Marijuana

 
Marijuana  refers  to  the  dried  leaves,  
flowers,  stems,  and  seeds  from  the  hemp  
plant  Cannabis  sativa,  which  contains  the  
psychoactive  (mind-­‐altering)  chemical  
delta-­‐9-­‐tetrahydrocannabinol  (THC),  as  
well  as  other  related  compounds.  This  
plant  material  can  also  be  concentrated  
in  a  resin  called  hashish  or  a  sticky  black  
liquid  called  hash  oil.    

Marijuana  is  the  most  common  illicit  

drug  used  in  the  United  States.  After  a   THC's  chemical  structure  is  similar  to  the  brain  c hemical  anan-­‐
period  of  decline  in  the  last  decade,  its   damide.  Similarity  in  structure  allows  drugs  to  be  recognized  by  
the  body  and  to  alter  normal  brain  communication.  
use  has  been  increasing  among  young  
people  since  2007,  corresponding  to  a   marijuana  and  tobacco.  Marijuana  smoke  
diminishing  perception  of  the  drug’s   has  a  pungent  and  distinctive,  usually  
risks  that  may  be  associated  with  in-­‐ sweet-­‐and-­‐sour,  odor.  Marijuana  can  al-­‐
creased  public  debate  over  the  drug’s  le-­‐ so  be  mixed  in  food  or  brewed  as  a  tea.    
gal  status.  Although  the  federal  govern-­‐
ment  considers  marijuana  a  Schedule  I   How  Does  Marijuana  Affect  the  Brain?  
substance  (having  no  medicinal  uses  and  
high  risk  for  abuse),  two  states  have  le-­‐ When  marijuana  is  smoked,  THC  rapidly  
galized  marijuana  for  adult  recreational   passes  from  the  lungs  into  the  blood-­‐
use,  and  21  states  have  passed  laws  alo stream,  which  carries  the  chemical  to  the  
lowing  its  use  as  a  treatment  for  certain   brain  and  other  organs  throughout  the  
medical  conditions  (see  “Is  Marijuana   body.  It  is  absorbed  more  slowly  when  
Medicine?”,  below).       ingested  in  food  or  drink.    
How  Is  Marijuana  Used?   However  it  is  ingested,  THC  acts  on  spe-­‐
cific  molecular  targets  on  brain  cells,  
Marijuana  is  usually  smoked  in  hand-­‐ called  cannabinoid  receptors.  These  re-­‐
rolled  cigarettes  (joints)  or  in  pipes  or   ceptors  are  ordinarily  activated  by  chem-­‐
water  pipes  (bongs).  It  is  also  smoked  in   icals  similar  to  THC  that  naturally  occur  
blunts—cigars  that  have  been  emptied  of   in  the  body  (such  as  anandamide;  see  
tobacco  and  refilled  with  a  mixture  of   picture,  above)  and  are  part  of  a  neural  
Marijuana • January 2014 • Page 1
communication  network  called  the  endo-­‐ ness,  and  a  heightened  risk  of  lung  infec-­‐
cannabinoid  system.  This  system  plays   tions.  One  study  found  that  people  who  
an  important  role  in  normal  brain  devel-­‐ smoke  marijuana  frequently  but  do  not  
opment  and  function.   smoke  tobacco  have  more  health  prob-­‐
  lems  and  miss  more  days  of  work  than  
The  highest  density  of  cannabinoid  re-­‐ those  who  don’t  smoke  marijuana,  main-­‐
ceptors  is  found  in  parts  of  the  brain  that   ly  because  of  respiratory  illnesses.  It  is  
influence  pleasure,  memory,  thinking,   not  yet  known  whether  marijuana  smok-­‐
concentration,  sensory  and  time  percep-­‐ ing  contributes  to  risk  for  lung  cancer.  
tion,  and  coordinated  movement.  Mari-­‐  
juana  overactivates  the  endocannabinoid   Marijuana  also  raises  heart  rate  by  20-­‐
system,  causing  the  “high”  and  other  ef-­‐ 100  percent  shortly  after  smoking;  this  
fects  that  users  experience.  These  effects  
include  altered  perceptions  and  mood,   Is  Marijuana  Medicine?  
impaired  coordination,  difficulty  with  
 
thinking  and  problem  solving,  and  dis-­‐
Many  have  called  for  the  legalization  
rupted  learning  and  memory.    
of  marijuana  to  treat  conditions  in-­‐
 
