Concomitantly, there has been a reduction in CBD content so the natural RISK FACTORS FOR CANNABIS USE AND MENTAL HEALTH. CBD also has the effect of reducing the undesirable effects of high-THC cannabis , such as anxiety and paranoia, which allows a patient to. beautiful green cannabis cbd hemp leaf close up shot with water droplets in with roots in the Mexican Revolution and the Great Depression.
CBD mental primer a and health: Cannabis,
When looking at the effects of cannabis we need to be cognizant that different routes of cannabinoid administration have different effects. Inhaled THC enters capillaries in the lungs, passes into general circulation through the pulmonary arteries and goes directly to the brain without passing through the liver. The cannabinoids then cross the blood-brain barrier to affect the endocannabinoid receptors.
In addition, when cannabis is burned new compounds are created not found in the raw or dried plant. The respiratory route of administration allows THC and other constituents of the plant to go directly to the brain without going through the liver.
THC metabolites contribute significantly to the effects of cannabis consumption. It induces a high more potently than THC itself.
When ingested orally, however, THC and other cannabinoids and terpenes are absorbed from the small intestine over several hours. Like any oral medication, it will take about minutes before enough of the plant constituents are in the bloodstream to exert a therapeutic effect. All plants are chemically complex, containing hundreds of different molecules.
A tomato has about different molecules. Of these compounds, are cannabinoids and over are terpenes. Many of these chemicals have therapeutic value. The ECS is the largest neurotransmitter system in the brain. It can be affected by both exogenous from outside the body and endogenous from inside the body cannabinoids that exert their many pharmacological effects.
There are at least two types of cannabinoid receptors in mammalian tissues, dubbed CB1 and CB2 receptors.
CB1 receptors are not only in the brain and spinal cord but in peripheral tissues as well. CB2 receptors are found primarily in immune tissues. It is quite likely that in the near future, research will identify more components of the ECS. He focused on a young child who had intractable seizures. Several years earlier, Dr. Mechoulam described an experiment by Paul F. Consroe and colleagues in Brazil where CBD was tested as a treatment for intractable epilepsy.
The subjects were followed over the course of several months. Mechoulam noted that of the seven patients getting CBD; three became seizure-free; one experienced only one or two seizures; and two experienced reduced severity and occurrence of seizures.
Only one showed no improvement. CBD is one of the reasons that cannabis has been known for centuries as an anti-seizure medicine. Now in the second decade of the twenty-first century, there is increased public interest in this therapeutic property of cannabis. As a side note, earlier this year Brazil approved the use of CBD to treat epilepsy.
Prescribing is restricted to psychiatrists and neurologists. Cannabinoids help preserve brain matter in stroke and traumatic brain injury. Studies have shown that cannabidiol CBD at a concentration of 10 uM, was neuroprotective against both excitatory transmitter glutamate and oxidant hydroperoxide induced neurotoxicity. Mechoulam developed a synthetic cannabinoid, dextranabinol, that has been shown in basic science studies to help limit brain tissue death from decreased tissue oxygenation.
This can be caused by stroke, traumatic brain injury TBI , or being placed on a heart-lung machine during cardiac bypass surgery. Mechoulam has characterized post-traumatic stress disorder, certain phobias and forms of chronic pain as human situations which are conditioned and might be amenable to treatment with CBD. Cannabis has been shown in both tissue culture and mice to be effective at inhibiting the growth of many cancers.
However, some people experience panic when they use cannabis, probably related to the profound tachycardia which invariably accompanies intoxication. In terms of affective, there is evidence of an association between depression and cannabis consumption, but as detailed above, much of this association is confounded by other factors and reverse causality is also at play. Early reports of cannabis being useful as an antidepressant have not been supported in scientific studies.
There is very little literature on cannabis and bipolar disorder, despite many people with bipolar using it, again mostly for non-specific effects such as assistance with sleep.
Some people with bipolar disorder manifest psychotic relapses upon exposure to cannabis, but the delineation of which individuals are likely to experience this is difficult. A general approach to cannabis use amongst people with bipolar is to counsel against it but to try to understand individual reasons for use and tailor prescribed medications to deal with those features e.
This putative syndrome, as articulated by Schwartz includes the following parameters :. The veracity of this syndrome as a clinical entity has been contested, and a number of confounding factors need to be considered. A key question is whether cessation of cannabis results in restitution of premorbid functioning and it seems that the answer is largely in the affirmative.
Acute and chronic cannabis use comes with neuropsychological and cognitive performance issues that may even persist after discontinuing usage. Although if the period of abstinence is long enough then most neurocognitive functions should return to normal levels with no clinically significant deficits remaining. It has generally been thought that once the cannabinoids are cleared from the aliphatic brain cells and this can take up to a month in chronic heavy users , the individual will exhibit few —if any — enduring sequelae.
A recent systematic review and meta-analysis of cannabis-using individuals mean age This is in contrast to other drugs of abuse, including alcohol and methamphetamines. However, as described above, the use of cannabis at crucial stages of cognitive development is likely to impact learning. This is particularly important when considering the consequences of diminished learning capacity in younger users and its negative effect on maturation and neurological development at this critical time.
