Effect of Marijuana

Marijuana facts and information
medical or medicinal uses, types, effects, side effects, addiction and tests
zhion@zhion.com November 20, 2005

In the 1970s, the baby boom generation was coming of age, and its
drug of choice was marijuana. By 1979, more than 60 percent of
12th-graders had tried marijuana at least once in their lives. From
this peak, the percentage of 12th-graders who had ever used
marijuana decreased for more than a decade, dropping to a low of 33
percent in 1992. However, in 1993, first-time marijuana use by
12th-graders was on the upswing, reaching 50 percent by 1997.
Although the percentage of 12th-graders who have experience with
marijuana has remained roughly level since then, there is still reason
to be concerned.1 In 2002, an estimated 2.6 million Americans used
marijuana for the first time. Roughly two-thirds of them were under
age 18.2 Furthermore, the marijuana that is available today can be 5
times more potent than the marijuana of the 1970s. [S3]

WHAT IS MARIJUANA?
Marijuana - often called pot, grass, reefer, weed, herb, mary jane, or mj -
is a greenish-gray mixture of the dried, shredded leaves, stems, seeds,
and flowers of Cannabis sativa, the hemp plant. Most users smoke
marijuana in hand-rolled cigarettes called joints, among other names;
some use pipes or water pipes called bongs. Marijuana cigars called
blunts have also become popular. To make blunts, users slice open
cigars and replace the tobacco with marijuana, often combined with
another drug, such as crack cocaine.[21] Marijuana also is used to brew
tea and is sometimes mixed into foods.

The major active chemical in marijuana is delta-9-tetrahydrocannabinol
(THC), which causes the mind-altering effects of marijuana intoxication.
The amount of THC (which is also the psychoactive ingredient in hashish)
determines the potency and, therefore, the effects of marijuana.
Between 1980 and 1997, the amount of THC in marijuana available in
the United States rose dramatically.[22]

MARIJUANA STATISTICS
By combining three years of data from SAMHSA's National Survey on Drug
Use and Health from 1999 to 2001, SAMHSA's Office of Applied Studies
was able to produce substate estimates of substance use.
In 1999 to 2001, past month use of marijuana varied from 2.3% in
Northwest Iowa and 2.6% in Southern Texas to 10.3% in Boulder,
Colorado and 12.2% in Boston. [S2]

Of the 15 substate areas with the highest rates of past month marijuana
use in the United States, five were in Massachusetts, three were in
California, and two were in Colorado. [S2]

A greater percentage of White youth smoke marijuana than Black youth
or Hispanics. (American Indian youth have the highest rate of marijuana
use of all ethnic groups.) [S1]

Forty-five percent of reckless drivers not impaired by alcohol tested
positive for marijuana. Illegal drugs are used by 10 to 22 percent of
drivers involved in crashes.[S1]

The risk of using cocaine is 104 times greater for those who have tried
marijuana than for those who haven't.[S1]

The average marijuana smoker spends $816 a year on his habit.[S1]

Marijuana is the number one cash crop in poor areas of Kentucky,
Tennessee, and West Virginia-more than 40 percent of the nationwide
total.[S1]

The average THC content of marijuana today is about 5 percent, more
than twice the potency of the average marijuana in the sixties. It is not
uncommon to find marijuana with 10 times the THC potency of twenty
years ago. Hash oil can be found to have 55 percent THC content.[S1]

Marijuana is the Nation's most commonly used illicit drug. More than 94
million Americans (40 percent) age 12 and older have tried marijuana at
least once, according to the 2003 National Survey on Drug Use and
Health (NSDUH).23 [S3]

Marijuana use is widespread among adolescents and young adults. The
percentage of middle-school students who reported using marijuana
increased throughout the early 1990s.24 In the past few years,
according to the 2004 Monitoring the Future Survey, an annual survey of
drug use among the Nation's middle and high school students, illicit drug
use by 8th-, 10th-, and 12th-graders has leveled off.24 Still, in 2004, 16
percent of 8th-graders reported that they had tried marijuana, and 6
percent were current users (defined as having used the drug in the 30
days preceding the survey).24 Among 10th-graders, 35 percent had tried
marijuana sometime in their lives, and 16 percent were current users.24
As would be expected, rates of use among 12th-graders were higher
still. Forty-six percent had tried marijuana at some time, and 20 percent
were current users.24 [S3]

