Cannabis (drug)
Template:Pp-move-indef Template:Pp-semi-vandalismTemplate:Infobox botanical product Cannabis, also known as marijuana<ref>Template:Cite bookSee also article on Marijuana as a word.</ref> and by numerous other names,Template:Cref is a preparation of the Cannabis plant intended for use as a psychoactive drug or medicine.<ref>Template:ShorterOxfordEnglishDictionary</ref><ref name="Dictionaries2007">Template:Cite book</ref> The main psychoactive part of cannabis is tetrahydrocannabinol (THC); it is one of 483 known compounds in the plant,<ref name="Russo2013">Template:Cite book</ref> including at least 84 other cannabinoids, such as cannabidiol (CBD), cannabinol (CBN), and tetrahydrocannabivarin (THCV).<ref>Template:Cite journal</ref><ref name="pmid19124693">Template:Cite journal</ref>
Cannabis is often consumed for its mental and physical effects, such as a "high" or "stoned" feeling, a general alteration of conscious perception,<ref>https://cannabislink.ca/info/MotivationsforCannabisUsebyCanadianAdults-2008.pdfTemplate:Full citation needed</ref> heightened mood, relaxation,<ref name="NLMNIH">Template:Cite web</ref> and an increase in appetite.<ref>Template:Cite web</ref> Possible side effects include a decrease in short-term memory, dry mouth, impaired motor skills, red eyes,<ref name="NLMNIH" /> and feelings of paranoia or anxiety.<ref>Template:Cite journal</ref> Onset of effects is within minutes when smoked and about 30 minutes when eaten as a cooked cannabis edible.<ref name=Ri2010/> They last for between two and six hours.<ref name=Ri2010>Template:Cite book</ref>
Cannabis is mostly used recreationally or as a medicinal drug. It may also be used as part of religious or spiritual rites. In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65).<ref name=WDR2015>Template:Cite book</ref> In 2015, almost half of the people in the United States have tried marijuana, 12% have used it in the past year, and 7.3% have used it in the past month.<ref name="6 facts about marijuana">Template:Cite web</ref>
The earliest recorded uses date from the 3rd millennium BC.<ref name="Booth2003">Template:Cite book</ref> Since the early 20th century, cannabis has been subject to legal restrictions, with the possession, use, and sale of cannabis preparations containing psychoactive cannabinoids currently illegal in most countries of the world; the United Nations deems it the most-used illicit drug in the world.<ref>Template:Cite web</ref><ref name="UN-WDR-2010">Template:Cite book</ref> Medical cannabis refers to the physician-recommended use of cannabis, which is taking place in Canada, Belgium, Australia, the Netherlands, Spain, and 23 U.S. states.<ref>Template:Cite web</ref> Cannabis use started to become popular in the US in the 1970s.<ref name="gallup.com">https://www.gallup.com/poll/184298/four-americans-say-tried-marijuana.aspx?g_source=marijuana&g_medium=search&g_campaign=tiles</ref> Support for legalization has been increasing in the United States in recent years and several US states have legalized recreational or medical use.<ref>*****o</ref>
Uses
Medical
Template:Main Cannabis is used to reduce nausea and vomiting during chemotherapy, to improve appetite in people with HIV/AIDS, to treat chronic pain, and help with muscle spasms.<ref name=Borgelt2013>Template:Cite journal</ref><ref name=JAMA2015>Template:Cite journal</ref> Its use for other medical applications is insufficient for conclusions about safety or efficacy. Short-term use increases minor adverse effects, but does not appear to increase major adverse effects.<ref name=Wang2008/> Long-term effects of cannabis are not clear,<ref name=Wang2008>Template:Cite journal</ref><ref name=Jordan2007>Template:Cite journal</ref> and there are concerns including memory and cognition problems, risk for addiction, risk of schizophrenia among ***** people, and the risk of *****ren taking it by accident.<ref name=Borgelt2013/>
The medicinal value of cannabis is disputed. The American Society of Addiction Medicine dismisses medical use because of concerns about dependence and adverse health effects.<ref>Template:Cite web</ref> The US Food and Drug Administration (FDA) states that cannabis is associated with numerous harmful health effects, and that significant aspects such as content, production, and supply are unregulated. The FDA approves of the prescription of two products (not for smoking) that have pure THC in a small controlled dose as the active substance.<ref>Template:Cite web</ref>
Recreational
Cannabis has psychoactive and physiological effects when consumed.<ref name="OnaiviSugiura2005">Template:Cite book</ref> The immediate desired effects from consuming cannabis include relaxation and mild euphoria (the "high" or "stoned" feeling), a general alteration of conscious perception, euphoria, increased awareness of sensation, increased libido<ref>https://cannabislink.ca/info/MotivationsforCannabisUsebyCanadianAdults-2008.pdfTemplate:Full citation needed</ref> and distortions in the perception of time and space. At higher doses, effects can include altered body image, auditory and/or visual illusions, pseudo-hallucinatory, and ataxia from selective impairment of polysynaptic reflexes. In some cases, cannabis can lead to dissociative states such as depersonalization<ref name="medscape1">Template:Cite web</ref><ref name="pmid15889607">Template:Cite journal</ref> and derealization.<ref name="Johnson1990">Template:Cite journal</ref>
Some immediate undesired side effects include a decrease in short-term memory, dry mouth, impaired motor skills and reddening of the eyes.<ref name="HallPacula2003ew">Template:Cite book</ref> Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite and consumption of food, lowered blood pressure, impairment of short-term and working memory,<ref name="Mathre1997">Template:Cite book</ref><ref name="memoryhindered">Template:Cite journal</ref> psychomotor coordination, and concentration. Some users may experience an episode of acute psychosis, which usually abates after 6 hours, but in rare instances heavy users may find the symptoms continuing for many days.<ref>Barceloux, Donald G (20 March 2012). "Chapter 60: Marijuana (Cannabis sativa L.) and synthetic cannabinoids". Medical Toxicology of Drug *****: Synthesized Chemicals and Psychoactive Plants. John Wiley & Sons. p. 915. ISBN 978-0-471-72760-6.</ref>
Spiritual
Photos taken by Marcus Prasad
