Cannabis
A dried flowered bud of the Cannabis sativa plant; this variety is known as "Orange Crush"
Scientific classification
Kingdom: Plantae Division: Magnoliophyta Class: Magnoliopsida Order: Urticales Family: Cannabaceae Genus: Cannabis Species: C. sativa
Binomial name
Cannabis sativa Linnaeus
Subspecies
C. sativa L. subsp. sativa C. sativa L. subsp. indica

Cannabis plant

Cannabis, also known as marijuana^[1] or marihuana, or ganja (from Hindi/Sanskrit: गांजा gānjā, hemp),^[2] is a psychoactive product of the plant Cannabis sativa, or more often, Cannabis sativa subsp. indica. The herbal form of the drug consists of dried mature flowers and subtending leaves of pistillate (female) plants. The resinous form, known as hashish,^[3] consists primarily of glandular trichomes collected from the same plant material. The major biologically active chemical compound in cannabis is Δ⁹-tetrahydrocannabinol (delta-9-tetrahydrocannabinol), commonly referred to as THC.

Humans have been consuming cannabis since prehistory,^[4] although in the 20th century there was a rise in its use for recreational, religious or spiritual, and medicinal purposes. It is estimated that about four percent^[5] of the world's adult population use cannabis annually and 0.6 percent daily. Cannabis is the world's most often used illegal drug.^[6] The possession, use, or sale of psychoactive cannabis products became illegal in most parts of the world in the early 20th century. Since then, some countries have intensified the enforcement of cannabis prohibition while others have reduced the priority of enforcement.

Forms

Marijuana

Marijuana

• Marijuana or ganja: the flowering tops of female plants,^[7] from less than 1% THC to 22% THC; the wide range is probably one of the reasons for the conflicting results from different studies.

Psychoactive potency by cannabis plant part is approximately as follows (descending order):^[8]

1. Trichomes
2. Female flowering buds
3. Male flowering buds
4. New shoots
5. Leaves from flower buds
6. Leaves in ascending order of size
7. Stems of leaves (petioles) in ascending order of size
8. Stems in ascending order of size
9. Roots and seeds

Hashish

Hashish

Main article: Hashish

• Hashish (pressed keif) or charas: a concentrated resin composed of heated glandular trichomes that have been physically extracted,^[9] usually by rubbing, sifting, or with ice.

Kief

Kief

Main article: Kief

• Kief:

(1) The sticky resin saturated bits of plant before pressed into hashish. It's chopped flowering tops of female cannabis plants, often mixed with tobacco;
(2) Moroccan hashish produced in the Rif mountains;^[10]
(3) sifted cannabis trichomes consisting of only the glandular "heads" (often incorrectly referred to as "crystals" or "pollen");
(4) the crystal (trichomes) left at the bottom of a grinder after grinding marijuana, then smoked.

Hash oil

Golden cannabis oil (hash oil) on a card

Main article: Honey oil

For example, an ethanol extract of cannabis that has had the ethanol evaporated from it, to leave hash oil.

Methods of consumption

Lifetime cannabis use in the European Union

Main article: Cannabis consumption

Cannabis is consumed in myriad ways, most of which either involve inhaling smoke from ignited plant or administering orally.

Various devices exist for smoking, most common are implements such as bongs, chillums and smoking pipes, joints or blunts. Local methods differ by the preparation of the cannabis plant before use, the parts of the cannabis plant which are used, and the treatment of the smoke before inhalation.

Vaporizer heats herbal cannabis to 365–410 °F (185–210 °C), which causes the active ingredients to evaporate into a gas without burning the plant material (the boiling point of THC is 392 °F (200°C) at 0.02 mmHg pressure, and somewhat higher at standard atmospheric pressure),^[11][12] A lower proportion of toxic chemicals are released than by smoking, although this may vary depending on the design of the vaporizer and the temperature at which it is set.

An e-cigarette has a rechargeable battery and a heating element which vaporizes (in most brands) liquid nicotine from an insertable cartridge. If THC is loaded into the cartridge instead of nicotine, cannabis users may receive the benefits of a vaporizer at lower initial cost.

