Marijuana for Medicinal Purposes

MJ lowers test. in men. Lowering test has feminising effects - or a better way to put it, less masculinising effects. My observations of teenage male regular smokers is that they tend to look more girly, baby faced and for longer. But I’ve never done a study on this.

MJ raises test in women and can lead to all sorts of un-pretty results.

MJ also raises testosterone in men AT FIRST. I don’t know if that is a good reason for people to occassionally use it though.

Are you saying that MJ lowers test. but doesn’t affect your ambition?

In my experience MJ users are the first to deny this. Amongst other things. Some people describe them as “gonnas” … “I’m gonna do this, I’m gonna do that” so maybe they think they have ambition, but they never actually do it. But they will argue aggressively that they are ambitious and the drug doesn’t affect them.

Note I am not saying they can’t achieve anything, and it is not accurate to say that it necessarily makes a person less effective. There is a lot to be said for being able to relax and unwind. And it is quite possible that, like you say, the people who are losers on it, would be losers off it as well. But in my experience, long term chronic users are pretty stuffed up.

Back to the original poster, it is always better to get a good nights’ sleep naturally. If you can’t do that, find something to get a good nights’ sleep. There may be better alternatives to MJ, if so use them. If not, use MJ, because lack of sleep will screw you up more than MJ ever could.

[quote]CaliforniaLaw wrote:

If you have ambition, mary jane won’t destroy it. If you’re a loser, well, you would have been that way even without the m.j.[/quote]

But now you are a happy and relaxed loser, with a healthy appetite!

[quote]Magarhe wrote:
MJ lowers test. in men. Lowering test has feminising effects - or a better way to put it, less masculinising effects. My observations of teenage male regular smokers is that they tend to look more girly, baby faced and for longer. But I’ve never done a study on this.

[/quote]

Moooooooooo!

PS: Can`t write “Bullshit!” all the time, though it is my favorite English word.

[quote]bushidobadboy wrote:
Hagar wrote:
bushidobadboy wrote:
Hagar wrote:
Just understand it is addictive.

I would say it’s ‘habitual’ but technically not addictive.

I used to smoke it all the time back in the day, and I never found it to be physically addictive, and neither did any of my friends.

As to the health benefits, my next door neighbour smokes it for her multiple sclerosis.

Bushy

The lid has been blown off pot’s popularity … or, at least dispelled the myth that pot isn’t harmful. Boomers who use marijuana for a number of years can become addicted, say researchers at the University of Connecticut Health Center (UCHC). The UCHC study is investigating the characteristics of 130 long term pot smokers who are participating in a three year research project.

Investigators said that when these marijuana smokers aren’t using pot, they have a strong craving for it. They think about it. They want it. When they aren’t using it they get jittery, restless, and irritable. “It’s a common thread that contradicts the widespread assumption that pot is not addictive,” said Ronald Kadden, Ph.D., Health Center professor of psychiatry and the study’s principal investigator.

“What the participants tell us is they didn’t know how hooked they were until they tried to quit.” It’s a vicious cycle. Because you become tolerant, you need to smoke more to achieve the desired effect, says Dr. Kadden. “The more you smoke, the more you need to smoke. The more you need to smoke, the more you need to stop,” he said.

Researchers and health professionals have long maintained that marijuana is psychologically addictive. Research shows that marijuana is also physically addictive, although withdrawal effects are not as debilitating as with alcohol, heroin, cocaine, amphetamine or barbiturate dependence. Users who are familiar with the severe effects of physical addiction to other drugs tend to believe their marijuana use is optional and elective. That’s simply not the case.

The psychological and physical addiction of the long term pot smokers interferes with leading a normal life because they can’t cope or function adequately without marijuana. Dr. Kadden’s study, which began in 1997, is a three-year project consisting of 130 subjects with an average age of 36, and an age range from the teens to late 50s. The subjects come from all walks of life, the unemployed to the six-figure manager, men and women alike.
Source: University of Connecticut Health Center
AgeVenture News Service, www.demko.com

Well OK, I take the point that in some people, pot may exhibit mild psychological and physical withdrawal symptoms.

