Cannabis

What is cannabis?

  • Cannabis sativa, also known as hemp, is a species of the Cannabinaceae family of plants.
  • Cannabis is also known as Ganja, grass, Hashish, Hemp, Indian hemp, marijuana, Pot, reefer, weed.
  • Cannabis contains the chemical compound THC (delta-9 tetrahydrocannabinol), which is believed to be responsible for most of the characteristic psychoactive effects of cannabis.
  • The dried leaves and flowers of the cannabis plant are known as marijuana, which can be smoked (through a pipe or bong or hand-rolled into a joint) or taken orally with food (baked in cookies).
  • The resinous secretions of the plant are known as hashish, which can be smoked or eaten.
  • The fiber of the cannabis plant is cultivated as industrial hemp with uses in textile manufacturing.

Important information

  • Do not drive, operate machinery, or perform other hazardous activities while using cannabis. It may cause dizziness, drowsiness, and impaired judgment.
  • Do not drink alcohol while using cannabis. Alcohol will increase dizziness, drowsiness, and impaired judgment.
  • Cannabis may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants.
  • Cannabis is a Schedule 1 drug under the Controlled Substances Act.

What are the effects of cannabis?

  • The effects experienced by the cannabis user are variable and will depend upon the dose, method of administration, prior experience, any concurrent drug use, personal expectations, mood state and the social environment in which the drug is used.
  • Effects of cannabis include:
    • an altered state of consciousness. The user may feel "high", very happy, euphoric, relaxed, sociable and uninhibited.
    • distorted perceptions of time and space. The user may feel more sensitive to things around them, and may also experience a more vivid sense of taste, sight, smell and hearing.
    • increased pulse and heart rate, bloodshot eyes, dilated pupils, and often increased appetite.
    • impaired coordination and concentration, making activities such as driving a car or operating machinery difficult and dangerous.
    • negative experiences, such as anxiousness, panic, self-consciousness and paranoid thoughts.
  • People who use large quantities of cannabis may become sedated or disoriented and may experience toxic psychosis - not knowing who they are, where they are, or what time it is. High doses may also cause fluctuating emotions, fragmentary thoughts, paranoia, panic attacks, hallucinations and feelings of unreality.
  • The effects of cannabis are felt within minutes, reach their peak in 10 to 30 minutes, and may linger for two or three hours. THC is highly lipid soluble and can be stored in fat cells potentially for several months. The stored THC is released very slowly, and unevenly, back into the bloodstream.

Medical uses

  • While cannabis remains a Schedule 1 substance, research has resulted in development and marketing of dronabinol and nabilone which are synthetic cannabinoid products.
    • Marinol (dronabinol) is used for the control of nausea and vomiting caused by chemotherapeutic agents used in the treatment of cancer and to stimulate appetite in AIDS patients.
    • Cesamet (nabilone) is used for the control of nausea and vomiting caused by chemotherapeutic agents used in the treatment of cancer.

Medical Cannabis (Medical Marijuana)


There are eight medical conditions for which patients can use cannabis:

As of July 2014, 23 states and the District of Columbia legally allow cannabis for personal medical use. Rules surrounding the use of medical cannabis (medical marijuana) vary by state. The first state in the union to legalize the medical use of marijuana was California in 1996. States that allow medical marijuana include Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia. It is important to recognize that these state marijuana laws do not change the fact that using marijuana continues to be an offense under Federal law.

Medical marijuana in the U.S. is controlled at the state level. Per federal law, cannabis is illegal as noted in the Controlled Substances Act, but the federal government has stated they will not actively prosecute patients and caregivers complying with state medical marijuana laws. However, use of medical marijuana outside of the state laws for illegal use or trafficking will not be tolerated by state or federal government.

States with bills or pending legislation to legalize medical marijuana include: Florida, New York, Ohio, and Pennsylvania.

CBD Oil or Realm Oil

Several states are now considering or have passed bills to allow legalization of medical marijuana oil (CBD oil or Realm Oil) for intractable seizures in children with Dravet Syndrome. These children can suffer 40 or more seizures per day; the seizures are often prolonged in length. The oil is made a from a special strain of marijuana called “Charlotte's Web” that has extremely low levels of tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana that leads to the “high”. However, the strain has elevated levels of cannabidiol, or CBD, a non-psychoactive component that has been shown to have a number of therapeutic benefits, including those that limit seizure activity. The oil is taken in an oral liquid form, not smoked like traditional marijuana. News media has showcased several families from states that do not allow the CBD oil. These families have moved to Colorado from their home states to access the oil legally for their children who suffer from the debilitating seizures. Legislation is currently under review in several states to allow the oil for children with this debilitating seizure condition.