As an alternative to smoking, cannabis may be consumed orally. However, the cannabis or its extract must be sufficiently heated or dehydrated to cause decarboxylation of its most abundant cannabinoid, tetrahydrocannabinolic acid, into psychoactive THC.^[13]

Cannabis material can be leached in high-proof spirits (often grain alcohol) to create a “Green Dragon”. This process is often employed to make use of low-potency stems and leaves.^{citation needed}

Cannabis can also be consumed as a cannabis tea. Although THC is lipophilic and only slightly water soluble (with a solubility of 2800 mg per liter),^[14] enough THC can be dissolved to make a mildly psychoactive tea.

History

The use of cannabis, at least as fiber, has been shown to go back at least 10,000 years in Taiwan. Má (Pinyin pronunciation), the Chinese expression for hemp, is a pictograph of 2 cannabis plants being raised in a sheltered area.

Evidence of the inhalation of cannabis smoke can be found as far back as the 3rd millennium BC as indicated by charred cannabis seeds found in a ritual brazier at an ancient burial site in present day Romania.^[4] The most famous users of cannabis were the ancient Hindus of India and Nepal. The herb was called ganjika in Sanskrit (गांजा/গাঁজা ganja in modern Indic languages).^[15][16] The ancient drug soma, mentioned in the Vedas as a sacred intoxicating hallucinogen, was sometimes associated with cannabis.^[17]

Cannabis was also known to the ancient Assyrians, who discovered its psychoactive properties through the Aryans.^[18] Using it in some religious ceremonies, they called it qunubu (meaning "way to produce smoke"), a probable origin of the modern word 'Cannabis'.^[19] Cannabis was also introduced by the Aryans to the Scythians and Thracians/Dacians, whose shamans (the kapnobatai—“those who walk on smoke/clouds”) burned cannabis flowers to induce a state of trance.^[20] Members of the cult of Dionysus, believed to have originated in Thrace (Bulgaria, Greece and Turkey), are also thought to have inhaled cannabis smoke. In 2003, a leather basket filled with cannabis leaf fragments and seeds was found next to a 2,500- to 2,800-year-old mummified shaman in the northwestern Xinjiang Uygur Autonomous Region of China.^[21][22]

Cannabis sativa from Vienna Dioscurides, 512 A.D.

Cannabis has an ancient history of ritual use and is found in pharmacological cults around the world. Hemp seeds discovered by archaeologists at Pazyryk suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century BCE, confirming previous historical reports by Herodotus.^[23] Some users have claimed that cannabis was used as a religious sacrament by ancient Jews and early Christians^[24] due to the similarity between the Hebrew word qannabbos (cannabis) and the Hebrew phrase qené bósem (aromatic cane). It was used by Muslims in various Sufi orders as early as the Mamluk period, for example by the Qalandars.^[25]

Medical use

Main article: Medical cannabis

A synthetic form of one chemical in marijuana, Δ(delta)-9 tetrahydrocannabinol (THC), is a controversial treatment for medical use. The American Marijuana Policy Project, a pro-cannabis organization, claims that cannabis is an ideal therapeutic drug for cancer and AIDS patients, who often suffer from clinical depression, and from nausea and resulting weight loss due to chemotherapy and other aggressive treatments.^[26] Other medical uses may included fighting cancer, according to an isolated study by scientists in Italy. This study states that cannabidiol (CBD), a chemical found in marijuana, inhibits growth of cancer cells in animals.^[27]

The FDA and comparable authorities in Western Europe, including the Netherlands, have not approved smoked marijuana for any condition or disease. The current view of the United States Food and Drug Administration is that if there is any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives.^[28]

A synthetic version of the cannabinoid THC named dronabinol has been shown to relieve symptoms of anorexia and reduce agitation in elderly Alzheimer's patients.^[29] Dronabinol has been approved for use with anorexia in patients with HIV/AIDS and chemotherapy-related nausea. This drug, while demonstrating the effectiveness of cannabis at combating several disorders, is more expensive and less available than "pot" and has not been shown to be effective or safe.^[30]

Glaucoma, a condition of increased pressure within the eyeball causing gradual loss of sight, can be treated with medical marijuana to decrease this intraocular pressure. There has been debate for 25 years on the subject. Some data exist, showing a reduction of IOP in glaucoma patients who smoke marijuana,^[31] but the effects are short-lived, and the frequency of doses needed to sustain a decreased IOP can cause systemic toxicity. There is also some concern over its use since it can also decrease blood flow to the optic nerve. Marijuana lowers IOP by acting on a cannabinoid receptor on the ciliary body called the CB receptor.^[32] Although marijuana is not a good therapeutic choice for glaucoma patients, it may lead researchers to more effective, safer treatments. A promising study shows that agents targeted to ocular CB receptors can reduce IOP in glaucoma patients who have failed other therapies.^[33]

