What Are The Cannabis-Related Events?

By Maria Saade (edited by Karim Rhayem)

Every year on the 20^th of April, thousands of Americans gather around the country to celebrate marijuana, a drug that is still illegal in many states and countries. However, most people tend to get caught in the hype of big gatherings or protests and forget their original purpose, making the festivities more mainstream and commercialized, as support for marijuana legalization still grows. There are many theories about the origin of 420, but the real explanation behind the number remains unknown. The most common theory is issued from a group of high school students back in the 1970s who would ritualistically smoke marijuana every day at 4:20 PM, thus generating the code “420” for consuming cannabis, which was later converted into 4/20 for calendar purposes. Another common belief is that 420 was the California police or penal code for marijuana. The earliest link between marijuana and 420 comes from a short story written by Lovecraft and Sterling back in 1939 titled “In the Walls of Eryx”, where the narrator describes a curious plant which would get him euphoric every day at 4:20 PM according to his watch.

About Cannabis

1- Cannabis Preparations:

Cannabis is a plant which two products can be derived from: marijuana, prepared from the dried flowering tops and leaves of the plant; or hashish, consisting of dried cannabis resin. Both have isolated pure compounds that can be divided into two categories: non-cannabinoids and cannabinoids compounds. 

The cannabinoids can either be:

• Inactive:  more than 60 compounds.
• Psychoactive: D-9 Tetrahydro-cannabidiol (THC)
• Active but not psychoactive: cannabidiol (CBD) – knowing that this substance is protective against the adverse effects of THC.

2- Methods of use and pharmacology

It is important to keep in mind that THC does not dissolve in water; therefore, cannabis cannot be injected like heroin for example. However, there are many ways to consume cannabis:

• Smoked (joints) remains the most common method of use: cannabis is mixed with tobacco and rolled in a piece of paper.
• Water-pipe (bong) where cannabis is also mixed with tobacco.
• Oral: cooked in sweets in general, such as brownies.

The method of use determines the intensity and the timing of the effects of the drug. For instance, inhalation is quicker than oral use, but oral use is more intense than inhalation.

Moreover, THC can be distinguished by its very high liposolubility and slow rate of clearance, as it may be stored in body fat for more than 28 days if regularly consumed. This is an important feature as it makes it very difficult to track cannabis consumption when one is trying to quit – it makes it impossible to know on a urine drug test if the subject has recently consumed the substance or not.

Moreover, THC can be distinguished by its very high liposolubility and slow rate of clearance, as it may be stored in body fat for more than 28 days if regularly consumed. This is an important feature as it makes it very difficult to track cannabis consumption when one is trying to quit – it makes it impossible to know on a urine drug test if the subject has recently consumed the substance or not.

3- Clinical effects

When people consume cannabis, two types of effects can be experienced depending on the dose taken and on their individual vulnerability:

• Lower doses:
  • Relaxation.
  • Euphoria.
  • Altered time and sensory perception.
  • Increased appetite.
• Higher doses, also known as “bad trip”:
  • Hypervigilance or paranoia.
  • Anxiety or panic.
  • Derealization or depersonalization.
  • Hallucination (auditory or visual).

Some crucial facts worth noting:

• Consuming cannabis can be very dangerous to patients with heart disease, as it can lead to tachycardia (increased heart rate) and increased blood pressure.
• Consuming cannabis can impair driving performance.
• There are no cases of fatal acute overdose deaths because of cannabis in the human medical literature.

4- Intoxication

The recent use of cannabis can lead to typical – but not specific – symptoms within two hours of the consumption:

• Conjunctival injection which is the most classic symptom.
• Increased appetite.
• Dry mouth.
• Tachycardia, which is why patients with heart problems must avoid consuming cannabis.

5- Withdrawal

What people don’t usually know about cannabis is that there are withdrawal symptoms, which means that there is an addiction to the substance. The withdrawal symptoms usually occur within one week after the cessation of the substance, the most common being:

• Irritability, anger, or aggression.
• Nervousness or anxiety.
• Sleep difficulty.
• Decreased appetite or weight loss.
• Restlessness.
• Depressed mood.
• At least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills or headache

6- Cannabis and Mental Health

The concerns parents usually get about their child consuming cannabis is whether cannabis is a gateway drug towards the consumption of stronger and more dangerous substances. However, there is no proof that cannabis itself can lead to the consumption of stronger substances. Nevertheless, the same risk factors that lead to the consumption of cannabis in the first place might make one more vulnerable to the consumption of stronger substances.

A critical point to note is that cannabis use can precipitate psychosis among vulnerable people. Cannabis use can also exacerbate symptoms or prolong the illness in people who have already been diagnosed with psychosis or schizophrenia, even after an occasional consumption. Even though people are convinced that using cannabis will help them cope with depression and anxiety, it has also been proven that cannabis increases anxiety, depression, and suicide attempts on the long run, while increasing paranoia, tiredness, and low motivation.

Legalization:

Although many countries are starting to make medical or recreational cannabis legal, the topic remains subject to debate, especially in countries like Lebanon. However, if cannabis were to become legal in Lebanon in the future, the molecules of interest should be studied very carefully and legalization should be followed up and controlled closely.

References:

U.S. Department of Health and Human Services. (n.d.). Substance use and co-occurring mental disorders. National Institute of Mental Health. Retrieved April 21, 2022, from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health#:~:text=A%20substance%20use%20disorder%20(SUD,most%20severe%20form%20of%20SUDs.

Lopez, G. (2021, 20 april). What is 4/20? The marijuana holiday, explained. Vox. Geraadpleegd op 21 april 2022, van https://www.vox.com/policy-and-politics/2019/4/19/18484698/what-is-420-meaning-marijuana-legalization

Sharma P, Murthy P, Bharath MM. Chemistry, metabolism, and toxicology of cannabis: clinical implications. Iran J Psychiatry. 2012 Fall;7(4):149-56. PMID: 23408483; PMCID: PMC3570572.