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Cannabis (drug)

Cannabis,[a] also known as marijuana among other names, is a psychoactive drug from the cannabis plant. Native to Central or South Asia, the cannabis plant has been used as a drug for both recreational and entheogenic purposes and in various traditional medicines for centuries. Tetrahydrocannabinol (THC) is the main psychoactive component of cannabis, which is one of the 483 known compounds in the plant, including at least 65 other cannabinoids, such as cannabidiol (CBD). Cannabis can be used by smoking, vaporizing, within food, or as an extract.

Cannabis has various mental and physical effects, which include euphoria, altered states of mind and sense of time, difficulty concentrating, impaired short-term memory, impaired body movement (balance and fine psychomotor control), relaxation, and an increase in appetite. Onset of effects is felt within minutes when smoked, but may take up to 90 minutes when eaten. The effects last for two to six hours, depending on the amount used. At high doses, mental effects can include anxiety, delusions (including ideas of reference), hallucinations, panic, paranoia, and psychosis. There is a strong relation between cannabis use and the risk of psychosis, though the direction of causality is debated. Physical effects include increased heart rate, difficulty breathing, nausea, and behavioral problems in children whose mothers used cannabis during pregnancy; short-term side effects may also include dry mouth and red eyes. Long-term adverse effects may include addiction, decreased mental ability in those who started regular use as adolescents, chronic coughing, susceptibility to respiratory infections, and cannabinoid hyperemesis syndrome.

Cannabis is mostly used recreationally or as a medicinal drug, although it may also be used for spiritual purposes. In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65). It is the most commonly used largely-illegal drug in the world, with the highest use among adults in Zambia, the United States, Canada, and Nigeria, as of 2018.

While cannabis plants have been grown since at least the 3rd millennium BCE, evidence suggests that it was being smoked for psychoactive effects at least 2,500 years ago in the Pamir Mountains, Asia. Since the 14th century, cannabis has been subject to legal restrictions. The possession, use, and cultivation of cannabis has been illegal in most countries since the 20th century. In 2013, Uruguay became the first country to legalize recreational use of cannabis. Other countries to do so are Canada, Georgia, Malta, Mexico, and South Africa. In the U.S., the recreational use of cannabis is legalized in 21 states, two territories, and the District of Columbia, though the drug remains federally illegal.

Medical

Medical cannabis, or medical marijuana, refers to the use of cannabis to treat disease or improve symptoms; however, there is no single agreed-upon definition (e.g., cannabinoids derived from cannabis and synthetic cannabinoids are also used).[3][4][5] The rigorous scientific study of cannabis as a medicine has been hampered by production restrictions and by the fact that it is classified as an illegal drug by many governments.[6] There is limited evidence suggesting cannabis can be used to reduce nausea and vomiting during chemotherapy, to improve appetite in people with HIV/AIDS, or to treat chronic pain and muscle spasms. Its use for other medical applications is insufficient for drawing conclusions about safety or efficacy.[7][8][9] There is evidence supporting the use of cannabis or its derivatives in the treatment of chemotherapy-induced nausea and vomiting, neuropathic pain, and multiple sclerosis. Lower levels of evidence support its use for AIDS wasting syndrome, epilepsy, rheumatoid arthritis, and glaucoma.[10]

So far, the medical use of cannabis is legal only in a limited number of territories, including Canada,[11] Belgium, Australia, the Netherlands, New Zealand,[12][13] Spain, and many U.S. states. This usage generally requires a prescription, and distribution is usually done within a framework defined by local laws.[10]

Recreational

According to DEA Chief Administrative Law Judge, Francis Young, "cannabis is one of the safest therapeutically active substances known to man."[14] Being under the effects of cannabis is usually referred to as being "high" or "stoned."[15] Cannabis consumption has both psychoactive and physiological effects.[16] The "stoned" experience can vary widely, based (among other things) on the user's prior experience with cannabis, and the type of cannabis consumed.[17]: p647  When smoking cannabis, a euphoriant effect can occur within minutes of smoking.[18]: p104  Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite, impairment of short-term and working memory, and psychomotor coordination.[19][20]

Additional desired effects from consuming cannabis include relaxation, a general alteration of conscious perception, increased awareness of sensation, increased libido[21] and distortions in the perception of time and space. At higher doses, effects can include altered body image, auditory and/or visual illusions, pseudohallucinations and ataxia from selective impairment of polysynaptic reflexes.[citation needed] In some cases, cannabis can lead to dissociative states such as depersonalization[22][23] and derealization.[24]

Spiritual

Cannabis has held sacred status in several religions and has served as an entheogen – a chemical substance used in religious, shamanic, or spiritual contexts[25] – in the Indian subcontinent since the Vedic period. The earliest known reports regarding the sacred status of cannabis in the Indian subcontinent come from the Atharva Veda, estimated to have been composed sometime around 1400 BCE.[26] The Hindu god Shiva is described as a cannabis user, known as the "Lord of bhang.[27]: p19 

In modern culture, the spiritual use of cannabis has been spread by the disciples of the Rastafari movement who use cannabis as a sacrament and as an aid to meditation.[26]

Consumption

Modes of consumption

Cannabis is consumed in many different ways,[28] all of which involve heating to decarboxylate THCA in the plant into THC.[29] Common available forms are:

Smoking, which typically involves burning and inhaling vaporized cannabinoids ("smoke") from small pipes, bongs (portable versions of hookahs with a water chamber), paper-wrapped joints or tobacco-leaf-wrapped blunts, and other items.[30]
Vaporizer, which heats any form of cannabis to 165–190 °C (329–374 °F),[31] causing the active ingredients to evaporate into vapor without burning the plant material (the boiling point of THC is 157 °C (315 °F) at atmospheric pressure).[32]
Cannabis tea, which contains relatively small concentrations of THC because THC is an oil (lipophilic) and is only slightly water-soluble (with a solubility of 2.8 mg per liter).[33] Cannabis tea is made by first adding a saturated fat to hot water (e.g. cream or any milk except skim) with a small amount of cannabis.[34]
Edibles, where cannabis is added as an ingredient to one of a variety of foods, including butter and baked goods. In India it is commonly made into a beverage, bhang.
Tincture of cannabis, sometimes known as green dragon, is an alcoholic cannabis concentrate.
Capsules, typically containing cannabis oil, and other dietary supplement products, for which some 220 were approved in Canada in 2018.[11]

Onset of effects is felt within minutes when smoked, and may take up to 90 minutes when eaten.[35] Depending on the amount used, the effects last for two to six hours.[36]
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