The old Ray Charles song wails, "Let's Go Get Stoned..."
It is an anthem to a human practice as old as history. Man has sought escape, intoxication, insight, camaraderie, and bliss in the use of mind-altering substances throughout the ages. It is a practice that threads through cultures, eras, fads, substances, and prohibitions. The predilection to get stoned, high, wasted, etc. seems to be a common, perhaps ingrained, form of debauchery as are such leanings toward violence, rape, promiscuity, criminal behavior, and other "me-first" behaviors.
A most prevalent go-to substance for getting stoned is the ubiquitous marijuana. Known by many names (weed, grass, hemp, pot, hash, etc.), marijuana is typically smoked (though sometimes swallowed or rubbed) for its euphoric and calming effects. It has also been extolled for its enhancing effects upon sensual pleasures and creativity. In some cultures, it has been used ceremoniously in spiritual rituals. In America and other lands, marijuana use has become a staple among cross sections of the populace, including counterculture and mainstream, young and old, the sick and the able-bodied.
Marijuana is often hailed as a harmless recreation, a palliative for anxiety, stress, and aggression. It has been increasingly promoted for its "healing" effects, especially for painful and debilitative maladies such as cancer and chronic pain. It is heralded as a natural remedy for sleep and for loss of appetite, a common side effect of chronic illness and some medications.
Often touted as innocuous and compared favorably to known deleterious intoxicants and painkillers (e.g., alcohol and opiates), marijuana has been increasingly legitimized by various levels of legalization. Some states allow medical marijuana use (with cards easily obtained from a doctor), entitling the holders of this privilege to purchase varieties of marijuana dispensed commercially by neighborhood "pot" stores. Some states have legalized marijuana for recreational use. In Colorado and Washington, users openly enjoy the weed in public, flaunting and celebrating their liberty and intoxication in public gatherings.
Though it is increasingly accepted as safe and even helpful, the effects of marijuana are insidious and harmful. Here is an overview of marijuana's effects on the body and brain and its impact upon users:
Marijuana comes from the hemp plant Cannabis sativa. It has an active ingredient called THC that makes you feel high. THC and other compounds in marijuana can also affect the way your body works.
Most people smoke the plant's dried leaves, flowers, stems, and seeds. But marijuana can also be mixed into food (like brownies, cookies, and lollipops), brewed as a tea, or inhaled with a vaporizer.
No matter how it gets into your system, it affects almost every organ in your body, and your nervous system and immune system, too. When you smoke pot, your body absorbs THC right away. (If you eat a baked good or another item, it may take much longer for your body to absorb THC, because it has to break down in your stomach before it enters your bloodstream). You may notice changes in your body right after you smoke. The effects usually stop after 3 or 4 hours.
Smoking pot can increase your heart rate by as much as two times for up to 3 hours. That's why some vulnerable people have a heart attack right after they use marijuana. It can also increase bleeding, lower blood pressure, and affect your blood sugar, too.
Other physical effects of marijuana include:
If you're a habitual user, you can have physical withdrawal symptoms—like cravings, irritability, sleeplessness, and irregular appetite—when you stop.
Most people use marijuana because the high makes them feel happy, relaxed, or detached from reality.
Electroencephalography or EEG shows somewhat more persistent alpha waves of slightly lower frequency than usual. Cannabinoids produce a marked depression of motor activity via activation of neuronal cannabinoid receptors.
Smoking pot can also have less pleasant effects on your mind and mood, too. You might have:
The psychoactive effects of cannabis, known as a "high" are subjective and can vary, based on the person and the method of use.
When THC enters the blood stream and reaches the brain, it binds to cannabinoid receptors. (Receptors are proteinous membranes in cells; they allow cells to communicate with one another through chemical signals that affect the ease with which particular nerve cells fire and transmit electrical signals about what the body perceives is happening and what, if any, action to take.)
