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Toxicology – Marijuana (Cannabis)
Source
Marijuana is derived from the female Cannabis plant and can be used in various forms, including smoking, ingestion, or as a brewed preparation.
Typical Presentation
A common scenario involves recreational use in social settings, leading to feelings of relaxation, euphoria, altered perception, and impaired coordination. Users may describe changes in time perception and sensory experiences.
Clinical Features
Psychological effects include euphoria, calmness, altered perception, impaired attention, decreased concentration, and possible hallucinations. Physical findings may include increased heart rate, elevated blood pressure, dry mouth, rapid breathing, red eyes (conjunctival injection), and increased appetite. Coordination and motor function may also be impaired.
Mechanism of Action
The primary psychoactive component, delta-9-tetrahydrocannabinol (THC), is highly lipophilic and rapidly absorbed, with peak levels occurring shortly after inhalation. THC acts on cannabinoid receptors (CB1 in the central nervous system and CB2 in peripheral tissues), modulating neurotransmitter release. Due to its fat solubility, THC accumulates in adipose tissue and may remain detectable for extended periods, especially in frequent users.
Management
Treatment is supportive. Reassurance is often sufficient, and benzodiazepines may be used for significant anxiety or agitation.
Key Points
Source
Marijuana is derived from the female Cannabis plant and can be used in various forms, including smoking, ingestion, or as a brewed preparation.
Typical Presentation
A common scenario involves recreational use in social settings, leading to feelings of relaxation, euphoria, altered perception, and impaired coordination. Users may describe changes in time perception and sensory experiences.
Clinical Features
Psychological effects include euphoria, calmness, altered perception, impaired attention, decreased concentration, and possible hallucinations. Physical findings may include increased heart rate, elevated blood pressure, dry mouth, rapid breathing, red eyes (conjunctival injection), and increased appetite. Coordination and motor function may also be impaired.
Mechanism of Action
The primary psychoactive component, delta-9-tetrahydrocannabinol (THC), is highly lipophilic and rapidly absorbed, with peak levels occurring shortly after inhalation. THC acts on cannabinoid receptors (CB1 in the central nervous system and CB2 in peripheral tissues), modulating neurotransmitter release. Due to its fat solubility, THC accumulates in adipose tissue and may remain detectable for extended periods, especially in frequent users.
Management
Treatment is supportive. Reassurance is often sufficient, and benzodiazepines may be used for significant anxiety or agitation.
Key Points
- Cannabis can be consumed by smoking, ingestion, or brewing into beverages.
- Oral use has a delayed onset (typically 1–3 hours) and may lead to stronger or unpredictable effects.
- Marijuana may sometimes be contaminated with other substances such as PCP or stimulants.
- Substances marketed as “formaldehyde-treated” marijuana are often actually contaminated with PCP rather than formaldehyde itself.
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