In psychiatry, of most interest are THC, which is psychotomimetic, and CBD, which seems to have some antipsychotic properties. Cannabis use has been associated with mood and psychotic disorders but understanding causal pathways is difficult, and many early studies used plant product which is highly variable in terms of its constituent chemicals. What is clear is that THC can exacerbate psychosis is people with an underlying predisposition and such individuals need to explicitly counselled in this regard: Cognitive effects of cannabis are usually short-lived, but heavy accumulative use can result in impaired cognition across a number of domains and is especially worrying during adolescence as the brain is still developing and the bedrocks of learning are being laid down.
Degenhardt L et al. Results from the GBD Study. Arendt M et al. Arndt S et al. The Role of Premorbid Adjustment. Zammit S et al. Posted on September 25, Time to read: THC and synthetic cannabinoids are exogenous cannabinoids.
THC acts via the cannabinoid receptor CB1 , which is found diffusely throughout the brain and spinal cord but also in the periphery throughout the body. The other cannabinoid of particular interest to psychiatry is cannabidiol CBD , which appears to have antipsychotic properties: Other known risk factors that increase the risk of mental health disorders with cannabis are: Smoking Prior mental health issues School difficulties Low socioeconomic status Negative family atmosphere For those who start at the age of years old these risk factors are not as strongly associated with mental health disorder as those aged years old.
So, what is the relationship between cannabis use and psychotic disorders? Self-medication and Affect Regulation Hypothesis Cannabis use is often used as a coping mechanism to relieve or reduce negative psychotic symptoms.
Most cannabis users with schizophrenia acknowledge it exacerbates the positive symptoms of psychosis . Co-occurrence Cannabis users with schizophrenia tend to have a lower negative symptom burden than those who have never used, and this has been suggested to increase the risk of exposure to other substance abuses. Neurobiological As outlined above, schizophrenia and cannabis use share some aetiological factors. This is supported by observations of cannabis use being shown to alter the onset, course, and relapse rates in schizophrenia.
Risk factor The Diathesis-Stress hypothesis suggests that cannabis use can accelerate and aggravate schizophrenia in vulnerable populations. As outlined above, although causality is difficult to establish, in heavy users and early age users who have latent psychotic problems, there is a probable relationship between cannabis use and psychosis in these vulnerable individuals.
This is a crucial clinical point as people with a psychotic predisposition through having a family history of psychosis or having a psychotic disorder such as schizophrenia should be warned very emphatically that cannabis is likely to cause an exacerbation of symptoms and contribute to relapse and hospitalisation.
Contributor Cannabis use itself has previously been suggested to increase the risk of developing a psychotic disorder. In comparison to non-users, the adjusted probability ratio of developing schizophrenia was shown to be 6. Also, there is the simple fact that, while rates of cannabis use show large variation across the world, the rates of schizophrenia are fairly uniform at a country-by-country level, speaking to there being no major effect at a population level.
Many cannabis users say they like it because it makes them feel calm and assists sleep. This putative syndrome, as articulated by Schwartz includes the following parameters : Loss of interest in things in general, with associated apathy and passivity Loss of desire to work, and loss of concern with work performance, resulting in loss of productivity Loss of energy and easy fatigability Moodiness and irritability Impaired concentration Lack of concern for personal appearance and hygiene A lifestyle that prioritises cannabis procurement and consumption.
Anhedonia Amotivational syndrome could be a subclinical symptom of anhedonia that is associated with cannabis use. Depressive disorder Amotivational syndrome could instead be related to the underlying presence of depression.
Cannabis intoxication The characteristics of amotivational syndrome could be a natural biological consequence of cannabis use. Personality issues Or, the symptoms of the amotivational syndrome are instead related to dysfunctional personality traits that are revealed with cannabis use in a population subset. What parts of cognition are directly affected by cannabis use? This has been suggested to cause cognitive functioning deficits in working memory that then has a disruptive effect on attention processes.
Short-term memory When performing neuropsychological tasks, cannabis users showed an increase in forgetfulness and a remarkable impairment in learning ability. These data show that cannabis use has an acute and significant effect on short-term memory.
Processing speed In one study it showed that heavy cannabis use was associated with deficits in information processing speed abilities. This impairment in processing speed was also evident for several weeks after cessation of use. Estimation of time One of the most interesting cognitive functioning impairments that are specifically associated with long-term cannabis use is time estimation. This impairment has been shown to worsen with the number of years of regular cannabis use and can endure well beyond the cessation of use.
Executive functions Deficits in executive functioning and cognitive control of behaviour have been shown to persist in tests carried out on day abstinent heavy cannabis users. Moreover, weeks of abstinence may still be associated with continued worsening of executive function abilities in some individuals. Motor control In a randomised controlled trial, psychomotor control deficits were observed in a linear dose-response relationship with increasing THC content.
However, these motor impairments were not observed in every subject, which could be due to tolerance and blunting of the pharmacological effects normally observed on motor skills with cannabis use. Cannabinoid receptors and the endocannabinoid system: International journal of molecular sciences , 19 3 , Cannabinoid Receptors and Signal. Gone to pot—a review of the association between cannabis and psychosis Radhakrishnan, R.
Gone to pot—a review of the association between cannabis and psychosis.
In the unprocessed form, Δ9-THC and CBD concentrations depend on the species, The cannabis trials for acute anxiety, schizophrenia, and. Patients without mental health or substance abuse problems, who use Many new products contain varied ratios of THC and CBD in order to create Contemporary Routes of Cannabis Consumption: A Primer for Clinicians. A primer to medicinal cannabis medicinal cannabis (the cannabinoids THC and CBD) has vomiting and appetite stimulation; epilepsy; and anxiety.