Some effects may include a general alteration of conscious perception, euphoria, feelings of well-being, relaxation or stress reduction, increased appreciation of humor, music (especially discerning its various components/instruments) or the arts, joviality, metacognition and introspection, enhanced recollection (episodic memory), increased sensuality, increased awareness of sensation, increased libido, and a sense of creativity. Abstract or philosophical thinking, disruption of linear memory and paranoia or anxiety are also typical. Anxiety is the most commonly reported side effect of smoking marijuana. It may surprise you that up to 30 percent of recreational users experience intense anxiety and/or panic attacks after smoking cannabis; however, some also report anxiety after not smoking cannabis for a prolonged period of time.
Cannabis also produces many subjective and highly visceral effects, such as greater enjoyment of food taste and aroma, an enhanced enjoyment of music and comedy, and marked distortions in the perception of time and space (where experiencing a "rush" of ideas from the bank of long-term memory can create the subjective impression of long elapsed time, while a clock reveals that only a short time has passed). At higher doses, effects can include altered body image, auditory and/or visual illusions or hallucinations, and ataxia (loss of muscle control). In some cases, cannabis can lead to dissociative states such as depersonalization, and can potentially induce panic attacks, paranoia, and psychotic episodes.
Some of the short-term physical effects of cannabis use include increased heart rate, dry mouth, reddening of the eyes (congestion of the conjunctival blood vessels), a reduction in intra-ocular pressure, muscle relaxation, and a sensation of cold or hot hands and feet.
Electroencephalography or EEG shows somewhat more persistent alpha waves of slightly lower frequency than usual. Cannabinoids produce a marked depression of motor activity via activation of neuronal cannabinoid receptors.
While many psychoactive drugs clearly fall into the categories of stimulant, depressant, or hallucinogen, cannabis exhibits a mix of these properties.
Most cannabinoids are lipophilic (fat soluble) compounds that are easily stored in fat, thus yielding a long elimination half-life relative to other recreational drugs (and in sharp contrast to alcohol). This means that marijuana compounds are stored in the fat cells (with delayed effects upon liver metabolism) and can stay in the body for several months. Thus, while the "high" dissipates in a matter of hours, the body retains and metabolizes active cannabis compounds long after ingestion. Thus, the brain and nervous system are affected by marijuana even after the user may be unaware of its effects.
The THC molecule and related compounds are usually detectable in drug tests from 3 days up to 10 days after usage; heavy users can produce positive tests for up to 3 months after ceasing cannabis use. The influence of marijuana on developing lung cancer is unclear. But the process of smoking does irritate the lungs, and even marijuana contains toxic substances such as tars—explaining why regular pot smokers are more likely to have an ongoing cough and to have lung-related health problems like chest colds and lung infections.
Though you may have heard otherwise, marijuana can be addictive: conservatively, at least 10% of people who use it become dependent on it. The argument continues over whether marijuana is a gateway drug that makes people more likely to try harder drugs like cocaine and heroin. However, two factors predispose pot users to become more likely to try and be harmed by stronger drugs:
Thus the problem becomes ingrained in both the user and the environment.
The amount of THC in marijuana has gone up in recent years. Most leaves used to contain between 1% and 4% THC. Now, most have closer to 7%, and some as high as 16%. Experts worry this might make it easier to become dependent on or addicted to marijuana—and it also strengthens many of the drug's mind-altering effects. Even if you buy from a legal, state-regulated dispensary, it can be hard to know exactly how much THC or other compounds found in marijuana you're ingesting, so the effects can be unpredictable.
Marijuana can also cause more health problems if you have a condition like liver disease, low blood pressure, or diabetes.
If you're a man, heavy use could lower your testosterone levels, and your sperm count and quality. That, in turn, can zap your libido and fertility.
Research shows a link between marijuana use and mental health problems like depression, anxiety, suicidal thoughts, short-term psychosis, and schizophrenia. While it's not clear if marijuana causes these conditions, it often makes them worse.