However, in some people, chocolate causes psychological dependance, and physical withdrawal.

Take my fiancee for example. She “craves” chocolate, and gets irritable when she can’t have it. She thinks about it a lot, and if she does eat some, she tends to binge on it, even though she knows she shouldn’t. Too much chocolate gives her a headache.

Personally, I think that it’s more to do with the ‘weakness’ of the individual, rather than the addictive properties of the substance, at least when talking about pot and chocolate…

Bushy[/quote]

        As someone who smoked a LOT of pot over a twenty plus period of years...I know first hand all about the addictive nature of the beast..

    While it is true that the more you smoke, the more you need to get the same high, etc...And it is true that to differing extents for different people, the shit is slightly to very addictive....

All in all there are a lot of factors that come into play IMO. I think it depends on how much you smoke, when I was smoking several joints a day, it was more difficult to go without… when I smoked less, it was much less “needed”.

        The thing is, it's hard to go from the extremely large intake to the relatively small amount of intake, without some problems psychologically in dealing with not having it.

Once you are off it, you can sort of “right” yourself and maintain a lot better attitude about using and not abusing it. This takes some time for the chronic user like I was…

But now I take a few puffs maybe once a month, or once every two months and that’s it. I don’t buy it anymore, I don’t have any on me or the around the house anymore either. I don’t feel the need for it anymore, as IMO it can contribute to lung issues of which I have no desire to experience in the later years of life especially…

        Having said all this, I firmly believe what bushy was saying about the fact that it basicly comes down to the individual and how "strong" or "weak" they tolerate any substance that is double edged so to speak, whether that's chocolate, weed, fatty foods, high glycemic carb foods etc..and on and on. I think it's more closely resemblant of these things than alcohol or harder drugs..

   So there we are, let's go have a puff now and get on with the day...lol...
         ToneBone

I subscribe to the Adam Corolla, Joe Rogan school of thought: if you can afford to smoke go ahead. If you’re an idiot (and be honest) then don’t.

I use a large amount of aggression when I lift, so far nothing has affected it. Then again, I’ve lifted with hangovers and hit pr’s. I think you just have to knuckle down and get after it in the gym.

[quote]Chewie wrote:
Hagar wrote:
Investigators said that when these marijuana smokers aren’t using pot, they have a strong craving for it. They think about it. They want it. When they aren’t using it they get jittery, restless, and irritable. “It’s a common thread that contradicts the widespread assumption that pot is not addictive,” said Ronald Kadden, Ph.D., Health Center professor of psychiatry and the study’s principal investigator.

I get the same when I don’t get any nookie. Does that mean sex is addictive?
[/quote]

And money? And golf? And jiu jitsu? And running? And anything that people enjoy doing?

Hell, if you define addiction the way those scientists do, anyone who has a hobby is an addict.

[quote]Magarhe wrote:
In my experience MJ users are the first to deny this. Amongst other things. Some people describe them as “gonnas” … “I’m gonna do this, I’m gonna do that” so maybe they think they have ambition, but they never actually do it. But they will argue aggressively that they are ambitious and the drug doesn’t affect them.[/quote]

So you are saying that the vast majority of non-pot smokers don’t say the same shit? So you live in a world where people who don’t smoke marijuana are all highly motivated and successful people. LOL.

Get real, dude. Most people never accomplish anything. Pot smokers, like the rest of society, don’t accomplish much. But the issue is one of causation.

Does using marijuana cause people to lose ambition? As someone living in California, I think you are incredibly unworldly if not outright dumb for even suggesting that.

[quote]Hagar wrote:
For $669.00 that thing should grow pot, load itself and blow you while you smoke.
[/quote]

it does make your pot go 3-4 times further, so assuming local price (150-200/oz), that means after a QP you are even. for those of you in the US paying 2-3 times that, even quicker. the high is more euphoric to boot with less couch-lock all things equal. also no burning weed smell.