As of July 20, 2014, 12 states had okayed the use of CBD oil, some states as part of research studies: these states include Utah, Alabama, Kentucky, Wisconsin, Mississippi, Tennessee, Georgia, South Carolina, Iowa, Florida, North Carolina, and Illinois. Missouri and New York are considering CBD oil bills; although medical marijuana for other conditions is now legal in New York.

Recreational Use of Cannabis

In 2012, voters in Colorado and Washington state passed initiatives legalizing cannabis for adults 21 and older under state law. It is important to note that the federal government still considers cannabis a dangerous drug and that the illegal distribution and sale of marijuana is a serious crime. Under the Controlled Substances Act (CSA), marijuana is still considered a Schedule 1 drug. Cultivation and distribution of marijuana are felonies; possession for personal use is a misdemeanor; possession of “paraphernalia” is also illegal. Cultivating 100 plants or more carries a mandatory minimum sentence of five years according to federal statutes.

That being said, it is unlikely that the federal government is interested in pursuing individuals complying with state-mandated regulations surrounding legalized cannabis for recreational use, although the CSA law still gives them authority to do so.

The Department of Justice (DOJ) has attempted to clarify this issue. On August 29, 2013, the DOJ issued guidance to Federal prosecutors concerning marijuana enforcement under the CSA. The DOJ is focused on priorities, such as:

  • Preventing the distribution to minors
  • Preventing revenues from sale of marijuana towards criminal activity
  • Preventing diversion of marijuana from states where it is legal to states where it is not legal
  • Preventing state-legalized marijuana from being a cover for other illegal drugs or activity
  • Prevent violence and guns in the cultivation and distribution of marijuana
  • Prevent drugged driving and other public health issues
  • Prevent the use of public land for marijuana cultivation
  • Preventing marijuana possession or use on federal property

Additional states may undertake or pursue citizen petitions in the future to legalize the recreational use of cannabis. Reportedly there may be initiatives for full commercial legalization on the ballot in Alaska in 2014 and in California, Maine, and Oregon in 2016. According to the Brookings Institute, Presidential years bring out an electorate more favorable to cannabis legalization than the off-year electorate. Other states pursuing legalization may include Arizona, Nevada, Massachusetts, Montana, Rhode Island, and Vermont. Maine and Michigan citizen voters have also passed legalization of cannabis for recreational use, but state law will likely override these voter referendums; only medical marijuana is currently legal according to state law in these states.

A majority of Americans support legalization of marijuana - 52 percent pro versus 45 percent con - according to findings from a Pew Research Center survey in March 2013. Support for marijuana legalization has increased dramatically since 2010, by 11 percentage points.

Specific city and county laws have been enacted to regulate how citizens and tourists may possess and consume marijuana. Penalties exist for driving while under the influence of marijuana. Someone driving under the influence of marijuana is considered impaired in both Colorado and Washington when five nanograms per milliliter (ng/mL) of blood or more of active THC is detected.

For more information see: Marijuana

Cannabis side effects

Long term effects of heavy use can include:

  • irritation to the lungs, risk of developing chronic bronchitis and an increased risk of developing cancer of the respiratory tract (more likely to do with smoking).
  • exacerbation of pre-existing cardiovascular disease, as cannabis use significantly raises the heart rate.
  • decreased concentration levels, reduced short-term memory and difficulties with thinking and learning (resolved if cannabis use stops).
  • decreased sex drive in some people. Chronic use can lower sperm count in males and lead to irregular periods in females (resolved if cannabis use stops).
  • dependence on cannabis - compulsive need to use the drug, coupled with problems associated with chronic drug use.

What should I avoid?

  • Do not drive, operate machinery, or perform other hazardous activities while using cannabis. Cannabis may cause dizziness, drowsiness, and impaired judgment.
  • Do not drink alcohol while using cannabis. Alcohol will increase dizziness, drowsiness, and impaired judgment.
  • Cannabis may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants.
  • Do not use cannabis if you are pregnant or could become pregnant. There is some evidence that women who smoke cannabis during the time of conception or while pregnant may increase the risk of their child being born with birth defects. Pregnant women who continue to smoke cannabis are probably at greater risk of giving birth to low birthweight babies.
  • Do not use cannabis if you are breast-feeding a baby.

What happens if I overdose?

  • Seek emergency medical attention.
  • Symptoms of overdose include fatigue, lack of coordination, paranoia and psychosis.

What other drugs will affect cannabis?

  • Cannabis may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants.
  • For more information on Drug Interactions, please visit the Drugs.com Drug Interactions Checker.

See Also:

Last updated: 2014-07-20 by Leigh Anderson, PharmD.

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