Cannabis All of the answers are from DSM-IV-TR or Substance Use Disorders, AJP Supplement, August 2006 As of 5Sep08. THC Q. What is THC? THC Ans. Delta-9-tetrahyfrocannabinol, the substance identified as responsible for the psychological effects of cannabis. Sensimilla Q. What is sensimilla? Sensimilla Ans. A high potency form of cannabis. Cannabinoid receptors Q. Is there such a thing in the human brain as canabinoid receptors, and, if so, where are they located? Cannabinoid receptors Ans. They are located throughout CNS. Cannabis intoxication Q. Criteria for cannabis intoxication are? Cannabis intoxication Ans. A. Recent use B. Significant behavioral/psychological maladaptive changes. C. Two or more of: -- conjunctival injection -- increased appetite -- dry mouth -- tachycardia “bad trips” Q. What constitute “bad trips”? How recorded as to specifier? “bad trips” Ans. Especially with high amounts of cannabis, hallucinations and related delusions may occur. DSM specifier is “With Perceptual Disturbance.” Positive urines Q. For moderate use, how long are the urines positive? For heavy use, how long? Positive urines Ans. Moderate use: 7-10 days. Heavy use: 2-4 weeks. Reason of long presence is that cannabis derivatives are fat soluble. Lab findings Q. Hormone changes produced, temporarily, by cannabis ingestion? Lab findings Ans. -- suppresses testosterone -- suppresses luteinizing hormone -- suppresses immunological function Sleep studies Q. Cannabis produces what sleep changes? Sleep studies Ans. -- diffuse slowing on EEG -- REM suppression Physical examination Q. When you do a physical exam on a chronic marihuana user, what is commonly found? Physical examination Ans. Respiratory changes of chronic cough, sinusitis, pharyngitis, bronchitis. Prevalence - gender Q. Which gender predominates? Prevalence - gender Ans. Males [remember, that the answers is “males” for all substance dependences except nicotine.] Prevalence - age Q. Highest prevalence as to age? Prevalence - age Ans. 18 – 30 year old. Prevalence – ever used Q. What proportion of the US population has ever used marihuana? Prevalence – ever used Ans. 1/3. Childhood disorders Q. Which childhood disorder, if any, is related to use of marihuana as an adult? Childhood disorders Ans. Conduct disorder. [Again, this answer will usually be correct with almost any substance.] Cannabis withdrawal Q. Status of cannabis withdrawal in DSM-IV. Cannabis withdrawal Ans. Not in DSM-IV, as it is uncertain if there is such an entity. Psychosocial approaches Q. What psychosocial approaches have been proven to be useful? Psychosocial approaches Ans. No controlled studies. Medications Q. Which meds have been shown to be beneficial? Medications. Ans. None have been shown in controlled studies to treat intoxication or to treat the dependence.