Medical marijuana is used for analgesia, or pain relief. “Marijuana is used for analgesia only in the context of a handful of illnesses (e.g., headache, dysentery, menstrual cramps, and depression) that are often cited by marijuana advocates as medical reasons to justify the drug being available as a prescription medication.”^[34] It is also reported to be beneficial for treating certain neurological illnesses such as epilepsy, and bipolar disorder.^[35] Case reports have found that cannabis can relieve tics in people with obsessive compulsive disorder and Tourette syndrome. Patients treated with tetrahydrocannabinol, the main psychoactive chemical found in cannabis, reported a significant decrease in both motor and vocal tics, some of 50% or more.^[36][37][38] Some decrease in obsessive-compulsive behavior was also found.^[36] A recent study has also concluded that cannabinoids found in cannabis might have the ability to prevent Alzheimer's disease.^[39] THC has been shown to reduce arterial blockages.^[40]

Another use for medical marijuana is movement disorders. Marijuana is frequently reported to reduce the muscle spasms associated with multiple sclerosis; this has been acknowledged by the Institute of Medicine, but it noted that these abundant anecdotal reports are not well-supported by clinical data. Evidence from animal studies suggests that there is a possible role for cannabinoids in the treatment of certain types of epileptic seizures.^[41] Marijuana "numbs" the nervous system slightly, possibly preventing shock. A synthetic version of the major active compound in cannabis, THC, is available in capsule form as the prescription drug dronabinol (Marinol) in many countries. The prescription drug Sativex, an extract of cannabis administered as a sublingual spray, has been approved in Canada for the treatment of multiple sclerosis.^[42]

New breeding and cultivation techniques

Main article: Cannabis (drug) cultivation

It is often claimed by growers and breeders of herbal cannabis that advances in breeding and cultivation techniques have increased the potency of cannabis since the late 1960s and early '70s, when delta-9-tetrahydrocannabinol was discovered and understood. However, potent seedless marijuana such as "Thai sticks" were already available at that time. In fact, the sinsemilla technique of producing high-potency marijuana has been practiced in India for centuries.^{citation needed} Sinsemilla (Spanish for "without seed") is the dried, seedless inflorescences of female cannabis plants. Because THC production drops off once pollination occurs, the male plants (which produce little THC themselves) are eliminated before they shed pollen to prevent pollination. Advanced cultivation techniques such as hydroponics, cloning, high-intensity artificial lighting, and the sea of green method are frequently employed as a response (in part) to prohibition enforcement efforts that make outdoor cultivation more risky. These intensive horticultural techniques have led to fewer seeds being present in cannabis and a general increase in potency over the past 20 years. The average levels of THC in marijuana sold in United States rose from 3.5% in 1988 to 7% in 2003 and 8.5% in 2006.^[43]

"Skunk" cannabis is a potent strain of cannabis, grown through selective breeding and usually hydroponics, that is a cross-breed of Cannabis sativa and C. indica. Skunk cannabis potency ranges usually from 6% to 15% and rarely as high as 20%. The average THC level in coffeehouses in the Netherlands is about 18–19%.^[44]

The average THC content of Skunk #1 is 8.2%; it is a 4-way combination of the cannabis strains Afghani indica, Mexican Gold, Colombian Gold, and Thai: 75% sativa, 25% indica.^{citation needed} This was done via extensive breeding by cultivators in California in the 1970s using the traditional outdoor cropping methods used for centuries.^{citation needed}

In proposed revisions to cannabis rescheduling in the UK, the government is considering rescheduling cannabis back from C to B. One of the reasons is the high-potency marijuana.^[45]

