marijuana-washington-idUSLNE8B502120121207 |archive-date=24 September 2015}}</ref> with the state of ] following close behind (]).<ref>{{Cite news |last=Duke |first=Alan |name-list-style=vanc |date=8 November 2012 |title=2 states legalize pot, but don't 'break out the Cheetos' yet |publisher=CNN.com |url=http://www.cnn.com/2012/11/07/politics/marijuana-legalization/index.html |access-date=2 January 2013}}</ref> On 1 January 2013, the first cannabis "]" for private marijuana smoking (no buying or selling, however) was allowed for the first time in Colorado.<ref>{{Cite web |date=1 January 2013 |title=Marijuana clubs ring in new year in Colorado as legalized pot smoking begins |url=https://abcnews.go.com/US/marijuana-clubs-ring-year-colorado-legalized-pot-smoking/story?id=18108083 |access-date=2 January 2013 |publisher=Abcnews.go.com}}</ref> The California Supreme Court decided in May 2013 that local governments can ban medical cannabis dispensaries despite a state law in California that permits the use of cannabis for medical purposes. At least 180 cities across California have enacted bans in recent years.<ref>{{Cite news |last=Mintz |first=Horward |name-list-style=vanc |date=6 May 2013 |title=Medical pot: California Supreme Court allows cities to ban weed dispensaries |work=Marin Independent Journal |url=http://www.marinij.com/digitalfirstmedia/ci_23184556/ |archive-url=https://web.archive.org/web/20131102202631/http://www.marinij.com/digitalfirstmedia/ci_23184556/ |archive-date=2 November 2013}}</ref> ] discussess rescheduling of cannabis.]] | |||
On 30 April 2024, the United States ] announced it would move to reclassify cannabis from a Schedule I to a ].<ref>{{Cite web |date=2024-04-30 |title=US drug control agency will move to reclassify marijuana in a historic shift, AP sources say |url=https://apnews.com/article/marijuana-biden-dea-criminal-justice-pot-f833a8dae6ceb31a8658a5d65832a3b8 |access-date=2024-04-30 |website=AP News |language=en}}</ref><ref>{{Cite web |title=Biden administration plans to drastically change federal rules on marijuana |url=https://www.usatoday.com/story/news/nation/2024/04/30/dea-reclassifies-marijuana-reports/72865632007/ |access-date=2024-04-30 |website=USA TODAY |language=en-US}}</ref> | |||
In December 2013, ] became the first country to legalize growing, sale and use of cannabis.<ref>{{Cite news |last=Baker |first=Vicky |name-list-style=vanc |date=11 December 2013 |title=Marijuana laws around the world: what you need to know |work=The Guardian |url=https://www.theguardian.com/travel/2013/dec/11/uruguay-marijuana-laws-around-world}}</ref> After a long delay in implementing the retail component of the law, in 2017 sixteen pharmacies were authorized to sell cannabis commercially.<ref name="UrGuardian">{{Cite news |last=Castaldi |first=Malena |date=19 July 2017 |title=Uruguay pharmacies start selling cannabis straight to consumers |work=Reuters |location=Montevideo |url=https://www.reuters.com/article/us-uruguay-cannabis-idUSKBN1A41MH}}</ref> On 19 June 2018, the Canadian Senate passed a bill and the Prime Minister announced the effective legalization date as 17 October 2018.<ref name=canada2018/><ref>{{Cite web |last=Scotti |first=Monique |date=20 June 2018 |title=Marijuana to be legal in Canada starting October 17, Trudeau confirms |url=https://globalnews.ca/news/4285946/marijuana-legal-date-october-17-canada-trudeau-confirms/}}</ref> Canada is the second country to legalize the drug.<ref>{{Cite web |last=Sapra |first=Bani |date=20 June 2018 |title=Canada becomes second nation in the world to legalize marijuana |url=https://www.cnn.com/2018/06/20/health/canada-legalizes-marijuana/index.html |website=]}}</ref> | |||
In November 2015, ] became the first state of India to legalize the cultivation of hemp for industrial purposes.<ref>{{Cite web |date=27 November 2015 |title=Uttarakhand To Become First Indian State To Legalise Cannabis Cultivation |url=http://www.indiatimes.com/news/india/uttarakhand-to-become-first-indian-state-to-legalise-cannabis-cultivation-247769.html |access-date=12 March 2017 |website=Indiatimes |language=en}}</ref> Usage within the Hindu and Buddhist cultures of the ] is common, with many street vendors in India openly selling products infused with cannabis, and traditional medical practitioners in Sri Lanka selling products infused with cannabis for recreational purposes and well as for religious celebrations.<ref name=":1" /> Indian laws criminalizing cannabis date back to the ]. India and Sri Lanka have allowed cannabis to be taken in the context of traditional culture for recreational/celebratory purposes and also for medicinal purposes.<ref name=":1">{{Cite web |title=South Asia Regional Profile Report |url=https://www.unodc.org/pdf/india/publications/south_Asia_Regional_Profile_Sept_2005/13_srilanka.pdf |website=UNODC}}</ref> | |||
On 17 October 2015, Australian health minister ] presented a new law that will allow the ] of cannabis for scientific research and medical trials on patients.<ref>Alchimia Blog, ''''</ref> | |||
On 17 October 2018, ] for recreational adult use<ref name="Butler">{{Cite news |last=Butler |first=Patrick |date=17 October 2018 |title=Cannabis is legal in Canada – here's what you need to know |work=CBC |url=https://www.cbc.ca/news/canada/marijuana-faq-legalization-need-to-know-1.4862207/ |access-date=1 November 2018}}</ref> making it the second country in the world to do so after Uruguay and the first G7 nation.<ref>{{Cite news |last=Sapra |first=Bani |date=20 June 2018 |title=Canada becomes second nation in the world to legalize marijuana |work=CNN |url=https://www.cnn.com/2018/06/20/health/canada-legalizes-marijuana/index.html |access-date=1 November 2018}}</ref> This legalization comes with regulation similar to that of ], age restrictions, limiting home production, distribution, consumption areas and sale times.<ref name="Justice">{{cite web |title=Cannabis Act (S.C. 2018, c. 16) |url=https://laws-lois.justice.gc.ca/eng/acts/C-24.5/index.html |website=Justice Canada |publisher=Government of Canada |access-date=24 November 2018 |archive-date=25 March 2022 |archive-url=https://web.archive.org/web/20220325210722/https://laws-lois.justice.gc.ca/eng/acts/c-24.5/index.html |url-status=live }}</ref> Laws around use vary from province to province including age limits, retail structure, and growing at home.<ref name="Butler" /> The ] system aims to become the Gold Standard in the world for safe and secure cannabis production,<ref>{{Cite web |date=5 July 2018 |title=This Application Seems Rigorous. Are All These Hoops Necessary? |url=https://licensedproducerscanada.ca/faq/application-seems-rigorous-hoops-necessary |access-date=1 November 2018 |website=LicensedProducersCanada.com}}</ref> including provisions for a robust craft cannabis industry where many expect opportunities for experimenting with different strains.<ref>{{Cite web |date=October 2018 |title=Will Craft Cannabis Growers in Canada Succeed Like Craft Brewers? |url=https://licensedproducerscanada.ca/faq/will-craft-cannabis-growers-in-canada-succeed-like-craft-brewers |access-date=1 November 2018 |website=LicensedProducersCanada.com}}</ref> | |||
As the drug has increasingly been seen as a health issue instead of criminal behavior, cannabis has also been legalized or ] in: ],<ref name="Cz expl rep">{{Citation |last=Parliament of the Czech Republic |title=Explanatory Report to Act No. 112/1998 Coll., which amends the Act No. 140/1961 Coll., the Criminal Code, and the Act No. 200/1990 Coll., on misdemeanors |date=1998 |place=Prague |language=cs}} "''Podle čl. 36 Jednotné úmluvy o omamných látkách ze dne 31. března 1961 (č. 47/1965 Sb.) se signatáři zavazují k trestnímu postihu tam uvedených forem nakládání s drogami včetně jejich držby. Návrh upouští od dosavadní beztrestnosti držby omamných a psychotropních látek a jedů pro svoji potřebu. Dosavadní beztrestnost totiž eliminuje v řadě případů možnost postihu dealerů a distributorů drog.''"</ref> ],<ref>{{Cite web |last=Castaneda |first=Jorge G |name-list-style=vanc |date=31 March 2012 |title=The summit of muted intentions |url=http://www.aljazeera.com/indepth/opinion/2012/03/2012327125714281880.html |website=aljazeera.com}}</ref><ref>{{Cite web |date=25 May 2016 |title=Congreso aprobó, en último debate, uso medicinal de la marihuana |url=http://www.noticiasrcn.com/nacional-pais/congreso-aprobo-ultimo-debate-uso-medicinal-marihuana}}</ref> ],<ref> {{webarchive |url=https://web.archive.org/web/20130624025336/http://www.elcomercio.com/seguridad/Dosis-maximas-droga-consumo-vigentes_0_941905849.html |date=24 June 2013 }} at ].com.</ref><ref> {{webarchive|url=https://web.archive.org/web/20130625023421/http://www.elnuevoherald.com/2013/06/21/1505650/ecuador-aprueban-tenencia-de-drogas.html |date=25 June 2013 }} at '']''</ref><ref>{{Cite web |title=Ecuador could regulate the drug industry |url=http://www.telegrafo.com.ec/english-bulletin/item/ecuador-could-regulate-drug-sales.html |archive-url=https://archive.today/20130624225110/http://www.telegrafo.com.ec/english-bulletin/item/ecuador-could-regulate-drug-sales.html |archive-date=24 June 2013}}</ref> ],<ref>{{Cite web |date=1 June 2011 |title=Drug policy profiles – Portugal |url=http://www.emcdda.europa.eu/system/files/publications/642/PolicyProfile_Portugal_WEB_Final_289201.pdf |access-date=5 February 2017}}</ref> ]<ref>{{Cite news |last=Lindeque |first=Mia |title=Dagga users celebrate following ConCourt ruling on private use |language=en |url=https://ewn.co.za/2018/09/18/dagga-users-celebrate-following-concourt-ruling-on-private-use |access-date=3 November 2018}}</ref> and Canada.<ref name=canada2018/> Medical marijuana was legalized in Mexico in mid-2017 and legalized for recreational use in June 2021.<ref>{{Cite web |last=Williams |first=Sean |date=28 April 2019 |title=Mexico Aims to Legalize Recreational Marijuana Before October |url=https://www.fool.com/investing/2019/04/28/mexico-aims-to-legalize-recreational-marijuana-bef.aspx |access-date=29 April 2019 |website=The Motley Fool |language=en}}</ref><ref>{{Cite web |url=http://www.elpensador.com.mx/2009/10/17/Ley-de-Narcomenudeo/ |title=Ley de Narcomenudeo |first=Manuel |last=Vélez |date=17 October 2009 |website=El Pensador |archive-url=https://web.archive.org/web/20120327044314/http://www.elpensador.com.mx:80/2009/10/17/Ley-de-Narcomenudeo/ |archive-date=27 March 2012}}</ref><ref>{{Cite news |date=2021-06-28 |title=Mexico marijuana: Top court decriminalises recreational use of cannabis |language=en-GB |work=BBC News |url=https://www.bbc.com/news/world-latin-america-57645016 |archive-url=https://web.archive.org/web/20240120042948/https://www.bbc.com/news/world-latin-america-57645016 |archive-date=20 January 2024}}</ref> | |||