Cannabis has held sacred status in several religions. It has been used in an entheogenic context – a chemical substance used in a religious, shamanic, or spiritual context<ref>Template:Cite web</ref> - in India and Nepal since the Vedic period dating back to approximately 1500 BCE, but perhaps as far back as 2000 BCE. There are several references in Greek mythology to a powerful drug that eliminated anguish and sorrow. Herodotus wrote about early ceremonial practices by the Scythians, thought to have occurred from the 5th to 2nd century BCE. Itinerant Hindu saints have used it in Nepal and India for centuries.<ref>Template:Cite book</ref> In modern culture the spiritual use of cannabis has been spread by the disciples of the Rastafari movement who use cannabis as a sacrament and as an aid to meditation. The earliest known reports regarding the sacred status of cannabis in India and Nepal come from the Atharva Veda estimated to have been written sometime around 2000–1400 BCE.<ref>Template:Cite book</ref>
Available forms
Cannabis is consumed in many different ways:<ref name="Golub2012a">Template:Cite book</ref>
- smoking, which typically involves burning and inhaling vaporized cannabinoids ("smoke") from small pipes, bongs (portable versions of hookahs with a water chamber), paper-wrapped joints or tobacco-leaf-wrapped blunts, roach clips, and other items.<ref name="TasmanKay2011">Template:Cite book</ref>
- vaporizer, which heats any form of cannabis to Template:Convert,<ref name="Rosenthal2002b">Template:Cite book</ref> causing the active ingredients to evaporate into a vapor without burning the plant material (the boiling point of THC is Template:Convert at 760 mmHg pressure).<ref>Template:Cite web</ref>
- cannabis tea, which contains relatively small concentrations of THC because THC is an oil (lipophilic) and is only slightly water-soluble (with a solubility of 2.8 mg per liter).<ref name="Physical Properties – Dronabinol">Template:ChemID</ref> Cannabis tea is made by first adding a saturated fat to hot water (e.g. cream or any milk except skim) with a small amount of cannabis.<ref name="Ph.D.Rosenthal2008yt">Template:Cite book</ref>
- edibles, where cannabis is added as an ingredient to one of a variety of foods, including butter and baked goods.
Adverse effects
Template:Main Template:Further2
According to the United States Department of Health and Human Services, there were 455,000 emergency room visits associated with cannabis use in 2011. These statistics include visits in which the patient was treated for a condition induced by or related to recent cannabis use. The drug use must be "implicated" in the emergency department visit, but does not need to be the direct cause of the visit. Most of the illicit drug emergency room visits involved multiple drugs.<ref>Template:Cite web</ref> In 129,000 cases, cannabis was the only implicated drug.<ref>Template:Cite web</ref><ref name = NEJM2014 />
A 2013 literature review said that heavy, long term exposure to marijuana may have biologically-based physical, mental, behavioral and social health consequences and may be "associated with diseases of the liver (particularly with co-existing hepatitis C), lungs, heart, and vasculature".<ref name="Gordon2013">Template:Cite journal</ref> It is recommended that cannabis use be stopped before and during pregnancy.<ref>Template:Cite journal</ref> A 2014 review found that while cannabis use may be less harmful than alcohol use, the recommendation to substitute it for problematic drinking is premature without further study.<ref>Template:Cite journal</ref>
Toxicity
THC, the principal psychoactive constituent of the cannabis plant, has low toxicity. The dose of THC needed to kill 50% of tested rodents is extremely high. Acute effects may include anxiety and panic, impaired attention, and memory (while intoxicated), an increased risk of psychotic symptoms, and possibly an increased risk of accidents if a person drives a motor vehicle while intoxicated.<ref name="W. Hall, N. Solowij 1611–16">Template:Cite journal</ref> Short-term Cannabis intoxication can hinder the mental processes of organizing and collecting thoughts. This condition is known as temporal disintegration.<ref>Template:Cite book</ref> Psychotic episodes are well-documented and typically resolve within minutes or hours. There have been few reports of symptoms lasting longer.<ref>Template:Cite web</ref><ref>Template:Cite journal</ref> Cannabis has not been reported to cause fatal overdose.<ref name="Calabria2010">Template:Cite journal</ref> Studies have shown that cannabis use causes impairments in memory that persist beyond short-term intoxication.<ref>Template:Cite journal</ref>
Lungs
There has been a limited amount of studies that have looked at the effects of smoking cannabis on the respiratory system.<ref name="MaistoGalizio2014">Template:Cite book</ref> Chronic heavy marijuana smoking is associated with coughing, production of sputum, wheezing, and other symptoms of chronic bronchitis.<ref name="W. Hall, N. Solowij 1611–16"/> Regular cannabis use has not been shown to cause significant abnormalities in lung function.<ref name="Tashkin2013">Template:Cite journal</ref> Short-term use of cannabis is associated with bronchodilation.<ref>Template:Cite journal</ref>
Cancer
Cannabis smoke contains thousands of organic and inorganic chemical compounds. This tar is chemically similar to that found in tobacco smoke,<ref>Template:Cite journal</ref> and over fifty known carcinogens have been identified in cannabis smoke,<ref>Template:Cite journal</ref> including; nitrosamines, reactive aldehydes, and polycylic hydrocarbons, including benz[a]pyrene.<ref>Template:Cite journal</ref> Cannabis smoke is also inhaled more deeply than is tobacco smoke.<ref>Template:Cite journal</ref> As of 2015, there is no consensus regarding whether cannabis smoking is associated with an increased risk of cancer.<ref>Template:Cite journal</ref> Light and moderate use of cannabis is not believed to increase risk of lung or upper airway cancer. Evidence for causing these cancers is mixed concerning heavy, long-term use. In general there are far lower risks of pulmonary complications for regular cannabis smokers when compared with those of tobacco.<ref name="Tashkin2013" /> A 2015 review found an association between cannabis use and the development of testicular germ cell tumors (TGCTs), particularly non-seminoma TGCTs.<ref>Template:Cite journal</ref> Combustion products are not present when using a vaporizer, consuming THC in pill form, or consuming cannabis foods.
