There are about 400 chemical compounds in an average cannabis plant. The four main compounds are called delta-9-tetrahydrocannabinol (delta-9-THC), cannabidiol, delta-8-tetrahydrocannabinol and cannabinol. Apart from cannabidiol (CBD), these compounds are psychoactive, the strongest one being delta-9-tetrahydrocannabinol. The stronger varieties of the plant contain little cannabidiol (CBD), whilst the delta-9-THC content is a lot higher.
When cannabis is smoked, its compounds rapidly enter the bloodstream and are transported directly to the brain and other parts of the body. The feeling of being ‘stoned’ or ‘high’ is caused mainly by the delta-9-THC binding to cannabinoid receptors in the brain. A receptor is a site on a brain cell where certain substances can stick or “bind” for a while. If this happens, it has an effect on the cell and the nerve impulses it produces. Curiously, there are also cannabis-like substances produced naturally by the brain itself – these are called endocannabinoids.
Most of these receptors are found in the parts of the brain that influence pleasure, memory, thought, concentration, sensory and time perception. Cannabis compounds can also affect the eyes, the ears, the skin and the stomach.
What are its effects?
Pleasant
A ‘high’ - a sense of relaxation, happiness, sleepiness, colours appear more intense, music sounds better.
Unpleasant
Around 1 in 10 cannabis users have unpleasant experiences, including confusion, hallucinations, anxiety and paranoia. The same person may have either pleasant or unpleasant effects depending on their mood and circumstances. These feelings are usually only temporary – although as the drug can stay in the system for some weeks, the effect can be more long-lasting than users realise. Long-term use can have a depressant effect, reducing motivation.
Mental health problems
There is growing evidence that people with serious mental illness, including depression and psychosis, are more likely to use cannabis or have used it for long periods of time in the past. Regular use of the drug has appeared to double the risk of developing a psychotic episode or long-term schizophrenia. However, does cannabis cause depression and schizophrenia or do people with these disorders use it as a medication?
Over the past few years, research has strongly suggested that there is a clear link between early cannabis use and later mental health problems in those with a genetic vulnerability - and that there is a particular issue with the use of cannabis by adolescents.
Depression
A study following 1600 Australian school-children, aged 14 to 15 for seven years, found that while children who use cannabis regularly have a significantly higher risk of depression, the opposite was not the case - children who already suffered from depression were not more likely than anyone else to use cannabis. However, adolescents who used cannabis daily were five times more likely to develop depression and anxiety in later life.
Schizophrenia
Three major studies followed large numbers of people over several years, and showed that those people who use cannabis have a higher than average risk of developing schizophrenia. If you start smoking it before the age of 15, you are 4 times more likely to develop a psychotic disorder by the time you are 26. They found no evidence of self-medication. It seemed that, the more cannabis someone used, the more likely they were to develop symptoms.
Why should teenagers be particularly vulnerable to the use of cannabis? No one knows for certain, but it may be something to do with brain development. The brain is still developing in the teenage years – up to the age of around 20, in fact. A massive process of ‘neural pruning’ is going on. This is rather like streamlining a tangled jumble of circuits so they can work more effectively. Any experience, or substance, that affects this process has the potential to produce long-term psychological effects.
Recent research in Europe, and in the UK, has suggested that people who have a family background of mental illness – and so probably have a genetic vulnerability anyway - are more likely to develop schizophrenia if they use cannabis as well.
Physical health problems
The main risk to physical health from cannabis is probably from the tobacco that is is often smoked with.
Is there such a thing as ‘cannabis psychosis’?
Recent research in Denmark suggests that yes, there is. It is a short-lived psychotic disorder that seems to be brought on by cannabis use but which subsides fairly quickly once the individual has stopped using it. It's quite unusual though – in the whole of Denmark they found only around 100 new cases per year.
However, they also found that:
Three quarters had a different psychotic disorder diagnosed within the next year.
Nearly half still had a psychotic disorder 3 years later.
So, it also seems probable that nearly half of those diagnosed as having cannabis psychosis are actually showing the first signs of a more long-lasting psychotic disorder, such as schizophrenia. It may be this group of people who are particularly vulnerable to the effects of cannabis, and so should probably avoid it in the future.
http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/alcoholanddrugs/cannabisandmentalhealth.aspx