Germany legalized cannabis for recreational use in April 2024.<ref>{{Cite news |date=2024-04-01 |title=Germany becomes largest EU country to legalize cannabis for recreational use |url=https://www.lemonde.fr/en/germany/article/2024/04/01/germany-becomes-largest-eu-country-to-legalize-cannabis-for-recreational-use_6667013_146.html |access-date=2024-04-19 |work=Le Monde.fr |language=en}}</ref> | |||
==== Legal status by country ==== | |||
As of 2022, ] and ] are the only countries that have fully legalized the cultivation, consumption and bartering of recreational cannabis nationwide.<!--Whereas decriminalization would simply remove laws restricting the use of cannabis products, as has been implemented in many countries, legalization allows for the taxation of legally produced cannabis--><ref>{{Cite news |last=Ross |first=Selena |date=6 June 2018 |title=All eyes on Canada as first G7 nation prepares to make marijuana legal |work=] |url=https://www.theguardian.com/world/2018/jun/06/all-eyes-on-canada-as-first-g7-nation-prepares-to-make-marijuana-legal |access-date=10 July 2018}}</ref><ref name="auto3">{{Cite news |last=Sapra |first=Bani |date=20 June 2018 |title=Canada becomes second nation in the world to legalize marijuana |work=] |url=https://www.cnn.com/2018/06/20/health/canada-legalizes-marijuana/index.html}}</ref> ], 24 states, 3 territories, and the District of Columbia have legalized the recreational use of cannabis – though the drug remains illegal at the federal level.<ref name="ncsl rec">{{Cite web |title=Marijuana Overview |url=http://www.ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx |access-date=29 August 2019 |website=National Conference of State Legislatures |archive-date=24 June 2018 |archive-url=https://web.archive.org/web/20180624085932/http://www.ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx |url-status=dead }}</ref> Laws vary from state to state when it comes to the commercial sale. Court rulings in ] and South Africa have led to the legalization of cannabis consumption, but not legal sales. A policy of limited enforcement has also been adopted in many countries, in particular Spain and the ] where the sale of cannabis is tolerated at licensed establishments.<ref name="clubs jane">{{Cite news |last=Smith |first=Tasha |date=5 June 2018 |title="New Amsterdam" No More? Spain's Cannabis Clubs Fight to Stay Open |work=Merry Jane |url=https://merryjane.com/culture/spains-cannabis-social-clubs-feature-june-2018 |access-date=23 August 2018}}</ref><ref name="coffeeshops">{{Cite news |last=Haines |first=Gavin |date=21 February 2017 |title=Everything you need to know about marijuana smoking in the Netherlands |work=The Telegraph |url=https://www.telegraph.co.uk/travel/destinations/europe/netherlands/amsterdam/articles/everything-you-need-to-know-about-smoking-marijuana-in-the-netherlands/ |url-status=live |url-access=subscription |access-date=22 July 2018 |archive-url=https://ghostarchive.org/archive/20220110/https://www.telegraph.co.uk/travel/destinations/europe/netherlands/amsterdam/articles/everything-you-need-to-know-about-smoking-marijuana-in-the-netherlands/ |archive-date=10 January 2022}}{{cbignore}}</ref> Contrary to popular belief, cannabis is not legal in the Netherlands,<ref>{{Cite web |date=20 May 2020 |title=The Legal Situation of Cannabis in the Netherlands |url=https://straininsider.com/legal-situation-cannabis-netherlands/ |url-status=dead |archive-url=https://web.archive.org/web/20200618065204/https://straininsider.com/legal-situation-cannabis-netherlands/ |archive-date=18 June 2020 |access-date=2 June 2020}}</ref> but it has been decriminalized since the 1970s. In 2021, ] was the first ] member to legalize the use of cannabis for recreational purposes.<ref>{{Cite news |last=Bubola |first=Emma |date=15 December 2021 |title=Malta Becomes First E.U. Country to Legalize Marijuana |work=The New York Times |url=https://www.nytimes.com/2021/12/15/world/europe/malta-eu-marijuana-legalize.html |url-access=limited |archive-url=https://ghostarchive.org/archive/20211228/https://www.nytimes.com/2021/12/15/world/europe/malta-eu-marijuana-legalize.html |archive-date=2021-12-28}}{{cbignore}}</ref> In ], it is only legal to sell cannabis products with a THC content of less than 0.2%, although products may contain more cannabidiol.<ref>{{Cite web |last=Massa |first=Silja |date=29 June 2019 |title=Kevytkannabis saapui Viroon – Suomalaisturistin ei kannata ostaa tuliaisiksi Virossa laillisia tuotteita |url=https://yle.fi/uutiset/3-10853221 |access-date=25 September 2022 |website=] |language=fi}}</ref> ] has recently become the first Arab country to legalize the plantation of cannabis for medical use.<ref>{{Cite news |date=21 April 2020 |title=Lebanon legalizes cannabis farming for medicinal use |work=Reuters |url=https://www.reuters.com/article/us-lebanon-crisis-cannabis/lebanon-legalizes-cannabis-farming-for-medicinal-use-idUSKCN2232YI}}</ref> | |||
Penalties for illegal recreational use ranges from confiscation or small fines to jail time and even death.<ref>{{Cite web |date=6 February 2020 |title=Is Weed Legal in Japan? And Other Vacation Info for Cannabis Users |url=https://www.vice.com/en_us/article/wxexym/weed-legal-indonesia-bali-japan}}</ref> In some countries citizens can be punished if they have used the drug in another country, including Singapore and South Korea.<ref>{{Cite news |title=Here are the absolute worst places on earth to be caught with weed |url=https://thegrowthop.com/cannabis-news/here-are-the-absolute-worst-places-on-earth-to-be-caught-with-weed |website=thegrowthop}}</ref><ref>{{Cite web |date=23 October 2018 |title=Bong arm of the law: South Korea says it will arrest citizens who smoke weed in Canada |url=https://www.theguardian.com/world/2018/oct/23/bong-arm-of-the-law-south-korea-says-it-will-arrest-citizens-who-smoke-weed-in-canada |website=]}}</ref> | |||
===Economics=== | |||
====Production==== | |||
{{Main|Cannabis cultivation|Cannabis industry|Cannabis product testing}} | |||
] in ], Assam, India]] | |||
<!-- PLEASE, do not add more detail to this section, contributions are more than welcome at ]. THANKS. --> | |||
{{lang|es|Sinsemilla}} (Spanish for "without seed") is the dried, seedless (i.e. ]) ]s of female ]. Because THC production drops off once pollination occurs, the male plants (which produce little THC themselves) are eliminated before they shed pollen to prevent pollination, thus inducing the development of ] fruits gathered in dense ]s. Advanced cultivation techniques such as ], ], ], and ] are frequently employed as a response (in part) to prohibition enforcement efforts that make outdoor cultivation more risky. | |||
{{anchor|Skunk}}"Skunk" refers to several named strains of potent cannabis, grown through selective breeding and sometimes ]. It is a cross-breed of ''Cannabis sativa'' and ''C. indica'' (although other strains of this mix exist in abundance). Skunk cannabis potency ranges usually from 6% to 15% and rarely as high as 20%. The average THC level in coffee shops in the Netherlands is about 18–19%.<ref>{{Cite web |title=World Drug Report 2006 |url=http://www.unodc.org/unodc/en/data-and-analysis/WDR-2006.html |publisher=United Nations Office on Drugs and Crime}} Ch. 2.3.</ref> | |||
The average levels of THC in cannabis sold in the United States rose dramatically between the 1970s and 2000.<ref name="Giz" /> This is disputed for various reasons, and there is little consensus as to whether this is a fact or an artifact of poor testing methodologies.<ref name="Giz" /> According to Daniel Forbes writing for slate.com, the relative strength of modern strains are likely skewed because undue weight is given to much more expensive and potent, but less prevalent, samples.<ref>{{Cite web |last=Forbes |first=Daniel |name-list-style=vanc |date=19 November 2002 |title=The Myth of Potent Pot |url=http://www.slate.com/id/2074151 |publisher=Slate.com}}</ref> Some suggest that results are skewed by older testing methods that included low-THC-content plant material such as leaves in the samples, which are excluded in contemporary tests. Others believe that modern strains actually are significantly more potent than older ones.<ref name="Giz">{{Cite web |last=Turco |first=Bucky |date=25 September 2017 |title=Why is Weed Getting More Potent |url=https://gizmodo.com/why-is-weed-getting-more-potent-1818662872 |website=Gizmodo}}</ref> | |||
The main producing countries of cannabis are Afghanistan,<ref name="UNDRUG2013">{{Cite web |last=United Nations |title=World Drug Report 2013 |url=http://www.unodc.org/unodc/secured/wdr/wdr2013/World_Drug_Report_2013.pdf |access-date=13 December 2014 |publisher=]}}</ref> Canada,<ref>{{Cite web |title=Medical Use of Marijuana |url=http://www.hc-sc.gc.ca/dhp-mps/marihuana/index-eng.php |access-date=12 January 2015 |website=Health Canada}}</ref> China, Colombia,<ref>{{Cite press release |title=New Colombia Resources Inc Subsidiary, Sannabis, Produces First Batch of Medical Marijuana Based Products in Colombia to Fill Back Orders |publisher=PR Newswire |url=http://www.prnewswire.com/news-releases/new-colombia-resources-inc-subsidiary-sannabis-produces-first-batch-of-medical-marijuana-based-products-in-colombia-to-fill-back-orders-879870332.html |access-date=12 January 2015 |website=prnewswire.com}}</ref> India,<ref name="UNDRUG2013" /> Jamaica,<ref name="UNDRUG2013" /> Lebanon,<ref>{{Cite news |last=Moussaoui |first=Rana |name-list-style=vanc |date=25 November 2013 |title=Lebanon cannabis trade thrives in shadow of Syrian war |publisher=AFP |url=http://www.nzherald.co.nz/world/news/video.cfm?c_id=1503076&gal_cid=1503076&gallery_id=139379}}</ref> Mexico,<ref name=Garelli/> Morocco,<ref name="UNDRUG2013" /> the Netherlands, Pakistan, Paraguay,<ref name="Garelli">{{Cite news |last=Garelli |first=Sanie Lopez |name-list-style=vanc |date=25 November 2008 |title=Mexico, Paraguay top pot producers, U.N. report says |work=CNN International |url=http://edition.cnn.com/2008/WORLD/americas/11/25/paraguay.mexico.marijuana/ |access-date=28 September 2013}}</ref> Spain,<ref name="UNDRUG2013" /> Thailand, Turkey, the United Kingdom,<ref>{{Cite web |last=Jackman |first=Robert |date=12 January 2019 |title=How Britain became the world's largest exporter of medical marijuana |url=https://www.spectator.co.uk/2019/01/how-britain-became-the-worlds-largest-expert-in-medical-marijuana/amp/ |access-date=27 December 2019 |website=The Spectator}}</ref> and the United States.<ref name="UNDRUG2013" /> | |||