Marijuana  also  affects  brain  develop-­‐ cluding  pain  and  nausea  caused  by  
ment,  and  when  it  is  used  heavily  by   HIV/AIDS,  cancer,  and  other  condi-­‐
young  people,  its  effects  on  thinking  and   tions,  but  clinical  evidence  has  not  
memory  may  last  a  long  time  or  even  be   shown  that  the  therapeutic  benefits  of  
permanent.  A  recent  study  of  marijuana   the  marijuana  plant  outweigh  its  
users  who  began  using  in  adolescence   health  risks.  To  be  considered  a  legiti-­‐
revealed  substantially reduced  connectivi-­‐ mate  medicine  by  the  FDA,  a  sub-­‐
ty among brain areas responsible for learn- stance  must  have  well-­‐defined  and  
ing and memory.  And  a  large  long-­‐term   measureable  ingredients  that  are  con-­‐
study  in  New  Zealand  showed  that  peo-­‐ sistent  from  one  unit  (such  as  a  pill  or  
ple  who  began  smoking  marijuana  heavi-­‐ injection)  to  the  next.  As  the  marijua-­‐
ly  in  their  teens  lost  an  average  of  8   na  plant  contains  hundreds  of  chemi-­‐
points  in  IQ  between  age  13  and  age  38.   cal  compounds  that  may  have  differ-­‐
Importantly,  the  lost  cognitive  abilities   ent  effects  and  that  vary  from  plant  to  
were  not  fully  restored  in  those  who  quit   plant,  and  because  the  plant  is  typical-­‐
smoking  marijuana  as  adults.  Those  who   ly  ingested  via  smoking,  its  use  as  a  
started  smoking  marijuana  in  adulthood   medicine  is  difficult  to  evaluate.  
did  not  show  significant  IQ  declines.      
  However,  THC-­‐based  drugs  to  treat  
What  Are  the  Other  Health  Effects  of   pain  and  nausea  are  already  FDA  ap-­‐
Marijuana?   proved  and  prescribed,  and  scientists  
 
continue  to  investigate  the  medicinal  
Marijuana  use  may  have  a  wide  range  of  
properties  of  other  chemicals  found  in  
effects,  particularly  on  cardiopulmonary  
the  cannabis  plant—such  as  canna-­‐
and  mental  health.  
bidiol,  a  non-­‐psychoactive  cannabinoid  
 
Marijuana  smoke  is  an  irritant  to  the   compound  that  is  being  studied  for  its  
lungs,  and  frequent  marijuana  smokers   effects  at  treating  pain,  pediatric  epi-­‐
can  have  many  of  the  same  respiratory   lepsy,  and  other  disorders.  For  more  
problems  experienced  by  tobacco  smok-­‐ information,  see  
ers,  such  as  daily  cough  and  phlegm  pro-­‐ http://www.drugabuse.gov/publicatio
duction,  more  frequent  acute  chest  ill-­‐ ns/drugfacts/marijuana-­‐medicine    
 
