Cannabis (drug)

Cannabis
A flowering cannabis plant
Botanical	Cannabis
Source plant(s)	Cannabis sativa, Cannabis sativa forma indica, Cannabis ruderalis
Part(s) of plant	flower
Geographic origin	Central and South Asia.[1]
Active ingredients	Tetrahydrocannabinol, cannabidiol, cannabinol, tetrahydrocannabivarin
Main producers	Afghanistan,[2] Canada,[3] China, Colombia,[4] India,[2] Jamaica,[2] Lebanon,[5] Mexico,[6] Morocco,[2] Netherlands, Pakistan, Paraguay,[6] Spain,[2] Thailand, Turkey, United States[2]
Legal status	AU: Prohibited (S9) CA: Schedule II UK: Class B US: Schedule I UN: Narcotic Schedule I

Cannabis, also known as marijuana^[7] and by numerous other names,^a[›] is a preparation of the Cannabis plant intended for use as a psychoactive drug or medicine.^[8][9] The main psychoactive part of cannabis is tetrahydrocannabinol (THC); it is one of 483 known compounds in the plant,^[10] including at least 84 other cannabinoids, such as cannabidiol (CBD), cannabinol (CBN), and tetrahydrocannabivarin (THCV).^[11][12]

Cannabis is often consumed for its mental and physical effects, such as heightened mood, relaxation,^[13] and an increase in appetite.^[14] Possible side effects include a decrease in short-term memory, dry mouth, impaired motor skills, red eyes,^[13] and feelings of paranoia or anxiety.^[15] Onset of effects is within minutes when smoked and about 30 minutes when eaten.^[16] They last for between two and six hours.^[16]

Cannabis is mostly used recreationally or as a medicinal drug. It may also be used as part of religious or spiritual rites. In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65).^[17] In 2015, almost half of the people in the United States have tried marijuana, 12% have used it in the past year, and 7.3% have used it in the past month.^[18]

The earliest recorded uses date from the 3rd millennium BC.^[19] Since the early 20th century, cannabis has been subject to legal restrictions, with the possession, use, and sale of cannabis preparations containing psychoactive cannabinoids currently illegal in most countries of the world; the United Nations deems it the most-used illicit drug in the world.^[20][21] Medical cannabis refers to the physician-recommended use of cannabis, which is taking place in Canada, Belgium, Australia, the Netherlands, Spain, and 23 U.S. states.^[22] Cannabis use started to become popular in the US in the 1970s.^[23] Support for legalization has been increasing in the United States in recent years and several US states have legalized recreational or medical use.^[24]

Uses

Medical

Cannabis is used to reduce nausea and vomiting during chemotherapy, to improve appetite in people with HIV/AIDS, to treat chronic pain, and help with muscle spasms.^[25][26] Its use for other medical applications is insufficient for conclusions about safety or efficacy. Short-term use increases minor adverse effects, but does not appear to increase major adverse effects.^[27] Long-term effects of cannabis are not clear,^[27][28] and there are concerns including memory and cognition problems, risk for addiction, risk of schizophrenia among young people, and the risk of children taking it by accident.^[25]

The medicinal value of cannabis is disputed. The American Society of Addiction Medicine dismisses medical use because of concerns about dependence and adverse health effects.^[29] The US Food and Drug Administration (FDA) states that cannabis is associated with numerous harmful health effects, and that significant aspects such as content, production, and supply are unregulated. The FDA approves of the prescription of two products (not for smoking) that have pure THC in a small controlled dose as the active substance.^[30]

Recreational

Cannabis has psychoactive and physiological effects when consumed.^[31] The immediate desired effects from consuming cannabis include relaxation and mild euphoria (the "high" or "stoned" feeling), a general alteration of conscious perception, euphoria, increased awareness of sensation, increased libido^[32] and distortions in the perception of time and space. At higher doses, effects can include altered body image, auditory and/or visual illusions, pseudo-hallucinatory, and ataxia from selective impairment of polysynaptic reflexes. In some cases, cannabis can lead to dissociative states such as depersonalization^[33][34] and derealization.^[35]

Some immediate undesired side effects include a decrease in short-term memory, dry mouth, impaired motor skills and reddening of the eyes.^[36] Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite and consumption of food, lowered blood pressure, impairment of short-term and working memory,^[37][38] psychomotor coordination, and concentration. Some users may experience an episode of acute psychosis, which usually abates after 6 hours, but in rare instances heavy users may find the symptoms continuing for many days.^[39]