====Price==== | |||
The price or street value of cannabis varies widely depending on geographic area and potency.<ref>{{Cite web |date=2005 |title=Cannabis: Wholesale, street prices and purity levels |url=http://www.unodc.org/pdf/WDR_2005/volume_2_chap7_cannabis.pdf |access-date=9 January 2013 |publisher=UNODC.org}}</ref> Prices and overall markets have also varied considerably over time. | |||
* In 1997, cannabis was estimated to be overall the number four value crop in the US, and number one or two in many states, including California, New York, and Florida. This estimate is based on a value to growers of ~60% of retail value, or {{convert|3000|$/lb|$/kg}}.<ref>{{Cite web |title=Report on U.S. Domestic Marijuana Production |url=http://norml.org/index.cfm?Group_ID=4444 |archive-url=https://web.archive.org/web/20091226011927/http://www.norml.org//index.cfm?Group_ID=4444 |archive-date=26 December 2009 |access-date=2 January 2010 |publisher=NORML}}</ref> | |||
* In 2006, cannabis was estimated to have been a $36 billion market.<ref>{{Cite web |date=20 December 2006 |title=Marijuana Called Top U.S. Cash Crop |url=https://abcnews.go.com/business/story?id=2735017&page=1 |publisher=2008 ABCNews Internet Ventures}}</ref> This estimate has been challenged as exaggerated.<ref name="CaulkinsHawken2012" /> The UN World Drug Report (2008) estimated that 2006 street prices in the US and Canada ranged from about US$8.8 to $25 per gram (approximately $250 to $700 per ounce), depending on quality.<ref>{{Cite book |last=United Nations Office on Drugs and Crime |url=http://www.unodc.org/documents/wdr/WDR_2008/WDR_2008_eng_web.pdf |title=World drug report |publisher=United Nations Publications |date=2008 |isbn=978-92-1-148229-4 |page=268}}</ref> Typical U.S. retail prices were $10–15 per gram (approximately $280–420 per ]). | |||
* In 2017, the U.S. was estimated to constitute 90% of the worldwide $9.5 billion legal trade in cannabis.<ref>{{Cite web |last=Sharma |first=Rakesh |date=25 June 2019 |title=How Federal Legalization Could Transform The US Cannabis Market |url=https://www.investopedia.com/insights/how-federal-legalization-could-transform-us-cannabis-market/ |access-date=24 July 2019 |website=Investopedia |language=en}}</ref> | |||
After some U.S. states legalized cannabis, street prices began to drop. In Colorado, the price of smokable buds (infructescences) dropped 40 percent between 2014 and 2019, from $200 per ounce to $120 per ounce ($7 per gram to $4.19 per gram).<ref>{{Cite web |last=Hughes |first=Trevor |date=23 May 2019 |title=As marijuana prices drop, growers push 'organic' cannabis – with a higher price tag |url=https://www.usatoday.com/story/news/2019/05/23/pot-growers-push-organic-cannabis-cleaner-option-but-buyers-remain-skeptical/1206364001/ |access-date=24 July 2019 |website=USA Today |language=en}}</ref> | |||
The ] reports that typical retail prices in Europe for cannabis varied from €2 to €20 per gram in 2008, with a majority of European countries reporting prices in the range €4–10.<ref>{{Cite book |last=European Monitoring Centre for Drugs and Drug Addiction |url=http://www.emcdda.europa.eu/attachements.cfm/att_64227_EN_EMCDDA_AR08_en.pdf |title=Annual report: the state of the drugs problem in Europe |publisher=Office for Official Publications of the European Communities |date=2008 |isbn=978-92-9168-324-6 |location=Luxembourg |page=38 |access-date=1 July 2009 |archive-url=https://web.archive.org/web/20130425191815/http://www.emcdda.europa.eu/attachements.cfm/att_64227_EN_EMCDDA_AR08_en.pdf |archive-date=25 April 2013}}</ref> | |||
==Cannabis as a gateway drug== | |||
{{See also|Gateway drug effect}} | |||
The gateway hypothesis states that cannabis use increases the probability of trying "harder" drugs. The hypothesis has been hotly debated as it is regarded by some as the primary rationale for the United States prohibition on cannabis use.<ref name="Rand">{{Cite web |date=2 December 2002 |title=RAND study casts doubt on claims that marijuana acts as a "gateway" to the use of cocaine and heroin |url=https://www.rand.org/news/press.02/gateway.html |archive-url=https://web.archive.org/web/20061104124529/https://www.rand.org/news/press.02/gateway.html |archive-date=4 November 2006 |publisher=RAND Corporation}}</ref><ref name="Benavie2009x">{{Cite book |last=Benavie |first=Arthur |url=https://books.google.com/books?id=DQxXDgLnKD8C&pg=PA90 |title=Drugs: America's Holy War |publisher=Routledge |date=2009 |isbn=978-0-7890-3840-1 |pages=90– |name-list-style=vanc}}</ref> A ] poll found that political opposition to marijuana use was significantly associated with concerns about the health effects and whether legalization would increase cannabis use by children.<ref>{{Cite web |date=2 April 2014 |title=Public Views of Marijuana – Legalization, Decriminalization, Concerns |website=Pew Research Center for the People and the Press |url=http://www.people-press.org/2014/04/02/section-2-views-of-marijuana-legalization-decriminalization-concerns/}}</ref> | |||
Some studies state that while there is no proof for the gateway hypothesis,<ref name="MosherAkins2007">{{Cite book |last1=Mosher |first1=Clayton J. |url=https://books.google.com/books?id=aDMvoMxx0-IC&pg=PA18 |title=Drugs and Drug Policy: The Control of Consciousness Alteration |last2=Akins |first2=Scott |publisher=Sage Publications |date=2007 |isbn=978-0-7619-3007-5 |page=18 |name-list-style=vanc}}</ref> young cannabis users should still be considered as a risk group for intervention programs.<ref name="journalwatch">{{Cite journal |last=Saitz |first=Richard |name-list-style=vanc |date=18 February 2003 |title=Is marijuana a gateway drug? |url=http://general-medicine.jwatch.org/cgi/content/full/2003/218/1 |journal=Journal Watch |volume=2003 |issue=218 |page=1 |archive-url=https://web.archive.org/web/20030710150041/http://general-medicine.jwatch.org/cgi/content/full/2003/218/1 |archive-date=10 July 2003}}</ref> Other findings indicate that ] users are likely to be ], and that interventions must address the use of multiple drugs instead of a single hard drug.<ref>{{Cite journal |vauthors=Degenhardt L, Coffey C, Carlin JB, Moran P, Patton GC |date=August 2007 |title=Who are the new amphetamine users? A 10-year prospective study of young Australians |journal=Addiction |volume=102 |issue=8 |pages=1269–79 |doi=10.1111/j.1360-0443.2007.01906.x |pmid=17624977}}</ref> Almost two-thirds of the poly drug users in the 2009–2010 Scottish Crime and Justice Survey used cannabis.<ref>{{Cite web |date=21 January 2011 |title=3 The Experience of Drug Users |url=http://www.scotland.gov.uk/Publications/2011/01/21134813/7 |access-date=5 November 2013 |website=2009/10 Scottish Crime and Justice Survey: Drug Use |publisher=The Scottish Government}}</ref> | |||
The gateway effect may appear due to social factors involved in using any illegal drug. Because of the illegal status of cannabis, its consumers are likely to find themselves in situations allowing them to acquaint with individuals using or selling other illegal drugs.<ref name="morral2002">{{Cite journal |vauthors=Morral AR, McCaffrey DF, Paddock SM |date=December 2002 |title=Reassessing the marijuana gateway effect |journal=Addiction |volume=97 |issue=12 |pages=1493–504 |doi=10.1046/j.1360-0443.2002.00280.x |pmid=12472629 |s2cid=2833456}}</ref><ref>{{Cite web |title=Marijuana Policy Project – FAQ |url=http://www.mpp.org/about/faq.html |archive-url=https://web.archive.org/web/20080622204803/http://www.mpp.org/about/faq.html |archive-date=22 June 2008}}</ref> Studies have shown that alcohol and tobacco may additionally be regarded as gateway drugs;<ref name="pmid8246462">{{Cite journal |vauthors=Torabi MR, Bailey WJ, Majd-Jabbari M |date=September 1993 |title=Cigarette smoking as a predictor of alcohol and other drug use by children and adolescents: evidence of the "gateway drug effect" |journal=The Journal of School Health |volume=63 |issue=7 |pages=302–06 |doi=10.1111/j.1746-1561.1993.tb06150.x |pmid=8246462}}</ref> however, a more parsimonious explanation could be that cannabis is simply more readily available (and at an earlier age) than illegal hard drugs.{{Citation needed|date=January 2024}} In turn, alcohol and tobacco are typically easier to obtain at an earlier age than is cannabis (though the reverse may be true in some areas), thus leading to the "gateway sequence" in those individuals, since they are most likely to experiment with any drug offered.<ref name="Rand" /> | |||
A related alternative to the gateway hypothesis is the common liability to addiction (CLA) theory. It states that some individuals are, for various reasons, willing to try multiple recreational substances. The "gateway" drugs are merely those that are (usually) available at an earlier age than the harder drugs. Researchers have noted in an extensive review that it is dangerous to present the sequence of events described in gateway "theory" in causative terms as this hinders both research and intervention.<ref name="Vanyukov2012">{{Cite journal |vauthors=Vanyukov MM, Tarter RE, Kirillova GP, Kirisci L, Reynolds MD, Kreek MJ, Conway KP, Maher BS, Iacono WG, Bierut L, Neale MC, Clark DB, Ridenour TA |date=June 2012 |title=Common liability to addiction and "gateway hypothesis": theoretical, empirical and evolutionary perspective |journal=Drug and Alcohol Dependence |type=Review |volume=123 |issue=Suppl 1 |pages=S3–17 |doi=10.1016/j.drugalcdep.2011.12.018 |pmc=3600369 |pmid=22261179}}</ref> | |||