The Drug Abuse Warning Network (DAWN), a system for monitoring the
health impact of drugs, estimated that, in 2002, marijuana was a
contributing factor in over 119,000 emergency department (ED) visits in
the United States, with about 15 percent of the patients between the
ages of 12 and 17, and almost two-thirds male.25 [S3]

In 2002, the National Institute of Justice's Arrestee Drug Abuse
Monitoring (ADAM) Program, which collects data on the number of adult
arrestees testing positive for various drugs, found that, on average, 41
percent of adult male arrestees and 27 percent of adult female arrestees
tested positive for marijuana.26 On average, 57 percent of juvenile male
and 32 percent of juvenile female arrestees tested positive for
marijuana. [S3]

NIDA's Community Epidemiology Work Group (CEWG), a network of
researchers that tracks trends in the nature and patterns of drug use in
major U.S. cities, consistently reports that marijuana frequently is
combined with other drugs, such as crack cocaine, PCP, formaldehyde,
and codeine cough syrup, sometimes without the user being aware of
it.21 Thus, the risks associated with marijuana use may be compounded
by the risks of added drugs, as well. [S3]

MEDICAL/MEDICINAL MARIJUANA HEALTH BENEFITS
There is a legal extract of marijuana's THC for cancer sufferers. It's a pill
called Merinol and requires a doctor's prescription. However, there are
no studies which indicate smoking any substance is good for the lungs or
health in general. In short, smoking marijuana for health benefits is a
contradiction in terms.[S1]

Marijuana [HU210] helps depression, research finds.
Marijuana and its derivatives have been found to be good for the brain
of rats.A drug (called HU210) modeled on marijuana's active ingredient
increased brain cells and appeared to cut anxious, depressed behavior in
rats. It is a synthetic drug that is chemically similar to marijuana's active
ingredient and activates cannabinoid receptors in the brain. [A1}

Researchres have shown that both embryonic and adult rat hippocampal
NS/PCs are immunoreactive for CB1 cannabinoid receptors, indicating
that cannabinoids could act on CB1 receptors to regulate neurogenesis.
This hypothesis is supported by further findings that HU210 promotes
proliferation, but not differentiation, of cultured embryonic hippocampal
NS/PCs likely via a sequential activation of CB1 receptors, G(i/o) proteins,
and ERK signaling. Chronic, but not acute, HU210 treatment promoted
neurogenesis in the hippocampal dentate gyrus of adult rats and
exerted anxiolytic- and antidepressant-like effects. X-irradiation of the
hippocampus blocked both the neurogenic and behavioral effects of
chronic HU210 treatment, suggesting that chronic HU210 treatment
produces anxiolytic- and antidepressant-like effects likely via promotion
of hippocampal neurogenesis.[A1, A4]

Sativex, an experimental inhaler dispensing medical marijuana in mist
form, is in its final stages of testing for marijuana. Sativex is made by GW
Pharmaceuticals, UK. It may be the first prescription for a real marijuana
product. [A2}

Marijuana has anti-inflammatory activities, research finds
Excessive inflammatory responses can emerge as a potential danger for
organisms' health. Physiological balance between pro- and
anti-inflammatory processes constitutes an important feature of
responses against harmful events. Researchers from Germany have
shown that cannabinoid receptors type 1 (CB1) mediate intrinsic
protective signals that counteract proinflammatory responses.

Both intrarectal infusion of 2,4-dinitrobenzene sulfonic acid (DNBS) and oral administration of dextrane
sulfate sodium induced stronger inflammation in CB1-deficient mice (CB1(-/-)) than in wild-type littermates
(CB1(+/+)). Treatment of wild-type mice with the specific CB1 antagonist
N-(piperidino-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-pyrazole-3-carboxamide
(SR141716A) mimicked the phenotype of CB1(-/-) mice, showing an acute requirement of CB1 receptors for
protection from inflammation. Consistently, treatment with the cannabinoid receptor agonist
R(-)-7-hydroxy-Delta(6)-tetra-hydrocannabinol-dimethylheptyl (HU210) or genetic ablation of the
endocannabinoid-degrading enzyme fatty acid amide hydrolase (FAAH) resulted in protection against
DNBS-induced colitis. Electrophysiological recordings from circular smooth muscle cells, performed 8 hours
after DNBS treatment, revealed spontaneous oscillatory action potentials in CB1(-/-) but not in CB1(+/+)
colons, indicating an early CB1-mediated control of inflammation-induced irritation of smooth muscle cells.
DNBS treatment increased the percentage of myenteric neurons expressing CB1 receptors, suggesting an
enhancement of cannabinoid signaling during colitis. Our results indicate that the endogenous cannabinoid
system represents a promising therapeutic target for the treatment of intestinal disease conditions
characterized by excessive inflammatory responses. [A3]

