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الحشيش:

الحشيش وليد سرحان

CANNABIS FAMILY:

CANNABIS FAMILY Cannabaceae contains two genera Cannabis Humulus (hop plant) Resin used as a preservative and as a natural flavor in beer

CANNABIS:

CANNABIS Known as cannabis, hashish, hemp and marijuana 3

Marijuana – Cannabis sativa:

Marijuana – Cannabis sativa Source of: Strong fiber for rope and paper Nutritious fruit Industrial oil Medicine Cannabis Sativa is a fiber plant Cannabis Indica is a resin plant

CANNABIS:

CANNABIS Male and female plants Female plants are better resin producers If female plant is not allowed to be fertilized, it flowers but does not produce seeds – sinsemilla (spanish for “without seeds”) Greatest resin producers

CANNABIS:

CANNABIS Resin contains Hallucinogenic compounds called cannabinoids Delta-1 Tetrahydrocannabinol, also known as Delta-1-THC THC Major active compound in the cannabis plant

CANNABIS:

CANNABIS How is it used? Leaves and flowering tips are dried Smoked Consumed as tea Mixed into food Resin from flowering heads Smoked Mixed with tobacco Alcohol extract (cannabis oil) is mixed with tobacco and smoked

CANNABIS HISTORY:

CANNABIS HISTORY 4,000 BC - used as a medicine Rheumatism – loss of yin (female energy) 2,700 BC - Chinese emperor said “liberator of sin - good for female weakness, gout, rheumatism, malaria, beri beri, constipation and absent-mindedness”

CANNABIS HISTORY:

CANNABIS HISTORY 1,400 BC - in India used to treat anxiety Bhang (drink from leaves) Ganja (dried resin) 1,200 BC - found in a Chinese burial site, also used for bow strings and paper (mixed with mulberry bark)

CANNABIS HISTORY:

CANNABIS HISTORY

CANNABIS HISTORY:

CANNABIS HISTORY

Al-Hasan ibn al-Sabbah :

Al-Hasan ibn al-Sabbah By 1090 had established fortress on trade routes to China and India – ruled army of thieves whom he supplied with hashish and women in return for their loyalty 3/20/2011 12 sarhan

Introduction to Europe:

Introduction to Europe Europeans were introduced to Cannabis as a psychoactive plant by Napoleon’s soldiers after the conquest of Egypt in 1800. They began by consuming resin of Cannabis flowers and leaves (hashish ).

Marijuana and cannabinoids:

Marijuana and cannabinoids Cannabis sativa , hemp One of earliest non-food plants cultivated fiber for rope, seeds for oil and birdseed 8000 BC 2700 BC 2000 BC 1000 AD 1850s 1996 1st archaeological evidence of hemp use Medical use in China Ritual use in India Hashish use in Arab world Westerm world find bioactiv . Use semi-legal in CA/AZ from Childers & Breivogel (1998)

CANNABINOIDS:

CANNABINOIDS 60 cannabinoids have been isolated from the hemp plant and there are naturally occurring cannabinoids in most species called endocannabinoids, in a similar fashion as endorphins (opiates) have been found.

CANNABINOIDS:

CANNABINOIDS There are two main receptors for cannabinoids in humans CB1(in brain) if stimulated produces Euphoria Impaired short term memory and sense of time CB2 (in spleen, peripheral sites) if stimulated produces Immunosuppressant activity Not psychoactive

CANNABINOIDS:

CANNABINOIDS Receptors have also been found in the Cerebellum – body movement and coordination Cortex – higher cognitive functions Nucleus accumbens – reward Basal ganglia – movement control Hypothalamus – body temperature, salt and water balance, reproductive functions Amygdala – emotional responses, fear

PREPARATION OF CANNABIS:

PREPARATION OF CANNABIS Marijuana Not a single drug but a complex mixture of over 400 chemicals Dried flowering tops and leaves of the plant THC concentration 0.5% - 5% in the past, now up to 20 – 25% Dried cannabis buds 18

PREPARATION OF CANNABIS:

PREPARATION OF CANNABIS Hashish – dried cannabis resin and flowers THC concentration, 2 - 8% or higher Pieces of Hash 19

Slide 20:

Cannabis names Bhang, black, blast, blow, blunts. Bob Hope, bush, dope, draw, ganja, grass, hash, hashish, hemp, herb, marijuana, pot, puff, Northern Lights, resin, sensi , sensemilla , shit, skunk, smoke, soap, spliff , wacky backy , weed, zero. pot, herb, grass, weed, boom, Mary Jane, gangster,

أسماء بين الحشاشين:

أسماء بين الحشاشين صاروخ حشيش ماريوانا ماريجوانا جوزه سيجاره ملغومه

Modern Water Pipe and Hashish:

Modern Water Pipe and Hashish

How is it Used? :

