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.