Killing me softly Mary Jane
by Nestor C. Punay, MD
MARIJUANA is the most common illicit substance worldwide,
used by at least 77% of drug abusers. WHO data indicates increasing
prevalence of marijuana use worldwide especially among teen-agers.
This is very disturbing since marijuana use is a high predictor
for future abuse of cocaine and other illicit substances.
Furthermore, the increasing trend worldwide reflects the abundance
of marijuana and the prevailing ignorance and false belief
that marijuana is a benign substance.
Marijuana is called joints, grass, pot, Mary Jane, weed and
tea. Depending on its form, it is also called hashis, hemp,
bhang, ganja, dagga, sinsemilla and chasra. Marijuana comes
from Cannabis sativa, a plant that contains psychoactive substances.
The most potent part of cannabis is the flowering tops or
the dried, black-brown, resinous exudates of the leaves (hashis).
Marijuana is commonly smoked but it could also be incorporated
in foods such as cake.
 The
euphoric effect of marijuana has been known for thousands
of years. TheGreek historian Herodotus (5th century B.C.)
described nomads who became euphoric after smoking roasted
hemp seeds in a tent. Chinese medical text dating 2500 B.C.
documents use of marijuana for medicinal purposes. As late
as 1941, marijuana was being used as anticonvulsant, muscle
relaxant and analgesic in the US. There are anecdotal reports
of glaucoma treated with marijuana. But the most widely accepted
medical use of marijuana is as anti-nausea among cancer patients,
AIDS and terminally ill patients. In 1996, the State of California
and Arizona voted to give physicians the right to prescribe
marijuana cigarettes for medical purposes despite the opposition
of American Medical Association. The federal government subsequently
challenged this in court. In 1997, the New England Journal
of Medicine wrote an editorial endorsing the medical use of
marijuana. Recently, tetrahydrocannabinol (THC) has been commercially
marketed as a controlled substance for nausea.
Marijuana contains about 400 chemicals with THC as the principal,
most potent component. Its receptors are found mainly in the
basal ganglia, cerebellum and hippocampus, which partly responsible
for its euphoric and cognitive effects. Few receptors are
found in the cerebral cortex and virtually none in the brainstem.
Minutes after marijuana is smoked, its euphoric effect appears,
peaks in 30 minutes and lasts 2-4 hours after. It impairs
motor and cognitive functions up to 5-12 hours. Abusers also
experience depersonalization and derealization, leading to
odd behavior and detachment from reality. Abusers have heightened
sensitivity to external stimuli and see colors brighter and
richer. They have subjective decreased appreciation of time.
Abusers have impaired reaction time, perception, motor agility,
and attention. Literature indicates that cannabis tolerance
does not develop. However, physiological and psychological
dependence do occur, leading to withdrawal syndrome characterized
by irritability, restlessness, insomnia, anorexia and mild
nausea.
Conjunctival injection (red eye) due to dilatation of blood
vessels in the eye is the most common physical effect of marijuana.
This explains why people look like Dracula with red eyes after
smoking joints. Cannabis can also cause mild increase in heart
rate and in high doses, orthostatic hypotension. It also causes
increased appetite and dry mouth. It virtually has no effect
on respiration.
Since marijuana contains carcinogens similar to tobacco, it
causes the same harmful effects to the body as cigarettes
when smoked. There is indeed higher rate of chronic respiratory
diseases and lung cancer among users. Its long-term use has
been associated with birth defects, chromosomal damage, impaired
immune system, decreased testosterone, irregular menses, shrinkage
of the brain and increased seizure susceptibility. WHO also
warned about permanent damage to the brain causing memory
impairment and cognitive decline.
Thus, teen-agers who use marijuana usually perform poorly
in school and work. And let me reiterate that marijuana use
has been considered as a "gateway drug" leading
to further drug abuse. Furthermore, marijuana causes a variety
of psychological disorders including psychosis, delirium,
flashbacks, amotivational syndrome and anxiety disorder.
How do you recognize if your child abuses marijuana? Look
out for the physical effects of marijuana such as red eyes
and unexplained increased appetite leading to weight gain.
Observe for deterioration in school performance, memory and
concentration. Another clue, especially with heavy use, is
their lack of willingness to do certain tasks at school, at
work or at home that require prolonged concentration, attention
and tenacity (amotivational syndrome). Finally, the smell
of marijuana smoke is unmistakable.
Like all other substance abuse, marijuana abuse is treated
with abstinence and support, with active participation of
the family. Compliance is monitored with urine drug screen
that detects marijuana up to 4 weeks. Education increases
success of rehabilitation. Withdrawal is treated cautiously
with mild anti-anxiety drug. And treatment of underlying depression
is a must for success.
Mary Jane is an angel of death that kills you slowly and painfully!
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