Cannabis Intoxication

Cannabis or marijuana, produced from the Cannabis sativa or Cannabis indica plant, is the most frequently used illicit drug in the US. ^{[1] [2]} It has been employed medically for several thousand years until it was proclaimed illegal in several countries. Marijuana contains active ingredients responsible for its effects such as delta-9-tetrahydrocannabinol (THC) and cannabidiol.^[3]

Epidemiology

Males are reported to abuse marijuana more than females. ^[3]

Causes

Risk factors include concomitant substance abuse and social stress.^[3]

Signs and Symptoms

Marijuana is a sedative thus intoxication makes a person feel relaxed, sleepy or in euphoric state. ^{[2] [4]} Higher doses can lead to diminished short term memory, and reduced movements. A person can also have increased appetite, dry mouth, red eyes, concentration difficulty, headache, sweating, visual distortions and increased heart rate. Psychological manifestations include mood changes, anxiety, social withdrawal and impaired judgment. Thus, a person may have an affect that can be euphoric or the contrast which is anxious. If it is used for a long time, the person can have a flat affect or absent emotions. ^{[4] [3]}

Serious effects of marijuana abuse are paranoia or acute psychosis. ^[1] A patient may have delusions and hallucinations. ^[3]

Diagnosis

For long term users, cannabinoids can be detected until 21 days after use. The standard period whereby urinalysis gives a positive result is 1 up to 5 days. To measure the quantity of the drug components, blood sampling can be done. A new way for detection is via saliva test that indicates presence of delta-9-THC. ^[3]

Treatment

Resolution of acute cannabis intoxication usually spans 4 to 6 hours. Reassurance and calming the patient are extremely important especially for those experiencing panic. When anxiety is considerable, benzodiazepines are prescribed. ^[3] Prevention of injury is vital. Heart and brain monitoring are also essential. ^[1]

Behavioural therapy and other modes of treatment such as family and individual therapy cater to different cases. To monitor abstinence, periodic urinalysis is done. Those with dependence may have episodes of relapse thus treatment may be given repeatedly.

Primary prevention programs such as school based programs help dissuade cannabis abuse. ^[3]

References:

1. http://www.nlm.nih.gov/medlineplus/ency/article/000952.htm
2. http://www.bbc.co.uk/health/emotional_health/addictions/cannabis.shtml
3. http://emedicine.medscape.com/article/286661-clinical
4. http://www.nlm.nih.gov/medlineplus/ency/article/000952.htm