EFFECTS OF MARIJUANA IN GENERAL
Marijuana can cause severe anxiety, psychotic behavior, depression, and
may, in people disposed to the illness, trigger or worsen schizophrenia
[S1]

More teens smoke marijuana for the first time in June and July than any
other time of the year. Summer's unsupervised time is the likely
reason.[S1]

Within 2 weeks to 3 months of quitting smoking tobacco or marijuana,
lung function improves 30 percent. Within 9 months, lungs are better
able to fight infection. After five years, risk of lung cancer is cut in half.
After 10 years, lung cancer risk is equivalent to someone who never
smoked.[S1]

MARIJUANA EFFECTS ON BRAIN
Scientists have learned a great deal about how THC acts in the brain to
produce its many effects. When someone smokes marijuana, THC rapidly
passes from the lungs into the bloodstream, which carries the chemical
to organs throughout the body, including the brain. In the brain, THC
connects to specific sites called cannabinoid receptors on nerve cells and
thereby influences the activity of those cells. Some brain areas have
many cannabinoid receptors; others have few or none. Many
cannabinoid receptors are found in the parts of the brain that influence
pleasure, memory, thought, concentration, sensory and time perception,
and coordinated movement.27

MARIJUANA ACUTE EFFECTS
When marijuana is smoked, its effects begin immediately after the drug
enters the brain and last from 1 to 3 hours. If marijuana is consumed in
food or drink, the short-term effects begin more slowly, usually in 1/2 to
1 hour, and last longer, for as long as 4 hours. Smoking marijuana
deposits several times more THC into the blood than does eating or
drinking the drug.28

Within a few minutes after inhaling marijuana smoke, an individual's
heart begins beating more rapidly, the bronchial passages relax and
become enlarged, and blood vessels in the eyes expand, making the
eyes look red. The heart rate, normally 70 to 80 beats per minute, may
increase by 20 to 50 beats per minute or, in some cases, even double.15
This effect can be greater if other drugs are taken with marijuana.29

As THC enters the brain, it causes a user to feel euphoric - or "high" - by
acting in the brain's reward system, areas of the brain that respond to
stimuli such as food and drink as well as most drugs of abuse. THC
activates the reward system in the same way that nearly all drugs of
abuse do, by stimulating brain cells to release the chemical
dopamine.30,31,32

A marijuana user may experience pleasant sensations, colors and
sounds may seem more intense, and time appears to pass very slowly.
The user's mouth feels dry, and he or she may suddenly become very
hungry and thirsty. His or her hands may tremble and grow cold. The
euphoria passes after awhile, and then the user may feel sleepy or
depressed. Occasionally, marijuana use produces anxiety, fear, distrust,
or panic.

Heavy marijuana use impairs a person's ability to form memories, recall
events (see Marijuana, Memory, and the Hippocampus), and shift
attention from one thing to another.8,33 THC also disrupts coordination
and balance by binding to receptors in the cerebellum and basal ganglia,
parts of the brain that regulate balance, posture, coordination of
movement, and reaction time.11 Through its effects on the brain and
body, marijuana intoxication can cause accidents. Studies show that
approximately 6 to 11 percent of fatal accident victims test positive for
THC. In many of these cases, alcohol is detected as well.34, 35, 36

In a study conducted by the National Highway Traffic Safety
Administration, a moderate dose of marijuana alone was shown to impair
driving performance; however, the effects of even a low dose of
marijuana combined with alcohol were markedly greater than for either
drug alone37. Driving indices measured included reaction time, visual
search frequency (driver checking side streets), and the ability to
perceive and/or respond to changes in the relative velocity of other
vehicles.