Spiritual

Cannabis has held sacred status in several religions. It has been used in an entheogenic context – a chemical substance used in a religious, shamanic, or spiritual context^[40] - in India and Nepal since the Vedic period dating back to approximately 1500 BCE, but perhaps as far back as 2000 BCE. There are several references in Greek mythology to a powerful drug that eliminated anguish and sorrow. Herodotus wrote about early ceremonial practices by the Scythians, thought to have occurred from the 5th to 2nd century BCE. Itinerant Hindu saints have used it in Nepal and India for centuries.^[41] In modern culture the spiritual use of cannabis has been spread by the disciples of the Rastafari movement who use cannabis as a sacrament and as an aid to meditation. The earliest known reports regarding the sacred status of cannabis in India and Nepal come from the Atharva Veda estimated to have been written sometime around 2000–1400 BCE.^[42]

Available forms

Cannabis is consumed in many different ways:^[43]

• smoking, which typically involves burning and inhaling vaporized cannabinoids ("smoke") from small pipes, bongs (portable versions of hookahs with a water chamber), paper-wrapped joints or tobacco-leaf-wrapped blunts, roach clips, and other items.^[44]
• vaporizer, which heats any form of cannabis to 165–190 °C (329–374 °F),^[45] causing the active ingredients to evaporate into a vapor without burning the plant material (the boiling point of THC is 157 °C (315 °F) at 760 mmHg pressure).^[46]
• cannabis tea, which contains relatively small concentrations of THC because THC is an oil (lipophilic) and is only slightly water-soluble (with a solubility of 2.8 mg per liter).^[47] Cannabis tea is made by first adding a saturated fat to hot water (e.g. cream or any milk except skim) with a small amount of cannabis.^[48]
• edibles, where cannabis is added as an ingredient to one of a variety of foods, including butter and baked goods.

Adverse effects

According to the United States Department of Health and Human Services, there were 455,000 emergency room visits associated with cannabis use in 2011. These statistics include visits in which the patient was treated for a condition induced by or related to recent cannabis use. The drug use must be "implicated" in the emergency department visit, but does not need to be the direct cause of the visit. Most of the illicit drug emergency room visits involved multiple drugs.^[50] In 129,000 cases, cannabis was the only implicated drug.^[51][52]

A 2013 literature review said that heavy, long term exposure to marijuana may have biologically-based physical, mental, behavioral and social health consequences and may be "associated with diseases of the liver (particularly with co-existing hepatitis C), lungs, heart, and vasculature".^[53] It is recommended that cannabis use be stopped before and during pregnancy.^[54] A 2014 review found that while cannabis use may be less harmful than alcohol use, the recommendation to substitute it for problematic drinking is premature without further study.^[55]

Toxicity

THC, the principal psychoactive constituent of the cannabis plant, has low toxicity. The dose of THC needed to kill 50% of tested rodents is extremely high. Acute effects may include anxiety and panic, impaired attention, and memory (while intoxicated), an increased risk of psychotic symptoms, and possibly an increased risk of accidents if a person drives a motor vehicle while intoxicated.^[57] Short-term Cannabis intoxication can hinder the mental processes of organizing and collecting thoughts. This condition is known as temporal disintegration.^[58] Psychotic episodes are well-documented and typically resolve within minutes or hours. There have been few reports of symptoms lasting longer.^[59][60] Cannabis has not been reported to cause fatal overdose.^[61] Studies have shown that cannabis use causes impairments in memory that persist beyond short-term intoxication.^[62]

Lungs

There has been a limited amount of studies that have looked at the effects of smoking cannabis on the respiratory system.^[63] Chronic heavy marijuana smoking is associated with coughing, production of sputum, wheezing, and other symptoms of chronic bronchitis.^[57] Regular cannabis use has not been shown to cause significant abnormalities in lung function.^[64] Short-term use of cannabis is associated with bronchodilation.^[65]

Cancer

Cannabis smoke contains thousands of organic and inorganic chemical compounds. This tar is chemically similar to that found in tobacco smoke,^[66] and over fifty known carcinogens have been identified in cannabis smoke,^[67] including; nitrosamines, reactive aldehydes, and polycylic hydrocarbons, including benz[a]pyrene.^[68] Cannabis smoke is also inhaled more deeply than is tobacco smoke.^[69] As of 2015, there is no consensus regarding whether cannabis smoking is associated with an increased risk of cancer.^[70] Light and moderate use of cannabis is not believed to increase risk of lung or upper airway cancer. Evidence for causing these cancers is mixed concerning heavy, long-term use. In general there are far lower risks of pulmonary complications for regular cannabis smokers when compared with those of tobacco.^[64] A 2015 review found an association between cannabis use and the development of testicular germ cell tumors (TGCTs), particularly non-seminoma TGCTs.^[71] Combustion products are not present when using a vaporizer, consuming THC in pill form, or consuming cannabis foods.