[quote]bushidobadboy wrote:
Hagar wrote:
bushidobadboy wrote:

However, in some people, chocolate causes psychological dependance, and physical withdrawal.

Take my fiancee for example. She “craves” chocolate, and gets irritable when she can’t have it. She thinks about it a lot, and if she does eat some, she tends to binge on it, even though she knows she shouldn’t. Too much chocolate gives her a headache.[/quote]

Actually sugar can be extremely addictive. I’ve met some people in overeaters anonymous that have struggled most their lives with it. I had a friend who developed bulimia trying to make weight for wrestling. He can’t have any high GI carbs or he goes nuts.

[quote]
Personally, I think that it’s more to do with the ‘weakness’ of the individual, rather than the addictive properties of the substance, at least when talking about pot and chocolate…

Bushy[/quote]

I used to be addicted cigarettes and chew tobacco. I quit for a year and now I can have a cigarette once in a while. I’ve been like this for 7 years but if I smoke too many cigarettes I start to crave them. So my rule is 2 a month. You could call addiction a weakness (I agree) but I wouldn’t call addicts weak. They tend to be very strong willed in other ways.

Sigmund Freud cigars and cocaine, Stephen King and Robert Louis Stevenson cocaine, Anthony Eden MP (british prime minister in the 50’s) amphetamines Franklin D Roosevelt cigarettes, Howard Hughes everything, Charlie Parker and a bunch of other jazz greats heroin. To name a few.

Since there seems to be a good amount of interest in the topic, I figured I could put up an article from UpToDate.com on MJ (since most people don’t have access to it). Its always a bit easier when people in disagreement both have access to basic informations.

Cheers,
AlexH

Marijuana use in adults

Michael F Weaver, MD

UpToDate performs a continuous review of over 375 journals and other resources. Updates are added as important new information is published. The literature review for version 15.2 is current through April 2007; this topic was last changed on April 16, 2007. The next version of UpToDate (15.3) will be released in October 2007.

INTRODUCTION �?? “Marijuana” refers to the dried material (leaves, stems, seeds) of the hemp plant, Cannabis sativa; this is the form used most commonly in the United States. “Hashish” refers to the dried resin made from hemp flowers. “Hash oil” is a liquid extracted from the plant material, and this form is the most potent. The active ingredient in all forms of marijuana is delta-9-tetrahydrocannabinol (THC) [1].

The most common route of administration for marijuana is smoking, either as a rolled cigarette (“joint” or “blunt”) or through a pipe (“bong”). It can be taken orally, which results in a slower onset but longer duration of action. It is rarely used intravenously due to the risk of complications from injection of undissolved plant material.

THC and other cannabinoids are rapidly absorbed from the lungs and bind to endogenous cannabinoid receptors in the central nervous system. This binding is responsible for the psychoactive properties that users seek. Two endogenous cannabinoid receptors have been identified in the central nervous system [2,3].

This topic review discusses marijuana use in adults. Abuse of other substances is discussed separately. (See “Heroin and other opioids: Overview and patient evaluation”, and see “Heroin and other opioids: Management of chronic use” and see “Opioid intoxication in adults” and see “Designer drugs in adults” and see “Hallucinogen and inhalant abuse in adults” and see “Sedative and stimulant abuse in adults”).

EPIDEMIOLOGY �?? Marijuana is the most frequently used illicit drug in the United States. Its use is on the rise [4], especially among junior high and high school students. Among adults in the United States, the prevalence of use has stayed relatively steady at 4 percent since the early 1990s. However, the prevalence of marijuana abuse and dependence (as defined by DSM-IV [5]) has increased significantly [6].
Data from a survey of over 40,000 US adults found the 12 month prevalence of marijuana abuse and dependence to be 1.1 and 0.3 percent respectively; risk factors for abuse and dependence included being male, Native American, widowed/separated/divorced, and living in the West [7]. There was a strong association between Axis I and II disorders and abuse or dependence on marijuana.

