Effects of Unrefined Marijuana – Drugs of Abuse

00:01 Cannabis is the fourth most widely used psychoactive substance globally, with 19% of Americans reporting usage in 2021.

00:11 Its legal status varies, with 23 states permitting recreational use and 38 allowing medical use, though this remains subject to change.

00:23 Clinically, about 22% of regular users develop Cannabis Use Disorder (CUD), particularly when they start young (under 18) or consume heavily.

00:36 Cannabis use during pregnancy has also risen from 3% to 7% over recent years, raising concerns due to potential risks to fetal health.

00:48 Unregulated cannabis can contain harmful contaminants like pesticides, mold, and sometimes other drugs added by producers, posing additional health risks.

01:00 THC potency has also escalated drastically—from 1-3% in the 1990s to as high as 15-30% today, leading to more intense effects and a greater likelihood of intoxication, dependency, and even psychotic symptoms in susceptible individuals.

01:23 The increased strength of modern cannabis also correlates with a higher incidence of accidental pediatric exposure, particularly since legalization.

01:35 These trends highlight cannabis's evolving impact on public health, from dependency risks to heightened exposure for vulnerable populations, underscoring the need for clinicians to stay informed on its effects and potential complications.

01:52 When you look at other forces all over the world, whether they be military, paramilitary or police, you see the similar kind of guidelines being put forward.

02:02 Where do they come up with these guidelines and what are they basing it on? Well, let's take a look at defined medically confirmed effects of unrefined marijuana which isn't, let's say a joint.

02:15 Between 30 and 120 minutes of ingestion, you'll have a change in perception.

02:20 Patients will often complain of a dry mouth.

02:23 There are decreased motor skills that are measurable in standardized testing.

02:27 Patients will have red eyes due to capillary dilatation in the sclera.

02:31 Patients will often have a heightened mood, so they feel better.

02:35 They are generally happier.

02:37 There is often an increased appetite.

02:39 So, this is something that has been seen as a benefit or a boon in patients who have cancer who are traditionally losing weight.

02:46 There's also a decrease in short-term memory which tends to be relatively transient.

02:52 Acute cannabis intoxication, while rare in adults and adolescents, can be life-threatening in young children who accidentally ingest high doses.

03:03 Symptoms vary widely depending on the dose, the route of administration, and the individual.

03:10 Psychological symptoms are common and can include anxiety, panic attacks, paranoia, and even psychosis, particularly with higher doses or oral ingestion.

03:22 Neurologically, users may experience dizziness, memory impairment, sedation, and an altered sense of time; in severe cases, especially with children, this can progress to seizures or even coma.

03:38 Cardiovascular symptoms, like palpitations and tachycardia, are frequently reported, and chest pain can sometimes mimic a cardiac event.

03:49 On the gastrointestinal side, nausea and vomiting are common, and chronic users may develop cannabinoid hyperemesis syndrome.

03:58 Physiologically, dry mouth, red eyes, and increased appetite are typical effects.

04:05 Diagnosis is primarily clinical.

04:08 While urine drug screens can help confirm cases in children, they’re generally less informative for older patients.

04:15 Management mostly involves supportive care.

04:19 In children, airway support and benzodiazepines for seizures may be needed, while mild cases in adults are often resolved with a calm environment and reassurance.

04:31 Notably, activated charcoal is not recommended due to its limited efficacy in cannabis cases and potential risks.

04:40 Ultimately, while most cases are mild, it’s important to recognize that severe complications, though rare, can occur—especially with high doses or in vulnerable populations like young children.

04:55 Long-term cannabis use affects health across many areas, with effects varying widely among individuals.

05:03 The majority of users smoke cannabis, though younger users often consume it orally or vape.

05:10 For disability and mortality, Cannabis Use Disorder (CUD) contributes notably to the global burden of disease, with deaths typically resulting from accidents, suicide, or combined cardiovascular and respiratory issues, especially when alcohol is involved.

05:29 Psychiatrically, cannabis can increase risks for depression, worsen existing mental health conditions, and lead to cognitive deficits, including lower IQ and impaired memory.

05:42 It’s also linked to a higher risk of psychosis and schizophrenia, especially for early and frequent users.

05:50 Reproductive impacts include reduced sperm production in males and increased risks of low birth weight and preterm birth in pregnant users.

06:01 THC’s presence in breast milk adds uncertainty about its effects on infants.

06:07 For pulmonary health, smoking can lead to chronic bronchitis and respiratory infections, while vaping cannabis carries the risk of EVALI, a serious lung injury.

06:21 Gastrointestinal effects include Cannabinoid Hyperemesis Syndrome, characterized by cyclic vomiting, while cardiovascular risks include an increased likelihood of heart attack, stroke, and arrhythmias.

06:37 Cancer risks remain uncertain, with mixed evidence for lung and head/neck cancers but a possible association with nonseminoma testicular cancer.

06:48 Additionally, cannabis use impairs driving and increases crash risk by about one-third.

06:55 Finally, CUD significantly raises ER visits, with cannabis-related cases making up about 12% of drug-related visits in 2022.

07:07 as these effects have meaningful public health implications.

07:14 Understanding these risks is essential for clinicians managing patients with long-term cannabis use