Cardiovascular

There is serious suspicion among cardiologists, spurring research but falling short of definitive proof, that cannabis use has the potential to contribute to cardiovascular disease.^[72] Cannabis is believed to be an aggravating factor in rare cases of arteritis, a serious condition that in some cases leads to amputation. Because 97% of case-reports also smoked tobacco, a formal association with cannabis could not be made. If cannabis arteritis turns out to be a distinct clinical entity, it might be the consequence of vasoconstrictor activity observed from delta-8-THC and delta-9-THC.^[73] Other serious cardiovascular events including myocardial infarction, stroke, sudden cardiac death, and cardiomyopathy have been reported to be temporally associated with cannabis use. Research in these events is complicated because cannabis is often used in conjunction with tobacco, and drugs such as alcohol and cocaine.^[74] These putative effects can be taken in context of a wide range of cardiovascular phenomena regulated by the endocannabinoid system and an overall role of cannabis in causing decreased peripheral resistance and increased cardiac output, which potentially could pose a threat to those with cardiovascular disease.^[75] There is some evidence from case reports that cannabis use may provoke fatal cardiovascular events in young people who have not been diagnosed with cardiovascular disease.^[76]

Neurological

A 2013 review comparing different structural and functional imaging studies showed morphological brain alterations in long-term cannabis users which were found to possibly correlate to cannabis exposure.^[77] A 2010 review found resting blood flow to be lower globally and in prefrontal areas of the brain in cannabis users, when compared to non-users. It was also shown that giving THC or cannabis correlated with increased bloodflow in these areas, and facilitated activation of the anterior cingulate cortex and frontal cortex when participants were presented with assignments demanding use of cognitive capacity.^[78] Both reviews noted that some of the studies that they examined had methodological limitations, for example small sample sizes or not distinguishing adequately between cannabis and alcohol consumption.^[77][78] A 2011 review found that cannabis use impaired cognitive functions on several levels, ranging from basic coordination to executive function tasks.^[79] A 2013 review found that cannabis users consistently had smaller hippocampi than nonusers, but noted limitations in the studies analyzed such as small sample sizes and heterogeneity across studies.^[80] A 2012 meta-analysis found that the effects of cannabis use on neurocognitive functions were "limited to the first 25 days of abstinence" and that there was no evidence that such use had long-lasting effects.^[81]

It is not clear whether cannabis use affects the rate of suicide.^[61][82]

Chronic use

Effects of chronic use may include bronchitis, a cannabis dependence syndrome, and subtle impairments of attention and memory. These deficits persist while chronically intoxicated.^[57] There is little evidence that cognitive impairments persist in adult abstinent cannabis users.^[83] Compared to non-smokers, people who smoked cannabis regularly in adolescence exhibit reduced connectivity in specific brain regions associated with memory, learning, alertness, and executive function.^[52] A study has suggested that sustained heavy, daily, adolescent onset cannabis use over decades is associated with a decline in IQ by age 38. No effects were found in those who initiated cannabis use later, or in those who ceased use earlier in adulthood.^[76]

Tolerance and withdrawal

Cannabis usually causes no tolerance or withdrawal symptoms except in heavy users. In a survey of heavy users 42.4% experienced withdrawal symptoms when they tried to quit marijuana such as craving, irritability, boredom, anxiety and sleep disturbances.^[84] About 9% of those who experiment with marijuana eventually become dependent. The rate goes up to 1 in 6 among those who begin use as adolescents, and one quarter to one-half of those who use it daily according to a NIDA review.^[52] A 2013 review estimates daily use is associated with a 10-20% rate of dependence.^[25] The highest risk of cannabis dependence is found in those with a history of poor academic achievement, deviant behavior in childhood and adolescence, rebelliousness, poor parental relationships, or a parental history of drug and alcohol problems.^[85] Cannabis withdrawal is less severe than withdrawal from alcohol.^[86]

Motor vehicle crashes

A 2012 meta-analysis found that cannabis use was associated with an increased risk of being involved in a motor vehicle crash.^[87]

Pharmacology

Mechanism of action

The high lipid-solubility of cannabinoids results in their persisting in the body for long periods of time.^[88] Even after a single administration of THC, detectable levels of THC can be found in the body for weeks or longer (depending on the amount administered and the sensitivity of the assessment method).^[88] A number of investigators have suggested that this is an important factor in marijuana's effects, perhaps because cannabinoids may accumulate in the body, particularly in the lipid membranes of neurons.^[89]

