Cannabis use disorder ( CUD ) (also known as marijuana or marijuana addiction) is defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) and ICD-10 published by the World Health Organization as a continued use of marijuana despite clinically significant decreases, ranging from mild to severe.
Video Cannabis use disorder
Signs and symptoms
The use and abuse of marijuana has symptoms that affect the behavior, physical, cognitive, and psychosocial aspects of a person's life. Symptoms include agitation, red eyes, challenges in problem solving, and paranoia.
The use of marijuana is associated with comorbid mental health problems, such as mood and anxiety disorders, and cessation of cannabis use that is difficult for some users. Psychiatric comorbidities are often present in dependent cannabis users including multiple personality disorders.
The use of marijuana at a young age such as adolescence can have a serious impact on depression and anxiety in youth and later on. There is evidence that the use of cannabis during adolescence, at a time when the brain is still developing, may have a damaging effect on neural development and later cognitive function. The brain has not fully developed until a person reaches the age range 22-27. Excessive use of marijuana can cause damage to these developments.. Based on an annual survey data of 7 percent of senior high school seniors who smoke daily functions at a lower level in school than students who do not. The sedative and anxiolytic properties of THC in some users may make the use of marijuana in an attempt to treat personality or psychiatric disorders.
Dependency
The old use of marijuana produces pharmacokinetic changes (how medicines are absorbed, distributed, metabolized, and excreted) and pharmacodynamic changes (how drugs interact with target cells) to the body. These changes require the user to take higher doses of the drug to achieve the desired general effect (known as higher tolerance), strengthen the body's metabolic system to eliminate the drug more efficiently and further lower the cannabinoid receptors in the brain. This effect blends with oneself because chronic users should consume more frequently to cope with accelerated opening, and higher doses to cope with blunt responses to receptor activation.
Users of marijuana have shown a decrease in reactivity to dopamine, suggesting a possible link to the brain system's brain rectification and increased negative emotions and severity of addiction.
Users of cannabis can develop tolerance to the effects of THC. Tolerance to the behavioral and psychological effects of THC has been shown in humans and adolescent animals. The mechanisms that create tolerance to THC are thought to involve changes in the function of cannabinoid receptors.
According to the National Center for Caliber and Cause Information in Australia, the sign of a cannabis dependency is that a person spends more time than the average recreational user who recovers from using or obtaining cannabis. For some people, using marijuana becomes an important and disturbing part of a person's life and he may show difficulties in fulfilling personal obligations or participating in important life events, preferring to use marijuana instead. People who have hanging marijuana have the inability to stop or down using marijuana alone.
Cannabis addiction is more common among heavy users. The use of cannabis can lead to increased tolerance and, in some users, withdrawal symptoms when trying to quit.
Withdrawal
Symptoms of withdrawal of cannabis can occur in half of patients in the treatment for disruption of cannabis use. These symptoms include dysphoria (anxiety, irritability, depression, anxiety), disturbed sleep, gastrointestinal symptoms, and decreased appetite. Most symptoms begin during the first week of abstinence and improve after a few weeks. The withdrawal symptoms are usually not severe, even after heavy use.
Maps Cannabis use disorder
Cause
Cannabis addiction is often due to prolonged and increased drug use. Increasing the strength of cannabis taken and increasing use of more effective delivery methods often increases the development of cannabis dependence. This can also be caused by a tendency to become addicted to substances, which can be obtained genetically or environmentally.
Risk factors
Certain factors are thought to increase the risk of developing cannabis dependence and longitudinal studies over several years has allowed researchers to track aspects of social and psychological development along with marijuana use. More and more evidence is shown for an increase in issues related to the frequency and age at which marijuana is used, with younger users and often at greatest risk.
The main factors in Australia, for example, are associated with an increased risk of developing problems with the use of cannabis including frequent use at a young age; personal disability; emotional distress; poor parenting; dropout; affiliation with colleagues who use drugs; moving from home at an early age; smoking daily; and ready access to marijuana. The researchers conclude there is growing evidence that a positive experience for early marijuana use is a significant predictor of late dependence and that genetic predisposition plays a role in the development of problematic use.
High risk group
A number of groups have been identified as at greater risk of developing cannabis dependence and, in Australia, for example, have been found to include populations of teenagers, Aboriginal and Torres Strait residents and those suffering from mental health conditions.
Teen
Young people are at greater risk of developing cannabis dependence because of the relationship between early initiation into substance use and subsequent problems such as dependence, and the risks associated with marijuana use at a life-prone age.
Diagnosis
The disruption of cannabis use is recognized in the fifth version of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), which adds the cannabis withdrawal as a new condition.
Treatment
Doctors distinguish between ordinary users who have difficulty with the drug screens, and heavy users on a daily basis, for chronic users who use multiple times a day.