Marijuana users who have taken high doses of the drug may experience
acute toxic psychosis, which includes hallucinations, delusions, and
depersonalization - a loss of the sense of personal identity, or
self-recognition.10,15 Although the specific causes of these symptoms
remain unknown, they appear to occur more frequently when a high
dose of cannabis is consumed in food or drink rather than smoked.

MARIJUANA EFFECT ON HEALTH
Marijuana use has been shown to increase users' difficulty in trying to
quit smoking tobacco.38 This was reported in a study comparing smoking
cessation in adults who smoked both marijuana and tobacco with those
who smoked only tobacco. The relationship between marijuana use and
continued smoking was particularly strong in those who smoked
marijuana daily at the time of the initial interview, 13 years prior to the
followup interview.

MARIJUANA SIDE EFFECTS
A study of 450 individuals found that people who smoke marijuana
frequently but do not smoke tobacco have more health problems and
miss more days of work than nonsmokers do.39 Many of the extra sick
days used by the marijuana smokers in the study were for respiratory
illnesses. [S3]

Even infrequent marijuana use can cause burning and stinging of the
mouth and throat, often accompanied by a heavy cough. Someone who
smokes marijuana regularly may have many of the same respiratory
problems that tobacco smokers do, such as daily cough and phlegm
production, more frequent acute chest illnesses, a heightened risk of
lung infections, and a greater tendency toward obstructed airways.4 [S3]

Cancer of the respiratory tract and lungs may also be promoted by
marijuana smoke.4 A study comparing 173 cancer patients and 176
healthy individuals produced strong evidence that smoking marijuana
increases the likelihood of developing cancer of the head or neck, and
that the more marijuana smoked, the greater the increase.17 A
statistical analysis of the data suggested that marijuana smoking
doubled or tripled the risk of these cancers. [S3]

Marijuana has the potential to promote cancer of the lungs and other
parts of the respiratory tract because it contains irritants and
carcinogens.40 In fact, marijuana smoke contains 50 percent to 70
percent more carcinogenic hydrocarbons than does tobacco smoke.41 It
also produces high levels of an enzyme that converts certain
hydrocarbons into their carcinogenic form, levels that may accelerate the
changes that ultimately produce malignant cells.42 Marijuana users
usually inhale more deeply and hold their breath longer than tobacco
smokers do, which increases the lungs' exposure to carcinogenic smoke.
These facts suggest that, puff for puff, smoking marijuana may increase
the risk of cancer more than smoking tobacco does. [S3]

Some adverse health effects caused by marijuana may occur because
THC impairs the immune system's ability to fight off infectious diseases
and cancer. In laboratory experiments that exposed animal and human
cells to THC or other marijuana ingredients, the normal
disease-preventing reactions of many of the key types of immune cells
were inhibited.16 In other studies, mice exposed to THC or related
substances were more likely than unexposed mice to develop bacterial
infections and tumors.14,43 [S3]

One study has indicated that a person's risk of heart attack during the
first hour after smoking marijuana is four times his or her usual risk.44
The researchers suggest that a heart attack might occur, in part,
because marijuana raises blood pressure and heart rate and reduces
the oxygen-carrying capacity of blood. [S3]

MARIJUANA USE -EFFECTS ON SCHOOL, WORK, AND SOCIAL LIFE
Students who smoke marijuana get lower grades and are less likely to
graduate from high school, compared with their nonsmoking
peers.20,45,46,47 [S3]

Workers who smoke marijuana are more likely than their coworkers to
have problems on the job. Several studies have associated workers'
marijuana smoking with increased absences, tardiness, accidents,
workers' compensation claims, and job turnover. A study among postal
workers found that employees who tested positive for marijuana on a
pre-employment urine drug test had 55 percent more industrial
accidents, 85 percent more injuries, and a 75 percent increase in
absenteeism compared with those who tested negative for marijuana
use.48 [S3]