The “gateway” theory of development of drug abuse describes sequential stages of progression in drug involvement from adolescence into adulthood, starting with legal drugs such as alcohol or cigarettes, followed by marijuana, illicit drugs other than marijuana, and abuse of prescription drugs [8]. As an example, in a cross-sectional survey of 311 monozygotic and dizygotic same-sex twin pairs who were discordant for early cannabis use, those who used cannabis by age 17 had odds of other drug use or alcohol dependence that were 2.1 to 5.2 times higher than their twin who did not use cannabis [9]. The authors hypothesized that this may represent a causal effect, but an alternative hypothesis is that similar genetic and environmental risk factors lead both to the use of marijuana and to the later use of other substances [10].

The gateway theory is also supported by a study of boys who transitioned from licit alcohol and tobacco use, to illicit marijuana use between the ages of 10 to 22 years [11]. The gateway sequence is not absolute, as 22 percent of boys who used marijuana had no prior history of licit drug use.

Whether the association is causal (ie, whether marijuana is a “gateway” drug [12]) or reflects shared risk factors, marijuana use appears to be the best predictor of later use of “harder drugs” like cocaine [13] or heroin. Marijuana use also predicts later ecstasy use [14].

According to an advance report of the Community Epidemiology Working Group in December 1999, a number of factors may be responsible for the overall trend in increased marijuana use [15]:

Marijuana has become more available and is relatively cheap.
Marijuana use is considered less risky than other drug use.
Law enforcement agents have been focusing more attention upon other drugs (eg heroin, cocaine, and methamphetamine).
More potent marijuana, such as sinsemilla, is available.
Marijuana is being packaged for use in larger quantities.
Marijuana is being used as a delivery medium for other psychoactive substances such as crack cocaine and phencyclidine (PCP). Marijuana joints containing crack are known as “fireweed.”
Marijuana use is spreading to all social strata.
Marijuana may be easier to sell than other drugs because profit margins are good and the penalties are relatively small.
ACUTE INTOXICATION �?? The onset of acute marijuana intoxication is within minutes when smoked and the effects last for three to four hours [5].

Signs and symptoms �?? Physiologic signs of acute intoxication include:

Tachycardia
Elevated blood pressure
Elevated respiratory rate
Conjunctival injection
Dry mouth
Increased appetite
Impaired reaction time.
Psychologic signs of intoxication include:

Euphoria
Time distortion
Anxiety
Depression
Impaired short-term memory
Paranoia
Mystical thinking
Impairment of concentration and motor performance last for 12 to 24 hours due to accumulation of marijuana in fatty tissue, with slow release of THC from fatty tissue stores and enterohepatic recirculation [16].

Thus, a marijuana user may think that he or she is no longer impaired several hours after use when the acute mood altering effects wear off. However, impairment of cognition, coordination, and judgment lasts much longer than the subjective feeling of being “high.” Impairment is intensified by combination with other drugs, especially alcohol.

These findings may help explain the observation that fatal traffic accidents occur more often among individuals who test positive for marijuana [17]. International studies have shown rates of positive urine or blood tests for marijuana varying from 10 to 57 percent in impaired or injured drivers [18-22]. Screening for marijuana and other drugs of abuse, in addition to alcohol, may be a useful adjunct to standard roadside sobriety testing [23].

Drug testing �?? Testing for drugs of abuse can be performed on multiple types of samples, including urine, blood, breath, hair, saliva, and sweat. Urine testing is most widely used. Marijuana metabolites are stored in adipose and can be excreted in the urine for several days. Therefore, a positive urine test does not necessarily prove current impairment. Nonetheless, a positive test does indicate recent marijuana ingestion and should lead to a determination of patterns of use, and potential for dependence. (See “Overview of the recognition and management of the drug abuser”). Marijuana is the most common drug detected in workplace drug screening programs [24].

