Marijuana
Marijuana consists of the leaves and flowering parts of the plant Cannabis sativa. It usually is smoked in cigarettes (“joints” or “reefers”) or pipes or added to food (usually cookies, brownies, or tea). Resin from the plant may be dried and compressed into blocks called hashish. Marijuana contains a number of cannabinoids; the primary psychoactive one is delta-9-tetrahydrocannabinol (THC). THC is also available by prescription in capsule form (dronabinol [Marinol]). THC is used medically as an appetite stimulant for patients with such conditions as AIDS-related anorexia; it also is used as treatment for vomiting associated with cancer chemotherapy, for chronic pain, and for multiple sclerosis, glaucoma, and other disorders.
Synthetic cannabinoid analogs such as JWH-018 and many similar compounds, sold as “K2” or “Spice” and in some so-called “herbal” preparations, are banned in some states but available via the Internet. These may produce acute toxicity similar to that seen with THC.
Mechanism of toxicity
THC, which binds to anandamide receptors in the brain, may have stimulant, sedative, or hallucinogenic actions, depending on the dose and time after consumption. Both catecholamine release (resulting in tachycardia) and inhibition of sympathetic reflexes (resulting in orthostatic hypotension) may be observed.
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