Depression18, anxiety18, and personality disturbances50 are all
associated with marijuana use. Research clearly demonstrates that
marijuana use has the potential to cause problems in daily life or make a
person's existing problems worse. Because marijuana compromises the
ability to learn and remember information, the more a person uses
marijuana the more he or she is likely to fall behind in accumulating
intellectual, job, or social skills. In one study of cognition, adults were
matched on the basis of their performance in the 4th grade on the Iowa
Test of Basic Skills. They were evaluated on a number of cognitive
measures including the 12th-grade version of the Iowa Test. Those who
were heavy marijuana smokers scored significantly lower on
mathematical skills and verbal expression than nonsmokers.9 [S3]

Moreover, research has shown that marijuana's adverse impact on
memory and learning can last for days or weeks after the acute effects of
the drug wear off.9,51 For example, a study of 129 college students
found that among heavy users of marijuana - those who smoked the
drug at least 27 of the preceding 30 days - critical skills related to
attention, memory, and learning were significantly impaired, even after
they had not used the drug for at least 24 hours.33 The heavy marijuana
users in the study had more trouble sustaining and shifting their
attention and in registering, organizing, and using information than did
the study participants who had used marijuana no more than 3 of the
previous 30 days. As a result, someone who smokes marijuana once
daily may be functioning at a reduced intellectual level all of the time.
More recently, the same researchers showed that a group of long-term
heavy marijuana users' ability to recall words from a list was impaired 1
week following cessation of marijuana use, but returned to normal by 4
weeks.51 An implication of this finding is that even after long-term heavy
marijuana use, if an individual quits marijuana use, some cognitive
abilities may be recovered. [S3]

Another study produced additional evidence that marijuana's effects on
the brain can cause cumulative deterioration of critical life skills in the
long run. Researchers gave students a battery of tests measuring
problem-solving and emotional skills in 8th grade and again in 12th
grade.52 The results showed that the students who were already
drinking alcohol plus smoking marijuana in 8th grade started off slightly
behind their peers, but that the distance separating these two groups
grew significantly by their senior year in high school. The analysis linked
marijuana use, independently of alcohol use, to reduced capacity for
self-reinforcement, a group of psychological skills that enable individuals
to maintain confidence and persevere in the pursuit of goals. [S3]

Marijuana users themselves report poor outcomes on a variety of
measures of life satisfaction and achievement. A recent study compared
current and former long-term heavy users of marijuana with a control
group who reported smoking cannabis at least once in their lives, but not
more than 50 times. Despite similar education and incomes in their
families of origin, significant differences were found on educational
attainment and income between heavy users and the control group:
fewer of the cannabis users completed college and more had household
incomes of less than $30,000. When asked how marijuana affected their
cognitive abilities, career achievements, social lives, and physical and
mental health, the overwhelming majority of heavy cannabis users
reported the drug's deleterious effect on all of these measures.53 [S3]

MARIJUANA USE- HEARMFUL EFFECT ON BABY DURING PREGNANCY
Research has shown that some babies born to women who used
marijuana during their pregnancies display altered responses to visual
stimuli, increased tremulousness, and a high-pitched cry, which may
indicate problems with neurological development.54, 75 During the
preschool years, marijuana-exposed children have been observed to
perform tasks involving sustained attention and memory more poorly
than nonexposed children do.55,56 In the school years, these children
are more likely to exhibit deficits in problem-solving skills, memory, and
the ability to remain attentive.55,56[S3]

MARIJUANA ADDICTION
Marijuana can be addictive. More youth ages 12 to 17 (60 percent in
1999) enter substance abuse treatment for marijuana use than all other
drug abuse combined, including alcohol.[S1]

Admission for drug treatment for marijuana dependence for youth ages
12 to 17 increased 43 percent from 1994 to 1999. More than half (57
percent) of these youth had used marijuana before the age of 14.[S1]

There are almost one million listings for "marijuana" on Internet search
engines, but about 90 percent of them are pro-legalization or glorify
marijuana use. [S1]

Some cognitive deficits associated with marijuana appear to be
reversible after a month of abstinence. However, those who use
marijuana heavily for several years, whether they finally quit or not, tend
to have markedly lower income and education levels than those who
have not used it.[S1]