Patients who are prescribed the prescription medication dronabinol for chemotherapy-induced nausea or HIV wasting syndrome will test positive for THC (show table 1). Urine screening may be ordered to ensure that the medication is being taken by the patient and not sold illegally. It is possible to differentiate smoked marijuana from ingested dronabinol on urine drug testing [25].

Treatment �?? Acute intoxication with marijuana alone rarely requires medical treatment, although dysphoria may result in distress that causes the user to seek help. First-time users, older persons, users of high-potency marijuana, or those predisposed to psychiatric illness are at higher risk of experiencing unpleasant effects during intoxication.

Unpleasant effects of acute intoxication, such as anxiety, paranoia, or palpitations, are managed with supportive treatment. Placing the distraught user in a quiet environment and maintaining gentle contact is often sufficient until the acute effects subside; more severe paranoia or psychosis may require close observation with possible administration of a benzodiazepine or haloperidol for sedation.

CHRONIC USE �?? Signs of chronic marijuana use include reduction in activities and relationships not associated with the drug, and impairment in cognitive skills.

Withdrawal �?? Physical dependence on marijuana definitely occurs [26], and heavy use for more than 21 days results in a withdrawal syndrome after abrupt cessation [27]. A significant proportion of marijuana users experience dependence symptoms, including tolerance and withdrawal (8 percent of low-frequency users compared with 46 percent of high-frequency users) [28].

Marijuana withdrawal begins within ten hours of the last dose and consists of irritability, agitation, depression, insomnia, nausea, anorexia, and tremor. Most symptoms peak in 48 hours and last for five to seven days. Some symptoms, such as unusual dreams and irritability, can persist for weeks [29].

Marijuana withdrawal is uncomfortable but not life-threatening. Thus, treatment is entirely supportive and nearly always accomplished without the need for adjunctive medications.

Chronic health problems �?? Chronic marijuana use may result in multiple health problems. Marijuana is not smoked with filters, unlike most tobacco cigarettes. The amount of particulate matter that irritates the mucous membrane lining of the upper airway and enters the lungs is increased compared to tobacco smoking. Marijuana smoke contains nearly four times as much tar and 50 percent more carcinogens than tobacco [30].

Marijuana users are five times more likely to smoke tobacco cigarettes than non-users [31]. Nicotine use can enhance some of the physiologic and psychologic effects of marijuana [32]. Additionally, concurrent use of nicotine and marijuana likely enhance the deleterious health effects of each used independently.

It remains controversial whether marijuana increases mortality [33,34]. Many adults who smoked marijuana when they were younger stop the behavior as they age. Thus, the duration of exposure seen with cigarette smoking is most often greater than with marijuana, which may result in less attributable mortality in people who smoke marijuana than tobacco cigarettes [33].

Cancer �?? Marijuana smokers probably are at increased risk for lung cancer, although the magnitude of risk has not been well quantified [35,36]. The absolute risk of lung cancer that a given individual accrues likely depends upon the magnitude and duration of drug use, the amount of adulterants coingested, and whether exposure to concomitant carcinogens (such as tobacco smoke) is present [37]. Several reports have documented histologic and molecular changes in the bronchial epithelium of marijuana smokers that are similar to the metaplastic premalignant alterations seen among tobacco smokers [38,39]. (See “Cigarette smoking and other risk factors for lung cancer”). A systematic review of 19 studies did not detect a significant association between lung cancer and marijuana use, after adjusting for tobacco smoking [40]. The negative association may reflect insufficient lag time for cancer development in the observational studies, given the relatively young age of study participants.

A review of clinical studies published in 1997 was unable to document a relationship between marijuana use and the development of head and neck squamous cell carcinoma (HNSCC) [41]. However, a later study suggested that marijuana use may modestly increase the risk of HNSCC, an effect that is magnified by cigarette smoking [42]. A population-based case-control study did not find an association between marijuana use and oral squamous cell carcinoma [43].