A Dutch double-blind, randomized, placebo-controlled, cross-over study examining male volunteers aged 18–45 years with a self-reported history of regular cannabis use concluded that smoking of cannabis with high THC levels (marijuana with 9–23% THC), as currently sold in coffee shops in the Netherlands, may lead to higher THC blood-serum concentrations. This is reflected by an increase of the occurrence of impaired psychomotor skills, particularly among younger or inexperienced cannabis smokers, who do not adapt their smoking-style to the higher THC content.^[46] High THC concentrations in cannabis was associated with a dose-related increase of physical effects (such as increase of heart rate, and decrease of blood pressure) and psychomotor effects (such as reacting more slowly, being less concentrated, making more mistakes during performance testing, having less motor control, and experiencing drowsiness). It was also observed during the study that the effects from a single joint lasted for more than eight hours. Reaction times remained impaired five hours after smoking, when the THC serum concentrations were significantly reduced, but still present. When subjects smoke on several occasions per day, accumulation of THC in blood-serum may occur.

Another study showed that consumption of 15 mg of Delta(9)-THC resulted in no learning whatsoever occurring over a three-trial selective reminding task after two hours. In several tasks, delta(9)-THC increased both speed and error rates, reflecting “riskier” speed–accuracy trade-offs.^[47]

Legal status

Main article: Legality of cannabis

See also: Drug prohibition and Drug liberalization

U.S. Federal Bureau of Narcotics propaganda used in 1935

Since the beginning of the 20th century, most countries have enacted laws against the cultivation, possession, or transfer of cannabis for recreational use. These laws have impacted adversely on the cannabis plant's cultivation for non-recreational purposes, but there are many regions where, under certain circumstances, handling of cannabis is legal or licensed. Many jurisdictions have lessened the penalties for possession of small quantities of cannabis, so that it is punished by confiscation or a fine, rather than imprisonment, focusing more on those who traffic the drug on the black market. There are also changes in a more restrictive direction such as the closing of coffee shops in the Netherlands, the closing of the open drug market in Christiania, Copenhagen, the Gonzales v. Raich rule in 2005 that the Commerce Clause of the United States Constitution allow the federal government to ban the use of marijuana, including medical use anywhere in the United States.

Some jurisdictions use free voluntary treatment programs and/or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution.

Effects

Main article: Effects of cannabis

Tetrahydrocannabinol (THC) is the main active compound in cannabis

Cannabis has psychoactive and physiological effects when consumed. The minimum amount of THC required to have a perceptible psychoactive effect is about 10 micrograms per kilogram of body weight.^[48]

Classification

Main article: Effects of cannabis#Psychoactive effects

While many drugs clearly fall into the category of either stimulant, depressant, hallucinogen, or antipsychotic, cannabis, containing both THC and CBD, exhibits a mix of all properties, leaning towards hallucinogen properties due to THC being the primary constituent.^[49][50][51]

Health issues

Comparison of physical harm and dependence regarding various drugs (the British medical journal The Lancet [1])

Smoking of cannabis is the most harmful method of consumption, since combustion of material and inhalation of smoke in itself from organic materials such as tobacco, wood, gasoline and cannabis causes various health problems. By using a vaporizer or orally consuming cannabis, many health problems and many objections to using cannabis as medicine can be eliminated.^{[52][53][54][55][56]}

A recent study by the Canadian government found cannabis smoke contained more toxic substances than tobacco smoke.^[57] The study determined that marijuana smoke contained 20 times more ammonia, and five times more hydrogen cyanide and nitrogen oxides than tobacco smoke.

Smoking cannabis is a potentially harmful method of consuming cannabis, yet the most practiced.

In spite of this, a recent large-scale study found no correlation between heavy marijuana use and lung cancer, despite noting that cannabis contains the same carcinogens as tobacco. The same study found a 20-fold increase in lung-cancer rates of smokers who consumed two or more packs of cigarettes per day.^[58] These researchers postulated that the THC present may have a "protective effect" by causing aging cells to die before they become cancerous.^[59] Other recent research suggest the cannabinoid CBD may stop certain cancers from spreading, although not in concentrations consumed during smoking.^[60]

Tar, a sticky incomplete combustion product from smoking, clogs the lungs of both tobacco and cannabis smokers; vaporization is a much healthier alternative.