Cardiovascular
There is serious suspicion among cardiologists, spurring research but falling short of definitive proof, that cannabis use has the potential to contribute to cardiovascular disease.<ref name="Riecher-Rössler2014a">Template:Cite book</ref> Cannabis is believed to be an aggravating factor in rare cases of arteritis, a serious condition that in some cases leads to amputation. Because 97% of case-reports also smoked tobacco, a formal association with cannabis could not be made. If cannabis arteritis turns out to be a distinct clinical entity, it might be the consequence of vasoconstrictor activity observed from delta-8-THC and delta-9-THC.<ref>Template:Cite journal</ref> Other serious cardiovascular events including myocardial infarction, stroke, sudden cardiac death, and cardiomyopathy have been reported to be temporally associated with cannabis use. Research in these events is complicated because cannabis is often used in conjunction with tobacco, and drugs such as alcohol and cocaine.<ref>Template:Cite journal</ref> These putative effects can be taken in context of a wide range of cardiovascular phenomena regulated by the endocannabinoid system and an overall role of cannabis in causing decreased peripheral resistance and increased cardiac output, which potentially could pose a threat to those with cardiovascular disease.<ref>Template:Cite journal</ref> There is some evidence from case reports that cannabis use may provoke fatal cardiovascular events in ***** people who have not been diagnosed with cardiovascular disease.<ref name=hall2015/>
Neurological
A 2013 review comparing different structural and functional imaging studies showed morphological brain alterations in long-term cannabis users which were found to possibly correlate to cannabis exposure.<ref name="Batalla">Template:Cite journal</ref> A 2010 review found resting blood flow to be lower globally and in prefrontal areas of the brain in cannabis users, when compared to non-users. It was also shown that giving THC or cannabis correlated with increased bloodflow in these areas, and facilitated activation of the anterior cingulate cortex and frontal cortex when participants were presented with assignments demanding use of cognitive capacity.<ref name="MartinSantos">Template:Cite journal</ref> Both reviews noted that some of the studies that they examined had methodological limitations, for example small sample sizes or not distinguishing adequately between cannabis and alcohol consumption.<ref name="Batalla" /><ref name="MartinSantos" /> A 2011 review found that cannabis use impaired cognitive functions on several levels, ranging from basic coordination to executive function tasks.<ref>Template:Cite journal</ref> A 2013 review found that cannabis users consistently had smaller hippocampi than nonusers, but noted limitations in the studies analyzed such as small sample sizes and heterogeneity across studies.<ref>Template:Cite journal</ref> A 2012 meta-analysis found that the effects of cannabis use on neurocognitive functions were "limited to the first 25 days of abstinence" and that there was no evidence that such use had long-lasting effects.<ref>Template:Cite journal</ref> A 2015 review found that cannabis use was associated with neuroanatomic alterations in brain regions rich in cannabinoid receptors, such as the hippocampus, prefrontal cortex, amygdala, and cerebellum. The same review found that greater dose of marijuana and earlier age at onset of use were also associated with such alterations.<ref>Template:Cite journal</ref>
It is not clear whether cannabis use affects the rate of suicide.<ref name="Calabria2010"/><ref>Template:Cite journal</ref>
Chronic use
Effects of chronic use may include bronchitis, a cannabis dependence syndrome, and subtle impairments of attention and memory. These deficits persist while chronically intoxicated.<ref name="W. Hall, N. Solowij 1611–16">Template:Cite journal</ref> There is little evidence that cognitive impairments persist in adult abstinent cannabis users.<ref>Template:Cite journal</ref> Compared to non-smokers, people who smoked cannabis regularly in adolescence exhibit reduced connectivity in specific brain regions associated with memory, learning, alertness, and executive function.<ref name = NEJM2014>Template:Cite journal</ref> A study has suggested that sustained heavy, daily, adolescent onset cannabis use over decades is associated with a decline in IQ by age 38. No effects were found in those who initiated cannabis use later, or in those who ceased use earlier in adulthood.<ref name=hall2015>Template:Cite journal</ref>
Tolerance and withdrawal
Template:Main Cannabis usually causes no tolerance or withdrawal symptoms except in heavy users. In a survey of heavy users 42.4% experienced withdrawal symptoms when they tried to quit marijuana such as craving, irritability, boredom, anxiety and sleep disturbances.<ref>https://www.webmd.com/mental-health/addiction/news/20080507/withdrawal-symptoms-from-smoking-pot</ref> About 9% of those who experiment with marijuana eventually become dependent. The rate goes up to 1 in 6 among those who begin use as adolescents, and one quarter to one-half of those who use it daily according to a NIDA review.<ref name = NEJM2014 /> A 2013 review estimates daily use is associated with a 10-20% rate of dependence.<ref name="Borgelt2013"/> The highest risk of cannabis dependence is found in those with a history of poor academic achievement, deviant behavior in *****hood and adolescence, rebelliousness, poor parental relationships, or a parental history of drug and alcohol problems.<ref>Template:Cite journal</ref> Cannabis withdrawal is less severe than withdrawal from alcohol.<ref>Template:Cite journal</ref>
Motor vehicle crashes
A 2012 meta-analysis found that cannabis use was associated with an increased risk of being involved in a motor vehicle crash.<ref>Template:Cite journal</ref> A 2016 review also found a statistically significant increase in crash risk associated with marijuana use, but noted that this risk was "of low to medium magnitude."<ref>Template:Cite journal</ref> The increase in risk of motor vehicle crash for cannabis use is between 2 and 3 times relative to baseline, whereas that for comparable doses of alcohol is between 6 and 15 times.<ref name=hall2015/>
Pharmacology
Mechanism of action
