Cannabis Opioids

A generic term relating to psychological and/a physical dependence when one or mae psychoactive substances or classes of psychoaaive substances are abused (alcohol sedatives, hypnotics and anxiolytics cannabis opioids cocaine amphetamine and other sympathomimetics hallucinogens caffeine nicotine ... 

Comparable findings for lifetime prevalence of psychiatric disorders were obtained in another study of 133 persons, which also found that 47% received a concurrent DSM-III diagnosis of substance abuse or dependence (Khantzian and Treece 1985). The most frequently abused substances were sedative-hypnotics (23%), alcohol (14%), and cannabis (13%). Similar rates of psychiatric disorders were found in other studies of drug abusers (Mirin et al. 1986 Woody et al. 1983). Although such diagnoses do not imply causality, and, in many cases, opioid dependence causes or exacerbates psychiatric problems, some causal link seems likely (Regier et al. 1990). 

Identify the typical signs and symptoms of intoxication associated with the use of alcohol, opioids, cocaine/amphetamines, and cannabis, and determine the appropriate treatment measures to produce a desired outcome following episodes of intoxication. 

The abused substances covered in this chapter include nicotine, alcohol, cocaine, amphetamines, cannabis, and opioids. While many more substances can be and have been abused, these drugs are among the most popular. 

Marijuana and hashish are derivatives of the cannabis sativa plant 919 Cannabinoid effects in the CNS are mediated by the CB1 receptor 919 Endocannabinoids are endogenous ligands for the CB1 receptor 919 Endocannabinoids serve as retrograde messengers 920 There are many similarities between endogenous opioid and cannabinoid systems 921... 

Cessation of chronic cannabis use is known to produce a withdrawal syndrome consisting of restlessness, irritability, insomnia, nausea, and muscle cramping (table 10.9) (O Brien 1996). However, this syndrome is only seen in people who use high daily amounts and then suddenly stop (O Brien 1996). These symptoms are not usually seen in clinical populations, and frequent users of cannabis are not driven by a fear to avoid a withdrawal syndrome as seen in opioid addiction. 

Ultimately, the cultivation, sale, and possession of cannabis is illegal at present in most places. Individuals who use it for whatever purpose in most areas carry the risk of arrest and prosecution. From the perspective of addictiveness, it seems inconsistent that cannabis use is prohibited, while the use of alcohol and nicotine are permitted. Apart from arguments about the recreational use of cannabis, resistance to its medical application is even more inconsistent. For example, the opioids carry some risk for dependence, but with medical supervision they are useful medications and their abuse is minimal (Joranson et al. 2000). Whether use of cannabis is to be permitted and for which purposes (medical or recreational) remains to be collectively decided by society and the legislators it appoints. 

Drugs used recreationally - LSD, MDMA, phencyclidine, ketamine, cannabis, volatile solvents, opioids, cocaine, amphetamines, benzodiazepines, anticholinergics. 

Minozzi S, Amato L, Vecchi S, Davoli M, Kirchmayer U, Verster A. Oral naltrexone maintenance treatment for opioid dependence. Cochrane Database Syst Rev 2006. Moore THM, Zammit S, Lingford-Hughes A, Barnes TRE, Jones PB, Burke M et al. Cannabis use and risk of psychotic or affective mental health outcomes a systematic review. Lancet 2007 370 319-28. 

CS285 HemandeZ Avila, C. A., B. J. Rounsa-ville, and H. R. Kranzler. Opioid-, cannabis- and alcohol-dependent women show more rapid progression to sub-... 

The opium alkaloids codeine and morphine served as models for the synthesis of naloxone, an important analog used to treat and diagnose opiate addicts, and also led to the discovery of endogenous opioids (enkephalins and endorphins) (see Chapter 47). Similarly, A9-tetrahydro-cannabinol (THC), the component of Cannabis sativa responsible for the central nervous system (CNS) effect, has also been found to reduce nausea associated with cancer chemotherapy (see Chapter 18). 

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