The Herald (Zimbabwe)

Marijuana recreation­al use and its dangers

- Dr Sacrifice Chirisa Mental Health Matters

DELTA-9-tetrahydro-cannabinol (THC) is the main psychoacti­ve that is a mind-altering ingredient in marijuana and is responsibl­e for the majority of the effects of using marijuana. THC is a highly lipid soluble, which means that it can cross the blood-brain barrier and reside in certain body tissues for extended periods of time up to 30 days. The central nervous system has endogenous receptors called cannabinoi­d receptors, which have high binding affinity towards THC.

When THC binds to the receptor, the receptor becomes activated and through second messenger actions -carried out by a molecular interactio­n separate from the initial THC/cannabinoi­d receptor binding - initiates a cascade of events that ultimately results in impaired cognition and altered mood.

When looking at heavy recreation­al marijuana use, there are adverse effects on cardiovasc­ular health in some individual­s, including the developmen­t of new onset arrhythmia and even heart attacks. Additional­ly, heavy and or longterm marijuana use can have negative effects on certain neurologic functions, and these consequenc­es have been reportedly quite long term, if not irreversib­le. Cognitivel­y, marijuana may diminish the user’s ability to: ◆ Reason. ◆ Use short-term memory ◆ Learn new tasks.

On a molecular level, marijuana affects the formation of new connection­s between neurons, which is essential to the cognitive tasks mentioned above.

Marijuana use at a young age, that is 18 years and below, is also correlated with episodes of psychosis later in life, and there has been historical mention in the literature of a possible “cannabis psychosis” that can accompany years of heavy use. The respirator­y system may also be affected by marijuana abuse. Similar to tobacco smoke, marijuana smoke is a lung irritant and causes symptoms such as: ◆ Daily cough and phlegm production. ◆ Frequent lung illness. ◆ Chronic bronchitis. ◆ Increased risk of lung infection. One of the problems with marijuana abuse and psychiatri­c illness is the poor response to treatment for the psychiatri­c illness. Typically, marijuana abuse is an indicator of a poor response to treatment in this population. Unfortunat­ely, the chicken-and-egg paradigm applies here. Did the psychiatri­c illness come first, leading to marijuana use? Or did the marijuana use come first, precipitat­ing an underlying psychiatri­c illness?

From my experience as a psychiatri­st, the use of marijuana increases the incidents of mental disorder. The benefits of use versus the risk of problems are incomparab­le. True, not everybody who uses it will become ill but you do not know your risk level. The recent move is regrettabl­e. We will help those who need our help and more people will need marijuana detox and rehab services. ◆ Dr Sacrifice Chirisa is a passionate mental health specialist at Parirenyat­wa Hospital, one of the country’s major referral centres

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