Habitual use of marijuana may be a risk factor for transitional cell cancer of the bladder, based on data from a case control study in a group of veterans younger than 60 years of age [44]. These are preliminary data, potentially confounded by a high rate of nicotine use in this population.

Reproductive effects �?? In men, marijuana causes decreased serum testosterone levels, sperm count, and sperm motility [45]. This may lead to decreased libido, impotence, and gynecomastia. An increased risk of infertility may result from changes in semen characteristics seen with marijuana smoking [46].

In women, chronic marijuana use causes shorter menstrual cycles and increased prolactin levels [47]. The latter may cause galactorrhea.

THC accumulates in breast milk and crosses the placenta [48]. This can lead to low birthweight babies [49] and abnormal reflexes and responses in newborns [50].

Chronic obstructive pulmonary disease �?? The association between tobacco smoking and chronic obstructive pulmonary disease (COPD) has been firmly established. A link between marijuana use and COPD (including an unusual form characterized by large lung bullae) is also suspected [51]. Marijuana smoking results in decreased pulmonary function, chronic cough, bronchitis, and decreased exercise tolerance [52,53].

Regular smokers of three to four marijuana cigarettes per day experience cough, wheeze, and sputum production and exhibit histologic abnormalities equivalent to those who smoke approximately 20 tobacco cigarettes per day [54,55]. This disparity may be due in part to the different manner in which marijuana and tobacco cigarettes are smoked. On average, inhalation from a marijuana cigarette delivers almost twice as much smoke, the depth of inspiration is one-third longer, and the breath holding time is four times longer than when a tobacco cigarette is smoked [30].

A decrease in lung function with marijuana use may start early in life. An eight-year study in young adults (ages 18 to 26) found a trend toward a reduced FEV1/FVC ratio with increased smoking of marijuana [56].

Cognitive dysfunction �?? The association between chronic marijuana exposure and cognitive dysfunction has been extensively studied but with varying results. A syndrome formerly known as the “amotivational syndrome,” now called the “chronic cannabis syndrome,” has been described in which chronic heavy users with cognitive impairment have a reduced ability to establish or attain goals in life, resulting in jobs that require less cognitive challenge or technological acuity [17].

A biologic basis for chronic cannabis syndrome was suggested by a study of cerebral blood perfusion, comparing intracranial doppler sonography between chronic marijuana users (n = 54) and nonusers (n = 18). Subjects were studied over 30 days of abstinence in an inpatient research unit; chronic marijuana use resulted in increased cerebrovascular resistance in heavy users, which persisted over a 30 day abstinence period [57].

In a meta-analysis that included 13 studies, long-term marijuana use did not result in deficits in seven of eight neuropsychological ability areas tested; there was a small but significant decrement in the area of learning new information [58]. Studies published after the meta-analysis have found conflicting results:

In one study, cognitive deficits that were apparent at days zero, one, and seven after last marijuana use were reversible and not related to cumulative lifetime use [59].
A second study compared cognitive function in longer term and shorter term marijuana users at a median of 17 hours after last reported marijuana use. Deficits in memory, attention, learning and retrieval function were significantly greater among the longer-term marijuana users [60].
Longer term (LT) marijuana users (four or more joints per week for a minimum of 10 years), tested after a minimum of 24 hours abstinence, had impaired verbal memory skills compared to shorter term (ST) users and controls; both LT and ST users showed inferior performance on psychomotor speed, attention, and executive functions compared with controls [61].
Most of these studies used duration of marijuana use as the patient variable in determining cognitive outcomes. In a study that relied instead on the amount of marijuana smoked (average joints per day), 22 marijuana users (mean age 22 years) were divided into groups of light use (2 to 14 joints per week), middle use (19 to 70 joints per week), and heavy use (78 to 117 joints per week) [62]. After 28 days of inpatient abstinence, a dose response effect was found for tests of verbal memory, visual learning and memory, executive function, psychomotor speed, and manual dexterity. These effects are biologically plausible since the affected functions require use of frontal, cerebellar, and hippocampal brain regions, all of which contain cannabinoid receptors [63,64]. Very heavy use of marijuana is associated with persistent decrements in neurocognitive performance even after 28 days of abstinence. However, despite the adverse effects of heavy marijuana use, performance on the majority of cognitive tests remained in the normal range. It is not clear whether continued heavy use would result in more significant declines.

