Dependence, marijuana

Marijuana is equated in law with the opiates, but the abuse characteristic of the two have almost nothing in common. The opiate produces physical dependence. Marijuana does not. A withdrawal sickness appears when use of the opiates is discontinued. No such symptoms are associated with marijuana. The desired dose of opiates tends to increase over time, but this is not true of marijuana. Both can lead to psychic dependence, but so can almost any substance that alters the state of consciousness. 

Keywords Cannabinoid Dependence Marijuana THC Withdrawal - Tolerance Rimonabant Cannabis... 

Psychosocial and environmental factors play a major role in the development and recovery from opioid dependence however, a detailed discussion is beyond the scope of this chapter. In general, the use of such drugs as marijuana and alcohol precedes the use of opioids (Clayton and Voss 1981 Kandel and Faust 1975). Although one cannot predict definitively which users will proceed to opioid use, those who do generally have low self-esteem, disrupted families, and/or difficult relationships with their parents. The increased availability of opioids in inner cities of major urban centers contributes to initiation of use and relapse. It is particularly difficult to avoid use and relapse in areas with high unemployment, poor school systems, and high crime rates, because living in such an area may contribute to the very affects opioid use temporarily reheves. 

Research on CBl knockout mice demonstrated the pivotal role of CBl receptors in cannabis dependence knockout mice have been shown not to self-administer cannabinoids (Ledent et al. 1999) and also to fail to exhibit symptoms ofSRl417l6A-precipitated withdrawal (Ledent et al. 1999 Lichtman et al. 2001). Although the research summarized earlier is consistent in reporting the occurrence of a variety of withdrawal symptoms following cessation of exposure to cannabinoids (which were injected), precipitated withdrawal in mice following chronic exposure to marijuana smoke was more recently reported (Lichtman and Martin 2002). 

Budney AJ, Radonovich KJ, Higgins ST, et al Adults seeking treatment for marijuana dependence a comparison with cocaine-dependent treatment seekers. Exp Clin Psychopharmacol 6 419 26, 1998... 

Budney AJ, Higgins ST, Radonivich KJ, et al Adding voucher-based incentives to coping skills and motivational enhancement improves outcomes during treatment for marijuana dependence. J Consult Clin Psychol 68 1051-1061, 2000... 

Roffman RA, Barnhart R Assessing need for marijuana dependence treatment through an anonymous telephone interview. Int J Addict 22 639-631, 1987 Russo EB Clinical endocannabinoid deficiency (CECD) can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions Neuro Endocrinol Lett 25(1-2) 31—39, 2004... 

J Consult Clin Psychol 61 1100—1104, 1993 Stephens RS, Roffman RA, Simpson EE Treating adult marijuana dependence a test of the relapse prevention model. J Consult Clin Psychol 62 92—99, 1994 Stephens RS, Roffman RA, Curtin L Comparison of extended versus brief treatments for marijuana use. J Counsul Clin Psychol 68 898—908, 2000 Substance Abuse and Mental Health Services Administration The BASIS Report Marijuana Treatment Admissions Increase 1993-1999. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002a Substance Abuse and Mental Health Services Administration Results from the 2001 National Household Survey on Brug Abuse Vol I. Summary of National Findings. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002b... 

Relatively few human imaging studies have evaluated the effects of marijuana or THC on metabolism or blood flow. Acute intravenous THC in both normal controls and habitual marijuana users led to increased an increased regional cerebral metabolic rate (CMR) in the cerebellum. This increase is positively correlated both with concentrations of THC in the plasma and with the intensity of the subjective sense of intoxication [5]. In a 1997 PET/[lsO]water study with 32 abusers [6], THC dose-depend-ently increased cerebral blood flow (CBF) in the frontal regions, insula... 

Miller NS and Gold MS (1989). The diagnosis of marijuana (cannabis) dependence. Journal of Substance Abuse and Treatment, 6, 183-192. 

In contrast, some drugs of abnse prodnce intense craving and are highly addictive bnt do not prodnce physical dependence. The absence of physical dependence indicates the relative lack of physiological withdrawal. This is not synonymous with meaning that discontinuation of these componnds may not be psychologically nncomfortable. Two examples are marijnana and cocaine. One need only look to the recent crack epidemic to see evidence of the way these substances can destroy lives, bnt they do not produce tolerance or risk of withdrawal to the same extent as alcohol or heroin. As a result, we would say that the daily crack or marijuana user meets the dehnition of substance dependence bnt does not exhibit true physical (or physiological) dependence. 

Social factors such as peer pressure at school or work as well as family patterns of substance use can also contribute to the risk. Teenagers who respond to pressure to use gateway drugs such as alcohol, tobacco, and marijuana in their early teens are more likely to develop substance dependence disorders than those who refrain from doing so until their late teens. 

Phase III study completed as obesity treatment. Also being studied as treatment for marijuana dependence. 

Depending on the circumstances, it is legal to use these drugs for medical purposes. Eight states currently allow sick people to use marijuana for... 

Tolerance develops to many of A -THC s effects in heavy marijuana users. Although chronic cannabis use does not result in severe withdrawal symptoms, numerous case reports attest to development of dependence in subjects taking high doses of THC for several weeks. The most prominent symptoms were irritability and restlessness others included insomnia, anorexia, increased sweating, and mild nausea. Cessation of mild or moderate use of marijuana, however, does not produce a withdrawal syndrome. 

Donovan et al. (1996, 1997) completed an open study evaluating the use of valproic acid (Depakote) in adolescent outpatients with marijuana abuse or dependence and explosive mood disorder (mood symptoms were not classified using the DSM FV Diagnostic System). Eight subjects were prescribed 1000 mg of valproic acid (Depakote) for 5 weeks, in addition to regular therapy sessions, but did not receive any other psychotropic medications. All subjects showed a significant improvement in their marijuana use (p <0.007) and their affective symptoms (p < 0.001), although both outcomes were measured only by self-report. The most common adverse events were nausea and sedation. No subjects discontinued because of these side effects, nor were there any reported interactions between the valproic acid (Depakote) and substances of abuse. 

Adolescents with mood lability and marijuana abuse/dependency in outpatient treatment... 

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