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{{Short description|Psychoactive drug from the cannabis plant}}
]'' plant]]
{{Redirect|Marijuana}}
{{ wiktionarypar |marijuana}}
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'''Cannabis''' is a ] produced from parts of the '']'' ], primarily the cured ]s and gathered ]s of the female plant ("bud") (as well as the less psychoactive remains of the plant, and its highly psychoactive resin.) The major active ] Δ9-], commonly referred to as THC, has ] and ] effects when consumed, usually by smoking or ingestion. Humans have been consuming cannabis since prehistory, though in the 20th century there was a rise in the use of cannabis for ] and ] purposes. At the beginning of the 21st century, it is estimated that cannabis is used by four per cent of the world's adult population each year, making cannabis more popular than all other illicit drugs combined.<ref name="WDR2006_chap2">{{cite book | title=World Drug Report 2006, Volume I: Analysis| chapter= CANNABIS: WHY WE SHOULD CARE | author = United Nations Office on Drugs and Crime | publisher = United Nations | id=ISBN 92-1-148214-3| url=http://www.unodc.org/pdf/WDR_2006/wdr2006_chap2_biggest_market.pdf | format=PDF | accessdate = 2006-11-10 }}</ref> The possession, use, or sale of psychoactive cannabis products became ] in the early 20th century. Since then, while some countries have intensified the enforcement of cannabis ], others have reduced the priority of enforcement to the point of tolerating consumption. The supplying of cannabis remains illegal almost everywhere in the world through the ] ], the ] ], and the ] ], while simple possession of small quantities is tolerated in a few countries.
{{pp-semi-vandalism|small=yes}}
{{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.&nbsp;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 ].
== Ancient history ==
Biologists generally agree that the cannabis plant first grew somewhere in the Himalayas. Evidence of the smoking of cannabis can be found as far back as the ] age, where charred hemp seeds were found in a ritual ] at a burial site in present day ].<ref name="Neolithic">{{cite book|author=Richard Rudgley|title=The Lost Civilizations of the Stone Age|date=1999}}</ref>
The most famous users of cannabis were the ancient ]s. It was called ''ganjika'' in ] (''ganja'' in modern Indian languages).<ref name="ganjikaEB">{{cite encyclopedia|encyclopedia=Encyclopædia Britannica |title=HEMP|url=http://57.1911encyclopedia.org/H/HE/HEMP.htm|accessdate=2006-06-15|edition=11|year=1911}}</ref> According to legend, ], the destroyer of evil in the Hindu trinity, told his disciples to revere the plant. The ancient drug ], mentioned in the ]s as a sacred intoxicating hallucinogen, was sometimes associated with cannabis. It has also been identified with a number of other plants and a mushroom, ], so the involvement of cannabis cannot be definitively quantified.


<!-- Effects -->
The citizens of the ] would partake in the ceremonial burning of massive cannabis bonfires, directly exposing themselves and neighboring tribes to the billowing fumes, oftentimes for over 24 hours.<ref name="persia1">{{cite|author=Abu Usaybia|title=Uyunu al-Anba fi Tabaquat al-Atibba|publisher= Berkeley: University of California Press |date=1965}}</ref><ref name="persia2">{{cite journal|coauthors=Edward Preble and Gabriel V. Laury|year=1967|month=Fall|title=Plastic Cement: The Ten Cent Hallucinogen|journal=International Journal of the Addictions|volume=2|pages=271-272}}</ref>
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 -->
Cannabis was also well known to the ], who discovered it from the ]. Using it in some religious ceremonies, they called it ''qunubu'', or ''the drug for sadness''. Also introduced by the ], the ]ns as well as the ]/]ns used it, whose ] (the ''kapnobatai'' - "those who walk on smoke/clouds") burned cannabis flowers in order to induce trances. The cult of ], which is believed to have originated in ], is also believed to have inhaled cannabis smoke.
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.


<!-- History and legality -->
== Religious and spiritual use ==
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 ].
{{main|Spiritual use of cannabis}}


==Etymology==
] has an ancient history of ritual use and is found in ]s around the world. Hemp seeds discovered by archaeologists at ] suggest early ceremonial practices by the ] occurred during the 5th to 2nd century BCE, confirming previous historical reports by ]. Some historians and etymologists have claimed that cannabis was used as a religious sacrament by ancient ], early ] and ] of the ] order. In ], it has been used by wandering spiritual ]s for centuries, and in modern times the ] has embraced it. Elders of the modern religious movement known as the ] consider cannabis to be the ], claiming it as an oral tradition from ] dating back to the time of ]. Like the Rastafari, some modern ] Christian sects have asserted that ''Cannabis'' is the Tree of Life. Other organized religions founded in the past century that treat cannabis as a sacrament are the ], the ], ], the ] and the ]. Many individuals also consider their use of cannabis to be spiritual regardless of organized religion.
{{main|Etymology of cannabis}}
''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" />


