Cannabis

  • Cannabis is a depressant drug
  • Cannabis is a drug that comes from Indian hemp plants such as Cannabis sativa and Cannabis indica.  The main active chemical in cannabis is THC [delta-9-tetrahydrocannabinol]. Leaves from the plant are bright green and have a distinctive shape with 5 or 7 leaflets.  The flowering tops and upper leaves are covered in sticky resin. 
  • Cannabis is used for the psychoactive effects of THC and other active ingredients.  THC is the chemical in cannabis that makes you feel “high”
  • There are three main forms of psychoactive cannabis: marijuana, hashish and hash oil. 
  • Marijuana is the most common and least potent form and is the dried leaves and flowers of the plant.  It looks like chopped grass and ranges in colour from grey-green to greenish-brown.  Its texture can be fine or coarse.  Marijuana may contain seeds and stems from the plant.
  • Hashish or hash is dried cannabis resin, usually in the form of a small block ranging in colour from light brown to almost black.  THC concentration is higher than in marijuana, producing stronger effects.
  • Hash oil is a thick oily liquid , golden brown to black in colour, extracted from cannabis.  It is the most potent form of cannabis.
Onset & Duration

Onset

  • 1-2 days of last use

Duration

  • Acute phase: 2-6 days, subsiding after 2-3 weeks
  • May persist for some months

Studies with cannabis users who have recently quit, report that withdrawal symptoms start on the first day, usually peak in the first two to three days, and with the exception of sleep disturbances, are usually very mild by the end of the first week of abstinence. Withdrawal symptoms are usually over after two weeks (http://ncpic.org.au/ncpic/publications/factsheets/article/cannabis-and-dependence).

Clinical Features

Cannabis withdrawal is similar to the withdrawal experienced from stopping tobacco smoking. As with tobacco, the withdrawal symptoms associated with cannabis can be disruptive enough to contribute to continued use and also contribute to relapse in people trying to quit. Cannabis withdrawal is not the same for everybody. Various factors influence the severity of cannabis withdrawal. Factors that may influence how severe cannabis withdrawal will be and how long it may last when someone tries to quit are:

  • how much cannabis the person uses (people who use cannabis frequently will have a more severe withdrawal)
  • how dependent someone is (people who are more dependent upon cannabis are likely to have a more severe withdrawal
  • how sensitive a person is to distress (people who are are less tolerant of emotional distress may experience a more pronounced cannabis withdrawal syndrome)

Most studies suggest that withdrawal symptoms start on the first day of abstinence, and usually peak within the first two to three days of quitting, with the exception of sleep disturbance. In general, withdrawal symptoms are usually over after two weeks, but this depends on how dependent someone is on cannabis before trying to quit.

What are the symptoms of cannabis withdrawal?

When people stop using cannabis after prolonged use (either because they cannot get any or because they are trying to quit) they may experience a variety of withdrawal symptoms including:

  • sleep difficulties including insomnia and strange dreams
  • mood swings/irritability
  • depression
  • anxiety/nervousness
  • restlessness/physical tension
  • reduced appetite
  • nausea
  • sweating
  • cravings to smoke cannabis

Whilst individual symptoms can be relatively mild, in combination they can still contribute to why a person keeps using cannabis and why they may relapse if trying to quit.

http://ncpic.org.au/ncpic/publications/factsheets/article/cannabis-and-dependence

Care & Treatment

Headaches

  • Paracetamol (Panadol)
  • Ibuprofen
  • Massage

Nausea and Vomiting

  • Metoclopramide (Maxolon)
  • Promethazine (Phenergan)
  • Eat small meals and snacks often
  • Drink plenty of water
  • If vomiting, stop eating solid food and try small sips of liquid, or sucking an ice cube. Try a small amount of food once you have kept fluids down for a few hours
  • Rehydration/sports/isotonic drinks such as ‘Powerade'
  • Avoid citrus and caffeine on an empty stomach

Pronounced agitation, irritability or insomnia

  • Tricyclic antidepressants (TCAs) may be useful for their sedative effects: Doxepin
  • Benzodiazepines: Diazepam, Temazepam tablets* (*Risk/benefit analysis required due to propensity for misuse and exacerbation of depressive symptoms)
  • Reduce coffee, tea, cola and energy drinks during the day and have none after 2 pm
  • Eat 3 meals a day and avoid heavy, spicy meals late at night
  • Avoid napping during the day and keep to regular bed and wake times
  • Exercise regularly (in the day, not after 6 pm)
  • Use relaxation techniques
  • Avoid doing things (i.e. tough phone calls) that might upset you before going to sleep
  • Have a bath in the evening

Aches and pains

  • Ibuprofen
  • Have a bath
  • Use a heat rub/ wheat bag
  • Do gentle exercise e.g. walking
  • Massage

Poor Appetite

  • Eat small meals and snack often
  • Avoid heavy, greasy, sweet or rich foods
  • Drink 6- 8 glasses of water a day

Anxiety

  • Use relaxation tapes
  • Reduce caffeine intake
  • Have a bath
  • Do some gentle exercise