How is it Used? Usually smoked as a cigarette rolled, hand-made (called a joint or a nail), in pipe or a bong. Has recently appeared in cigars called blunts and spliffs. 3/20/2011 23 sarhan

Bob Marley and the Wailers Album Cover - 1973:

Bob Marley and the Wailers Album Cover - 1973

Cannabis smoker – Southeast Asia:

Cannabis smoker – Southeast Asia

Forms and preparations:

Forms and preparations Marijuana mixture of leaves, stems, tops 1960’s: 1-3% THC; 1990’s: up to 8-10% “Bubble Gum” “Big Bud” “Dutch Northern Lights”

Forms and preparations:

Forms and preparations Hashish dried resin from top of female plant THC usually 2-5%, but up to 15% Hash Oil organic extraction from hashish THC usually ~ 10-20% up to 70%

Concentration of THC varies:

Concentration of THC varies Marijuana crushed dried leaves 5.2 % Hashish dried cakes of resin 5-10 times concentration Hash oil 80 %

Concentration of THC:

Concentration of THC Sinsemilla -flowering part of unfertilized female plant 13.4% Marijuana typically smoked as joints, blunts or water pipes

CANNABIS:

CANNABIS Routes of marijuana administration Joints Average is 500 mg of marijuana inside of rolling papers 20% - 50% of the THC makes it into the bloodstream Blunts (marijuana in hollowed out cigar) 6 times the amount of marijuana 20% of the THC makes it into the bloodstream 32

CANNABIS:

CANNABIS Routes of marijuana administration Pipes Stone, ceramic or glass 50% of the THC makes it into the bloodstream Water pipes Bongs – most efficient 90% of the THC makes it into the bloodstream

CANNABIS KINETICS:

CANNABIS KINETICS

CANNABIS KINETICS:

CANNABIS KINETICS

CANNABIS KINETICS:

CANNABIS KINETICS

CANNABIS KINETICS:

CANNABIS KINETICS SMOKING three cannabis joints will cause you to inhale the same amount of toxic chemicals as a whole packet of cigarettes.

CANNABIS KINETICS:

CANNABIS KINETICS Oral use Psychoactive effects slowed to about one hour Absorption is erratic High is less intense, but lasts longer than if smoked IV use Water insoluble so cannot be injected

Metabolism and clearance:

Metabolism and clearance rapid initial drop due to redistribution to fats slower metabolism in liver metabolites may persist for a week 1. Primary metabolic product of  9-THC (11-OH-  9-THC) is more potent than  9-THC 2. Delay between peak plasma levels and “high” Major biologically active compound may be metabolite

CANNABINOIDS:

CANNABINOIDS

PHARMACOLOGIC ACTIONS:

PHARMACOLOGIC ACTIONS Psychomotor effects Object distance distortion Object outlines distorted Inability to make rapid judgment Slowed reaction time Impaired tracking behavior Slowed time perception All are dose-related 41

PHARMACOLOGIC ACTIONS:

PHARMACOLOGIC ACTIONS “ Amotivational Syndrome” Tolerance to marijuana was supposed to be a manifestation of desensitization of brain cells, was supposed to create an amotivational syndrome characterized by apathy and inactivity. .

Cannabis and Motor Function: fMRI Changes Following 28 Days of Discontinuation :

Cannabis and Motor Function: fMRI Changes Following 28 Days of Discontinuation The results suggest that residual diminished brain activation is still observed 28 days after discontinuing cannabis use in motor cortical circuits. Source: Experimental and Clinical Psychopharmacology Volume 16, Issue, Feb. 2008, Pages 22-32.

Effects on behavior:

Effects on behavior

Effects on behavior:

Effects on behavior

PHARMACOLOGIC ACTIONS:

PHARMACOLOGIC ACTIONS Increased focus on taste Increased appetite (street slang - ”munchies”) Dry mouth 46

PHARMACOLOGIC ACTIONS:

PHARMACOLOGIC ACTIONS

PHARMACOLOGIC ACTIONS:

PHARMACOLOGIC ACTIONS

Effects of Exposure During Pregnancy:

Effects of Exposure During Pregnancy Babies display altered responses to visual stimuli, increased tremulousness, and a high-pitched cry. During the preschool years, marijuana-exposed children have been observed to perform tasks involving sustained attention and memory more poorly . In the school years, these children likely to exhibit deficits in problem-solving skills, memory, and the ability to remain attentive. Fried PA, Makin JE. Neonatal behavioral correlates of prenatal exposure to marihuana, cigarettes and alcohol in a low risk population. Neurotoxicology and Teratology 9(1):1–7, 1987. Lester BM, Dreher M. Effects of marijuana use during pregnancy on newborn crying. Child Development 60(23/24):764–771, 1989. Fried PA. The Ottawa prenatal prospective study (OPPS): Methodological issues and findings. It’s easy to throw the baby out with the bath water. Life Sciences 56(23–24):2159–2168, 1995. Fried PA, Smith AM. A literature review of the consequences of prenatal marihuana exposure: An emerging theme of a deficiency in aspects of executive function. Neurotoxicology and Teratology 23(1):1–11, 2001.