The areas of the brain where cannabinoid receptors are most prevalently located are consistent with the behavioral effects produced by cannabinoids. Brain regions in which cannabinoid receptors are very abundant are the basal ganglia, associated with movement control; the cerebellum, associated with body movement coordination; the hippocampus, associated with learning, memory, and stress control; the cerebral cortex, associated with higher cognitive functions; and the nucleus accumbens, regarded as the reward center of the brain. Other regions where cannabinoid receptors are moderately concentrated are the hypothalamus, which regulates homeostatic functions; the amygdala, associated with emotional responses and fears; the spinal cord, associated with peripheral sensations like pain; the brain stem, associated with sleep, arousal, and motor control; and the nucleus of the solitary tract, associated with visceral sensations like nausea and vomiting.
Most notably, the two areas of motor control and memory are where the effects of cannabis are directly and irrefutably evident. Cannabinoids, depending on the dose, inhibit the transmission of neural signals through the basal ganglia and cerebellum. At lower doses, cannabinoids seem to stimulate locomotion, whereas greater doses inhibit it; this is most commonly manifested by lack of steadiness (body sway and hand steadiness) in motor tasks that require conscious attention. Other brain regions, like the cortex, the cerebellum, and the neural pathway from cortex to striatum, are also involved in the control of movement and contain abundant cannabinoid receptors, indicating their possible involvement as well.
Experiments on animal and human tissue have demonstrated a disruption of short-term memory formation; this finding is consistent with the abundance of CB1 receptors on the hippocampus, the region of the brain most closely associated with memory. Cannabinoids inhibit the release of several neurotransmitters in the hippocampus such as acetylcholine, norepinephrine, and glutamate, resulting in a major decrease in neuronal activity in that region. This decrease in activity can resemble a "temporary hippocampal lesion."
In addition to the effects listed, cannabis has insidious consequences that accumulate and compound over time. These are addressed below; but first, let's note some possible upsides of the weed.
Marijuana does have benefits. For the hedonist, "feeling good" and pleasure become ends in themselves. Catering to these self-indulgent desires, however, is not the type of benefit that make marijuana worthy of legitimacy. The benefits that may count in favor of cannabis are its effects of lowering intraocular eye pressure in glaucoma, stimulating appetite in chronically ill patients receiving chemotherapy, and—possibly—reducing intractable seizures in severe epilepsy.
The medical therapeutic value of cannabis is mainly derived from one of the compounds in it called Cannabidiol (CBD). Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the two main ingredients in the marijuana plant. Both CBD and THC belong to a unique class of compounds known as cannabinoids. However, it is the THC compound that makes people feel high and euphoric. By contrast, the CBD compound does not produce this effect.
Interestingly, in the contemporary commercial cultivation of marijuana, growers can genetically engineer the amount and strengths of both THC and CBD in their marijuana plants. Growers who want to sell lots of marijuana to users seeking pleasure and psychoactive effects breed their plants to augment the THC content and reduce the CBD content. Only a few growers specialize in reducing THC content while augmenting CBD, since the CBD is the active ingredient in healing effects.
So, CBD does not produce the pleasurable effects typically sought by marijuana users. Some possible benefits of CBD are:
Today's marijuana growers and distributors typically sell a product that is many times higher in THC than in CBD and also many times more potent than the marijuana of a generation ago. Therefore, any assessment of the therapeutic or medical benefits must consider the prevalent negative effects accruing from overly potent THC marijuana and the fact that the therapeutic compound (CBD) in cannabis is antithetical to the pleasure- inducing compound (THC). Thus, proponents of medical marijuana are often either disingenuous or are duped by this paradox: the getting high aspect is chemically and neurologically in opposition to the therapeutic aspect.