In contrast, a study published in the January 2008 edition of the journal Respirology found that "regular" cannabis smokers who developed bullous lung disease[2] did so on average 24 years sooner than tobacco smoking counterparts.^[61] Researchers attributed this to the inhalation of a larger volume of smoke, and typically holding it for four times longer than tobacco smokers. Bullous lung disease is considered an uncommon cause of respiratory distress.^[62] In general, habitual inhalation of any kind of smoke is detrimental to lung health.^[63]

Cannabis use has been assessed by several studies to be correlated with the development of anxiety, psychosis and depression,^[64][65] however, the causality of the correlation and its direction is a subject of debate that has not been resolved in the scientific community. Some studies assess that the causality is more likely to involve a path from cannabis use to psychotic symptoms rather than a path from psychotic symptoms to cannabis use,^[66] while others assess the opposite direction of the causality, or hold cannabis to only form parts of "causal constellation", while not inflicting mental health problems that would not have occurred in the absence of the cannabis use.^[67][68]

Studies have also shown links between heavy long-term use (over five joints daily over several years) and incidence of heart attacks, strokes, as well as abnormalities in the amygdala and hippocampus regions of the brain.^[69][70]

Gateway drug theory

Further information: Gateway drug theory

Since its origin in the 1950s, the "gateway drug" hypothesis has been one of the central pillars of cannabis drug policy in the United States, though the validity and implications of these hypotheses are highly debated.^[71] Studies have shown that tobacco smoking is a better predictor of concurrent illicit hard drug use than smoking cannabis.^[72]

A 2005 comprehensive review of the literature on the cannabis gateway hypothesis found that pre-existing traits may predispose users to addiction in general, the availability of multiple drugs in a given setting confounds predictive patterns in their usage, and drug sub-cultures are more influential than cannabis itself. The study called for further research on "social context, individual characteristics, and drug effects" to discover the actual relationships between cannabis and the use of other drugs.^[73]

The main variant of the gateway hypothesis is that people, upon trying cannabis for the first time and not finding it dangerous, are then tempted to try other, harder drugs. In such a scenario, a new user of cannabis who feels there is a difference between anti-drug information and their own experiences will apply this distrust to public information of other, more powerful drugs.^{citation needed} Some studies state that while there is little absolute proof for this gateway theory, young cannabis users should still be considered as a risk group for intervention programs.^[74] Other findings indicate that hard drug users are likely to be "poly-drug" users, and that interventions must address the use of multiple drugs instead of a single hard drug.^[75]

Another gateway hypothesis is that while cannabis is not as harmful or addictive as any other drugs, a gateway effect may be detected as a result of the "common factors" involved with using any illegal drug. Because of its illegal status, cannabis users are more likely to be in situations which allow them to become acquainted with people who use and sell other illegal drugs.^[76][77] By this argument, some studies have shown that alcohol and tobacco may also be regarded as gateway drugs.^[72] At least one source has suggested that the practice of mixing tobacco with cannabis can be a gateway to nicotine dependence.^[78]

Religious use

Main article: Spiritual use of cannabis

In India and Nepal, cannabis has been used by some of the wandering Hindu spiritual sadhus for centuries, and in modern times the Rastafari movement has embraced it as a sacrament.^[79] Elders of the modern religious movement known as the Ethiopian Zion Coptic Church consider cannabis to be the Eucharist, claiming it as an oral tradition from Ethiopia dating back to the time of Christ, even though the movement was founded in the United States in 1975 and has no ties to either Ethiopia or the Coptic Church.^[80] Like the Rastafari, some modern Gnostic Christian sects have asserted that cannabis is the Tree of Life.^[81][82] Other organized religions founded in the 20th century that treat cannabis as a sacrament are the THC Ministry,^[83] the Way of Infinite Harmony, Cantheism,^[84] the Cannabis Assembly^[85] and the Church of Cognizance.

Truth serum

Cannabis female flowers closeup with trichomes (white). These plant parts contain the highest concentration of psychoactive compounds.

Cannabis was used as truth serum by the Office of Strategic Services (OSS), a US government intelligence agency formed during World War II. In the early 1940s, it was the most effective truth drug developed at the OSS labs at St. Elizabeths Hospital; it caused a subject "to be loquacious and free in his impartation of information."^[86]

In May 1943, Major George Hunter White, head of OSS counter-intelligence operations in the US, arranged a meeting with Augusto Del Gracio, an enforcer for gangster Lucky Luciano. Del Gracio was given cigarettes spiked with THC concentrate from cannabis, and subsequently talked openly about Luciano's heroin operation. On a second occasion the dosage was increased such that Del Gracio passed out for two hours.^[86]

See also

References