== Medical use == ==Uses==
{{main|Medical cannabis}}


===Medical===
Medically, cannabis is most often used as an appetite stimulant and pain reliever for certain illnesses, including ], ] and other diseases. It is used to relieve ] and certain neurological illnesses such as ], ] and ]. It has also been found to relieve nausea for ] patients. A recent study has also indicated that cannabis can be used to prevent ].{{fact}} The medical use of cannabis is politically controversial, but physicians sometimes recommend it informally. A synthetic version of the major active chemical in cannabis, THC, is available in many countries in the form of a pill as the prescription drug ] (Marinol). THC has also been found to reduce arterial blockages.<ref name="BloodVessels">{{cite news|url=http://www.nature.com/news/2005/050404/full/050404-7.html|publisher=Nature (magazine)|title=Cannabis compound benefits blood vessels|date=]}}</ref> A sublingual spray derived from an extract of cannabis has also been approved for treatment of ] in ] as the prescription drug ]<ref name="SativexC">{{cite news|url=http://www.usatoday.com/news/health/2005-06-23-pot-spray_x.htm|org=USA Today|title=Spray alternative to pot on the market in Canada|date=]}}</ref>&mdash;this drug may now be legally imported into the ] and ] on prescription.<ref name="SativexEu">{{cite web|url=http://stopthedrugwar.org/chronicle/411/sativex.shtml|title=Europe: Sativex Coming to England, Spain|accessdate=2006-03-25}}</ref>
{{Main|Medical cannabis}}
]


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" />
== New breeding and cultivation techniques ==
{{main|Cannabis (drug) cultivation}}


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" />
Advances in breeding and cultivation techniques have increased the diversity and potency of ] since 1970, and these strains are now widely smoked all over the world. These advances are known as the ] of production; sinsemilla, Spanish for ''without seed'', are the dried, seedless female flowers of cannabis plants which have been grown in the absence of males to ensure no pollination takes place. Because ] potency and production drops off once pollination takes place, various techniques such as ], ], ], ], and ] have been utilized, in part as a response to prohibition enforcement efforts which have made outdoor cultivation more risky; thus, efficient indoor cultivation has become more common. These same advances have led to fewer seeds being present in cannabis currently than were present 20 years ago.


===Recreational===
Many opponents of cannabis use, both in and out of government, have exaggerated the increases in potency and ramifications thereof. 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 --><!-- could you cite those ads? --> today is significantly stronger and thus more dangerous than that which they themselves might have smoked in the past.<ref name="More potent">{{cite press release|publisher=]|date=]|url=http://www.dhhs.gov/news/press/2004pres/20040909b.html|title=Nation's Youth Turning Away from Marijuana, as Perceptions of Risk Rise; Most Adults with Substance Abuse Problems Are Employed|accessdate=2006-05-30}}</ref> 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. Many cannabis proponents disagree vehemently, reasoning that as one must smoke less cannabis to achieve the same effect, it actually is safer and less potentially carcinogenic in the long run than that which was smoked in earlier times.
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>
There are two recognized subspecies of ''Cannabis sativa'', ''Cannabis sativa'' subsp. ''sativa'' and ''C. sativa'' subsp. ''indica''.<ref name="Plants">{{cite web|author = USDA, NRCS | date=2006 | title=The PLANTS Database| publisher=National Plant Data Center| location=Baton Rouge, LA 70874-4490 USA | url=http://plants.usda.gov/java/ClassificationServlet?source=profile&symbol=CASA3&display=31 | accessdate=2006-11-01 }}</ref> Sativas are reputed to induce a noticeably more cerebral high, while indicas induce more of a body high, also referred to as "couch-lock."


===Spiritual===
== Preparations for human consumption ==
{{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>
]
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==
Cannabis is prepared for human consumption in several forms:
{{Main|Cannabis consumption}}


=== Modes of consumption ===
* ''Marijuana'' or ''buds'', the resin gland-rich flowering tops of female plants.
]{{Cookbook|Cannabis}}
* '']'', a concentrated resin mostly comprised of trichomes that are extracted physically, as with ice hash, or chemically.
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:
* '']'' or ''kif'', a powder containing the resin glands (glandular ]s, often incorrectly called "crystals" or "pollen"); it is produced by sifting marijuana and leaves.
* ], 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>
* '']'', hand-made hashish produced by hand-rubbing the resin from the resin gland-rich parts of the plant. Often thin dark rectangular pieces.
* ], 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>
* '']'', prepared by the wet grinding of the leaves of the plant and used as a drink.
* ], 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 ].
* '']'', resulting from ] or ] of THC-rich parts of the plant.
* ], prepared with attention to the ] quality of THC, which is only slightly water-soluble (2.8&nbsp;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>
* '']'', processed hash oil. Ordinary hash oil is whipped to incorporate air, making it a foam. It has been marketed as being anywhere between 82% and 100% THC, though no actual lab tests have been done to validate this claim.
* ], sometimes known as green dragon, is an ] ].
* '']'', when smoked through a pipe all of the above will cause black goo to create a film on the sides or collect in certain nooks depending on its shape. This can be collected and resmoked. This method is commonly referred to as scraping.
* ], 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>
* Minimally potent leaves and detritus, called ''shake, brush, bush'', ''shwagg'', or ''leaf''.


=== Consumption by country ===
These forms are certainly not exclusive and combinations of two or more different forms of cannabis are common. Mixing different forms is done mainly to obtain a different or more powerful effect. Between the many different strains of ''Cannabis'' and the various ways that it is prepared for consumption, there are innumerable types of blends or mixes, similar to the countless varieties of mixed alcoholic beverages that are available.
{{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>


=== Smoking === ====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" />
{{main|Cannabis smoking}}


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>
There are a wide variety of methods of smoking cannabis. The most popular include the ], the ], the ], the ] more commonly called a "bowl" or "piece", the ], and the ]. These are sometimes smoked inside a small closed area (such as a car) used to trap smoke so that it is inhaled with every breath. This is often referred to as "]", "fishbowling", "clam-baking", "green-housing", or, in ], as using a "Dutch Oven".
]


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" />
To create a joint, cannabis is rolled up into a cigarette, using ] (where available). Brown paper, newsprint, and other assorted paper products can be used. Cannabis ]s, or ], can also be created by using the wrapper of a standard cigar.