Long-term marijuana use can lead to addiction for some people; that is,
they use the drug compulsively even though it often interferes with
family, school, work, and recreational activities. According to the 2003
National Survey on Drug Use and Health (NSDUH), an estimated 21.6
million Americans aged 12 or older were classified with substance
dependence or abuse (9.1 percent of the total population). Of the
estimated 6.9 million Americans classified with dependence on or abuse
of illicit drugs, 4.2 million were dependent on or abused marijuana.57 In
2002, 15 percent of people entering drug abuse treatment programs
reported that marijuana was their primary drug of abuse.58[S3]

Along with craving, withdrawal symptoms can make it hard for long-term
marijuana smokers to stop using the drug.49 People trying to quit report
irritability, difficulty sleeping, and anxiety.59,60 They also display
increased aggression on psychological tests, peaking approximately 1
week after they last used the drug.61[S3]

In addition to its addictive liability, research indicates that early exposure
to marijuana can increase the likelihood of a lifetime of subsequent drug
problems. A recent study of over 300 fraternal and identical twin pairs,
who differed on whether or not they used marijuana before the age of
17, found that those who had used marijuana early had elevated rates
of other drug use and drug problems later on, compared with their twins,
who did not use marijuana before age 17. This study re-emphasizes the
importance of primary prevention by showing that early drug initiation is
associated with increased risk of later drug problems, and it provides
more evidence for why preventing marijuana experimentation during
adolescence could have an impact on preventing addiction.62[S3]

MARIJUANA TREATMENTS
Treatment programs directed solely at marijuana abuse are rare, partly
because many who use marijuana do so in combination with other drugs,
such as cocaine and alcohol. However, with more people seeking help to
control marijuana abuse, research has focused on ways to overcome
problems with abuse of this drug.63[S3]

One study of adult marijuana users found comparable benefits from a
14-session cognitive-behavioral group treatment and a 2-session
individual treatment that included motivational interviewing and advice
on ways to reduce marijuana use.64 Participants were mostly men in
their early thirties who had smoked marijuana daily for over 10 years. By
increasing patients' awareness of what triggers their marijuana use,
both treatments sought to help them devise avoidance strategies. Use,
dependence symptoms, and psychosocial problems decreased for at
least 1 year after both treatments. About 30 percent of users were
abstinent during the last 3-month followup period. Another study
suggests that giving patients vouchers for abstaining from marijuana can
improve outcomes.65 Vouchers can be redeemed for such goods as
movie passes, sports equipment, or vocational training.[S3]

No medications are now available to treat marijuana abuse. However,
recent discoveries about the workings of THC receptors have raised the
possibility that scientists may eventually develop a medication that will
block THC's intoxicating effects. Such a medication might be used to
prevent relapse to marijuana abuse by reducing or eliminating its
appeal.[S3]

MARIJUANA TEST
Most THC/marijuana drug tests are based on the prinicple of the highly
specific immunochemical reactions between antigens and antibodies,
which are used for the analysis of specific substances in biological fluids.
The senstivity is usualy 50 ng/ml of THC.

The peak effect of smoking marijuana occurs in 20-30 minutes and the
duration is 90-120 minutes after one cigarette. Elevated urinary
metabolite levels are found within hours of exposure and remain
detectable for 3-20 days after smoking.

Currently, there are also saliva drug test kits for marijuana (THC).

GLOSSARY
Addiction: A chronic, relapsing disease characterized by compulsive
drug-seeking and abuse and by long-lasting chemical changes in the
brain.

Cannabinoids: Chemicals that help control mental and physical
processes when produced naturally by the body and that produce
intoxication and other effects when absorbed from marijuana.

Carcinogen: Any substance that causes cancer.

Dopamine: A brain chemical, classified as a neurotransmitter, found in
regions of the brain that regulate movement, emotion, motivation, and
pleasure.

Hippocampus: An area of the brain crucial for learning and memory.

Hydrocarbon: Any chemical compound containing only hydrogen and
carbon.

Psychoactive: Having a specific effect on the mind.

THC: Delta-9-tetrahydrocannabinol; the main active ingredient in
marijuana, which acts on the brain to produce its effects.

Withdrawal: Symptoms that occur after use of a drug is reduced or
stopped.

QUESTION: HOW LONG DOES MARIJUANA STAY IN OUR
BODY?

Pharmacokinetics of cannabinoids.Pain Res Manag. 2005
Autumn;10(A):15A-22A. McGilveray IJ., McGilveray Pharmacon Inc,
Ottawa, Canada.

