Cannabis-Related Disorders

DEFINITION

• Cannabis refers to a genus of flowering plants, including 3 separate species: C. sativa, C. indica and C. ruderalis.
• Street names for cannabis are numerous, and include: marijuana, pot, weed, herb, buddha, nugs, grass, trees, Mary Jane.
• Cannabis is most often consumed by smoking dried plant material, but concentrate forms (dabbing) and edible (oral) have increased markedly with legalization.
• The primary psychoactive component is Δ⁹ -tetrahydrocannabinol, also called Δ⁹-THC or simply THC which exerts its effects as via agonism of the cannabinoid type 1 (CB1) receptor.
• Clinical syndromes:
  • Cannabis intoxication involves behavioral, cognitive, or psychotic symptoms after use. Physical signs and occasional perceptual disturbances can be there[1].
  • Cannabis withdrawal refers to symptoms observed in heavy users with cessation of use, which may include dysphoria, irritability, sleep disturbance, GI symptoms, anxiety and appetite loss.[1]
  • Cannabis-use disorder According to DSM-5 criteria, use of cannabis for at least one year with significant impairment with at least two of the following symptoms[1]:
    • Difficulty containing cannabis use
    • Repeated failed attempts to cease use
    • Inordinate amount of time spent using, acquiring or recovering from effects of cannabis
    • Cravings
    • Continued use despite impairment
    • Cannabis use in situations that are potentially dangerous, such as operating machinery or vehicle
    • Use despite knowledge of physical/psychiatric
    • Tolerance
    • Withdrawal