Brain Functions

Treatment Options

Paul Nims MA, CRADC, CCDP-DCo-Occurring Disorders Program CoordinatorBJC Behavioral Health

MarijuanaMarijuana

The main intoxicating chemical in Marijuana is Tetrahydrocannabinol also known as delta-9-tetrahydrocannabinol (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).

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%

Inhaled smoke is a suboptimal delivery method for any agent intended to be health-promoting in any way. (ASAM-Public Policy Statement on Marijuana)

Smoked marijuana has the potential to be as, or more, harmful than cigarettes.

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).

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

Pic of brain with THC Receptors

The Reward PathwayThe 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.

8 Major Life Areas1. Psychological2. Physical3. Family4. Legal5. Financial6. School or Work 7. Friends8. Interpersonal Relationships

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 substanceOccasional intoxication – increasing frequencyPSYCHOLOGICAL relief useView drug as a friend

Physical tolerance mild to moderate Mood swings Pre- and post- using Fragmented Blackout

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.

When marijuana-dependent individuals stop using the drug, they experience symptoms of:◦ irritability◦ anger◦ cravings◦ decreased appetite◦ insomnia◦ interpersonal hypersensitivity◦ yawning and/or fatigue (Budney et al., 2001; Preuss et al., 2010)

Residential ◦ Hospital◦ Medical Assisted Detox◦ Inpatient Treatment

Out Patient Treatment◦ Partial Hospitalization or Intensive Out Patient◦ Traditional Out Patient◦ Relapse Prevention

Treatment Works

People Recover

NCADA-Helpline:◦ (314) 962-3456

MO Dept. of Mental Health◦ (573) 751-4942 or (800) 575-7480

ACT Missouri◦ (573)-635-6669