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" />
A ] is a water pipe through which cannabis smoke is filtered. Variants include the ], which consists of a cone atop a perforated or cut water bottle. This method of cannabis smoking is one of the most efficient, as the presence of a chamber and carburetor reduce smoke waste. One can consume massive amounts of cannabis in one "hit".


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>
Pipes are usually made of ], wood, or non-reactive metals. Metal pipes are often made of interchangeable pieces. Glass pipes often have a carburetor, colloquially referred to as a ''carb,'' ''rush,'' ''choke,'' ''shotgun,''or ''shooter'' (British use) that is covered for suction then released for inhalation. Some users also prefer vertically held pipes, or improvised pipes ("tinnies") made from aluminium foil (either constructed entirely from the foil or by using it as a gauze), small plumbing fittings, soda cans, crisp fruits or vegetables, or the cardboard from bathroom-tissue or aluminium foil rolls.


== Adverse effects ==
A "one-hitter" is a device that allows smaller amounts of cannabis to be smoked with equal suction. Cannabis buds are loaded into a compartment for combustion. The smoker then lights the compartment and the entire amount of cannabis is smoked. This is repeated for each hit. This method is also efficient in ] the exact dose desired.
{{Further|Effects of cannabis}}
One-hitters are often disguised as actual cigarettes in order to mislead or deceive people into believing that the person is smoking an authentic cigarette.


===Short-term===
]
]


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>}}
=== Oral consumption ===
Cannabis may be orally consumed. In order to release its psychoactive properties ] can be eaten raw or mixed with water but marijuana will only be absorbed into the bloodstream by blending it with ] or ]s. The effects of the drug take longer to begin, but last longer and may be perceived as more physical rather than mental, though there are claims to the contrary. A dose of oral cannabis is often considered to give a stronger experience than the equivalent dose of smoked cannabis. A common belief holds that smoking cannabis leads to a large amount of the active compounds being lost in the exhaled smoke or simply decomposing on burning, whereas ingested cannabis results in 100% consumption of the active compounds, an assertion which cannot be confirmed without objective analysis. It is thought that the active component of cannabis, Δ9-THC, is converted to the more psychoactive ] in the liver.<ref name="11-hydroxy">{{cite journal| author=Paulo Borini; Romeu Cardoso Guimarães; Sabrina Bicalho Borini| year=2004| month=May| title= ''Possible hepatotoxicity of chronic marijuana usage''| journal=Sao Paulo Medical Journal| volume=122| issue=3| doi=10.1590/S1516-31802004000300007| url=http://www.scielo.br/scielo.php?pid=S1516-31802004000300007&script=sci_arttext&tlng=en| accessdate=2006-05-02}}</ref> Titration is much more complex than through inhalation. Common preparations involve blending with ], to create ] that is used in preparing ], ], ], ]s or ]s. When blended with melted butter, the drug is finely minced almost into powder form. However there are some preparations that do not contain butter in them and therefore fall into a slightly different category; these include the ], which requires less preparation than more "conventional" recipes. Infusion in drinks containing ] and flavoring ]s is also possible, and more common in India. Hollowed-out gumballs filled with the drug, wrapped and distributed labeled as ], were identified in 2006 as being used by high school students in the United States.<ref name="Greenades">{{cite news|url=http://www.prweb.com/releases/2006/7/prweb414446.htm|title=Greenades, Marijuana Gumballs, Identified by Maryland Police, Used by High School Students|publisher=]|date=]|accessdate=2006-09-15}}</ref>


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" />
As with other drugs that are taken orally, it is sometimes customary to ] before taking the drug to increase the effect, possibly because an empty stomach will absorb the drug faster so it 'hits' stronger. However, some people do eat before consuming the drug because eating it on an empty stomach makes them feel sick. Still, time to effect onset is an hour or sometimes more, as opposed to smoking, where effects can be almost immediate.


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>
Cannabis can also be ] in high-percentage ] (often ]) to create ]. This process is often used to utilize otherwise low-quality stems and leaves.


===Fatality===
Cannabis can also be consumed as a ]. THC is lipophilic and only slightly ] ], with a solubility of only 2.8 grams per litre,<ref name="water solubility">{{cite web|url=http://lib1.bmcc.cuny.edu/studres/projectsakinde.html|title=The Medical Applications of Cannabinoids|author=Akinde Omotayo|publisher=]|accessdate=2006-09-15}}</ref> but enough to make a tea effective. Water-based infusion is generally considered to be inefficient.
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>
The seeds of the plant, high in ] and ]s, are appreciated by many species of birds. Many countries, including the United States, make the possession of viable cannabis seeds illegal,<ref name="DEA">{{cite web | url=http://www.usdoj.gov/dea/agency/csa.htm|title=Controlled Substances Act|work=21 USCS § 801|publisher=United States Drug Enforcement Agency|accessdate=November 4|accessyear=2005}}</ref> although they can be openly bought and sold legally in much of Europe, including the ].{{fact}}