The high lipid-solubility of cannabinoids results in their persisting in the body for long periods of time.<ref name="HallPacula2003hj">Template:Cite book</ref> Even after a single administration of THC, detectable levels of THC can be found in the body for weeks or longer (depending on the amount administered and the sensitivity of the assessment method).<ref name="HallPacula2003hj" /> A number of investigators have suggested that this is an important factor in marijuana's effects, perhaps because cannabinoids may accumulate in the body, particularly in the lipid membranes of neurons.<ref>Template:Cite journal</ref>
Not until the end of the 20th century was the specific mechanism of action of THC at the neuronal level studied. Researchers have subsequently confirmed that THC exerts its most prominent effects via its actions on two types of cannabinoid receptors, the CB1 receptor and the CB2 receptor, both of which are G-protein coupled receptors.<ref name="IovannaIsmailov2009">Template:Cite book</ref> The CB1 receptor is found primarily in the brain as well as in some peripheral tissues, and the CB2 receptor is found primarily in peripheral tissues, but is also expressed in neuroglial cells.<ref>Template:Cite journal</ref> THC appears to alter mood and cognition through its agonist actions on the CB1 receptors, which inhibit a secondary messenger system (adenylate cyclase) in a dose dependent manner. These actions can be blocked by the selective CB1 receptor antagonist SR141716A (rimonabant), which has been shown in clinical trials to be an effective treatment for smoking cessation, weight loss, and as a means of controlling or reducing metabolic syndrome risk factors.<ref>Template:Cite journal</ref> However, due to the dysphoric effect of CB1 antagonists, this drug is often discontinued due to these side effects.<ref name="RahmanReitz2005">Template:Cite book</ref>
Via CB1 activation, THC indirectly increases dopamine release and produces psychotropic effects.Template:Citation needed Cannabidiol also acts as an allosteric modulator of the mu and delta opioid receptors.<ref>Template:Cite journal</ref> THC also potentiates the effects of the glycine receptors.<ref>Template:Cite journal</ref> The role of these interactions in the "marijuana high" remains elusive.Template:Citation needed
Physical and chemical properties
Detection in body fluids
THC and its major (inactive) metabolite, THC-COOH, can be measured in blood, urine, hair, oral fluid or sweat using chromatographic techniques as part of a drug use testing program or a forensic investigation of a traffic or other criminal offense.<ref name="Barceloux2012">Template:Cite book</ref> The concentrations obtained from such analyses can often be helpful in distinguishing active use from passive exposure, elapsed time since use, and extent or duration of use. These tests cannot, however, distinguish authorized cannabis smoking for medical purposes from unauthorized recreational smoking.<ref name="Baselt2008">Template:Cite book</ref> Commercial cannabinoid immunoassays, often employed as the initial screening method when testing physiological specimens for marijuana presence, have different degrees of cross-reactivity with THC and its metabolites.<ref name="ShawKwong2001">Template:Cite book</ref> Urine contains predominantly THC-COOH, while hair, oral fluid and sweat contain primarily THC.<ref name="Barceloux2012" /> Blood may contain both substances, with the relative amounts dependent on the recency and extent of usage.<ref name="Barceloux2012" />
The Duquenois–Levine test is commonly used as a screening test in the field, but it cannot definitively confirm the presence of cannabis, as a large range of substances have been shown to give false positives.Template:Citation needed Despite this, it is common in the United States for prosecutors to seek plea bargains on the basis of positive D–L tests, claiming them definitive, or even to seek conviction without the use of gas chromatography confirmation, which can only be done in the lab.<ref name="alternet">Template:Cite journal</ref> In 2011, researchers at John Jay College of Criminal Justice reported that dietary zinc supplements can mask the presence of THC and other drugs in urine.<ref>Template:Cite journal</ref> However, a 2013 study conducted by researchers at the University of Utah School of Medicine refute the possibility of self-administered zinc producing false-negative urine drug tests.<ref>Template:Cite journal</ref>
Varieties and strains
CBD is a 5-HT1A receptor agonist, which may also contribute to an anxiolytic effect.<ref name="joy">Template:Cite book</ref> This likely means the high concentrations of CBD found in Cannabis indica mitigate the anxiogenic effect of THC significantly.<ref name="joy" /> The effects of sativa are well known for their cerebral high, hence its daytime use as medical cannabis, while indica is well known for its sedative effects and preferred night time use as medical cannabis.<ref name="joy" />
Psychoactive ingredients
According to the United Nations Office on Drugs and Crime (UNODC), "the amount of THC present in a cannabis sample is generally used as a measure of cannabis potency."<ref name="Why Does Cannabis Potency Matter?">Template:Cite journal</ref> The three main forms of cannabis products are the flower, resin (hashish), and oil (hash oil). The UNODC states that cannabis often contains 5% THC content, resin "can contain up to 20% THC content", and that "Cannabis oil may contain more than 60% THC content."<ref name="Why Does Cannabis Potency Matter?" />
A 2012 review found that the THC content in marijuana had increased worldwide from 1970 to 2009.<ref>Template:Cite journal</ref> It is unclear, however, whether the increase in THC content has caused people to consume more THC or if users adjust based on the potency of the cannabis. It is likely that the higher THC content allows people to ingest less tar. At the same time Cannabidiol (CBD) levels in seized samples have lowered, in part because of the desire to produce higher THC levels and because more illegal growers cultivate indoors using artificial lights. This helps avoid detection but reduces the CBD production of the plant.<ref>https://www.theguardian.com/science/blog/2014/jan/17/cannabis-memory-loss-cbd</ref>
Australia's National Cannabis Prevention and Information Centre (N*****IC) states that the buds (flowers) of the female cannabis plant contain the highest concentration of THC, followed by the leaves. The stalks and seeds have "much lower THC levels".<ref name="urlCannabis Potency">Template:Cite journal</ref> The UN states that leaves can contain ten times less THC than the buds, and the stalks one hundred times less THC.<ref name="Why Does Cannabis Potency Matter?" />