Delta-9-tetrahydrocannabinol (Delta-9-THC) is the main psychoactive
ingredient of cannabis (marijuana). The present review focuses on the
pharmacokinetics of THC, but also includes known information for
cannabinol and cannabidiol, as well as the synthetic marketed
cannabinoids, dronabinol (synthetic THC) and nabilone. The variability of
THC in plant material (0.3% to 30%) leads to variability in tissue THC
levels from smoking, which is, in itself, a highly individual process. THC
bioavailability averages 30%. With a 3.55% THC cigarette, a peak
plasma level of 152&mnplus;86.3 ng/mL occured approximately 10 min
after inhalation. Oral THC, on the other hand, is only 4% to 12%
bioavailable and absorption is highly variable. THC is eliminated from
plasma in a multiphasic manner, with low amounts detectable for over
one week after dosing. A major active 11-hydroxy metabolite is formed
after both inhalation and oral dosing (20% and 100% of parent,
respectively). THC is widely distributed, particularly to fatty tissues, but
less than 1% of an administered dose reaches the brain, while the
spleen and body fat are long-term storage sites. The elimination of THC
and its many metabolites (from all routes) occurs via the feces and urine.
Metabolites persist in the urine and feces for several weeks. Nabilone is
well absorbed and the pharmacokinetics, although variable, appear to be
linear from oral doses of 1 mg to 4 mg (these doses show a plasma
elimination half-life of approximately 2 h). As with THC, there is a high
first-pass effect, and the feces to urine ratio of excretion is similar to
other cannabinoids. Pharmacokinetic-pharmacodynamic modelling with
plasma THC versus cardiac and psychotropic effects show that after
equilibrium is reached, the intensity of effect is proportional to the
plasma THC profile. Clinical trials have found that nabilone produces less
tachycardia and less euphoria than THC for a similar antiemetic response.

Assay of plasma cannabidiol by capillary gas chromatography/ion
trap mass spectroscopy following high-dose repeated daily oral
administration in humans.Pharmacol Biochem Behav. 1991
Nov;40(3):517-22. Consroe P, Kennedy K, Schram K.College of
Pharmacy, University of Arizona Health Sciences Center, Tucson 85721.

Plasma levels of cannabidiol (CBD) were ascertained weekly in 14
Huntington's disease patients undergoing a double-blind,
placebo-controlled, crossover trial of oral CBD (10 mg/kg/day = about
700 mg/day) for 6 weeks. The assay procedure involved trimethylsilyl
(TMS) derivatization of CBD and the internal standard
delta-6-tetrahydrocannabinol (THC), capillary column gas
chromatography, ion trap mass spectroscopy in positive ion chemical
ionization mode using isobutane, and calculations of CBD levels based on
peak ion intensity of the 387 M + H peak of delta-6-THC-TMS and the 459
M + H peak of CBD-2TMS. The sensitivity of the assay was about 500
pg/ml, and the precision was about 10-15%. Mean plasma levels of CBD
ranged from 5.9-11.2 ng/ml over the 6 weeks of CBD administration. CBD
levels averaged 1.5 ng/ml one week after CBD was discontinued, and
were virtually undetectable thereafter. The elimination half-life of CBD
was estimated to be about 2-5 days, and there were no differences
between genders for half-life or CBD levels. Additionally, no plasma
delta-1-THC, the major psychoactive cannabinoid of marijuana, was
detected in any subject.

Human urinary excretion profile after smoking and oral administration
of [14C]delta 1-tetrahydrocannabinol.J Anal Toxicol. 1990
May-Jun;14(3):176-80. Johansson E, Gillespie HK, Halldin MM.
Department of Pharmacognosy, BMC, Uppsala, Sweden.

