Transcript Document

Marijuana
Brain Functions
Treatment Options
Paul Nims MA, CRADC, CCDP-D
Co-Occurring Disorders Program Coordinator
BJC Behavioral Health
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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).
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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%
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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.
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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).
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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
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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.
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8 Major Life Areas
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3.
4.
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Psychological
Physical
Family
Legal
Financial
School or Work
Friends
Interpersonal Relationships
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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
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Physical tolerance mild to moderate
 Mood swings
 Pre- and post- using
 Fragmented Blackout
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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.
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When marijuana-dependent individuals stop
using the drug, they experience symptoms of:
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irritability
anger
cravings
decreased appetite
insomnia
interpersonal hypersensitivity
yawning and/or fatigue
(Budney et al., 2001; Preuss et al., 2010)
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Residential
◦ Hospital
◦ Medical Assisted Detox
◦ Inpatient Treatment
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Out Patient Treatment
◦ Partial Hospitalization or Intensive Out Patient
◦ Traditional Out Patient
◦ Relapse Prevention
 Treatment
 People
Works
Recover
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NCADA-Helpline:
◦ (314) 962-3456
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MO Dept. of Mental Health
◦ (573) 751-4942 or (800) 575-7480
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ACT Missouri
◦ (573)-635-6669