CANNABIS


Cannabis, also known as marijuana among several other names,[n 1] is a preparation of the Cannabis plant intended for use as a psychoactive drug or medicine.[12][13][14] The main psychoactive part of cannabis is tetrahydrocannabinol (THC); one of 483 known compounds in the plant,[15] including at least 65 other cannabinoids.[16] Cannabis can be used by smoking, vaporization, within food, or as an extract.[17]

Cannabis is often used for its mental and physical effects, such as a "high" or "stoned" feeling, a general change in perception, euphoria (heightened mood), and an increase in appetite.[17][18] Short term side effects may include a decrease in short-term memory, dry mouth, impaired motor skills, red eyes, and feelings of paranoia or anxiety.[17][19][20] Long term side effects may include addiction, decreased mental ability in those who started as teenagers, and behavioral problems in children whose mothers used cannabis during pregnancy.[17] Onset of effects is within minutes when smoked and about 30 to 60 minutes when cooked and eaten.[17][21] They last for between two and six hours.[21]

Cannabis is mostly used recreationally or as a medicinal drug. It may also be used for religious or 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).[22] In 2015, 43% of Americans had used cannabis, which increased to 51% in 2016.[23] About 12% have used it in the past year, and 7.3% have used it in the past month.[24] This makes it the most commonly used illegal drug both in the world and the United States.[17][22]

The earliest recorded uses date from the 3rd millennium BC.[25] Since the early 20th century, cannabis has been subject to legal restrictions. The possession, use, and sale of cannabis is illegal in most countries of the world.[26][27] Medical cannabis refers to the physician-recommended use of cannabis, which is taking place in Canada, Belgium, Australia, the Netherlands, Spain, and 23 U.S. states.[28] Cannabis use started to become popular in the US in the 1970s.[29] Support for legalization has increased in the United States and several US states have legalized recreational or medical use.[30]

Medical
Main article: Medical cannabis
Medical cannabis, or medical marijuana can refer to the use of cannabis and its cannabinoids to treat disease or improve symptoms; however, there is no single agreed upon definition.[31][32] The use of cannabis as a medicine has not been rigorously scientifically tested, often due to production restrictions and other federal regulations.[33] There is limited evidence suggesting cannabis can be used to reduce nausea and vomiting during chemotherapy, to improve appetite in people with HIV/AIDS, and to treat chronic pain and muscle spasms.[34][35][36] Its use for other medical applications is insufficient for conclusions about safety or efficacy.

Short-term use increases the risk of both minor and major adverse effects.[35] Common side effects include dizziness, feeling tired, vomiting, and hallucinations.[35] Long-term effects of cannabis are not clear.[35] Concerns include memory and cognition problems, risk of addiction, schizophrenia in young people, and the risk of children taking it by accident.[34]

Recreational
Main article: Effects of cannabis

A woman smoking a marijuana "joint".
Cannabis has psychoactive and physiological effects when consumed.[37] The immediate desired effects from consuming cannabis include relaxation and euphoria (the "high" or "stoned" feeling), a general alteration of conscious perception, increased awareness of sensation, increased libido[38] 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. In some cases, cannabis can lead to dissociative states such as depersonalization[39][40] and derealization.[41]

Some immediate undesired side effects include a decrease in short-term memory, dry mouth, impaired motor skills and reddening of the eyes.[42] Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite and consumption of food, lowered blood pressure, impairment of short-term and working memory,[43][44] psychomotor coordination, and concentration. Some users may experience an episode of acute psychosis, which usually abates after six hours, but in rare instances, heavy users may find the symptoms continuing for many days.[45] A reduced quality of life is associated with heavy cannabis use, although the relationship is inconsistent and weaker than for tobacco and other substances.[46]

Spiritual
Main article: Entheogenic use of cannabis

Process of making bhang in a Sikh village in Punjab, India. On the festival of colors called Holi, it is a customary addition to some intoxicating drinks.[47]
Cannabis has held sacred status in several religions. It has been used in an entheogenic context – a chemical substance used in a religious, shamanic, or spiritual context[48] - in India and Nepal since the Vedic period dating back to approximately 1500 BCE, but perhaps as far back as 2000 BCE. There are several references in Greek mythology to a powerful drug that eliminated anguish and sorrow. Herodotus wrote about early ceremonial practices by the Scythians, thought to have occurred from the 5th to 2nd century BCE. 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. The earliest known reports regarding the sacred status of cannabis in India and Nepal come from the Atharva Veda estimated to have been written sometime around 2000–1400 BCE.[49]

Available forms
Main article: Cannabis consumption

A joint prior to rolling, with a paper handmade filter on the left
Cannabis is consumed in many different ways:[50]

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.[51]
vaporizer, which heats any form of cannabis to 165–190 °C (329–374 °F),[52] causing the active ingredients to evaporate into a vapor without burning the plant material (the boiling point of THC is 157 °C (315 °F) at 760 mmHg pressure).[53]
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).[54] 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.[55]
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.
Adverse effects
Main article: Long-term effects of cannabis
Further information: Cannabis in pregnancy

Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Cannabis was ranked 11th in dependence, 17th in physical harm, and 10th in social harm.[56]
According to the United States Department of Health and Human Services, there were 455,000 emergency room visits associated with cannabis use in 2011. These statistics include visits in which the patient was treated for a condition induced by or related to recent cannabis use. The drug use must be "implicated" in the emergency department visit, but does not need to be the direct cause of the visit. Most of the illicit drug emer