The urinary excretion profiles of delta 1-tetrahydrocannabinol (delta
1-THC) metabolites have been evaluated in two chronic and two naive
marijuana users after smoking and oral administration of [14C]delta
1-THC. Urine was collected for five days after each administration route
and analyzed for total delta 1-THC metabolites by radioactivity
determination, for delta 1-THC-7-oic acid by high-performance liquid
chromatography, and for cross-reacting cannabinoids by the EMIT d.a.u.
cannabinoid assay. The average urinary excretion half-life of 14C-labeled
delta 1-THC metabolites was calculated to be 18.2 +/- 4.9 h (+/- SD). The
excretion profiles of delta 1-THC-7-oic acid and EMIT readings were
similar to the excretion profile of 14C-labeled metabolites in the naive
users. However, in the chronic users the excretion profiles of delta
1-THC-7-oic acid and EMIT readings did not resemble the radioactive
excretion due to the heavy influence from previous Cannabis use.
Between 8-14% of the radioactive dose was recovered in the urine in
both user groups after oral administration. Lower urinary recovery was
obtained both in the chronic and naive users after smoking--5 and 2%,
respectively.

Urinary excretion half-life of delta 1-tetrahydrocannabinol-7-oic acid
in heavy marijuana users after smoking.J Anal Toxicol. 1989
Jul-Aug;13(4):218-23. Johansson E, Halldin MM. Department of
Pharmacognosy, Uppsala, Sweden.

The urinary excretion of the total amount of delta 1-tetrahydrocannabinol
(delta 1-THC) metabolites, with special emphasis on delta
1-tetrahydrocannabinol-7-oic acid (delta 1-THC-7-oic acid), was studied
in thirteen heavy Cannabis users after smoking administration of delta
1-THC, followed by a four week discontinuation period. The total amount
of delta 1-THC metabolites and the levels of delta 1-THC-7-oic acid could
be followed up to 25 days after abstinence using EMIT d.a.u. cannabinoid
assay and high-performance liquid chromatography (HPLC). The urinary
excretion half-life, calculated from the concentrations of delta 1-THC-7-oic
acid versus time, ranged from 0.8-9.8 days with a mean (+/- SD) of 3.0
+/- 2.3 days. Most of the delta 1-THC-7-oic acid was excreted as
conjugate and only trace amounts of unconjugated delta 1-THC-7-oic
acid were detected. The total concentrations of delta 1-THC-7-oic acid in
urine were compared to the concentrations of "cross-reacting
cannabinoids", within the linear range of 20-75 ng/mL, obtained in the
semiquantitative EMIT d.a.u. cannabinoid assay. The average ratio of
"EMIT concentrations"/delta 1-THC-7-oic acid concentrations obtained by
HPLC analysis was 1.23 +/- 84% (C.V.) for 78 urine samples. A total of
83% of the samples with positive EMIT levels (cutoff 20 ng/mL) was
confirmed by HPLC analysis (cutoff 7 ng/mL).

Terminal elimination plasma half-life of delta 1-tetrahydrocannabinol
(delta 1-THC) in heavy users of marijuana. Eur J Clin Pharmacol.
1989;37(3):273-7. Johansson E, Halldin MM, Agurell S, Hollister LE,
Gillespie HK. Department of Pharmacognosy, Uppsala University, Sweden.

The terminal elimination half-life of delta 1-tetrahydrocannabinol (delta
1-THC) was investigated in eight men who were heavy users of
marijuana. A stable isotope assay, following smoking deuterium-labeled
delta 1-THC, was used to determine plasma concentrations. In two
additional users plasma levels were followed after administration of
unlabeled delta 1-THC. The subjects were asked to smoke a "loading
dose" of 56 mg delta 1-THC during two days and then abstain from all
marijuana use for 4 weeks. The pharmacokinetic behavior was consistent
with a multicompartment model with a mean plasma elimination half-life
of delta 1-THC of 4.3 days when concentrations were followed for 10-15
days after smoking. In the two subjects with detectable plasma levels
during 4 weeks, half-lives of 9.6 and 12.6 days was obtained.

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[A1] Marijuana can relieve depression, scientists say.999 Today, UK October 14,
2005
[A2} Medical marijuana test inhaler, Medical News Today, Feb 16, 2004[A3] Massa
F, et al, The endogenous cannabinoid system protects against colonic
inflammation.J Clin Invest. 2004 Apr;113(8):1202-9. [A4] Jiang W et al,
Cannabinoids promote embryonic and adult hippocampus neurogenesis and
produce anxiolytic- and antidepressant-like effects.J Clin Invest. 2005 Nov
1;115(11):3104-3116. Epub 2005 Oct 13.

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