In 2020, the ] released a study backing allegations that marijuana is a gateway to harder drugs, though not for the majority of marijuana users.<ref name="marijuanagateway">{{Cite web |date=July 2020 |title=Marijuana Research Report:Is marijuana a gateway drug? |url=https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-gateway-drug |access-date=7 November 2020 |publisher=National Institute on Drug Abuse}}</ref> The National Institute on Drug Abuse determined that marijuana use is "likely to precede use of other licit and illicit substances" and that "adults who reported marijuana use during the first wave of the survey were more likely than adults who did not use marijuana to develop an alcohol use disorder within 3 years; people who used marijuana and already had an alcohol use disorder at the outset were at greater risk of their alcohol use disorder worsening. Marijuana use is also linked to other substance use disorders including nicotine addiction."<ref name="marijuanagateway" /> It also reported that "These findings are consistent with the idea of marijuana as a "gateway drug". However, the majority of people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs and are, like marijuana, also typically used before a person progresses to other, more harmful substances."<ref name="marijuanagateway" /> | |||
==Research== | |||
{{See also|Medical cannabis research}} | |||
Research on cannabis is challenging since the plant is ].<ref>{{Cite journal |date=22 November 2004 |title=Marijuana Research: Current restrictions on marijuana research are absurd |url=http://www.scientificamerican.com/article.cfm?id=marijuana-research |journal=Scientific American |archive-url=https://web.archive.org/web/20101107192934/http://www.scientificamerican.com/article.cfm?id=marijuana-research |archive-date=7 November 2010 |access-date=15 January 2013}}</ref><ref>{{Cite journal |vauthors=Ponto LL |date=May 2006 |title=Challenges of marijuana research |journal=Brain |volume=129 |issue=Pt 5 |pages=1081–83 |doi=10.1093/brain/awl092 |pmid=16627464 |doi-access=free}}</ref><ref>{{Cite news |last=Jha |first=Alok |name-list-style=vanc |date=31 May 2012 |title=Ecstasy and cannabis should be freely available for study, says David Nutt |work=The Guardian |url=https://www.theguardian.com/science/2012/may/31/ecstasy-cannabis-study-david-nutt |access-date=15 January 2013}}</ref><ref>{{Cite web |date=15 May 2012 |title=Medical Marijuana Policy in the United States |url=https://www.stanford.edu/group/hopes/cgi-bin/wordpress/2012/05/medical-marijuana-policy-in-the-united-states/#medical-marijuana-and-research |access-date=15 January 2013 |publisher=Stanford.edu}}</ref><ref>{{Cite web |last=Conaboy |first=Chelsea |name-list-style=vanc |date=19 October 2012 |title=Research into marijuana's medical benefits limited; scientists cite challenge of studying an illegal drug |url=https://www.bostonglobe.com/lifestyle/health-wellness/2012/10/18/research-into-marijuana-medical-benefits-limited-scientists-cite-challenge-studying-illegal-drug/f6Ydip4xF5VfFWEV9mpwYJ/story.html |archive-url=https://web.archive.org/web/20121021003220/https://www.bostonglobe.com/lifestyle/health-wellness/2012/10/18/research-into-marijuana-medical-benefits-limited-scientists-cite-challenge-studying-illegal-drug/f6Ydip4xF5VfFWEV9mpwYJ/story.html |archive-date=21 October 2012 |access-date=15 January 2013 |website=Boston Globe}}</ref> Research-grade samples of the drug are difficult to obtain for research purposes, unless granted under authority of national regulatory agencies, such as the US ].<ref name="fda20">{{Cite web |date=14 January 2020 |title=FDA and Cannabis: Research and Drug Approval Process |url=https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process |access-date=21 January 2020 |publisher=US Food and Drug Administration}}</ref> | |||
There are also other difficulties in researching the effects of cannabis. Many people who smoke cannabis also smoke tobacco.<ref>{{Cite journal |vauthors=Peters EN, Budney AJ, Carroll KM |date=August 2012 |title=Clinical correlates of co-occurring cannabis and tobacco use: a systematic review |journal=Addiction |volume=107 |issue=8 |pages=1404–17 |doi=10.1111/j.1360-0443.2012.03843.x |pmc=3377777 |pmid=22340422}}</ref> This causes confounding factors, where questions arise as to whether the tobacco, the cannabis, or both that have caused a cancer. Another difficulty researchers have is in recruiting people who smoke cannabis into studies. Because cannabis is an illegal drug in many countries, people may be reluctant to take part in research, and if they do agree to take part, they may not say how much cannabis they actually smoke.<ref>{{Cite web |date=30 August 2017 |title=Does smoking cannabis cause cancer? |url=http://www.cancerresearchuk.org/cancer-help/about-cancer/cancer-questions/does-smoking-cannabis-cause-cancer |url-status=dead |archive-url=https://web.archive.org/web/20131219150250/http://www.cancerresearchuk.org/cancer-help/about-cancer/cancer-questions/does-smoking-cannabis-cause-cancer |archive-date=19 December 2013 |access-date=26 December 2013 |website=Cancer Research UK (CRUK)}}</ref> | |||
== See also == | |||
* ] | |||
* ] | |||
* ] | |||
* ] | |||
== References == | |||
'''Footnotes''' | |||
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{{notelist|30em}} | |||
'''Citations''' | |||
{{Reflist}} | |||
== External links == | |||
{{Wiktionary|Appendix:Cannabis slang}} | |||
*{{Commons category inline|Cannabis}} | |||
*{{Wiktionary inline|marijuana}} | |||
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Latest revision as of 02:50, 20 December 2024
Psychoactive drug from the cannabis plant "Marijuana" redirects here. For other uses, see Marijuana (disambiguation).
Cannabis | |
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Cannabis in the drying phase | |
Pronunciation |
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Source plant(s) | Cannabis sativa, Cannabis indica, Cannabis ruderalis |
Part(s) of plant | Flower and fruit |
Geographic origin | Central or South Asia |
Active ingredients | Tetrahydrocannabinol, cannabidiol, cannabinol, tetrahydrocannabivarin |
Main producers | Afghanistan, Canada, China, Colombia, India, Jamaica, Lebanon, Mexico, Morocco, Netherlands, Pakistan, Paraguay, Spain, Thailand, Turkey, United Kingdom, United States |
Legal status |
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Part of a series on |
Cannabis |
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Chemistry
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Pharmacology
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Consumption |
Economics |
Effects |
Forms |
Law
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Variants
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Related |
Cannabis (/ˈkænəbɪs/), commonly known as marijuana (/ˌmærəˈwɑːnə/), weed, and pot, among other names, is a non-chemically uniform drug from the cannabis plant. Native to Central or South Asia, the cannabis plant has been used as a drug for both recreational and entheogenic purposes and in various traditional medicines for centuries. Tetrahydrocannabinol (THC) is the main psychoactive component of cannabis, which is one of the 483 known compounds in the plant, including at least 65 other cannabinoids, such as cannabidiol (CBD). Cannabis can be used by smoking, vaporizing, within food, or as an extract.
Cannabis has various mental and physical effects, which include euphoria, altered states of mind and sense of time, difficulty concentrating, impaired short-term memory, impaired body movement (balance and fine psychomotor control), relaxation, and an increase in appetite. Onset of effects is felt within minutes when smoked, but may take up to 90 minutes when eaten (as orally consumed drugs must be digested and absorbed). The effects last for two to six hours, depending on the amount used. At high doses, mental effects can include anxiety, delusions (including ideas of reference), hallucinations, panic, paranoia, and psychosis. There is a strong relation between cannabis use and the risk of psychosis, though the direction of causality is debated. Physical effects include increased heart rate, difficulty breathing, nausea, and behavioral problems in children whose mothers used cannabis during pregnancy; short-term side effects may also include dry mouth and red eyes. Long-term adverse effects may include addiction, decreased mental ability in those who started regular use as adolescents, chronic coughing, susceptibility to respiratory infections, and cannabinoid hyperemesis syndrome.
Cannabis is mostly used recreationally or as a medicinal drug, although it may also be used for spiritual purposes. In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65). It is the most commonly used largely-illegal drug in the world, with the highest use among adults in Zambia, the United States, Canada, and Nigeria. Since the 1970s, the potency of illicit cannabis has increased, with THC levels rising and CBD levels dropping.
Cannabis plants have been grown since at least the 3rd millennium BCE and there is evidence of it being smoked for its psychoactive effects around 500 BCE in the Pamir Mountains, Central Asia. Since the 14th century, cannabis has been subject to legal restrictions. The possession, use, and cultivation of cannabis has been illegal in most countries since the 20th century. In 2013, Uruguay became the first country to legalize recreational use of cannabis. Other countries to do so are Canada, Georgia, Germany, Luxembourg, Malta, South Africa, and Thailand. In the U.S., the recreational use of cannabis is legalized in 24 states, 3 territories, and the District of Columbia, though the drug remains federally illegal. In Australia, it is legalized only in the Australian Capital Territory.
Etymology
Main article: Etymology of cannabisCannabis is a Scythian word. The ancient Greeks learned of the use of cannabis by observing Scythian funerals, during which cannabis was consumed. In Akkadian, cannabis was known as qunubu (𐎯𐎫𐎠𐎭𐏂). The word was adopted in to the Hebrew as qaneh bosem (קָנֶה בֹּשׂם).
