On Smoking Marijuana
By Dr. Ravi Shankar

The word Marijuana is used for the dried flowers, seeds and leaves of the hemp plant. The plant ‘Cannabis sativa’ grows readily in many parts of the world. The drug has a number of street names like bhang, dagga, dope, ganja and grass.

In the early 12th century, Hasan Ibn-Sabbah terrorized Arabia. The world traveler Marco Polo has given a detailed description of this shadowy figure. His men murdered Hasan’s political opponents under the influence of hashish, a strong unadulterated derivate of Cannabis. The cult was called ‘hashishiyya’ from which the word ‘hashish’ is derived.

Marijuana and South Asia:
South Asia has a long tradition of marijuana use. It has been a part of religious ceremonies for thousands of years. Its use gradually spread throughout Asia, Africa, Europe and the Americas. In Nepal, marijuana and its derivatives have been and are widely used, especially during the week of the Shivaratri festival. Unlike Marijuana, Hashish is made from resin of the plant while Cannabis is a broader term and refers to the various drugs which come from the hemp plant including marijuana and hashish. Different terms are used for preparations from various parts of the hemp plant.

Effects on the mind:
The mechanism of action is not very well understood. The drug mainly produces psychological reactions (effects on the mind). Euphoria (a feeling of intense happiness) is very common. Sensations become more vivid and contrast and intensity of color can increase. Size of objects and distance are distorted. The sensation of time can disappear completely and a sense of timelessness can occur, which may help in greater experience of various religious sensations. Recent memory and attention to specific tasks can be impaired. There may be feelings of deep insight and truth. Religious users report greater identification with and awareness of ‘God’ and oneness with the Universe. After the initial euphoria (up) though, the user can feel sleepy or depressed. The heart rate increases and there may be greater risk of heart attacks, especially in people with diseased hearts. Some users may find the effects unpleasant, especially the timelessness and the sensation that mental processes are not under control. Feelings of unease and acute panic attacks can occur.

Effects on the body:
Regular use of marijuana leads to reduced resistance to common illnesses like colds; suppression of the immune system can occur. Growth disorders, reduced sexual capacity, personality and mood changes, and reduction in intellectual abilities have also been reported. Like with other drugs, tolerance occurs with habitual use. This means that the user will need a larger amount of the drug to experience the behavioral and other effects.

Amotivational syndrome:
On chronic use of a ‘drug’, various adaptive changes occur in the body. On suddenly stopping the use of the drug, these adaptive changes are unopposed and the person experiences withdrawal symptoms. Most drugs produce ‘craving’, which is an intense desire to obtain the drug at any cost. With marijuana, the symptoms are mainly psychological characterized by depression, anxiety, sleep disturbances and other problems. ‘Amotivational syndrome’ is caused by heavy use of marijuana. There is lack of motivation and reduced productivity. The user shows apathy, poor short-term memory, difficulty in concentration and lack of drive to pursue tasks. It is difficult to conclusively prove that the syndrome is due to chronic use of the drug. Certain scientists argue that poorly motivated people are more likely to use and abuse marijuana, which further worsens the condition.

Other effects:
Cannabis causes unsteadiness and reddening of the eyeballs. This is due to dilation of blood vessels and can also cause a decrease in blood pressure. The smoke from the cigarette can produce a smoker’s cough, and studies have shown that a typical cannabis user inhales more smoke and holds it longer in the lungs than s/he would do with a nicotine cigarette. Smoking one joint of cannabis can cause five times as much exposure to cancer producing substances as smoking five cigarettes.

Mild adverse reactions can be managed by reassuring the person, talking to him/her and helping understand that their mental experiences are due to the drug and will soon abate. All anxious subjects can be sedated with diazepam or another member of the benzodiazepine group of tranquilizers.

Marijuana in therapy:
The use of marijuana in treatment has been controversial. The drug or its active principle, THC, has been used to calm or relieve symptoms of an illness. Marijuana has a long history of use in treating illness in many countries. The drug may relax muscles and relieve spasms, reduce seizures and depression. The drug has been used to relieve pain. Reports of its benefits in other conditions like glaucoma and multiple sclerosis, a disorder of the nerves, exist. Dronabinol, a derivative, has been approved as a drug in certain countries. The drug is used for controlling nausea and vomiting among patients receiving anticancer drugs who do not respond to other measures. The drug can stimulate appetite and has been used in anorexia with weight loss in people living with AIDS.

Cannabis can have additive effects with drugs like alcohol and other brain function depressants. Marijuana is the most popular illicit drug worldwide, just behind alcohol and tobacco that are licit drugs. Marijuana is also the second most frequently found substance in bodies of drivers involved in fatal car accidents. The drug can act as a ‘gateway’ for the use of other substances. I end with the sad words of an addict who states, “I was given my first joint in the playground of my school. I’m a heroin addict now and I’ve just finished my eighth treatment for drug addiction.”