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Cannabis pharyngitis


  All of the answers are from DSM-IV-TR or
 Substance Use Disorders, AJP Supplement,
                 August 2006
As of 5Sep08.
Q. What is THC?
Ans. Delta-9-tetrahyfrocannabinol, the
 substance identified as responsible for the
 psychological effects of cannabis.
Q. What is 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
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
 -- suppresses testosterone
 -- suppresses luteinizing hormone
 -- suppresses immunological function
           Sleep studies
Q. Cannabis produces what sleep changes?
            Sleep studies
 -- diffuse slowing on EEG
 -- REM suppression
       Physical examination
Q. When you do a physical exam on a
 chronic marihuana user, what is commonly
       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.
Q. Which meds have been shown to be
Ans. None have been shown in controlled
 studies to treat intoxication or to treat the

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