Uses
Medical
Main article: Medical cannabisMedical cannabis, or medical marijuana, refers to the use of cannabis to treat disease or improve symptoms; however, there is no single agreed-upon definition (e.g., cannabinoids derived from cannabis and synthetic cannabinoids are also used). The rigorous scientific study of cannabis as a medicine has been hampered by production restrictions and by the fact that it is classified as an illegal drug by many governments. There is some evidence suggesting cannabis can be used to reduce nausea and vomiting during chemotherapy, to improve appetite in people with HIV/AIDS, or to treat chronic pain and muscle spasms. Evidence for its use for other medical applications is insufficient for drawing conclusions about safety or efficacy. There is evidence supporting the use of cannabis or its derivatives in the treatment of chemotherapy-induced nausea and vomiting, neuropathic pain, and multiple sclerosis. Lower levels of evidence support its use for AIDS wasting syndrome, epilepsy, rheumatoid arthritis, and glaucoma.
The medical use of cannabis is legal only in a limited number of territories, including Canada, Belgium, Australia, the Netherlands, New Zealand, Spain, and many U.S. states. This usage generally requires a prescription, and distribution is usually done within a framework defined by local laws.
Recreational
According to DEA Chief Administrative Law Judge, Francis Young, "cannabis is one of the safest therapeutically active substances known to man". Being under the effects of cannabis is usually referred to as being "high". Cannabis consumption has both psychoactive and physiological effects. The "high" experience can vary widely, based (among other things) on the user's prior experience with cannabis, and the type of cannabis consumed. When smoking cannabis, a euphoriant effect can occur within minutes of smoking. Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite, impairment of short-term and working memory, and impairment of psychomotor coordination.
Additional desired effects from consuming cannabis include relaxation, a general alteration of conscious perception, increased awareness of sensation, increased libido and distortions in the perception of time and space. At higher doses, effects can include altered body image, auditory or visual illusions, pseudohallucinations and ataxia from selective impairment of polysynaptic reflexes. In some cases, cannabis can lead to dissociative states such as depersonalization and derealization.
Spiritual
Main article: Entheogenic use of cannabisCannabis has held sacred status in several religions and has served as an entheogen – a chemical substance used in religious, shamanic, or spiritual contexts – in the Indian subcontinent since the Vedic period. The earliest known reports regarding the sacred status of cannabis in the Indian subcontinent come from the Atharva Veda, estimated to have been composed sometime around 1400 BCE. The Hindu god Shiva is described as a cannabis user, known as the "Lord of bhang".
In modern culture, the spiritual use of cannabis has been spread by the disciples of the Rastafari movement who use cannabis as a sacrament and as an aid to meditation.
Consumption
Main article: Cannabis consumptionModes of consumption
Many different ways to consume cannabis involve heat to decarboxylate THCA into THC; common modes include:
- Smoking, involves burning and inhaling cannabinoids ("smoke") from small pipes, bongs (portable versions of hookahs with a water chamber), paper-wrapped joints, tobacco-leaf-wrapped blunts, or the like.
- Vaporizing, heating various forms of cannabis to 165–190 °C (329–374 °F), causing the active ingredients to form vapor without combustion of the plant material (the boiling point of THC is 157 °C (315 °F) at atmospheric pressure).
- Edibles, adding cannabis as an ingredient to a wide variety of foods, including butter and baked goods. In India it is commonly consumed as the beverage bhang.
- Cannabis tea, prepared with attention to the lipophilic quality of THC, which is only slightly water-soluble (2.8 mg per liter), often involving cannabis in a saturated fat.
- Tincture of cannabis, sometimes known as green dragon, is an alcoholic cannabis concentrate.
- Capsules, typically containing cannabis oil, and other dietary supplement products, for which some 220 were approved in Canada in 2018.
Consumption by country
Main article: Annual cannabis use by countrySubstance | Best estimate |
Low estimate |
High estimate |
---|---|---|---|
Amphetamine- type stimulants |
34.16 | 13.42 | 55.24 |
Cannabis | 192.15 | 165.76 | 234.06 |
Cocaine | 18.20 | 13.87 | 22.85 |
Ecstasy | 20.57 | 8.99 | 32.34 |
Opiates | 19.38 | 13.80 | 26.15 |
Opioids | 34.26 | 27.01 | 44.54 |
In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65). Cannabis is by far the most widely used illicit substance, with the highest use among adults (as of 2018) in Zambia, the United States, Canada, and Nigeria.
United States
Between 1973 and 1978, eleven states decriminalized marijuana. In 2001, Nevada reduced marijuana possession to a misdemeanor and since 2012, several other states have decriminalized and even legalized marijuana.
In 2018, surveys indicated that almost half of the people in the United States had tried marijuana, 16% had used it in the past year, and 11% had used it in the past month. In 2014, surveys said daily marijuana use amongst US college students had reached its highest level since records began in 1980, rising from 3.5% in 2007 to 5.9% in 2014 and had surpassed daily cigarette use.
In the US, men are over twice as likely to use marijuana as women, and 18–29-year-olds are six times more likely to use as over-65-year-olds. In 2015, a record 44% of the US population has tried marijuana in their lifetime, an increase from 38% in 2013 and 33% in 1985.
Marijuana use in the United States is three times above the global average, but in line with other Western democracies. Forty-four percent of American 12th graders have tried the drug at least once, and the typical age of first-use is 16, similar to the typical age of first-use for alcohol but lower than the first-use age for other illicit drugs.
A 2022 Gallup poll concluded Americans are smoking more marijuana than cigarettes for the first time.
Adverse effects
Further information: Effects of cannabisShort-term
Acute negative effects may include anxiety and panic, impaired attention and memory, an increased risk of psychotic symptoms, the inability to think clearly, and an increased risk of accidents. Cannabis impairs a person's driving ability, and THC was the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes. Those with THC in their system are from three to seven times more likely to be the cause of the accident than those who had not used either cannabis or alcohol, although its role is not necessarily causal because THC stays in the bloodstream for days to weeks after intoxication.
Some immediate undesired side effects include a decrease in short-term memory, dry mouth, impaired motor skills, reddening of the eyes, dizziness, feeling tired and vomiting. Some users may experience an episode of acute psychosis, which usually abates after six hours, but in rare instances, heavy users may find the symptoms continuing for many days.
Legalization has increased the rates at which children are exposed to cannabis, particularly from edibles. While the toxicity and lethality of THC in children is not known, they are at risk for encephalopathy, hypotension, respiratory depression severe enough to require ventilation, somnolence and coma.
Fatality
There is no clear evidence for a link between cannabis use and deaths from cardiovascular disease, but a 2019 review noted that it may be an under-reported, contributory factor or direct cause in cases of sudden death, due to the strain it can place on the cardiovascular system. Some deaths have also been attributed to cannabinoid hyperemesis syndrome. There is an association between cannabis use and suicide, particularly in younger users.
A 16-month survey of Oregon and Alaska emergency departments found a report of the death of an adult who had been admitted for acute cannabis toxicity.
Long-term
Main article: Long-term effects of cannabisPsychological effects
A 2015 meta-analysis found that, although a longer period of abstinence was associated with smaller magnitudes of impairment, both retrospective and prospective memory were impaired in cannabis users. The authors concluded that some, but not all, of the deficits associated with cannabis use were reversible. A 2012 meta-analysis found that deficits in most domains of cognition persisted beyond the acute period of intoxication, but was not evident in studies where subjects were abstinent for more than 25 days. Few high quality studies have been performed on the long-term effects of cannabis on cognition, and the results were generally inconsistent. Furthermore, effect sizes of significant findings were generally small. One review concluded that, although most cognitive faculties were unimpaired by cannabis use, residual deficits occurred in executive functions. Impairments in executive functioning are most consistently found in older populations, which may reflect heavier cannabis exposure, or developmental effects associated with adolescent cannabis use. One review found three prospective cohort studies that examined the relationship between self-reported cannabis use and intelligence quotient (IQ). The study following the largest number of heavy cannabis users reported that IQ declined between ages 7–13 and age 38. Poorer school performance and increased incidence of leaving school early were both associated with cannabis use, although a causal relationship was not established. Cannabis users demonstrated increased activity in task-related brain regions, consistent with reduced processing efficiency.
A reduced quality of life is associated with heavy cannabis use, although the relationship is inconsistent and weaker than for tobacco and other substances. The direction of cause and effect, however, is unclear.
The long-term effects of cannabis are not clear. There are concerns surrounding memory and cognition problems, risk of addiction, and the risk of schizophrenia in young people.
Neuroimaging
Although global abnormalities in white matter and grey matter are not consistently associated with cannabis use, reduced hippocampal volume is consistently found. Amygdala abnormalities are sometimes reported, although findings are inconsistent.
Cannabis use is associated with increased recruitment of task-related areas, such as the dorsolateral prefrontal cortex, which is thought to reflect compensatory activity due to reduced processing efficiency. Cannabis use is also associated with downregulation of CB1 receptors. The magnitude of down regulation is associated with cumulative cannabis exposure, and is reversed after one month of abstinence. There is limited evidence that chronic cannabis use can reduce levels of glutamate metabolites in the human brain.
Cannabis dependence
Main article: Cannabis dependenceAbout 9% of those who experiment with marijuana eventually become dependent according to DSM-IV (1994) criteria. A 2013 review estimates daily use is associated with a 10–20% rate of dependence. The highest risk of cannabis dependence is found in those with a history of poor academic achievement, deviant behavior in childhood and adolescence, rebelliousness, poor parental relationships, or a parental history of drug and alcohol problems. Of daily users, about 50% experience withdrawal upon cessation of use (i.e. are dependent), characterized by sleep problems, irritability, dysphoria, and craving. Cannabis withdrawal is less severe than withdrawal from alcohol.
According to DSM-V criteria, 9% of those who are exposed to cannabis develop cannabis use disorder, compared to 20% for cocaine, 23% for alcohol and 68% for nicotine. Cannabis use disorder in the DSM-V involves a combination of DSM-IV criteria for cannabis abuse and dependence, plus the addition of craving, without the criterion related to legal troubles.
Psychiatric
See also: Long-term effects of cannabis § Mental healthFrom a clinical perspective, two significant school of thought exists for psychiatric conditions associated with cannabis (or cannabinoids) use: transient, non-persistent psychotic reactions, and longer-lasting, persistent disorders that resemble schizophrenia. The former is formally known as acute cannabis-associated psychotic symptoms (CAPS).
At an epidemiological level, a dose–response relationship exists between cannabis use and increased risk of psychosis and earlier onset of psychosis. Although the epidemiological association is robust, evidence to prove a causal relationship is lacking.
Cannabis may also increase the risk of depression, but insufficient research has been performed to draw a conclusion. Cannabis use is associated with increased risk of anxiety disorders, although causality has not been established.
A review in 2019 found that research was insufficient to determine the safety and efficacy of using cannabis to treat schizophrenia, psychosis, or other mental disorders. Another found that cannabis during adolescence was associated with an increased risk of developing depression and suicidal behavior later in life, while finding no effect on anxiety.