After revisions to cannabis rescheduling in the UK, the government moved cannabis back from a class C to a class B drug. A purported reason was the appearance of high potency cannabis. They believe skunk accounts for between 70 and 80% of samples seized by police<ref>*****o</ref> (despite the fact that skunk can sometimes be incorrectly mistaken for all types of herbal cannabis).<ref>Template:Cite journal</ref><ref>*****o</ref> Extracts such as hashish and hash oil typically contain more THC than high potency cannabis flowers.<ref name="Doweiko2011">Template:Cite book</ref>
Preparations
- Marijuana-Cannabis-Weed-Bud-Gram.jpg
Dried flower buds
- Kief (yellow).jpg
Kief
- Hashish-2.jpg
Hashish
- Whitewillowtincture.jpg
Tincture
- Drop of cannabis oil.jpg
Hash oil
- Cannabis Butter.JPG
Infusion (dairy butter)
- Resin.jpg
Pipe resin
- Volcano Vaporizer.jpg
A forced-air vaporizer. The detachable balloon fills with vapors
Marijuana
Marijuana or marihuana (herbal cannabis),<ref name="Dictionaries2007m">Template:Cite book</ref> consists of the dried flowers and subtending leaves and stems of the female Cannabis plant.<ref name="PotterBouchard2013">Template:Cite book</ref><ref name="HallPacula2003">Template:Cite book</ref><ref>Template:Cite book</ref><ref name="Houck2015">Template:Cite book</ref> This is the most widely consumed form,<ref name="Houck2015"/> containing 3% to 20% THC,<ref name="AdlerAdler2012">Template:Cite book</ref> with reports of up-to 33% THC.<ref name="MosherAkins2013">Template:Cite book</ref> In contrast, cannabis varieties used to produce industrial hemp contain less than 1% THC and are thus not valued for recreational use.<ref>Template:Cite web</ref>
This is the stock material from which all other preparations are derived. It is noted that cannabis or its extracts must be sufficiently heated or dehydrated to cause decarboxylation of its most abundant cannabinoid, tetrahydrocannabinolic acid (THCA), into psychoactive THC.<ref name="CC-Decarboxylation">Template:Cite web</ref>
Kief
Template:Main Kief is a powder, rich in trichomes,<ref name="Rosenthal2002">Template:Cite book</ref> which can be sifted from the leaves and flowers of cannabis plants and either consumed in powder form or compressed to produce cakes of hashish.<ref>Template:Cite web</ref> The word "kif" derives from colloquial Arabic كيف{{#if:| {{#if:Template:Lang/도움말 고리|[[[Template:Lang/도움말 고리|*]]]}}|}}Template:일반 기타 Template:Transl, meaning pleasure.<ref name="Bukszpan2012">Template:Cite book</ref>
Hashish
Hashish (also spelled hasheesh, hashisha, or simply hash) is a concentrated resin cake or ball produced from pressed kief, the detached trichomes and fine material that falls off cannabis flowers and leaves.<ref name="urlHashish - Definitions from Dictionary.com">Template:Cite web</ref> or from scraping the resin from the surface of the plants and rolling it into balls. It varies in color from black to golden brown depending upon purity and variety of cultivar it was obtained from.<ref name="Castle1">Template:Cite book</ref> It can be consumed orally or smoked, and is also vaporised, or 'vaped'.<ref name="Goldberg2012q">Template:Cite book</ref> The term "Rosin Hash" refers to a high quality solventless product obtained through heat and pressure.<ref>Alchimia Blog, Rosin Hash</ref>
Tincture
Cannabinoids can be extracted from cannabis plant matter using high-proof spirits (often grain alcohol) to create a tincture, often referred to as "green dragon".<ref name="Iversen2000s">Template:Cite book</ref> Nabiximols is a branded product name from a tincture manufacturing pharmaceutical company.<ref name="CohenRudick2011">Template:Cite book</ref>
Hash oil
Template:Main Hash oil is a resinous matrix of cannabinoids obtained from the Cannabis plant by solvent extraction,<ref name="King2009c">Template:Cite book</ref> formed into a hardened or viscous mass.<ref>Template:Cite web</ref>
Hash oil can be the most potent of the main cannabis products because of its high level of psychoactive compound per its volume, which can vary depending on the plant's mix of essential oils and psychoactive compounds.<ref name="WD2009_98">Template:Cite book</ref> Butane and supercritical carbon dioxide hash oil have become popular in recent years.<ref>Alison Hallett for Wired. Feb. 20, 2013 Hash Oil is Blowing Up Across the U.S. –Literally</ref>
Infusions
There are many varieties of cannabis infusions owing to the variety of non-volatile solvents used.<ref name="Kintz2014">Template:Cite book</ref> The plant material is mixed with the solvent and then pressed and filtered to express the oils of the plant into the solvent. Examples of solvents used in this process are cocoa butter, dairy butter, cooking oil, glycerine, and skin moisturizers. Depending on the solvent, these may be used in cannabis foods or applied topically.<ref name="McDonoughMagazine2012">Template:Cite book</ref>
Adulterated cannabis
Contaminants or adulterants may be found in marijuana or hashish. Other substances may be added to cannabis to add weight to the product (lead has been used in some cases), to increase its psychoactive effects (e.g., Phencyclidine), or as part of the cultivation and processing of the cannabis (e.g., fertilizer). Hashish obtained from "soap bar"-type sources.<ref name="Oxford2007e">Template:Cite book</ref> The dried flowers of the plant may be contaminated by the plant taking up heavy metals and other toxins from its growing environment,<ref>Bombus<ref name="xeps-dnock">Template:Citation</ref></ref> or by the addition of glass.<ref>*****o</ref> In the Netherlands, chalk has been used to make cannabis appear to be of a higher quality.<ref>Template:Cite web</ref> Increasing the weight of hashish products in Germany with lead caused lead intoxication in at least 29 users.<ref name="pmid18403778">Template:Cite journal</ref>
Despite cannabis being generally perceived as a natural product,<ref>Template:Cite bookTemplate:Page needed</ref> in a recent Australian survey<ref>Template:Cite bookTemplate:Page needed</ref> one in four Australians consider cannabis grown indoors under hydroponic conditions to be a greater health risk due to increased contamination, added to the plant during cultivation to enhance the plant growth and quality.
Drug dealers may "spike" or lace marijuana with other chemicals such as P*****, creating a product known as "wet marijuana"; this enhances the effects of smoking it<ref>https://www.cchrflorida.org/p*****-laced-marijuana-creating-psychosis-and-psychiatric-commitment/</ref> and it can be used to make low-grade, low-potency marijuana seem more effective.