Marijuana • January 2014 • Page 2
 effect  can  last  up  to  3  hours.  In  one  
study,  it  was  estimated  that  marijuana   Rising  Potency  
users  have  a  4.8-­‐fold  increase  in  the  risk    
of  heart  attack  in  the  first  hour  after   The  amount  of  THC  in  marijuana  
smoking  the  drug.  This  risk  may  be   samples  confiscated  by  police  has  
greater  in  older  individuals  or  in  those   been  increasing  steadily  over  the  
with  cardiac  vulnerabilities.   past  few  decades.  In  2012,  THC  con-­‐
  centrations  in  marijuana  averaged  
A  number  of  studies  have  linked  chronic   close  to  15  percent,  compared  to  
marijuana  use  and  mental  illness.  High   around  4  percent  in  the  1980s.  For  a  
doses  of  marijuana  can  produce  a  tem-­‐ new  user,  this  may  mean  exposure  to  
porary  psychotic  reaction  (involving  hal-­‐ higher  concentrations  of  THC,  with  a  
lucinations  and  paranoia)  in  some  users,   greater  chance  of  an  adverse  or  un-­‐
and  using  marijuana  can  worsen  the   predictable  reaction.  Increases  in  po-­‐
course  of  illness  in  patients  with  schizo-­‐ tency  may  account  for  the  rise  in  
phrenia.  A  series  of  large  studies  follow-­‐ emergency  department  visits  involv-­‐
ing  users  across  time  also  showed  a  link   ing  marijuana  use.  For  frequent  us-­‐
between  marijuana  use  and  later  devel-­‐
ers,  it  may  mean  a  greater  risk  for  
opment  of  psychosis.  This  relationship  
addiction  if  they  are  exposing  them-­‐
was  influenced  by  genetic  variables  as  
selves  to  high  doses  on  a  regular  ba-­‐
well  as  the  amount  of  drug  used,  drug  
sis.  However,  the  full  range  of  conse-­‐
potency,  and  the  age  at  which  it  was  first  
taken—those  who  start  young  are  at  in-­‐ quences  associated  with  marijuana's  
creased  risk  for  later  problems.     higher  potency  is  not  well  under-­‐
  stood.  For  example,  experienced  us-­‐
Associations  have  also  been  found  be-­‐ ers  may  adjust  their  intake  in  accord-­‐
tween  marijuana  use  and  other  mental   ance  with  the  potency  or  they  may  
health  problems,  such  as  depression,   be  exposing  their  brains  to  higher  
anxiety,  suicidal  thoughts  among  adoles-­‐ levels  overall,  or  both.    
cents,  and  personality  disturbances,  in-­‐  
cluding  a  lack  of  motivation  to  engage  in   death  while  driving  a  car.  A  recent  analy-­‐
typically  rewarding  activities.  More  re-­‐ sis  of  data  from  several  studies  found  
search  is  still  needed  to  confirm  and  bet-­‐ that  marijuana  use  more  than  doubles  a  
ter  understand  these  linkages.   driver’s  risk  of  being  in  an  accident.  The  
  combination  of  marijuana  and  alcohol  is  
Marijuana  use  during  pregnancy  is  asso-­‐ worse  than  either  substance  alone  with  
ciated  with  increased  risk  of  neurobe-­‐ respect  to  driving  impairment.    
havioral  problems  in  babies.  Because    
THC  and  other  compounds  in  marijuana   Is  Marijuana  Addictive?  
mimic  the  body’s  own  endocannabinoid    
chemicals,  marijuana  use  by  pregnant   Contrary  to  common  belief,  marijuana  is  
mothers  may  alter  the  developing  endo-­‐ addictive.  Estimates  from  research  sug-­‐
cannabinoid  system  in  the  brain  of  the   gest  that  about  9  percent  of  users  be-­‐
fetus.  Consequences  for  the  child  may  in-­‐ come  addicted  to  marijuana;  this  num-­‐
clude  problems  with  attention,  memory,   ber  increases  among  those  who  start  
and  problem  solving.     young  (to  about  17  percent,  or  1  in  6)  
  and  among  people  who  use  marijuana  
Additionally,  because  it  seriously  impairs   daily  (to  25-­‐50  percent).  
judgment  and  motor  coordination,  mari-­‐  
juana  contributes  to  risk  of  injury  or  

Marijuana • January 2014 • Page 3

Long-­‐term  marijuana  users  trying  to  quit   petite,  anxiety,  and  drug  craving,  all  of  
report  withdrawal  symptoms  including   which  can  make  it  difficult  to  abstain.  
irritability,  sleeplessness,  decreased  ap-­‐ Behavioral  interventions,  including  cog-­‐
nitive-­‐behavioral  therapy  and  motiva-­‐
How  Does  Marijuana  Affect  a   tional  incentives  (i.e.,  providing  vouchers  
User’s  Life?   for  goods  or  services  to  patients  who  
  remain  abstinent)  have  proven  to  be  ef-­‐
Research  shows  marijuana  may  cause   fective  in  treating  marijuana  addiction.  
problems  in  daily  life  or  make  a  per-­‐ Although  no  medications  are  currently  
son's  existing  problems  worse.  Heavy   available,  recent  discoveries  about  the  
marijuana  users  generally  report  lower   workings  of  the  endocannabinoid  system  
life  satisfaction,  poorer  mental  and   offer  promise  for  the  development  of  
physical  health,  more  relationship   medications  to  ease  withdrawal,  block  
problems,  and  less  academic  and  ca-­‐ the  intoxicating  effects  of  marijuana,  and  
reer  success  compared  to  non-­‐ prevent  relapse.  
marijuana-­‐using  peers.  For  example,    
Learn    More  
marijuana  use  is  associated  with  a  
 
higher  likelihood  of  dropping  out  of  
For  additional  information  on  marijuana  
school.  Several  studies  also  associate  
and  marijuana  abuse,  please  see  
workers'  marijuana  smoking  with  in-­‐ http://www.drugabuse.gov/publication
creased  absences,  tardiness,  acci-­‐ s/research-­‐reports/marijuana-­‐abuse    
dents,  workers'  compensation  claims,    
and  job  turnover.    
 

Marijuana • January 2014 • Page 4