Physical
Heavy, long-term exposure to marijuana may have physical, mental, behavioral and social health consequences. It may be "associated with diseases of the liver (particularly with co-existing hepatitis C), lungs, heart, and vasculature". A 2014 review found that while cannabis use may be less harmful than alcohol use, the recommendation to substitute it for problematic drinking was premature without further study. Various surveys conducted between 2015 and 2019 found that many users of cannabis substitute it for prescription drugs (including opioids), alcohol, and tobacco; most of those who used it in place of alcohol or tobacco either reduced or stopped their intake of the latter substances.
Cannabinoid hyperemesis syndrome (CHS) is a severe condition seen in some chronic cannabis users where they have repeated bouts of uncontrollable vomiting for 24–48 hours. Four cases of death have been reported as a result of CHS.
A limited number of studies have examined the effects of cannabis smoking on the respiratory system. Chronic heavy marijuana smoking is associated with respiratory infections, coughing, production of sputum, wheezing, and other symptoms of chronic bronchitis. The available evidence does not support a causal relationship between cannabis use and chronic obstructive pulmonary disease. Short-term use of cannabis is associated with bronchodilation. Other side effects of cannabis use include cannabinoid hyperemesis syndrome (CHS), a condition which involves recurrent nausea, cramping abdominal pain, and vomiting.
Cannabis smoke contains thousands of organic and inorganic chemical compounds. This tar is chemically similar to that found in tobacco smoke, and over fifty known carcinogens have been identified in cannabis smoke, including; nitrosamines, reactive aldehydes, and polycyclic aromatic hydrocarbons, including benzpyrene. Cannabis smoke is also inhaled more deeply than tobacco smoke. As of 2015, there is no consensus regarding whether cannabis smoking is associated with an increased risk of cancer. Light and moderate use of cannabis is not believed to increase risk of lung or upper airway cancer. Evidence for causing these cancers is mixed concerning heavy, long-term use. In general there are far lower risks of pulmonary complications for regular cannabis smokers when compared with those of tobacco. A 2015 review found an association between cannabis use and the development of testicular germ cell tumors (TGCTs), particularly non-seminoma TGCTs. Another 2015 meta-analysis found no association between lifetime cannabis use and risk of head or neck cancer. Combustion products are not present when using a vaporizer, consuming THC in pill form, or consuming cannabis foods.
There is concern that cannabis may contribute to cardiovascular disease, but as of 2018, evidence of this relationship was unclear. Research in these events is complicated because cannabis is often used in conjunction with tobacco, and drugs such as alcohol and cocaine that are known to have cardiovascular risk factors. Smoking cannabis has also been shown to increase the risk of myocardial infarction by 4.8 times for the 60 minutes after consumption.
There is preliminary evidence that cannabis interferes with the anticoagulant properties of prescription drugs used for treating blood clots. As of 2019, the mechanisms for the anti-inflammatory and possible pain relieving effects of cannabis were not defined, and there were no governmental regulatory approvals or clinical practices for use of cannabis as a drug.
Emergency department visits
Emergency room (ER) admissions associated with cannabis use rose significantly from 2012 to 2016; adolescents from age 12–17 had the highest risk. At one Colorado medical center following legalization, approximately two percent of ER admissions were classified as cannabis users. The symptoms of one quarter of these users were partially attributed to cannabis (a total of 2567 out of 449,031 patients); other drugs were sometimes involved. Of these cannabis admissions, one quarter were for acute psychiatric effects, primarily suicidal ideation, depression, and anxiety. An additional third of the cases were for gastrointestinal issues including cannabinoid hyperemesis syndrome.
According to the United States Department of Health and Human Services, there were 455,000 emergency room visits associated with cannabis use in 2011. These statistics include visits in which the patient was treated for a condition induced by or related to recent cannabis use. The drug use must be "implicated" in the emergency department visit, but does not need to be the direct cause of the visit. Most of the illicit drug emergency room visits involved multiple drugs. In 129,000 cases, cannabis was the only implicated drug.
Reproductive health
This section is an excerpt from Cannabis in pregnancy. Cannabis consumption in pregnancy is an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.Pharmacology
Mechanism of action
See also: Effects of cannabis § Biochemical mechanisms in the brainTHC is a weak partial agonist at CB1 receptors, while CBD is a CB1 receptor antagonist. The CB1 receptor is found primarily in the brain as well as in some peripheral tissues, and the CB2 receptor is found primarily in peripheral tissues, but is also expressed in neuroglial cells. THC appears to alter mood and cognition through its agonist actions on the CB1 receptors, which inhibit a secondary messenger system (adenylate cyclase) in a dose-dependent manner.
Via CB1 receptor activation, THC indirectly increases dopamine release and produces psychotropic effects. CBD also acts as an allosteric modulator of the μ- and δ-opioid receptors. THC also potentiates the effects of the glycine receptors. It is unknown if or how these actions contribute to the effects of cannabis.
Pharmacokinetics
The high lipid-solubility of cannabinoids results in their persisting in the body for long periods of time. Even after a single administration of THC, detectable levels of THC can be found in the body for weeks or longer (depending on the amount administered and the sensitivity of the assessment method). Investigators have suggested that this is an important factor in marijuana's effects, perhaps because cannabinoids may accumulate in the body, particularly in the lipid membranes of neurons.
Chemistry
Chemical composition
See also: Difference between C. indica and C. sativaThe main psychoactive component of cannabis is tetrahydrocannabinol (THC), which is formed via decarboxylation of tetrahydrocannabinolic acid (THCA) from the application of heat. Raw leaf is not psychoactive because the cannabinoids are in the form of carboxylic acids. THC is one of the 483 known compounds in the plant, including at least 65 other cannabinoids, such as cannabidiol (CBD).
Detection in body fluids
Main article: Cannabis drug testingTHC and its major (inactive) metabolite, THC-COOH, can be measured in blood, urine, hair, oral fluid or sweat using chromatographic techniques as part of a drug use testing program or a forensic investigation of a traffic or other criminal offense. The concentrations obtained from such analyses can often be helpful in distinguishing active use from passive exposure, elapsed time since use, and extent or duration of use. These tests cannot, however, distinguish authorized cannabis smoking for medical purposes from unauthorized recreational smoking. Commercial cannabinoid immunoassays, often employed as the initial screening method when testing physiological specimens for marijuana presence, have different degrees of cross-reactivity with THC and its metabolites. Urine contains predominantly THC-COOH, while hair, oral fluid and sweat contain primarily THC. Blood may contain both substances, with the relative amounts dependent on the recency and extent of usage.
The Duquenois–Levine test is commonly used as a screening test in the field, but it cannot definitively confirm the presence of cannabis, as a large range of substances have been shown to give false positives. Researchers at John Jay College of Criminal Justice reported that dietary zinc supplements can mask the presence of THC and other drugs in urine. However, a 2013 study conducted by researchers at the University of Utah School of Medicine refute the possibility of self-administered zinc producing false-negative urine drug tests.
Varieties and strains
CBD is a 5-HT1A receptor agonist, which is under laboratory research to determine if it has an anxiolytic effect. It is often claimed that sativa strains provide a more stimulating psychoactive high while indica strains are more sedating with a body high. However, this is disputed by researchers.
A 2015 review found that the use of high CBD-to-THC strains of cannabis showed significantly fewer positive symptoms, such as delusions and hallucinations, better cognitive function and both lower risk for developing psychosis, as well as a later age of onset of the illness, compared to cannabis with low CBD-to-THC ratios.
Psychoactive ingredients
According to the United Nations Office on Drugs and Crime (UNODC), "the amount of THC present in a cannabis sample is generally used as a measure of cannabis potency." The three main forms of cannabis products are the flower/fruit, resin (hashish), and oil (hash oil). The UNODC states that cannabis often contains 5% THC content, resin "can contain up to 20% THC content", and that "Cannabis oil may contain more than 60% THC content."
Studies have found that the potency of illicit cannabis has greatly increased since the 1970s, with THC levels rising and CBD levels dropping. It is unclear, however, whether the increase in THC content has caused people to consume more THC or if users adjust based on the potency of the cannabis. It is likely that the higher THC content allows people to ingest less tar. At the same time, CBD levels in seized samples have lowered, in part because of the desire to produce higher THC levels and because more illegal growers cultivate indoors using artificial lights. This helps avoid detection but reduces the CBD production of the plant.
Australia's National Cannabis Prevention and Information Centre (NCPIC) states that the buds (infructescences) of the female cannabis plant contain the highest concentration of THC, followed by the leaves. The stalks and seeds have "much lower THC levels". The UN states that the leaves can contain ten times less THC than the buds, and the stalks 100 times less THC.
After revisions to cannabis scheduling in the UK, the government moved cannabis back from a class C to a class B drug. A purported reason was the appearance of high potency cannabis. They believe skunk accounts for between 70% and 80% of samples seized by police (despite the fact that skunk can sometimes be incorrectly mistaken for all types of herbal cannabis). Extracts such as hashish and hash oil typically contain more THC than high potency cannabis infructescences.
Laced cannabis and synthetic cannabinoids
See also: Synthetic cannabinoids § Hemp (or low potent cannabis) budsHemp buds (or low-potency cannabis buds) laced with synthetic cannabinoids started to be sold as cannabis street drug in 2020.
The short-term effects of cannabis can be altered if it has been laced with opioid drugs such as heroin or fentanyl. The added drugs are meant to enhance the psychoactive properties, add to its weight, and increase profitability, despite the increased danger of overdose.
Preparations
- Dried flower buds (marijuana)
- A gram of kief
- Hashish
- Hash oil
- Infusion (dairy butter)
Marijuana
Further information: Marijuana (word)Marijuana or marihuana (herbal cannabis) consists of the dried flowers and fruits and subtending leaves and stems of the female cannabis plant. This is the most widely consumed form, containing 3% to 20% THC, with reports of up to 33% THC. This is the stock material from which all other preparations are derived. Although herbal cannabis and industrial hemp derive from the same species and contain the psychoactive component (THC), they are distinct strains with unique biochemical compositions and uses. Hemp has lower concentrations of THC and higher concentrations of CBD, which gives lesser psychoactive effects.
Kief
Main article: KiefKief is a powder, rich in trichomes, which can be sifted from the leaves, flowers and fruits of cannabis plants and either consumed in powder form or compressed to produce cakes of hashish. The word "kif" derives from colloquial Arabic كيف kēf/kīf, meaning pleasure.
