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Cannabis: Myths and Facts. Medical Indications and Contraindications to usage.


MYTHS:

LEGAL IN THE BAHAMAS

HARMLESS & NO PHYSICAL EFFECTS

NO WITHDRAWAL SIDE EFFECTS/SYNDROME

NO RISK PSYCHOSIS OR PARANOIA DISORDERS

NO LINK TO SCHIZOPHRENIA


FACTS:

ILLEGAL IN THE BAHAMAS

THC-HARMFUL/ BINDS TO BRAIN SUBSTANCE; CHANGES THE BRAIN CHEMISTRY

WITHDRAWAL EFFECTS SEEN; DSM-V GIVES THE CRITERIA

RISK OF DEVELOPING PSYCHOSIS X7 FOLD; INCREASED RISK OF PARANOIA DISORDERS IN CHRONIC REGULAR USERS

CONTRIBUTING FACTOR IN DEVELOPMENT OF SCHIZOPHRENIA I.E. IF ONE HAS A POSITIVE FAMILY HISTORY




What is the psychoactive chemical compound in the marijuana smoke?

According to the body of evidence, chronic daily usage of marijuana is a contributing factor to the onset of marijuana induced psychosis and paranoia syndromes.

The psychoactive substance in the marijuana smoke, that is the delta-9-tetrahydrocannabinol (delta-9-THC) can disrupt neurochemicals/neurotransmitter systems in the brain, notably dopamine, serotonin, acetylcholine and norepinephrine neurotransmitters, that can result in the onset of psychosis (brief loss of contact of reality and presence of delusions, hallucinations, impaired functioning in life arenas i.e. education, occupational, family and social arenas of life). There are over 108+ other cannabinoids in the marijuana smoke (of the smoked whole plant) beside the delta-9-Tetrahydrocannabinol.

Persons who have a first degree relative who is diagnosed with Schizophrenia; Schizoaffective Disorder are vulnerable to the onset of these psychotic disorders and should not be using marijuana.

What are the effects of Marijuana usage?

Yes, there are many acute, chronic and physical effects of marijuana usage that persons should be aware of. Below you will find a list of side effects associated with Marijuana use:


Acute Use of Marijuana:

1. Onset of Panic attacks

2. Onset of Acute Psychosis

3. Impaired decision-making ability

4. Greater impulsivity and risk taking by marijuana users

5. Impaired driving ability


Chronic Daily Use of Marijuana:

1. Cannabis Use Disorders/addiction/tolerance and withdrawal effects when on abruptly stops the usage

2. Impaired Verbal Memory, impaired attention; impaired driving ability; drop in Intelligence Quotient; Amotivational syndrome (lack of the work drive)

3. Onset of psychotic episodes; increased risk of development of Major Depression; increased risk of suicidal ideation

Medical Complications of chronic regular usage:

1. Common--Chronic Bronchitis; ischemic stroke; Myocardial Infarctions (heart attacks); Transient Ischemic Attacks

2. Uncommon- Spontaneous Pneumothorax; Bullous Emphysema; cannabinoid hyperemesis syndrome; cyclical vomiting; sudden cardiac attack

3. Increased Risk of Lung Cancer

What are Cannabis Intoxication; Chronic marijuana use and Withdrawal symptoms?

Cannabis intoxication: red conjunctivae, delayed responsiveness, and normal pupil size

Chronic marijuana use: person exhibits signs of self-neglect, persons present with poor hygiene, anxiety, and psychosis

Cannabis withdrawal: syndrome of mood swings, anxiety and muscle cramps; usually lasts about one (1) to two (2) weeks


Which persons should not be using marijuana?

1. Patients with a previous adverse experience with marijuana, that is medical or recreational use

2. History of substance use disorder or psychosis or currently unstable mood or anxiety disorder

3. Recent heart attack, cardiac arrhythmia, or stroke

4. Taking medication that might interact with THC-tetrahyrocannabinol

5. Difficulty in avoiding driving, flying, or operating heavy machinery (professions of responsibility to the public)

6. Work in job requiring drug testing

7. Pregnant/breastfeeding women should not be using marijuana



What is the Current Legal Status of Cannabis and Cannabinoids in US, State Level?

´ 33 states, DC, Puerto Rico, Guam have medical cannabis programs

´ 13 states have medical cannabidiol (low THC) programs

´ 10 states also have “adult use” or “recreational” cannabis programs

´ Northern Mariana Islands has only “adult use” program

´ 4 states have no cannabis program




What is the Current Legal Status of Cannabis and Cannabinoids in US at the Federal Level—I?

By way of the Controlled Substances Act (CSA) schedule I = it is illegal to possess or dispense cannabis and cannabinoids in the United States at the Federal Level:


“no currently accepted medical use in treatment in the United States”

“lack of accepted safety for use … under medical supervision”

“high potential for abuse”


What is meant by the term Medical Marijuana?


Medical Marijuana is available only by prescription and is used to treat a variety of medical conditions such as seizure disorders; pain, anxiety, nausea and glaucoma. Also applies to any substance such as cannabidiols extracted from the whole plant and synthetic compounds created in legal chemical laboratories and used similarly.


What are the Indications for Medical Cannabinoids Legal at Federal Level in USA?


Dronabinol (FDA-approved)

• Nausea & vomiting from cancer chemotherapy not responsive to other treatment

• Anorexia & weight loss in patients with AIDS


Nabilone (FDA-approved)

• Nausea & vomiting from cancer chemotherapy not responsive to other treatment


Cannabidiol (FDA-approved)

• Intractable childhood seizures, e.g., Dravet (previously known as Severe Myoclonic Epilepsy of Infancy-SMEI), Lennox-Gastaut syndromes


Nabiximols (awaiting NDA submission)

• Pain, muscle spasticity in multiple sclerosis (approved in Canada); chronic cancer pain

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