=== Vaporization === ===Long-term===
{{main|Long-term effects of cannabis}}
With a '']'', cannabis can be heated to a temperature of about 365 °F (185 °C), at which the active ingredients are released into ]eous form with little or no burning of the plant material. With this method, the user does not inhale as many (or any) toxic chemicals depending on the quality of the vaporizer. Scientific studies by MAPS/NORML have yielded varied results on the effectiveness of vaporizing as a method of cannabis consumption. One particular study by MAPS/NORML found 95% THC and no toxins delivered in the vapor.<ref name="norml1">{{cite web|url=http://www.maps.org/mmj/Gieringer-vaporizer.pdf|title=Cannabis Vaporizer Combines Efficient Delivery of THC with Effective Suppression of Pyrolytic Compounds|last=Gieringer|first=Dale|coauthors=Joseph St. Laurent, Scott Goodrich|accessdate=2006-04-21}}</ref> However, an older study by MAPS/NORML showed minimal reduction of toxins.<ref name="norml2">{{cite web|url=http://www.maps.org/news-letters/v06n3/06359mj1.html|title=Marijuana Water Pipe and Vaporizer Study|last=Gieringer|first=Dale|accessdate=2006-04-21}}</ref>


] 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>]]
==== Hot-knifing (Blades) ====
{{main|Knifers}}
Hot-knifing, ], ''blasting'' or ''doing blades'' is a process in which the tips of two knives are heated to a very high temperature, often by inserting them into the heating element of an electric or gas stove. The cannabis is then pressed between the heated knife-tips, rapidly combusting, or vaporising it depending upon the amount of heat used. The vaporized cannabis is funneled into the mouth of the smoker through the use of a glass or plastic bottle, empty pen, or other hollow tube or funnel or free handed.


====Psychological effects====
In ] and ], this is known as "spots". "Spots" can refer to both the activity of hot-kniving (aka "spotting") and the small, rolled balls of cannabis consumed in the process. Spots are much more efficient than bongs or joints; as the amount of cannabis required to constitute a hit is less and the dosage is easily controlled. This method is most commonly employed with high quality cannabis or hashish.
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>


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/>
Another method of "]" uses knife blades heated to a much lower temperature, only hot enough to ] the active ingredients, leaving the organic material scorched, rather than burnt to ash, thus decreasing potential harmful consequences of the smoke itself.


The ] are not clear.<ref name=JAMA2015/> There are concerns surrounding ], risk of addiction, and the risk of ] in young people.<ref name=Borgelt2013/>
== Immediate effects of consumption ==


====Neuroimaging====
]
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 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 cannabis 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 drug varieties of ''Cannabis sativa'' subsp. ''sativa'' tend to produce more of the cognitive or perceptual effects, while ''C. sativa'' subsp. ''indica'' tends to produce more of the physical effects.


===Cannabis dependence===
=== Active ingredients, metabolism, and method of activity ===
{{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>
Of the approximately 315<ref name=chemicals>{{cite web|title=Urban Legends Reference Pages: Language (420)|url=http://www.snopes.com/language/stories/420.htm|accessdate=2006-05-11}}</ref> different psychoactive chemicals found in ''Cannabis'', the main active ingredient is ] (delta-9-tetrahydrocannabinol, '''THC'''). THC can degrade to other ], such as ] or ], which can make one feel sleepy and disoriented. Different cannabis products have different ratios of these and other cannabinoids. Depending on the ratio, the quality and nature of the "high" will vary.


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" />
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 the cause of ]. 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.


====Psychiatric====
A study has shown that holding cannabis smoke in one's lungs for longer periods of time does not conclusively increase THC's effects on psychological test performance.<ref name="Time Study">{{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 &ndash; 917}}</ref> However, a more recent study by the same authors indicates that a longer breath-holding duration increases the subjective ratings of ones' "high."<ref name="Time Study 2">{{cite journal|author=Block RI, Erwin W, Farinpour R & Braverman K.|title=Sedative, Stimulant, and Other Subjective Effects of Marijuana: Relationships to Smoking Techniques|journal=Pharmacology Biochemistry and Behaviour|year=1997|volume=59(2)|pages=405 &ndash; 412}}</ref> This latter study also found that a long breath-holding duration decreased subjects' subjective ratings of "calmness" more than a short breath-holding duration. Additionally, subjects who held cannabis smoke in their lungs for a long duration felt slightly less "relaxation" while subjects who held the smoke for a short period gave higher "relaxation" ratings.
{{See also|Long-term effects of cannabis#Mental health}}


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>
=== Lethal dose ===


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>
According to the ], 12th edition, the ], the lethal dose for 50% of rats tested by inhalation, is 42 mg/kg of body weight. That is the equivalent of a 165 lb (75 kg) man ingesting all of the ] in 21 one-gram cigarettes of high-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&nbsp;mg/kg and 730&nbsp;mg/kg for males and females, respectively, equivalent to the THC in about a pound of 15% THC cannabis. Only with ] administration may such a level be even theoretically possible.<ref name="Erowid">{{cite web|url=http://www.erowid.org/plants/cannabis/cannabis_chemistry.shtml|title=
Cannabis Chemistry|accessdate=2006-03-20|author=Erowid}}</ref> The ratio of cannabis required to saturate cannaboid receptors to the amount of cannabis required to have a fatal over dose is 1:40,000.


