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Marijuana Brain Functions Treatment Options Paul Nims MA, CRADC, CCDP-D Co-Occurring Disorders Program Coordinator BJC Behavioral Health The main intoxicating chemical in Marijuana is Tetrahydrocannabinol also known as delta-9tetrahydrocannabinol (Δ9-THC) is the principal psychoactive constituent of the cannabis plant. Among the best known of these actions is the ability of marijuana, and congeners of its active ingredient, Δ9-tetrahydrocannabinol (Δ9-THC), to disrupt sensory processing and learning and memory in animals and humans (Deadwyler et al., 1990; Hampson & Deadwyler, 1999; Sullivan, 2000). Marijuana has been altered from its original form with gene manipulation to be more potent. (Mendal and his peas) The potency of Marijuana varies greatly. Some samples from 2008 were as high as 37.20% Inhaled smoke is a suboptimal delivery method for any agent intended to be healthpromoting in any way. (ASAM-Public Policy Statement on Marijuana) Smoked marijuana has the potential to be as, or more, harmful than cigarettes. It contains 50 to 70 percent more carcinogenic compounds, including tar, than cigarettes (NIDA, 2005; Hubbard et al., 1999). Marijuana also produces high levels of a particular enzyme which converts certain hydrocarbons into their carcinogenic or malignant forms (NIDA, 2005). In 1988, Allyn Howlett and William Devane used radioimmunoassay techniques to characterize the existence of a cannabinoid receptor in a rat brain. In 1990, Miles Herkenham and his team mapped the locations of a cannabinoid receptor system in several mammalian species, including man. Receptors are most dense in the basal ganglia, hippocampus, and cerebellum Pic of brain with THC Receptors The Reward Pathway (ventral tegmental area) Based on this substantial body of empirical research, the American Psychiatric Association (APA) has long recognized cannabis dependence as a valid and reliable psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In a survey conducted by NIDA in 1994, epidemiologist James Anthony found that of those who tried marijuana at least once, about 9 percent eventually became addicted. 8 Major Life Areas 1. 2. 3. 4. 5. 6. 7. 8. Psychological Physical Family Legal Financial School or Work Friends Interpersonal Relationships Basic guidelines ◦ Substance Abuse Clinically Significant Impairment in Psychological plus 3 other major life areas ◦ Substance Dependence Clinically Significant Impairment in Psychological and Physical plus 3 other major life areas Activities center around the use of substance Occasional intoxication – increasing frequency PSYCHOLOGICAL relief use View drug as a friend Physical tolerance mild to moderate Mood swings Pre- and post- using Fragmented Blackout Makes poor/dangerous choices around substances “must have the substance to function normally.” Attempts to control fail Moderate to Severe Tolerance Geographical Escapes Significant impairment in social and School/occupational functioning Withdrawal symptoms pronounced A physiological change resulting from repeated drug use that requires the user to take larger amounts of the drug to get the same effects initially felt from a smaller dose. When marijuana-dependent individuals stop using the drug, they experience symptoms of: ◦ ◦ ◦ ◦ ◦ ◦ ◦ irritability anger cravings decreased appetite insomnia interpersonal hypersensitivity yawning and/or fatigue (Budney et al., 2001; Preuss et al., 2010) Residential ◦ Hospital ◦ Medical Assisted Detox ◦ Inpatient Treatment Out Patient Treatment ◦ Partial Hospitalization or Intensive Out Patient ◦ Traditional Out Patient ◦ Relapse Prevention Treatment People Works Recover NCADA-Helpline: ◦ (314) 962-3456 MO Dept. of Mental Health ◦ (573) 751-4942 or (800) 575-7480 ACT Missouri ◦ (573)-635-6669