Medical use
Template:Further2 Medical marijuana refers to the use of the Cannabis plant as a physician-recommended herbal therapy as well as synthetic<ref name="Backes2014">Template:Cite book</ref> THC and cannabinoids. So far, the medical use of cannabis is legal only in a limited number of territories, including Canada, Belgium, Australia, the Netherlands, Spain, and several U.S. states. This usage generally requires a prescription, and distribution is usually done within a framework defined by local laws. There is evidence supporting the use of cannabis or its derivatives in the treatment of chemotherapy-induced nausea and vomiting, neuropathic pain, and multiple sclerosis. Lower levels of evidence support its use for AIDS wasting syndrome, epilepsy, rheumatoid arthritis, and glaucoma.<ref name = NEJM2014 />
History
Cannabis is indigenous to Central and South Asia.<ref>"Marijuana and the Cannabinoids", ElSohly (p. 8).</ref> There is evidence of inhalation of cannabis smoke from the 3rd millennium BCE, namely charred cannabis seeds found in a ritual brazier at an ancient burial site in present-day Romania.<ref name="bookLost Civilisations of the Stone Age">Template:Cite book</ref> In 2003, a leather basket filled with cannabis leaf fragments and seeds was found next to a 2,500- to 2,800-year-old mummified shaman in the northwestern Xinjiang Uygur Autonomous Region of China.<ref name="peoplesdaily">Template:Cite journal</ref><ref name="jiang2006a">Template:Cite journal</ref> Evidence of cannabis consumption was also found in Egyptian mummies dated about 950 BC.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref>
Cannabis was also used by the ancient Hindus of India and Nepal thousands of years ago. The herb is called ganja (Template:Lang-sa, IAST: Template:IAST) or ganjika in Sanskrit and other modern Indo-Aryan languages.<ref name="bookFlashbacks">Template:Cite book</ref><ref name="pmid17759460">Template:Cite book</ref> Some scholars suggest that the ancient drug soma, mentioned in the Vedas, was cannabis, although this theory is disputed.<ref name="Rudgley-Encyclopedia">Template:Cite book</ref>
Cannabis was also known to the ancient Assyrians, who discovered its psychoactive properties through the Aryans.<ref>Template:Cite book</ref> Using it in some religious ceremonies, they called it qunubu (meaning "way to produce smoke"), a probable origin of the modern word "cannabis".<ref>Template:Cite book</ref> The Aryans also introduced cannabis to the Scythians, Thracians and Dacians, whose shamans (the kapnobatai—"those who walk on smoke/clouds") burned cannabis flowers to induce trance.<ref>Template:Cite book</ref>
Cannabis has an ancient history of ritual use and is found in pharmacological cults around the world. Hemp seeds discovered by archaeologists at Pazyryk suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century BCE, confirming previous historical reports by Herodotus.<ref>Template:Cite book</ref> It was used by Muslims in various Sufi orders as early as the Mamluk period, for example by the Qalandars.<ref>Template:Cite book</ref>
A study published in the South African Journal of Science showed that "pipes dug up from the garden of Shakespeare's home in Stratford-upon-Avon contain traces of cannabis."<ref name="Shakespeare-BBC-2001">*****o</ref> The chemical analysis was carried out after researchers hypothesized that the "noted weed" mentioned in Sonnet 76 and the "journey in my head" from Sonnet 27 could be references to cannabis and the use thereof.<ref name="Shakespeare-CNN-2001">*****o</ref> Examples of classic literature featuring cannabis include Les paradis artificiels by Charles Baudelaire and The Hasheesh Eater by Fitz Hugh Ludlow.
John Gregory Bourke described use of "mariguan", which he identifies as Cannabis indica or Indian hemp, by Mexican residents of the Rio Grande region of Texas in 1894. He described its uses for treatment of asthma, to expedite delivery, to keep away witches, and as a love-philtre. He also wrote that many Mexicans added the herb to their cigarritos or mescal, often taking a bite of sugar afterward to intensify the effect. Bourke wrote that because it was often used in a mixture with toloachi (which he inaccurately describes as Datura stramonium), mariguan was one of several plants known as "loco weed". Bourke compared mariguan to hasheesh, which he called "one of the greatest curses of the East", citing reports that users "become maniacs and are apt to commit all sorts of acts of violence and murder", causing degeneration of the body and an idiotic appearance, and mentioned laws against sale of hasheesh "in most Eastern countries".<ref>Template:Cite journal</ref><ref>Template:Cite web</ref><ref>Bourke cites an anonymous writer in the "Evening Star", Washington, D. C., January 13, 1894 for additional remarks on the use of mariguan and Jamestown weed by inhabitants of the area.</ref>
Cannabis was criminalized in various countries beginning in the early 20th century. In the United States, the first restrictions for sale of cannabis came in 1906 (in District of Columbia).<ref>Template:Cite journal</ref> It was outlawed in South Africa in 1911, in Jamaica (then a British colony) in 1913, and in the United Kingdom and New Zealand in the 1920s.<ref name="AlterNet">Template:Cite web</ref> Canada criminalized cannabis in the Opium and Drug Act of 1923, before any reports of use of the drug in Canada. In 1925 a compromise was made at an international conference in The Hague about the International Opium Convention that banned exportation of "Indian hemp" to countries that had prohibited its use, and requiring importing countries to issue certificates approving the importation and stating that the shipment was required "exclusively for medical or scientific purposes". It also required parties to "exercise an effective control of such a nature as to prevent the illicit international traffic in Indian hemp and especially in the resin".<ref>Template:Cite journal</ref><ref>Template:Google books</ref>
In the United States in 1937, the Marihuana Tax Act was passed, and prohibited the production of hemp in addition to cannabis. The reasons that hemp was also included in this law are disputed—several scholars have claimed that the act was passed in order to destroy the US hemp industry,<ref name="nafta-neocolonialism-129">Template:Cite book</ref><ref>Template:Cite book</ref><ref name="under-influence-55">Template:Cite book</ref> with the primary involvement of businessmen Andrew Mellon, Randolph Hearst, and the Du Pont family.<ref name="nafta-neocolonialism-129" /><ref name="under-influence-55" /> But the improvements of the decorticators, machines that separate the fibers from the hemp stem, could not make hemp fiber a very cheap substitute for fibers from other sources because it could not change that basic fact that strong fibers are only found in the bast, the outer part of the stem. Only about 1/3 of the stem are long and strong fibers.<ref name="nafta-neocolonialism-129" /><ref name="Werf">Hayo M.G. van der Werf : Hemp facts and hemp fiction. Template:Wayback</ref><ref>Dr. Ivan BÛcsa, GATE Agricultural Research Institute, Kompolt – Hungary, Book Review Re-discovery of the Crop Plant Cannabis Marihuana Hemp (Die Wiederentdeckung der Nutzplanze Cannabis Marihuana Hanf) Template:Wayback</ref><ref>Template:Cite book</ref> The company DuPont and many industrial historians dispute a link between nylon and hemp. They argue that the purpose of developing the nylon was to produce a fiber that could be used in thin stockings for females and compete with silk.<ref>Template:Cite web</ref><ref>Template:Cite web</ref><ref>American Chemical Society: THE FIRST NYLON PLANT. 1995</ref>