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>
=== Psychiatric Effects ===
Studies have found that the use of cannabis can relieve tics in patients suffering from ] and/or ]. Patients treated with marijuana reported a significant decrease in both motor and vocal tics, some of 50% or more.<ref name="ocd-ts-99">{{cite journal|author=K.R. Muller, U. Schneider, H. Kolbe, H.M. Emrich|title=''Treatment of Tourette's Syndrome With Delta-9-Tetrahydrocannabinol''|journal=American Journal of Psychiatry|year=1999|volume=156|issue=3|url=http://www.marijuana.org/AmJoPsychMarch99.html}}</ref><ref name="ocd-ts-02">{{cite journal|author=K.R. Muller, U. Schneider, A. Koblenz, M. Jöbges, H. Kolbe, T. Daldrup, H.M. Emrich|title=''Treatment of Tourette's Syndrome with Δ9-Tetrahydrocannabinol (THC): A Randomized Crossover Trial''|journal=Pharmacopsychiatry|year=2002|volume=35|issue=2|url=http://www.thieme-connect.com/ejournals/abstract/pharmaco/doi/10.1055/s-2002-25028}}</ref><ref name="ocd-ts-88">{{cite journal|author=R. Sandyk, G. Awerbuch|title=''Marijuana and Tourette's Syndrome''|journal=Journal of Clinical Psychopharmacology|year=1988|volume=8|issue=6|url=http://www.druglibrary.org/schaffer/hemp/medical/mjtouret.htm}}</ref> Some decrease in obsessive-compulsive behavior were also found.<ref name="ocd-ts-99">{{cite journal|author=K.R. Muller, U. Schneider, H. Kolbe, H.M. Emrich|title=''Treatment of Tourette's Syndrome With Delta-9-Tetrahydrocannabinol''|journal=American Journal of Psychiatry|year=1999|volume=156|issue=3|url=http://www.marijuana.org/AmJoPsychMarch99.html}}</ref>


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&nbsp;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>
]


====Physical====
== Health issues and the effects of cannabis ==
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>
{{main|Health issues and the effects of cannabis}}<!-- #######HIATEOC####### -->
{{NPOV-section}}
There has been a variety of studies investigating the health issues related to cannabis use and its long term use, and while some evidence appears strong<ref name="mthkcl">{{Cite web|url=http://www.mth.kcl.ac.uk/~streater/cannabis.html|title=The Dangers of Cannabis|accessdate=2006-12-04|year=2003|author=Professor Ray Streater|format=html}}</ref>, other studies have produced results that are far more controversial or are unverified.


] (CHS) is a severe condition seen in some chronic cannabis users where they have repeated bouts of uncontrollable vomiting for 24–48 hours.
The most obvious confounding factor in cannabis research is the very prevalent usage of other recreational drugs, including ] and ]. Such complications imply that cannabis studies must have stronger controls and investigations into the symptoms of cannabis that may also be caused by tobacco, for example, cannot be demonstrated. In addition, research using cannabis is heavily restricted in many countries, reducing the studies funded or approved. More controversial results that have been published in cannabis studies include one that suggests that cannabis may be less likely to cause ] or cancer than tobacco;<ref name="Tobacco">{{cite news|url=http://www.mapinc.org/drugnews/v05/n1106/a09.html?275821|title=Marijuana Smoking Does Not Cause Lung Cancer|org=Anderson Valley Advertiser|author=Fred Gardner|date=]}}</ref><ref>{{cite journal | title=Heavy habitual marijuana smoking does not cause an accelerated decline in FEV1 with age | author=D.P. Tashkin et al. | journal=Am. J. Respir. Crit. Care Med. | volume= 155 |issue= 1 | date= Jan 1997 | pages=141-148 | url=http://ajrccm.atsjournals.org/cgi/gca?SEARCHID=1127855512481_8334&AUTHOR1=Tashkin%252C%2BD&FULLTEXT=Marijuana&JOURNALCODE=&FIRSTINDEX=0&hits=10&RESULTFORMAT=&gca=155%2F1%2F141&sendit=Get+All+Checked+Abstract%28s%29}}</ref><ref name="UCLA study">{{cite news|url=http://www.washingtonpost.com/wp-dyn/content/article/2006/05/25/AR2006052501729_pf.html|title=Study finds no marijuana-lung cancer link|publisher=]|date=]|accessdate=2006-07-13}}</ref><!-- #######need better citation from HIATEOC####### --> other studies have suggested that cannabis may be less likely to cause birth defects or developmental delays in the children of users.<ref name="BirthDefects">{{cite journal|author=J.S. Hayes, R. Lampart, M.C. Dreher, L. Morgan|title=''Five-year follow-up of rural Jamaican children whose mothers used marijuana during pregnancy''|journal=West Indian Medical Journal|year=1991|volume=40|issue=3|pages=120-3}}</ref><ref name="BirthDefects2">{{cite journal|author=M.C. Dreher, K. Nugent, R. Hudgins|title=''Prenatal Marijuana Exposure and Neonatal Outcomes in Jamaica: An Ethnographic Study''|journal=Pediatrics|year=1994|volume=93|issue=3|pages=254-260}}</ref> According to a United Kingdom government report, using cannabis is less dangerous than both tobacco and alcohol in social harms, physical harm and addiction.<ref name="UK government report">{{cite news|url=http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/31_07_06_drugsreport.pdf|title=UK government report|publisher=House of Commons Science and Technology Committee|date=]|accessdate=2006-08-29}}]</ref>
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>
Research between the use of cannabis and mental illness has also brought significant results. Cannabis use has generally higher among sufferers of schizophrenia, but the causality between the two has not been established.<ref name="Causality">{{cite journal|author=Cécile Henquet, Lydia Krabbendam, Janneke Spauwen, Charles Kaplan, Roselind Lieb, Hans-Ulrich Wittchen and Jim van Os|title=''Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people''|journal=British Medical Journal|year=2004|volume=330|issue=11}}</ref><ref name ="Causality2">{{cite journal|author=G C Patton, Carolyn Coffey, J B Carlin, Louisa Degenhardt, Micheal Lynskey and Wayne Hall|title=''Cannabis use and mental health in young people: cohort study''|journal=British Medical Journal|year=2005|volume=325|issue=1195}}</ref> Another study concluded that sustained early-adolescent cannabis use among genetically predisposed individuals has been associated with a variety of mental illness outcomes; ranging from ] episodes to clinical ].<ref name="Dunedin">{{cite journal|author=Louise Arseneault, Mary Cannon, Richie Poulton, Robin Murray, Avshalom Caspi, Terrie E Moffitt|title=Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study|journal=British Medical Journal|year=2002|url=http://bmj.bmjjournals.com/cgi/reprint/325/7374/1212.pdf}}</ref><ref name="Dunedin2">{{cite journal|author=Avshalom Caspi, Terrie E. Moffitt, Mary Cannon, Joseph McClay, Robin Murray, HonaLee Harrington, Alan Taylor, Louise Arseneault, Ben Williams, Antony Braithwaite, Richie Poulton, and Ian W. Craig|title=''Moderation of the Effect of Adolescent-Onset Cannabis Use on Adult Psychosis by a Functional Polymorphism in the catechol-O-Methyltransferase Gene:Longitudinal Evidence of a Gene X Environment Interaction''|journal=Society of Biological Psychiatry|year=January 2005|url=http://www.ukcia.org/research/COMTgene.pdf}}</ref>