Hashish
Main article: HashishHashish (also spelled hasheesh, hashisha, or simply hash) is a concentrated resin cake or ball produced from pressed kief, the detached trichomes and fine material that falls off cannabis fruits, flowers and leaves, or from scraping the resin from the surface of the plants and rolling it into balls. It varies in color from black to golden brown depending upon purity and variety of cultivar it was obtained from. It can be consumed orally or smoked, and is also vaporized, or 'vaped'. The term "rosin hash" refers to a high quality solventless product obtained through heat and pressure.
Tincture
Main article: Tincture of cannabisCannabinoids can be extracted from cannabis plant matter using high-proof spirits (often grain alcohol) to create a tincture, often referred to as "green dragon". Nabiximols is a branded product name from a tincture manufacturing pharmaceutical company.
Hash oil
Main article: Hash oilHash oil is a resinous matrix of cannabinoids obtained from the cannabis plant by solvent extraction, formed into a hardened or viscous mass. Hash oil can be the most potent of the main cannabis products because of its high level of psychoactive compound per its volume, which can vary depending on the plant's mix of essential oils and psychoactive compounds. Butane and supercritical carbon dioxide hash oil have become popular in recent years.
Infusions
There are many varieties of cannabis infusions owing to the variety of non-volatile solvents used. The plant material is mixed with the solvent and then pressed and filtered to express the oils of the plant into the solvent. Examples of solvents used in this process are cocoa butter, dairy butter, cooking oil, glycerine, and skin moisturizers. Depending on the solvent, these may be used in cannabis foods or applied topically.
Marihuana prensada
Main article: Marihuana prensadaMarihuana prensada ('pressed marijuana') is a cannabis-derived product widespread among the lower classes of South America, especially from the 90s. Locally it is known as "paraguayo" or "paragua", since its main producer is Paraguay. Marijuana is dried and mixed with binding agents that make it toxic and highly harmful to health. It is cut into the shape of bricks (ladrillos) and sold for a low price in Argentina, Brazil, Chile, Peru, Venezuela, and even the United States.
History
Main articles: History of cannabis, Timeline of cannabis law, and Religion and drugsAncient history
Cannabis is indigenous to Central or South Asia and its uses for fabric and rope dates back to the Neolithic age in China and Japan. It is unclear when cannabis first became known for its psychoactive properties. The oldest archeological evidence for the burning of cannabis was found in Romanian kurgans dated 3,500 BC, and scholars suggest that the drug was first used in ritual ceremonies by Proto-Indo-European tribes living in the Pontic-Caspian steppe during the Chalcolithic period, a custom they eventually spread throughout Western Eurasia during the Indo-European migrations. Some research suggests that the ancient Indo-Iranian drug soma, mentioned in the Vedas, sometimes contained cannabis. This is based on the discovery of a basin containing cannabis in a shrine of the second millennium BC in Turkmenistan.
Cannabis was known to the ancient Assyrians, who discovered its psychoactive properties through the Iranians. Using it in some religious ceremonies, they called it qunubu (meaning "way to produce smoke"), a probable origin of the modern word cannabis. The Iranians also introduced cannabis to the Scythians, Thracians and Dacians, whose shamans (the kapnobatai – "those who walk on smoke/clouds") burned cannabis infructescences to induce trance. The plant was used in China before 2800 BC, and found therapeutic use in India by 1000 BC, where it was used in food and drink, including bhang.
Cannabis has an ancient history of ritual use and has been used by religions around the world. It has been used as a drug for both recreational and entheogenic purposes and in various traditional medicines for centuries. The earliest evidence of cannabis smoking has been found in the 2,500-year-old tombs of Jirzankal Cemetery in the Pamir Mountains in Western China, where cannabis residue were found in burners with charred pebbles possibly used during funeral rituals. Hemp seeds discovered by archaeologists at Pazyryk suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century BC, confirming previous historical reports by Herodotus. It was used by Muslims in various Sufi orders as early as the Mamluk period, for example by the Qalandars. Smoking pipes uncovered in Ethiopia and carbon-dated to around c. AD 1320 were found to have traces of cannabis.
Modern history
Cannabis was introduced to the New World by the Spaniards in 1530–1545. Following an 1836–1840 travel in North Africa and the Middle East, French physician Jacques-Joseph Moreau wrote on the psychological effects of cannabis use; he founded the Paris' Club des Hashischins in 1844. In 1842, Irish physician William Brooke O'Shaughnessy, who had studied the drug while working as a medical officer in Bengal with the East India Company, brought a quantity of cannabis with him on his return to Britain, provoking renewed interest in the West. Examples of classic literature of the period featuring cannabis include Les paradis artificiels (1860) by Charles Baudelaire and The Hasheesh Eater (1857) by Fitz Hugh Ludlow.
Cannabis was criminalized in some countries beginning in the 14th century and was illegal in most countries by the middle of the 20th century. The colonial government of Mauritius banned cannabis in 1840 over concerns on its effect on Indian indentured workers; the same occurred in Singapore in 1870. In the United States, the first restrictions on sale of cannabis came in 1906 (in the District of Columbia). Canada criminalized cannabis in The Opium and Narcotic Drug Act, 1923, before any reports of the use of the drug in Canada, but eventually legalized its consumption for recreational and medicinal purposes in 2018.
In 1925, a compromise was made at an international conference in The Hague about the International Opium Convention that banned exportation of "Indian hemp" to countries that had prohibited its use, and requiring importing countries to issue certificates approving the importation and stating that the shipment was required "exclusively for medical or scientific purposes". It also required parties to "exercise an effective control of such a nature as to prevent the illicit international traffic in Indian hemp and especially in the resin". In the United States in 1937, the Marihuana Tax Act was passed, and prohibited the production of hemp in addition to cannabis.
In 1972, the Dutch government divided drugs into more- and less-dangerous categories, with cannabis being in the lesser category. Accordingly, possession of 30 grams (1.1 oz) or less was made a misdemeanor. Cannabis has been available for recreational use in coffee shops since 1976. Cannabis products are only sold openly in certain local "coffeeshops" and possession of up to 5 grams (0.18 oz) for personal use is decriminalized, however: the police may still confiscate it, which often happens in car checks near the border. Other types of sales and transportation are not permitted, although the general approach toward cannabis was lenient even before official decriminalization.
In Uruguay, President Jose Mujica signed legislation to legalize recreational cannabis in December 2013, making Uruguay the first country in the modern era to legalize cannabis. In August 2014, Uruguay legalized growing up to six plants at home, as well as the formation of growing clubs (Cannabis social club), and a state-controlled marijuana dispensary regime.
As of 17 October 2018, when recreational use of cannabis was legalized in Canada, dietary supplements for human use and veterinary health products containing not more than 10 parts per million of THC extract were approved for marketing; Nabiximols (as Sativex) is used as a prescription drug in Canada.
The United Nations' World Drug Report stated that cannabis "was the world's most widely produced, trafficked, and consumed drug in the world in 2010", and estimated between 128 million and 238 million users globally in 2015.
Culture, legality and economics
Culture
Main article: Cannabis culture See also: Drug culture and 420 (cannabis culture)Cannabis has been one of the most used psychoactive drugs in the world since the late 20th century, following only tobacco and alcohol in popularity. According to Vera Rubin, the use of cannabis has been encompassed by two major cultural complexes over time: a continuous, traditional folk stream, and a more circumscribed, contemporary configuration. The former involves both sacred and secular use, and is usually based on small-scale cultivation: the use of the plant for cordage, clothing, medicine, food, and a "general use as an euphoriant and symbol of fellowship." The second stream of expansion of cannabis use encompasses "the use of hemp for commercial manufacturers utilizing large-scale cultivation primarily as a fiber for mercantile purposes"; but it is also linked to the search for psychedelic experiences (which can be traced back to the formation of the Parisian Club des Hashischins).
Legality
Main article: Legality of cannabis See also: Prohibition of drugs and Drug liberalizationSince the beginning of the 20th century, most countries have enacted laws against the cultivation, possession or transfer of cannabis. These laws have had an adverse effect on cannabis cultivation for non-recreational purposes, but there are many regions where handling of cannabis is legal or licensed. Many jurisdictions have lessened the penalties for possession of small quantities of cannabis so that it is punished by confiscation and sometimes a fine, rather than imprisonment, focusing more on those who traffic the drug on the black market.
In some areas where cannabis use had been historically tolerated, new restrictions were instituted, such as the closing of cannabis coffee shops near the borders of the Netherlands, and closing of coffee shops near secondary schools in the Netherlands. In Copenhagen, Denmark in 2014, mayor Frank Jensen discussed possibilities for the city to legalize cannabis production and commerce.
Some jurisdictions use free voluntary or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution. Political parties, non-profit organizations, and causes based on the legalization of medical cannabis or legalizing the plant entirely (with some restrictions) have emerged in such countries as China and Thailand.
In December 2012, the U.S. state of Washington became the first state to officially legalize cannabis in a state law (Washington Initiative 502) (but still illegal by federal law), with the state of Colorado following close behind (Colorado Amendment 64). On 1 January 2013, the first cannabis "club" for private marijuana smoking (no buying or selling, however) was allowed for the first time in Colorado. The California Supreme Court decided in May 2013 that local governments can ban medical cannabis dispensaries despite a state law in California that permits the use of cannabis for medical purposes. At least 180 cities across California have enacted bans in recent years.
On 30 April 2024, the United States Department of Justice announced it would move to reclassify cannabis from a Schedule I to a Schedule III controlled substance.
In December 2013, Uruguay became the first country to legalize growing, sale and use of cannabis. After a long delay in implementing the retail component of the law, in 2017 sixteen pharmacies were authorized to sell cannabis commercially. On 19 June 2018, the Canadian Senate passed a bill and the Prime Minister announced the effective legalization date as 17 October 2018. Canada is the second country to legalize the drug.
In November 2015, Uttarakhand became the first state of India to legalize the cultivation of hemp for industrial purposes. Usage within the Hindu and Buddhist cultures of the Indian subcontinent is common, with many street vendors in India openly selling products infused with cannabis, and traditional medical practitioners in Sri Lanka selling products infused with cannabis for recreational purposes and well as for religious celebrations. Indian laws criminalizing cannabis date back to the colonial period. India and Sri Lanka have allowed cannabis to be taken in the context of traditional culture for recreational/celebratory purposes and also for medicinal purposes.
On 17 October 2015, Australian health minister Sussan Ley presented a new law that will allow the cultivation of cannabis for scientific research and medical trials on patients.