In New York City, there were more than Template:Convert of marijuana growing like weeds throughout the boroughs until 1951, when the "White Wing Squad", headed by the Sanitation Department General Inspector John E. Gleason, was charged with destroying the many pot farms that had sprouted up across the city. The Brooklyn Public Library reports: this group was held to a high moral standard and was prohibited from "entering saloons, using foul language, and neglecting horses." The Squad found the most weed in Queens but even in Brooklyn dug up "millions of dollars" worth of the plants, many as "tall as Christmas trees". Gleason oversaw incineration of the plants in Woodside, Queens.<ref>*****o</ref>
The United Nations' 2012 Global Drug Report stated that cannabis "was the world's most widely produced, trafficked, and consumed drug in the world in 2010", identifying that between 119 million and 224 million users existed in the world's adult (18 or older) population.<ref>*****o</ref>
Society and culture
Template:Global estimates of illicit drug users
Legal status
Since the beginning of the 20th century, most countries have enacted laws against the cultivation, possession or transfer of cannabis.<ref name="Levinson2002">Template:Cite book</ref> These laws have impacted adversely on the cannabis plant's cultivation for non-recreational purposes, but there are many regions where, under certain circumstances, handling of cannabis is legal or licensed. Many jurisdictions have lessened the penalties for possession of small quantities of cannabis, so that it is punished by confiscation and sometimes a fine, rather than imprisonment, focusing more on those who traffic the drug on the black market.
In some areas where cannabis use has been historically tolerated, some new restrictions have been put in place, such as the closing of cannabis coffee shops near the borders of the Netherlands,<ref>Template:Cite web</ref> closing of coffee shops near secondary schools in the Netherlands and crackdowns on "Pusher Street" in Christiania, Copenhagen in 2004.<ref>EMCDDA Cannabis reader: Global issues and local experiences, Perspectives on Cannabis controversies, treatment and regulation in Europe, 2008, p. 157.</ref><ref>"43 Amsterdam coffee shops to close door", Radio Netherlands, Friday 21 November 2008 Template:Wayback</ref>
Some jurisdictions use free voluntary treatment programs and/or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution. More recently however, many political parties, non-profit organizations and causes based on the legalization of medical cannabis and/or legalizing the plant entirely (with some restrictions) have emerged.
In December 2012, the U.S. state of Washington became the first state to officially legalize cannabis in a state law (Washington Initiative 502) (but still illegal by federal law),<ref>Template:Cite journal</ref> with the state of Colorado following close behind (Colorado Amendment 64).<ref>*****o</ref> On January 1, 2013, the first marijuana "club" for private marijuana smoking (no buying or selling, however) was allowed for the first time in Colorado.<ref>Template:Cite web</ref> The California Supreme Court decided in May 2013 that local governments can ban medical marijuana dispensaries despite a state law in California that permits the use of cannabis for medical purposes. At least 180 cities across California have enacted bans in recent years.<ref>*****o</ref>
In December 2013, Uruguay became the first country to legalize growing, sale and use of cannabis.<ref>Template:Cite web</ref> However, as of August 2014, no cannabis has yet been sold legally in Uruguay. According to the law, the only cannabis that can be sold legally must be grown in the country by no more than five licensed growers, and these have yet to be selected; in fact the call for applications did not go out until August 1, 2014.<ref>"Lanzan llamado a interesados en producir y distribuir marihuana", "El País" [Uruguay], August 1, 2014, https://www.elpais.com.uy/informacion/llamado-interesados-producir-distribuir-marihuana.html</ref> In the elections of October 2014, there is a significant chance that lawmakers opposed to legal cannabis will come to control the legislature, and the law will be repealed before it has fully taken effect.<ref>"Marihuana: con mayoría en contra, la ley avanza lento", "El País" [Uruguay], July 24, 2014, https://www.elpais.com.uy/informacion/marihuana-mayoria-contra-ley-avanza.html</ref><ref>Leonardo Haberkorn (correspondent for the Associated Press in Uruguay), "Uruguay's budding plan for legal pot faces hurdles", "Houston Chronicle", August 1, 2014, https://www.houstonchronicle.com/news/nation-world/world/article/Uruguay-s-budding-plan-for-legal-pot-faces-hurdles-5663817.php</ref><ref> "Uruguay's Marijuana Marketplace Program Could Be Going Up In Smoke", Fox News Latino, August 3, 2014, https://latino.foxnews.com/latino/money/2014/08/03/uruguay-marijuana-marketplace-program-could-be-going-up-in-smoke/</ref>
On October 17, 2015, Australian health minister Sussan Ley presented a new law that will allow the cultivation of cannabis for scientific research and medical trails on patients.<ref>Alchimia Blog, Medical marijuana news, December 2015</ref> In December 2015, it was reported that the Canadian government had committed to legalizing cannabis, but at that time no timeline for the legalization was set out.<ref>https://www.theglobeandmail.com/news/british-columbia/canadians-facing-pot-charges-in-limbo-while-liberals-work-on-legalization/article27935465/?service=mobile</ref>
Usage
In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65).<ref name=WDR2015>Template:Cite book</ref>
United States
In 2015, almost half of the people in the United States have tried marijuana, 12% have used it in the past year, and 7.3% have used it in the past month.<ref name="6 facts about marijuana"/> Daily marijuana use amongst US college students has reached its highest level on record rising from 3.5% in 2007 to 5.9% in 2014 and has surpassed daily cigarette use.<ref>https://record.umich.edu/articles/daily-marijuana-use-among-college-students-highest-1980</ref>