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>
== Legality ==
] possession (small amount). Data is from multiple sources detailed on the ]. This map is a work in progress, please give corrections and additions ].]]
{{main|Legal issues of cannabis}}
Since the 20th century, most countries have enacted laws against the cultivation, use, possession, or transfer of cannabis for recreational use. Naturally, these laws impact adversely on the cannabis plant's cultivation for non-recreational purposes, but there are many regions where, under certain circumstances, handling of cannabis is 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 ] 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 cannabis, since buying or growing cannabis is still illegal. Increasingly, many jurisdictions also permit cannabis use for medicinal purposes. Some countries allow the sale through drug companies.{{fact}} However, simple possession can carry long jail sentences in some countries, particularly in ], where the sale of cannabis may lead to a sentence of life in prison or even execution.
] used in the late 1930s and 1940s.]]


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>
=== Recent history ===
Under the name ''cannabis'', 19th century medical practitioners sold the drug, (usually as a ]) popularizing the word amongst English-speakers. It was rumoured to have been used to treat ]'s ] pains as her personal physician, Sir John Russell Reynolds, was a staunch supporter of the benefits of cannabis.<ref name="Reynolds">{{cite web|url=http://jnnp.bmjjournals.com/cgi/content/full/75/8/1148|title=Positive and negative cerebral symptoms: the roles of Russell Reynolds and Hughlings Jackson|accessdate=2006-03-25}}</ref> Cannabis was also openly available from shops in the US. By the end of the 19th century, its medicinal use began to fall as other drugs like ] took over its use as a pain reliever.


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/>
In 1894, the ''Report of the Indian Hemp Drugs Commission'' commissioned by the UK Secretary of State and the government of India, was instrumental in the decision not to criminalize the drug in those countries. The ''Report'', which at over 500 pages remains one of the most complete collections of information on cannabis in existence, shows the stark contrast in the way that the American and British governments went about deciding whether to criminalize cannabis.<ref>Kaplan, J. (1969) "Introduction" of the ''Report of the Indian Hemp Drugs Commission'' ed. by The Honorable W. Mackworth Young, ''et al.'' (Simla: Government Central Printing Office, 1894) LCCN 74-84211, pp. v-vi.</ref>


=====Emergency department visits=====
The name ''marijuana'' (] ''marihuana'', ''mariguana'') is associated almost exclusively with the plant's psychoactive use. The term is now well known in English largely due to the efforts of American drug prohibitionists during the 1920s and 1930s, which deliberately used a ] name for cannabis in order to turn the populace against the idea that it should be legal. (''See ]'')
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>


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>
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 a prominent and life-long devotee. It was popular in the blues scene as well, and eventually became a prominent part of 1960s counterculture.


====Reproductive health====
=== Decriminalization and legalization ===
{{excerpt|Cannabis in pregnancy|paragraph=1}}
{{main|Legal issues of cannabis}}
] laws; red represents states with ] laws; purple represents states with both.]]
], ], on ], ].]]