On 17 October 2018, Canada legalized cannabis for recreational adult use making it the second country in the world to do so after Uruguay and the first G7 nation. This legalization comes with regulation similar to that of alcohol in Canada, age restrictions, limiting home production, distribution, consumption areas and sale times. Laws around use vary from province to province including age limits, retail structure, and growing at home. The Canadian Licensed Producer system aims to become the Gold Standard in the world for safe and secure cannabis production, including provisions for a robust craft cannabis industry where many expect opportunities for experimenting with different strains.
As the drug has increasingly been seen as a health issue instead of criminal behavior, cannabis has also been legalized or decriminalized in: Czech Republic, Colombia, Ecuador, Portugal, South Africa and Canada. Medical marijuana was legalized in Mexico in mid-2017 and legalized for recreational use in June 2021.
Germany legalized cannabis for recreational use in April 2024.
Legal status by country
As of 2022, Uruguay and Canada are the only countries that have fully legalized the cultivation, consumption and bartering of recreational cannabis nationwide. In the United States, 24 states, 3 territories, and the District of Columbia have legalized the recreational use of cannabis – though the drug remains illegal at the federal level. Laws vary from state to state when it comes to the commercial sale. Court rulings in Georgia and South Africa have led to the legalization of cannabis consumption, but not legal sales. A policy of limited enforcement has also been adopted in many countries, in particular Spain and the Netherlands where the sale of cannabis is tolerated at licensed establishments. Contrary to popular belief, cannabis is not legal in the Netherlands, but it has been decriminalized since the 1970s. In 2021, Malta was the first European Union member to legalize the use of cannabis for recreational purposes. In Estonia, it is only legal to sell cannabis products with a THC content of less than 0.2%, although products may contain more cannabidiol. Lebanon has recently become the first Arab country to legalize the plantation of cannabis for medical use.
Penalties for illegal recreational use ranges from confiscation or small fines to jail time and even death. In some countries citizens can be punished if they have used the drug in another country, including Singapore and South Korea.
Economics
Production
Main articles: Cannabis cultivation, Cannabis industry, and Cannabis product testingSinsemilla (Spanish for "without seed") is the dried, seedless (i.e. parthenocarpic) infructescences of female cannabis plants. Because THC production drops off once pollination occurs, the male plants (which produce little THC themselves) are eliminated before they shed pollen to prevent pollination, thus inducing the development of parthenocarpic fruits gathered in dense infructescences. Advanced cultivation techniques such as hydroponics, cloning, high-intensity artificial lighting, and the sea of green method are frequently employed as a response (in part) to prohibition enforcement efforts that make outdoor cultivation more risky.
"Skunk" refers to several named strains of potent cannabis, grown through selective breeding and sometimes hydroponics. It is a cross-breed of Cannabis sativa and C. indica (although other strains of this mix exist in abundance). Skunk cannabis potency ranges usually from 6% to 15% and rarely as high as 20%. The average THC level in coffee shops in the Netherlands is about 18–19%.
The average levels of THC in cannabis sold in the United States rose dramatically between the 1970s and 2000. This is disputed for various reasons, and there is little consensus as to whether this is a fact or an artifact of poor testing methodologies. According to Daniel Forbes writing for slate.com, the relative strength of modern strains are likely skewed because undue weight is given to much more expensive and potent, but less prevalent, samples. Some suggest that results are skewed by older testing methods that included low-THC-content plant material such as leaves in the samples, which are excluded in contemporary tests. Others believe that modern strains actually are significantly more potent than older ones.
The main producing countries of cannabis are Afghanistan, Canada, China, Colombia, India, Jamaica, Lebanon, Mexico, Morocco, the Netherlands, Pakistan, Paraguay, Spain, Thailand, Turkey, the United Kingdom, and the United States.
Price
The price or street value of cannabis varies widely depending on geographic area and potency. Prices and overall markets have also varied considerably over time.
- In 1997, cannabis was estimated to be overall the number four value crop in the US, and number one or two in many states, including California, New York, and Florida. This estimate is based on a value to growers of ~60% of retail value, or $3,000 per pound ($6,600/kg).
- In 2006, cannabis was estimated to have been a $36 billion market. This estimate has been challenged as exaggerated. The UN World Drug Report (2008) estimated that 2006 street prices in the US and Canada ranged from about US$8.8 to $25 per gram (approximately $250 to $700 per ounce), depending on quality. Typical U.S. retail prices were $10–15 per gram (approximately $280–420 per ounce).
- In 2017, the U.S. was estimated to constitute 90% of the worldwide $9.5 billion legal trade in cannabis.
After some U.S. states legalized cannabis, street prices began to drop. In Colorado, the price of smokable buds (infructescences) dropped 40 percent between 2014 and 2019, from $200 per ounce to $120 per ounce ($7 per gram to $4.19 per gram).
The European Monitoring Centre for Drugs and Drug Addiction reports that typical retail prices in Europe for cannabis varied from €2 to €20 per gram in 2008, with a majority of European countries reporting prices in the range €4–10.
Cannabis as a gateway drug
See also: Gateway drug effectThe gateway hypothesis states that cannabis use increases the probability of trying "harder" drugs. The hypothesis has been hotly debated as it is regarded by some as the primary rationale for the United States prohibition on cannabis use. A Pew Research Center poll found that political opposition to marijuana use was significantly associated with concerns about the health effects and whether legalization would increase cannabis use by children.
Some studies state that while there is no proof for the gateway hypothesis, young cannabis users should still be considered as a risk group for intervention programs. Other findings indicate that hard drug users are likely to be poly-drug users, and that interventions must address the use of multiple drugs instead of a single hard drug. Almost two-thirds of the poly drug users in the 2009–2010 Scottish Crime and Justice Survey used cannabis.
The gateway effect may appear due to social factors involved in using any illegal drug. Because of the illegal status of cannabis, its consumers are likely to find themselves in situations allowing them to acquaint with individuals using or selling other illegal drugs. Studies have shown that alcohol and tobacco may additionally be regarded as gateway drugs; however, a more parsimonious explanation could be that cannabis is simply more readily available (and at an earlier age) than illegal hard drugs. In turn, alcohol and tobacco are typically easier to obtain at an earlier age than is cannabis (though the reverse may be true in some areas), thus leading to the "gateway sequence" in those individuals, since they are most likely to experiment with any drug offered.
A related alternative to the gateway hypothesis is the common liability to addiction (CLA) theory. It states that some individuals are, for various reasons, willing to try multiple recreational substances. The "gateway" drugs are merely those that are (usually) available at an earlier age than the harder drugs. Researchers have noted in an extensive review that it is dangerous to present the sequence of events described in gateway "theory" in causative terms as this hinders both research and intervention.
In 2020, the National Institute on Drug Abuse released a study backing allegations that marijuana is a gateway to harder drugs, though not for the majority of marijuana users. The National Institute on Drug Abuse determined that marijuana use is "likely to precede use of other licit and illicit substances" and that "adults who reported marijuana use during the first wave of the survey were more likely than adults who did not use marijuana to develop an alcohol use disorder within 3 years; people who used marijuana and already had an alcohol use disorder at the outset were at greater risk of their alcohol use disorder worsening. Marijuana use is also linked to other substance use disorders including nicotine addiction." It also reported that "These findings are consistent with the idea of marijuana as a "gateway drug". However, the majority of people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs and are, like marijuana, also typically used before a person progresses to other, more harmful substances."
Research
See also: Medical cannabis researchResearch on cannabis is challenging since the plant is illegal in most countries. Research-grade samples of the drug are difficult to obtain for research purposes, unless granted under authority of national regulatory agencies, such as the US Food and Drug Administration.
There are also other difficulties in researching the effects of cannabis. Many people who smoke cannabis also smoke tobacco. This causes confounding factors, where questions arise as to whether the tobacco, the cannabis, or both that have caused a cancer. Another difficulty researchers have is in recruiting people who smoke cannabis into studies. Because cannabis is an illegal drug in many countries, people may be reluctant to take part in research, and if they do agree to take part, they may not say how much cannabis they actually smoke.
See also
- Cannabis rights
- Glossary of cannabis terms
- List of books about cannabis
- List of celebrities who own cannabis businesses
References
Footnotes
- Pure varieties of C. ruderalis are rarely used for recreational purposes.
- Psychotic episodes are well-documented and typically resolve within minutes or hours, while symptoms may last longer. The use of a single joint can temporarily induce some psychiatric symptoms.
- A 2016 review also found a statistically significant increase in crash risk associated with marijuana use, but noted that this risk was "of low to medium magnitude." The increase in risk of motor vehicle crash for cannabis use is between 2 and 3 times relative to baseline, whereas that for comparable doses of alcohol is between 6 and 15 times.
- Advocates of legalizing marijuana for recreational use, such as former Illinois state Senator Heather Steans, say that legalizing it would help reduce such hazardous added drugs: "Over 95 percent are buying it on the black market. You don't know what you're buying. It's not a safe product. We've seen it laced with rat poison, fentanyl, all sorts of things. It's funding the cartels and other criminal activity."
Citations
- Cervantes, Jorge (2006). Marijuana Horticulture: The Indoor/Outdoor Medical Grower's Bible (5th ed.). Van Patten Publishing. pp. 12. ISBN 9781878823236.
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Therefore, results indicate evidence for small neurocognitive effects that persist after the period of acute intoxication...As hypothesized, the meta-analysis conducted on studies eval- uating users after at least 25 days of abstention found no residual effects on cognitive performance...These results fail to support the idea that heavy cannabis use may result in long-term, persistent effects on neuropsychological functioning.
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Given that central nervous system is an intricately balanced, complex network of billions of neurons and supporting cells, some might imagine that extrinsic substances could cause irreversible brain damage. Our review paints a less gloomy picture of the substances reviewed, however. Following prolonged abstinence, abusers of alcohol (Pfefferbaum et al., 2014) or opiates (Wang et al., 2011) have white matter microstructure that is not significantly different from nonusers. There was also no evidence that the white matter microstructural changes observed in longitudinal studies of cannabis, nicotine, or cocaine were completely irreparable. It is therefore possible that, at least to some degree, abstinence can reverse effects of substance abuse on white matter. The ability of white matter to "bounce back" very likely depends on the level and duration of abuse, as well as the substance being abused.
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1) The studies reviewed so far demonstrated that chronic cannabis use has been associated with a volume reduction of the hippocampus...3) The overall conclusion arising from these studies is that recent cannabis users may experience subtle neurophysiological deficits while performing on working memory tasks, and that they compensate for these deficits by "working harder" by using additional brain regions to meet the demands of the task.
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