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Cannabis 101

At a Glance: Cannabis

Recreational cannabis is legal in California starting January 1, 2018.

Clinical Features of Cannabis Intoxication

  • Enhanced sensitivity to stimuli, such as colors or music
  • Altered perception of time
  • Increased appetite for sweet and fatty foods, as well as a dry mouth
  • Decreased short-term memory
  • Impaired perception and motor skills
  • Panic attacks and paranoid thoughts (rare)

Clinical Cannabis Intoxication vs. Alcohol Intoxication

  • Cannabis and alcohol have very different effects on the body
  • Alcohol generally has a linear physiological effect, with impairment linked to amount consumed, factors like weight and time passed
  • Cannabis intoxication is non-linear and more influenced by factors like individual metabolic rates and accumulated loss of sensitivity to the active ingredients of cannabis

Demonstrated Therapeutic Effects of Cannabis and Cannabinoids

  • Oral cannabinoids have been proven effective as anti-emetics in adults with chemotherapy-induced nausea
  • Patients with chronic pain treated with cannabis or cannabinoids have shown a clinically significant reduction in pain symptoms
  • Short-term use of oral cannabinoids in adults with multiple sclerosis have reported improvement with spasticity symptoms

Limited or Insufficient Evidence of Therapeutic Effects of Cannabis and Cannabinoids

  • For the following conditions, cannabis and cannabinoids have little or no evidence to support that cannabis and cannabinoids are effective treatment options:
    • Cancers, including glioma (cannabinoids)
    • Cancer-associated anorexia cachexia syndrome and anorexia nervosa (cannabinoids)
    • Symptoms of irritable bowel syndrome (dronabinol)
    • Epilepsy (cannabinoids)
    • Spasticity in patients with paralysis due to spinal cord injury (cannabinoids)
    • Symptoms associated with amyotrophic lateral sclerosis (cannabinoids)
    • Chorea and certain neuropsychiatric symptoms associated with Huntington’s disease (oral cannabinoids)
    • Motor system symptoms associated with Parkinson’s disease or the levodopa-induced dyskinesia (cannabinoids)

Public Health Concerns Related to Cannabis Legalization

  • Driving
    • There has been little research conducted on the effects of cannabis at different doses on driving skills
    • As legalized medical and recreational cannabis availability increase nationwide, the impairment of driving abilities during acute intoxication has become a public health and safety issue
    • UC San Diego Health was asked by the California legislature to investigate driving abilities and cannabis impairment clinical trial is currently under way
  • Cancer
    • Like tobacco smoke, cannabis smoke contains carcinogens
    • Current evidence suggests that, in adults, smoking cannabis does not increase the risk for certain cancers such as lung, head and neck
    • There is modest evidence that regular cannabis could be associated with one subtype of testicular cancer

Cannabis-based Drugs Approved by the U.S Food and Drug Administration

  • There are currently two FDA approved drugs
  • Both are taken orally
  • Dronabinol (Marinol®; Syndros®) uses a synthetic form of THC as an active ingredient. It is most prescribed as an anti-emetic in adults with chemotherapy-induced nausea. Additionally, it is also prescribed to increase the appetite of people living with AIDS.
  • Nabilone (Cesamet®) also uses a synthetic form of THC as an active ingredient. It is most prescribed as an anti-emetic in adults with chemotherapy-induced nausea. Additionally, it is frequently prescribed to treat neuropathic pain.