In the US, men are over twice as likely to use marijuana as women and 18-29 year-olds are six times more likely to use as over 65-year-olds.<ref name="gallup.com"/> In 2015, a record 44% of the US population has tried marijuana in their lifetime, an increase from 38% in 2013 and 33% in 1985.<ref name="gallup.com"/>
Economics
Production
It is often claimed by growers and breeders of herbal cannabis that advances in breeding and cultivation techniques have increased the potency of cannabis since the late 1960s and early '70s, when THC was first discovered and understood. However, potent seedless cannabis such as "Thai sticks" were already available at that time. Sinsemilla (Spanish for "without seed") is the dried, seedless inflorescences of female cannabis plants. Because THC production drops off once pollination occurs, the male plants (which produce little THC themselves) are eliminated before they shed pollen to prevent pollination. Advanced cultivation techniques such as hydroponics, cloning, high-intensity artificial lighting, and the sea of green method are frequently employed as a response (in part) to prohibition enforcement efforts that make outdoor cultivation more risky. It is often cited that the average levels of THC in cannabis sold in United States rose dramatically between the 1970s and 2000, but such statements are likely skewed because of undue weight given to much more expensive and potent, but less prevalent samples.<ref>Template:Cite web</ref>
Template:Anchor "Skunk" refers to several named strains of potent cannabis, grown through selective breeding and sometimes hydroponics. It is a cross-breed of Cannabis sativa and C. indica (although other strains of this mix exist in abundance). Skunk cannabis potency ranges usually from 6% to 15% and rarely as high as 20%. The average THC level in coffee shops in the Netherlands is about 18–19%.<ref>Template:Cite journal Ch. 2.3.</ref>
Price
The price or street value of cannabis varies widely depending on geographic area and potency.<ref>Template:Cite web</ref>
In the United States, cannabis is overall the number four value crop, and is number one or two in many states including California, New York and Florida, averaging $3,000/lb.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> It is believed to generate an estimated $36 billion market.<ref>Template:Cite journal</ref> The United Nations Office on Drugs and Crime claims in its 2008 World Drug Report that typical U.S. retail prices are $10–15 per gram (approximately $280–420 per ounce). Street prices in North America are known to range from about $40 to $400 per ounce, depending on quality.<ref>Template:Cite book</ref>
The European Monitoring Centre for Drugs and Drug Addiction reports that typical retail prices in Europe for cannabis varies from €2 to €20 per gram, with a majority of European countries reporting prices in the range €4–10.<ref>Template:Cite book</ref>
Distribution
Marijuana vending machines for selling or dispensing cannabis are in use in the United States and are planned to be used in Canada.<ref name="FirstForeignMarket">*****o</ref>
Gateway drug
The Gateway Hypothesis states that cannabis use increases the probability of trying "harder" drugs. The hypothesis has been hotly debated as it is regarded by some as the primary rationale for the United States prohibition on cannabis use.<ref name="Rand">Template:Cite journal</ref><ref name="Benavie2009x">Template:Cite book</ref> A Pew Research Center poll found that political opposition to marijuana use was significantly associated with concerns about health effects and whether legalization would increase marijuana use by *****ren.<ref>Template:Cite web</ref>
Some studies state that while there is no proof for the gateway hypothesis,<ref name="MosherAkins2007">Template:Cite book</ref> ***** cannabis users should still be considered as a risk group for intervention programs.<ref name="journalwatch">Template:Cite journal</ref> Other findings indicate that hard drug users are likely to be poly-drug users, and that interventions must address the use of multiple drugs instead of a single hard drug.<ref>Template:Cite journal</ref> Almost two-thirds of the poly drug users in the "2009/10 Scottish Crime and Justice Survey" used cannabis.<ref>Template:Cite web</ref>
The gateway effect may appear due to social factors involved in using any illegal drug. Because of the illegal status of cannabis, its consumers are likely to find themselves in situations allowing them to acquaint with individuals using or selling other illegal drugs.<ref name="morral2002">Template:Cite journal</ref><ref>Template:Cite web</ref> Utilizing this argument some studies have shown that alcohol and tobacco may additionally be regarded as gateway drugs;<ref name="pmid8246462">Template:Cite journal</ref> however, a more parsimonious explanation could be that cannabis is simply more readily available (and at an earlier age) than illegal hard drugs. In turn alcohol and tobacco are easier to obtain at an earlier point than is cannabis (though the reverse may be true in some areas), thus leading to the "gateway sequence" in those individuals since they are most likely to experiment with any drug offered.<ref name="Rand" />
An alternative to the gateway hypothesis is the common liability to addiction (CLA) theory. It states that some individuals are, for various reasons, willing to try multiple recreational substances. The "gateway" drugs are merely those that are (usually) available at an earlier age than the harder drugs. Researchers have noted in an extensive review, Vanyukov et al., that it is dangerous to present the sequence of events described in gateway "theory" in causative terms as this hinders both research and intervention.<ref name=Vanyukov2012>Template:Cite journal</ref>
Research
Template:Further2 Cannabis research is challenging since the plant is illegal in most countries.<ref>Template:Cite web</ref><ref>Template:Cite journal</ref><ref>Template:Cite journal</ref><ref>Template:Cite web</ref><ref>Template:Cite web</ref> Research-grade samples of the drug are difficult to obtain for research purposes, unless granted under authority of national governments.
There are also other difficulties in researching the effects of cannabis. Many people who smoke cannabis also smoke tobacco.<ref>Template:Cite journal</ref> This causes confounding factors, where questions arise as to whether the tobacco, the cannabis, or both that have caused a cancer. Another difficulty researchers have is in recruiting people who smoke cannabis into studies. Because cannabis is an illegal drug in many countries, people may be reluctant to take part in research, and if they do agree to take part, they may not say how much cannabis they actually smoke.<ref>Template:Cite web</ref>
Footnotes
See also
References
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<references group=""></references>External links
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