Psychological
Psychological interventions include cognitive behavioral therapy (CBT), motivation enhancement therapy (MET), contingency management (CM), expressive-psychotherapy (SEP), family and system interventions, and twelve-step programs.
Evaluation of the Marijuana Anonymous program, modeled on 12-steps of Alcoholics Anonymous and Anonymous Narcotics, has shown a small beneficial effect for general drug-use reduction. In 2006, the Wisconsin Initiative to Promote a Healthy Lifestyle implemented a program that helps primary care physicians identify and address the problem of cannabis use in patients.
Barriers to care
Research that sees barriers to marijuana treatment often cites lack of interest in treatment, lack of motivation and knowledge of treatment facilities, lack of overall facilities, medication-related costs, difficulty meeting program eligibility criteria and transportation difficulties.
Treatment for dependency
In the US, in 2013, marijuana is the most commonly identified illicit substance used by people treated at care facilities. Demand for treatment for marijuana disruption increased internationally between 1995 and 2002. In the United States, the average adult seeking treatment has consumed marijuana for more than 10 years almost daily and has attempted to quit six or more times.
No drug was found to be effective for cannabis dependency in 2014, but the psychotherapeutic model promises.
Treatment options for cannabis dependence are much less than opioid or alcohol dependence. Most treatments fall into the category of psychological or psychotherapy interventions, interventions, pharmacologic or treatment through peer support and environmental approaches. Short screening and intervention sessions can be administered in a variety of settings, especially on doctors' surgery, which is important because most marijuana users seeking help will do so from their GPs rather than from drug treatment agencies.
The most frequently accessed forms of treatment in Australia are the 12-step program, doctors, rehabilitation programs, and detox services, with inpatient and outpatient services being accessed evenly. In the EU, about 20% of all primary receipts and 29% of all new drug clients in 2005, have primary cannabis problems. And in all countries reporting data between 1999-2005 the number of people seeking treatment for marijuana use increased.
Medication
In 2012, no drug has been proven effective for treating cannabis use disorder; research focused on three treatment approaches: substitution of agonists, antagonists, and modulation of other neurotransmitter systems. Dronabinol is a legally available agonist; in some cases and trials, it reduces withdrawal symptoms and reduces cannabis use. Entacapone is well-tolerated and decreases cravings of cannabis in trials in a small number of patients. Acetylcysteine ​​â € <(NAC) reduces the use of cannabis and desire in experiments. Atomoxetine in a small study showed no significant change in the use of marijuana, and most patients experience side effects. Buspirone shows promise as a treatment for dependency; trials show it reduces desire, irritability and depression. Divalproex in small studies was poorly tolerated and showed no significant reduction in the use of marijuana among the subjects.
Epidemiology
Cannabis is one of the most widely used drugs in the world. In the United States, 49% of people have used marijuana. an estimated 9% of those who use cannabis develop dependence. 34.8% of Australians aged 14 and over have used marijuana once or more in their lives. In the United States, 42% have used marijuana. In the US, marijuana is the most commonly prohibited substance that is used by people treated in care facilities. Most of these people are called there by the criminal justice system. 16% of admissions either go alone, or be referred by family or friends.
There is a high prevalence of cannabis use in the US. Dependency of marijuana develops in 9% of users, much less than the heroin, cocaine, alcohol, and anxiolytics prescribed, but slightly higher than that for psilocybin, mescaline, or LSD. Of those who use marijuana every day, 10-20% develop dependence.
Research
Columbia University, in collaboration with the National Institute on Drug Abuse (NIDA), conducted a clinical trial looking at the effects of drug combinations on cannabis dependence, to see if lofexidine in combination with dronabinol was superior to placebo in achieving abstinence, reduced cannabis use and reduced withdrawal in cannabis-dependent patients seeking treatment for their cannabis use. Men and women between the ages of 18-60 who meet the DSM-IV criterion for cannabis dependency are currently enrolled in a 12-week trial beginning in January 2010.
Georgotas & amp; Zeidenberg (1979) conducted an experiment in which they gave an average daily dose of 210 mg of tetrahydrocannabinol (THC), the ingredient in cannabis that was responsible for its psychological effects, to a group of volunteers over a 4-week period. After the test ended, the subjects were found "irritable, uncooperative, resistant and sometimes unfriendly," and many patients had insomnia. This effect is likely due to withdrawal from the drug and lasts about 3 weeks after the trial.
Cochrane Collaboration 2014 reviews find insufficient data to evaluate the effectiveness of gabapentin and acetylcysteine ​​in the treatment of cannabis dependence and need further research.
See also
- La Guardia Committee, the first in-depth study on cannabis effects.
- Medical marijuana
References
Source of the article : Wikipedia
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