Cannabis and Cannabinoid Use Disorders
Pp. 109-120 (12)
Subhash C. Bhatia, Shashi K. Bhatia, Venkata Kolli and Jayakrishna Madabushi
Cannabis or marijuana also called pot, grass, weed, herb etc. is derived from
flowers, leaves, stem or seeds of cannabis sativa plant. It is consumed by smoking or
mixing it with foods and beverages. Hashish is a resinous material made from cannabis
plant . Cannabis and illicit synthetic THC compounds like “spice” K2” have similar
psychoactive effects which are mediated through binding with cannabinoid receptor
CB1. Whereas binding with CB2 receptors impacts immunity. Anandamides are the
endogenous ligands for these receptors. THC is lipophilic and is deposited in fatty
tissue and can be detected in the urine in chronic cannabis users for up to 30 days. THC
synthetic compounds, Dronabinol (Marinol) and Nabilone (Cesamet) are approved for
medicinal use in oncology, ophthalmology and AIDS. CB1 receptors binding in
hippocampus causes short-term memory problems whereas binding in nucleus
accumbens causes euphoria. Psychiatric disorders are mood and anxiety disorders.
Psychosis is also reported. Genetic factors, as evidenced by twin studies, contribute
from 30 to 80% variance to this risk. There are no pharmacological treatments
approved for cannabis withdrawal. Short-term symptomatic treatment with nonbenzodiazepine
anxiolytics, antidepressants, or hypnotics may be considered.
Cognitive-behavioral, motivational enhancement and family therapy, contingency
management and self-help groups are valuable psychosocial treatment options.
Anadamides, Cannabinoid receptors CB1 and CB2, Cannabis, Grass,
Hashish, Hemp, Herb, Herbal Incense, K2, Marijuana, Pot, Spice, Synthetic
Cannabinoids, THC, Weed.
Department of Psychiatry, Mental Health and Behavioral Sciences, Creighton University; Department VA Nebraska- Western Iowa Health Care System 4101 Woolworth Ave Omaha, NE 68105, USA.