==Pharmacology==
In recent decades, a movement to ] cannabis has arisen in several countries.{{fact}} This movement seeks to make simple possession of cannabis punishable by only confiscation or a fine, rather than prison. In the past several years, the movement has started to have some successes. These include ] legalizing possession of up to an ounce of cannabis,<ref name="Denver">{{cite news|url=http://www.usatoday.com/news/nation/2005-11-03-pot_x.htm|title=Denver votes to legalize marijuana possession|author=Patrick O'Driscoll|publisher=USA Today|date=]|accessdate=2006-03-11}}</ref> a broad coalition of ] in ], ] unveiling a pilot program to allow farmers to legally grow it,<ref name="NLfarming">{{cite web|url=http://www.twincities.com/mld/twincities/news/breaking_news/13313479.htm|title=Dutch Politicians Seek Marijuana Rules|accessdate=2006-02-25}}</ref> and ] voting in favor of a bill to decriminalize the possession of up to an ounce of cannabis.<ref name="Mass">{{cite web|url=http://www.heraldnews.com/site/news.cfm?newsid=16135095|title=Marijuana fight nears|accessdate=2006-02-17}}</ref>


===Mechanism of action===
In Alaska, cannabis was decided legal for in-home, personal use under the Ravin vs. State ruling in 1975. This ruling allowed up to four ounces of cannabis for these purposes. In response to former Governor Frank Murkowski's successive attempt to re-criminalize cannabis, the ] filed a lawsuit against the state. On July 17, 2006, Superior Court Judge Patricia Collins awarded the Case Summary judgement to the ACLU. In her ruling, she said "No specific argument has been advanced in this case that possession of more than 1 ounce of cannabis, even within the privacy of the home, is constitutionally protected conduct under Ravin or that any plaintiff or ACLU of Alaska member actually possesses more than 1 ounce of cannabis in their homes." This does not mean that the legal possession threshold has been reduced to one ounce, as this was a mere case summary review filed by the ACLU, not a full case. Reinforcing ''Ravin'', Collins wrote "A lower court cannot reverse the State Supreme Court's 1975 decision in Ravin v. State" and "Unless and until the Supreme Court directs otherwise, ''Ravin'' is the law in this state and this court is duty bound to follow that law". The law regarding possession of cannabis has not changed in Alaska, and the Supreme Court has declined to review the case, therefore the law still stands at 4 ounces.{{fact}}
{{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>
In 2002, Nevada voters defeated a ballot question which would legalize up to 3 ounces for adults 21 and older by 39% to 61%. In 2006, a similar Nevada ballot initiative, which would have legalized and regulated the cultivation, distribution, and possession of up to 1 ounce of marijuana by adults 21 and older, was defeated by 44% to 56%.
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.


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>
In 2001 in the United Kingdom, it was announced that cannabis would become a Class C drug, rather than a Class B, this change took effect on January 29th, 2004. Since then there has recently been some controversy amongst UK politicians about the message this sends out, with some calling for its reclassification to Class B.<ref name="Blunkett">{{cite web|url=http://www.idmu.co.uk/homeoffpr.htm|title=Home Office- Class B to Class C|accessdate=2006-03-27}}</ref>


===Pharmacokinetics===
The ] voted to legalize the possession of cannabis under 5 grams on ], ].<ref name="mexicolegal"> {{cite news|first=Noel|last=Randewich|Author=Noel Randewich|url=http://news.yahoo.com/s/nm/20060428/ts_nm/mexico_drugs_dc|title=Mexico to decriminalize pot, cocaine and heroin|publisher=]|date=]|accessdate=2006-04-28}}</ref> However, as of ], ], Mexican President
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>
] has said that he will not sign this proposed law until Congress removes the parts that would decriminalize the possession of small quantities of drugs<ref name="mexicoillegal">{{cite news|url=http://news.yahoo.com/s/nm/20060504/ts_nm/mexico_drugs_dc_3|title=Mexico's Fox won't sign drug law|publisher=]|date=]|accessdate=2006-05-04}}</ref> and vetoed the bill on ], ],<ref name="veto">{{cite news|url=http://www.signonsandiego.com/news/mexico/20060504-9999-1n4fox.html|title=Mexican legal drug proposal rejected|publisher=Sign On San Diego|date=]|accessdate=2006-05-13}}</ref> sparking broad controversy over the bill.<ref name="deniespressure">{{cite news|url=http://www.dominicantoday.com/app/article.aspx?id=13096|title=Mexico denies drug law veto result of US pressure|publisher=Dominican Today|date=]|accessdate=2006-05-13}}</ref><ref name="consulateprotest">{{cite news|url=http://www.scoop.co.nz/stories/HL0605/S00095.htm|title=Protest at Mexican Consulate in New York, Friday|publisher=Scoop|date=]|accessdate=2006-05-13}}</ref><ref name="smokein">{{cite news|url=http://www.foxnews.com/story/0,2933,194552,00.html|title=Drug Bill Veto Sparks Mexico City Marijuana Smoke-In|publisher=]|date=]|accessdate=2006-05-13}}</ref> In the early summer of 2006 Fox and the Mexican congress came to an agreement and legalized possession of small amounts (and also measured amounts of other drugs). On July 17th, 2006, ] Social Solidarity Minister ], speaking of the urgent need for depenalising the consumption of light drugs, said that "a joint is less harmful than a litre of ]."<ref name=Paolo>{{cite news|url=http://www.agi.it/english/news.pl?doc=200607171332-1085-RT1-CRO-0-NF82&page=0&id=agionline-eng.italyonline|accessdat2--6-07-26|title=DRUG: FERRERO DECRIMINALIZE CONSUMPTION OF LIGHT DRUGS|date=]|publisher=Agenzia Giornalistica Italia}}</ref> In ] and the ], two plants both less than 6 feet tall are allowed for personal use.{{fact}}