The documented negative effects of marijuana are legion. Cannabis products are associated with the following:
After the arguments pro and con for marijuana are rendered, I believe there is a bottom line for why people use it: marijuana relieves anxiety. Stated simply, that is the only real reason for its use, despite the many negatives associated with it. All the rest is justification. And, yes, marijuana is a great anxiety reliever—but the costs far outweigh the temporary benefits.
Any addiction pattern is a cycle involving anxiety relief, rebound and withdrawal, craving, and repeated use that becomes reinforced habit (see http://www.marksteinberg.com/services/addiction-and-treatment.html). Addictions are fundamentally anxiety driven. Habitual marijuana use is clearly an addiction, despite the justifications, disclaimers, or adornments of cultural validation.
The nature of addictions is that they disrupt self-regulation—that is, the biological systems that maintain homeostasis, balance, and flexibility of brain and nervous system functioning. (Self-regulation disruptions are also quite common in people who do not have substance addictions or who do not use cannabis.) Regardless of one's constitution or habits, marijuana use negatively affects the natural biological ability to self-regulate. When this ability becomes impaired, many disruptions and symptoms ensue, including problems with sleep, concentration, mood, appetite, immune function, and self-control.
There are effective, natural, non-drug methods for overcoming addictions (including marijuana), eliminating anxiety, and vastly improving self-regulation and brain function. These are outlined and explained in detail in my book, Living Intact: Challenge and Choice in Tough Times.
The contention that marijuana is superlative for reducing pain and stimulating appetite is one that should be challenged. Yes, it does help with pain and appetite, and it can be a boon to those with severe and debilitating illnesses. However, bear in mind two points:
The manner in which one approaches health, consciousness, responsibility, and attitudes about one's body and connection to others and the larger world will certainly influence one's perspective on pain and suffering, toleration of discomfort, self-regulation and self-soothing, and what one depends on for relief. There are people who steer very clear of any kind of lapse or impairment in judgment and mental functioning, however temporary. There are teetotalers who abstain on moral or aesthetic bases. And there are many who throw caution to the wind, reveling in hedonistic lifestyles, indulging in partying, carousing, and inebriation, sometimes taking indulgence to competitive levels with regard to one's ability to consume and become stoned. There are many struggling with addictions who never intended to become addicted and who never saw the handwriting on the wall that eventually imprisons them. The nature of addictive pleasure is that what seems like freedom at the beginning becomes inexorable constriction down the road. Though marijuana may relieve anxiety, stress, insomnia in the short term, there is almost always an intense rebound effect that exacerbates the symptoms for which cannabis was used in the first place—in particular, anxiety and difficulty sleeping and relaxing become more problematic in habitual users who ultimately attempt to reduce or cease their intake.
Marijuana use has many aspects, reasons, and justifications. It is a natural, versatile, and powerful substance. Its acceptance is growing, and its harvesters and merchants are dramatically expanding its legal and illegal availability in towns, cities, and states across the nation. It's easy and persuasive to sway to the Ray Charles ballad, "Let's Go Get Stoned..." Make no mistake, though, that the consequences of habitual marijuana use are devastating. Among its most tragic consequences are the relentless destruction of motivation, the degradation of concentration and organization, and the gradual erosion of the personality constructs that comprise wise judgment, the compromise of moral values and self-sacrifice, and the drive necessary for achievement and persistence in the face of frustration and adversity.
Surely, there are pleasures and palliatives in the world. We need them, and they are varied and plentiful. Asceticism is unnecessary. Yet to include marijuana among them is irresponsibly costly. The brain is a marvelous instrument, designed to maintain delicate functional balances, to process and reason, to replenish its self-regulating homeostasis. Why drain it of its ability and resources in the name of short-lived pleasure and deceptive rationalizations?
Many readers will appreciate these comments and details about the effects of marijuana. Some will argue with or dismiss what's written, or perhaps will justify their own behavior. If I've made you uncomfortable, I do apologize for that. However, given what's known about the deleterious effects of marijuana—individually and socially—I just can't hemp myself.
— Mark Steinberg, Ph.D.