In summary, the evidence is fairly consistent that marijuana use results in cognitive deficits that persist for at least hours, and likely days after acute intoxication. Whether these deficits persist in the long term and the effects of persistent heavy use have not been settled [65].

Psychiatric illness �?? There is evidence that marijuana use may increase the risk of schizophrenia [66,67] and depression [68,69]. As an example, in a cohort study of 1601 students ages 14 to 15 who were followed for seven years, there was a dose-effect relationship between marijuana use and anxiety or depression [69]. Daily use in young women was associated with an over five-fold increase in the odds of reporting depression and anxiety after adjustment for intercurrent use of other substances (odds ratio 5.6, 95% CI 2.6-12). In contrast, baseline depression and anxiety did not predict later marijuana use, suggesting that self medication was unlikely to explain the reported association.

A dose-response relationship between marijuana use and schizophrenia was initially reported in a study of Swedish conscripts [67]. Subsequently, multiple additional prospective studies have demonstrated an increased risk of psychosis or psychotic symptoms with marijuana use (odds ratios ranging from 1.77 to 10.9), and several have also shown a dose-response relationship [70]. These epidemiological studies cannot eliminate the possible influence of bias, confounding, and reverse causality (psychosocial problems leading to marijuana use) on the observed association.

A systematic review of studies evaluating the psychological and social effects of marijuana use by young people concluded that there is insufficient evidence to conclude that the relationship between marijuana use and psychosocial harm is causal [71]. Similarly, a twins study concluded that the association between marijuana use and major depression is likely due to shared genetic and environmental factors that predispose to both outcomes [72]. However, the study also concluded that an association between marijuana use and suicide attempts may be causal, with early-onset marijuana use predisposing to suicide.

Disputing the theory of reverse causality, a prospective study that followed 2437 young people (ages 14 to 24) for four years did not find that predisposition to psychosis (based on a psychological screening test) was a significant risk factor for marijuana use (OR 1.42, 95% CI 0.88-2.31) [73]. Additionally, this study found that in patients without a baseline predisposition for psychosis, marijuana use was associated with a small absolute increase in risk of psychotic symptoms at follow-up (21 versus 15 percent, adjusted risk difference 6 percent), while in patients with a baseline predisposition to psychosis the increase in risk was much greater (51 versus 26 percent, adjusted risk difference 24 percent).

If the association between marijuana use and psychiatric illness is causal, it remains unclear whether marijuana acts to trigger the onset of these conditions only in vulnerable people, or whether it can provoke psychiatric illness in people who would otherwise not be predisposed to develop it. There is reasonable evidence that marijuana use exacerbates psychosis, and accumulating evidence that marijuana can precipitate schizophrenia in vulnerable individuals [74].

Other effects �?? Tachycardia results from stimulation of the cardiac pacemaker by marijuana, which may worsen hypertension or underlying heart disease [75]. One case-crossover study found that the risk of myocardial infarction onset was increased almost five times over baseline in the 60 minutes after marijuana use [76].

Marijuana impairs the immune system by suppressing activity of natural killer cells and macrophages [77].

Marijuana use also generally results in an increase in appetite.

Marijuana use increases risk-taking behavior [78], and increases the risk of resumption of alcohol or cocaine dependence after hospital discharge for detoxification [79].

Therapy �?? Patients who agree to therapy for marijuana abuse or dependence should be referred to a drug abuse treatment program. Marijuana dependence may require individualized treatment strategies which differ from those for other drugs of abuse; further research is indicated to determine appropriate treatment options [80]. Trials of a number of agents drugs, including bupropion, divalproex, naltrexone, and nefazodone, have not demonstrated effectiveness in treating withdrawal symptoms, and there have been no pharmacological trials for prevention of recurrent marijuana use [81]. A general overview of the treatment of patients with drug abuse problems is found separately. (See “Overview of the recognition and management of the drug abuser”).