Cannabis and Schizophrenia:

Cannabis and Schizophrenia

ADDICTION LIABILITY:

ADDICTION LIABILITY 9% of those who ever used become dependent Dependence associated with gradual increase in use

ADDICTION LIABILITY Withdrawal difficult to demonstrate :

ADDICTION LIABILITY Withdrawal difficult to demonstrate 10 hour onset and 5 day duration Anxiety Mental clouding Insomnia Anorexia Irritability Tremor Depression Headache Craving

ADDICTION LIABILITY:

ADDICTION LIABILITY 71% of marijuana users relapse to marijuana use within 6 months after achieving initial 2 weeks of abstinence

Cannabis Use and Later Life Outcomes:

Cannabis Use and Later Life Outcomes The increasing cannabis use in late adolescence and early adulthood is associated with High levels of cannabis use are related to poorer educational outcomes, lower income, greater welfare dependence and unemployment and lower relationship and life satisfaction . Source: Fergusson, David M.; Boden , Joseph M.; Addiction Volume 103, Number 6, June 2008 , pp. 969-976(8).

TOXICITY AND ADVERSE EFFECTS:

TOXICITY AND ADVERSE EFFECTS Mental health issues have been seen to co-occur in users. Transient panic and anxiety Depersonalization Bizarre behavior Delusions Hallucinations Acute mania Acute paranoia Depression Psychosis Aggression

TOXICITY AND ADVERSE EFFECTS:

TOXICITY AND ADVERSE EFFECTS

TOXICITY AND ADVERSE EFFECTSIMMUNE SYSTEM :

TOXICITY AND ADVERSE EFFECTSIMMUNE SYSTEM

TOXICITY AND ADVERSE EFFECTS:

TOXICITY AND ADVERSE EFFECTS

TOXICITY AND ADVERSE EFFECTS:

TOXICITY AND ADVERSE EFFECTS

TOXICITY AND ADVERSE EFFECTS:

TOXICITY AND ADVERSE EFFECTS

TOXICITY AND ADVERSE EFFECTS:

TOXICITY AND ADVERSE EFFECTS

MEDICAL USES:

MEDICAL USES

MEDICAL USES:

MEDICAL USES

Warning Signs Parents Should Look For…:

Warning Signs Parents Should Look For…

Assessment of cannabis use:

Assessment of cannabis use

Clinical features of dependence:

Clinical features of dependence

Prevalence of dependence:

Prevalence of dependence

Withdrawal:

Withdrawal

Drug tests :

Drug tests Cannabis and its active ingredient THC is tested for in most drug tests. After one-off or occasional use its break-down products or metabolites can be detected between 3-5 days after use

Drug tests:

Drug tests However, THC can be detected in a chronic user up to 12 weeks after use , although the average is 25 -27 days

Drug tests:

Drug tests Cannabis is highly detectable a long time after use because THC lingers in the fatty tissues of the body and leaks steadily into the blood and then the urine over weeks

Drug tests:

Drug tests passive inhalation should be seriously considered as a possible explanation for a positive urine test for marijuana, although he noted that passive inhalation does not have a major effect outside the laboratory

Salivary tests:

Salivary tests After smoking a single cigarette containing 11mg THC, salivary THC levels substantially exceeded 100ng/ml for the first hour after smoking, with levels over 10ng/ml persisting for up to 4 hours

Blood Testing :

Blood Testing Cannabis is detectable in the blood for approximately 2-3 days after use in an infrequent user. Frequent use can be detected in the blood for approximately 2 weeks.

Drug tests:

Drug tests Most urine tests only detect an inactive metabolite - THC carboxylic acid. The results for cannabinoid metabolites in urine are of no significance whatsoever in determining intoxication or performance impairment

Hair Testing :

Hair Testing Cannabis use is detectable with hair tests and is generally included in the standard hair test. That provides a detection period of approximately 90 days.

Substances or Conditions which can cause false positives :

Substances or Conditions which can cause false positives

Adverse consequences of dependence:

Adverse consequences of dependence

Demand for treatment:

Demand for treatment Fewer than 10% seek any treatment Why so few? high rates of remission? fewer short term consequences? existing treatment services unattractive?

Treatment options:

Treatment options

Goals of psychotherapy:

Goals of psychotherapy

Societal Effects:

S ocietal Effects

As far as Media is Concerned…:

As far as Media is Concerned…

What parents could do to help…:

What parents could do to help…

The proposal for JORDAN:

The proposal for JORDAN The national forum for drug addiction

Thank you:

Thank you www.walidsarhan.net

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