Cannabis Use: Yes or No?

By Shermine Wardé and Nicole Saliba (edited by Karim Rhayem)

Cannabis is a plant that contains tetrahydrocannabinol (THC). THC is the psychoactive ingredient in marijuana. This ingredient makes marijuana an addictive substance.

The dried marijuana leaves are smoked. THC rapidly enters the bloodstream from the lungs producing an immediate “high.”

Cannabis Intoxication

• Recent use of cannabis.
• Problematic behavioral or psychological changes (impaired coordination, euphoria, anxiety, impaired judgment, social withdrawal).
• At least two of the following signs: conjunctival injection, increased appetite, dry mouth, tachycardia.
• Symptoms not due to a general medical condition and are not better accounted for by another mental disorder.

Cannabis Withdrawal

• Three or more of the following signs and symptoms develop within approximately 1 week after cessation of heavy, prolonged use: irritability or aggression, nervousness or anxiety, sleep difficulty, decreased appetite or weight loss, restlessness, depressed mood.
• At least one of the following physical symptoms: abdominal pain, shakiness/tremors, sweating, fever, chills, or a headache.
• Impairment in social, occupational, or other important areas of functioning.
• Signs not attributable to another medical condition and are not better explained by another mental disorder.

Protests & Events

• The Global Marijuana March (GMM) is an annual rally held at different locations around the world on the first Saturday in May. It is a notable event in cannabis culture, associated with cannabis-themed events, which may include marches, rallies, raves, concerts, festivals, and attempts at educational outreach.
• 4/20 is a counterculture holiday to protest against the social and legal stigmas against marijuana. April 20 (or 4/20) is cherished by marijuana smokers around the world as a reason to toke up with friends and massive crowds each year. The festivities are becoming more mainstream and commercialized.

A Potential Medicine?

The renewed interest in the therapeutic effects of cannabis emanates from the movement that began 20 years ago to make cannabis available as a medicine to patients with a variety of conditions.

The FDA has approved:

• Epidiolex, which contains a purified form of the drug substance cannabidiol (CBD) for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in patients 2 years of age and older.
• Marinol and Syndros for nausea associated with cancer chemotherapy and for the treatment of anorexia associated with weight loss in AIDS patients. Marinol and Syndros include the active ingredient dronabinol, which is considered the psychoactive intoxicating component of cannabis
• Cesamet, which contains the active ingredient nabilone that has a chemical structure similar to THC is indicated for nausea associated with cancer chemotherapy.

In Lebanon, a law legalizing the farming of medical cannabis for the international market was passed in Lebanese parliament in April 2020. It is possible to authorize the cultivation of the cannabis plant for medical, pharmaceutical, and industrial purposes but it remains illegal to use cannabis for recreational purposes.

References

https://www.ncbi.nlm.nih.gov/books/NBK425767/

https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process

https://pubmed.ncbi.nlm.nih.gov/35016798/

https://www.vox.com/policy-and-politics/2019/4/19/18484698/what-is-420-meaning-marijuana-legalization

https://cms.law/en/int/expert-guides/cms-expert-guide-to-a-legal-roadmap-to-cannabis/lebanon

The diagnostic criteria of the different Cannabis-related disorders are defined in the DSM-5.