==Chemistry==
=== Legality in the United States ===
{{main|Legality of cannabis in the United States}}
{{seealso|Cannabis rescheduling in the United States}}


===Chemical composition===
The United States federal government has illegalized the sale, transport, and possession of cannabis since 1937. Federal law in the United States preempts conflicting state and local laws. Nevertheless, some states and local governments have established laws attempting to decriminalize cannabis. Other state and local governments ask law enforcement agencies to limit enforcement of drug laws with respect to cannabis.
{{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" />
==See Also==
*]
*]


===Detection in body fluids===
== References ==
{{Main|Cannabis drug testing}}
=== Notes ===


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" />
<div class="references-small">
<references/>
</div>


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>
=== Bibliography ===


==Varieties and strains==
* {{cite news|url=http://select.nytimes.com/gst/abstract.html?res=F10E1FFB35580C748EDDA90994DA404482|author=Howard Markel|title=For Addicts, Relief May Be an Office Visit Away|publisher=New York Times|date=]}}
]
* {{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 &ndash; 1213}}
]
* {{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 &ndash; 1127}}
* {{cite news|url=http://www.timesonline.co.uk/article/0,,3561-1565337,00.html|title=One in four at risk of cannabis psychosis|first=Mark|last=Henderson|publisher=The Times|date=]}}
* Bruce Mirken and Neel Makwana (Aston Birmingham): {{cite news|url=http://www.alternet.org/drugreporter/21436/|date=]|title=Psychosis, Hype And Baloney|publisher=AlterNet}}
* {{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}}
* ''Cannabis: A History'' (2005). Martin Booth - ISBN 0-312-32220-8


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}}


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>
<!-- currently unused, need to merge back into the article


===Psychoactive ingredients===
== History ==
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====
{{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&nbsp;– 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&nbsp;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&nbsp;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&nbsp;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'''
Cannabis was known as a medicinal and psychoactive compound in some early societies, and has been used continuously in many parts of the world. Other societies have developed a social ] surrounding the drug. <!-- repression in various Islamic centuries (11th, 13th, and others), early modern (ex-Ottoman) Greece, Egypt under Mehemet Ali (19th century), need sections -->
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== External links ==
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] {{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
Cannabis in the drying phase
Pronunciation
Source plant(s)Cannabis sativa, Cannabis indica, Cannabis ruderalis
Part(s) of plantFlower and fruit
Geographic originCentral or South Asia
Active ingredientsTetrahydrocannabinol, cannabidiol, cannabinol, tetrahydrocannabivarin
Main producersAfghanistan, Canada, China, Colombia, India, Jamaica, Lebanon, Mexico, Morocco, Netherlands, Pakistan, Paraguay, Spain, Thailand, Turkey, United Kingdom, United States
Legal status
Part of a series on
Cannabis
Cannabis
Chemistry
  • Semi-synthetic cannabinoids
Pharmacology
Consumption
Economics
Effects
Forms
Law
Variants
  • Genus
  • Species
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 cannabis

Cannabis 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 cannabis
Example of a container and the recreational cannabis purchase in Canada

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., 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 cannabis

Cannabis 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 consumption

Modes of consumption

A joint prior to rolling, with a paper handmade filter on the left

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 country
Global estimates of drug users in 2016
(in millions of users)
Substance 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 cannabis

Short-term

Main short-term physical effects of cannabis

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 cannabis
Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Cannabis was ranked 11th in dependence, 17th in physical harm, and 10th in social harm.

Psychological 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 dependence

About 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 health

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).

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 brain

THC 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. sativa

The 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 testing

THC 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

Types of cannabis
A macro cannabis bud

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) buds

Hemp 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) Dried flower buds (marijuana)
  • A gram of kief A gram of kief
  • Hashish Hashish
  • Hash oil Hash oil
  • Infusion (dairy butter) 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: Kief

Kief 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: Hashish
Legal hashish shop in Kathmandu, Nepal in 1973
Legal hashish shop in Kathmandu, Nepal in 1973

Hashish (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 cannabis

Cannabinoids 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 oil

Hash 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 prensada

Marihuana 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 drugs

Ancient history

Present-day map of the Jirzankal Cemetery, site of the earliest evidence of cannabis smoking

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 sativa from Vienna Dioscurides, c. 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 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.

Anti-cannabis propaganda from 1935

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.

Cannabis indica fluid extract, American Druggists Syndicate (pre-1937)

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)
Process of making bhang in a village in Punjab, India. On the Indian festival of colors, Holi, it is a customary addition to some intoxicating drinks.

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 liberalization
Map of world cannabis laws
Legal status of cannabis possession for non-medical use
  Legal   Illegal but decriminalized   Illegal but often unenforced   Illegal
See also countries that have legalized medical use of cannabis.

Since 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.

President Biden discussess rescheduling of cannabis.

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 testing
Woman selling cannabis and bhang in Guwahati, Assam, India

Sinsemilla (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 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. 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 research

Research 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

References

Footnotes

  1. Pure varieties of C. ruderalis are rarely used for recreational purposes.
  2. 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.
  3. 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.
  4. 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."

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