MEDICINAL USE �?? There is considerable public and political pressure on the Drug Enforcement Agency to reschedule marijuana leaf as a medicinal drug [82]. As of August 2005, California and 10 other states have passed laws allowing the medicinal use of marijuana cigarettes. On May 14, 2001 the Supreme Court ruled that marijuana is an illegal substance and cannot be distributed for medicinal use. In 2005, the US Supreme Court, in Gonzalez versus Raich, held that patients prescribed marijuana in accordance with state law could be criminally prosecuted under the federal statutes [83].

A number of potential medical uses for marijuana and cannabinoids have been identified [84,85]:

Antiemetic [86,87] (see “Characteristics of antiemetic drugs”, section on Cannabinoids)
Treatment of intractable hiccups [88] (see “Overview of hiccups”)
Treatment of cachexia associated with AIDS or cancer [89-91] (see “Management of tissue wasting in patients with HIV infection” and see “Pharmacologic management of cancer anorexia/cachexia”)
Lowering intraocular pressure in patients with glaucoma [92]
Tremor reduction [93] and improvement of symptoms of multiple sclerosis [84,94-96] (see “Treatment of relapsing-remitting multiple sclerosis in adults”)
A systematic review of randomized, controlled trials that evaluated the use of cannabinoids for treatment of chronic pain (including cancer pain, chronic non-malignant pain, and acute postoperative pain) found that cannabinoids were no more effective than codeine in controlling pain, and they have depressant effects that limit their use [97].

The primary active ingredient in marijuana, THC, is available in purified form without other cannabinoids or carcinogens as an oral tablet under the name dronabinol. Other delivery forms currently in development are a transdermal patch, a nasal spray, and a metered dose inhaler. The debate over medicinal use of smoked marijuana will continue.

SUMMARY AND RECOMMENDATIONS

Marijuana is the most frequently used illicit drug in the US and its use is on the rise. Marijuana use predicts later use of opiates and other drugs, but its role in causality of other substance abuse is controversial (see “Epidemiology” above).
When smoked, marijuana has physiologic and psychologic effects for three to four hours. Motor performance may be impaired for up to 24 hours. There is a high prevalence of recent marijuana use in studies of drivers involved in motor vehicle accidents (see “Signs and symptoms” above).
Acute marijuana intoxication rarely requires treatment. Chronic use leads to physical dependence with withdrawal symptoms that can last five to seven days (see “Treatment” above).
Marijuana smoke contains carcinogens, but data do not show a definitive increase in lung or head and neck squamous cell cancers in marijuana users. Marijuana causes decreased libido and may cause male infertility. Smoking marijuana has been shown to impair pulmonary function tests and can cause cough; its association with chronic lung disease is suspected (see “Chronic health problems” above).
Chronic cannabis syndrome has been described in which chronic heavy users have a reduced ability to establish or attain life goals. Data are conflicting on chronic marijuana use as a cause of long-term cognitive impairment (see “Cognitive dysfunction” above).
Marijuana use is associated with increased prevalence of schizophrenia and depression; it is not clear that this is causal (see “Psychiatric illness” above).
Marijuana has multiple potential medicinal uses: treatment of nausea, intractable hiccups, cancer- or HIV-associated cachexia, glaucoma, tremor control in multiple sclerosis, sleep disorder, pain management and rheumatoid arthritis. Several states in the US have passed laws permitting its medicinal use, though it remains illegal under federal statutes (see “Medicinal use” above).

Yeah i agree with the joe rogan/adam corolla train of thought.

Dont quote me on this, but i remember a article on JB.com where JB stated that he doesnt have anything against marijuana. And if JB thinks its alrite, u can be damn sure its fine by me.