Not until the end of the 20th century was the specific mechanism of action of THC at the neuronal level studied. Researchers have subsequently confirmed that THC exerts its most prominent effects via its actions on two types of cannabinoid receptors, the CB₁ receptor and the CB₂ receptor, both of which are G-protein coupled receptors.^[90] The CB1 receptor is found primarily in the brain as well as in some peripheral tissues, and the CB2 receptor is found primarily in peripheral tissues, but is also expressed in neuroglial cells.^[91] THC appears to alter mood and cognition through its agonist actions on the CB1 receptors, which inhibit a secondary messenger system (adenylate cyclase) in a dose dependent manner. These actions can be blocked by the selective CB1 receptor antagonist SR141716A (rimonabant), which has been shown in clinical trials to be an effective treatment for smoking cessation, weight loss, and as a means of controlling or reducing metabolic syndrome risk factors.^[92] However, due to the dysphoric effect of CB1 antagonists, this drug is often discontinued due to these side effects.^[93]

Via CB1 activation, THC indirectly increases dopamine release and produces psychotropic effects. Cannabidiol also acts as an allosteric modulator of the mu and delta opioid receptors.^[94] THC also potentiates the effects of the glycine receptors.^[95] The role of these interactions in the "marijuana high" remains elusive.

Physical and chemical properties

Detection in body fluids

THC and its major (inactive) metabolite, THC-COOH, can be measured in blood, urine, hair, oral fluid or sweat using chromatographic techniques as part of a drug use testing program or a forensic investigation of a traffic or other criminal offense.^[96] The concentrations obtained from such analyses can often be helpful in distinguishing active use from passive exposure, elapsed time since use, and extent or duration of use. These tests cannot, however, distinguish authorized cannabis smoking for medical purposes from unauthorized recreational smoking.^[97] Commercial cannabinoid immunoassays, often employed as the initial screening method when testing physiological specimens for marijuana presence, have different degrees of cross-reactivity with THC and its metabolites.^[98] Urine contains predominantly THC-COOH, while hair, oral fluid and sweat contain primarily THC.^[96] Blood may contain both substances, with the relative amounts dependent on the recency and extent of usage.^[96]

The Duquenois–Levine test is commonly used as a screening test in the field, but it cannot definitively confirm the presence of cannabis, as a large range of substances have been shown to give false positives. Despite this, it is common in the United States for prosecutors to seek plea bargains on the basis of positive D–L tests, claiming them definitive, or even to seek conviction without the use of gas chromatography confirmation, which can only be done in the lab.^[99] In 2011, researchers at John Jay College of Criminal Justice reported that dietary zinc supplements can mask the presence of THC and other drugs in urine.^[100] However, a 2013 study conducted by researchers at the University of Utah School of Medicine refute the possibility of self-administered zinc producing false-negative urine drug tests.^[101]

Varieties and strains

CBD is a 5-HT_1A receptor agonist, which may also contribute to an anxiolytic effect.^[102] This likely means the high concentrations of CBD found in Cannabis indica mitigate the anxiogenic effect of THC significantly.^[102] The effects of sativa are well known for their cerebral high, hence its daytime use as medical cannabis, while indica is well known for its sedative effects and preferred night time use as medical cannabis.^[102]

Psychoactive ingredients

According to the United Nations Office on Drugs and Crime (UNODC), "the amount of THC present in a cannabis sample is generally used as a measure of cannabis potency."^[103] The three main forms of cannabis products are the flower, resin (hashish), and oil (hash oil). The UNODC states that cannabis often contains 5% THC content, resin "can contain up to 20% THC content", and that "Cannabis oil may contain more than 60% THC content."^[103]

A 2012 review found that the THC content in marijuana had increased worldwide from 1970 to 2009.^[104] It is unclear, however, whether the increase in THC content has caused people to consume more THC or if users adjust based on the potency of the cannabis. It is likely that the higher THC content allows people to ingest less tar. At the same time Cannabidiol (CBD) levels in seized samples have lowered, in part because of the desire to produce higher THC levels and because more illegal growers cultivate indoors using artificial lights. This helps avoid detection but reduces the CBD production of the plant.^[105]

Australia's National Cannabis Prevention and Information Centre (NCPIC) states that the buds (flowers) of the female cannabis plant contain the highest concentration of THC, followed by the leaves. The stalks and seeds have "much lower THC levels".^[106] The UN states that leaves can contain ten times less THC than the buds, and the stalks one hundred times less THC.^[103]

After revisions to cannabis rescheduling in the UK, the government moved cannabis back from a class C to a class B drug. A purported reason was the appearance of high potency cannabis. They believe skunk accounts for between 70 and 80% of samples seized by police^[107] (despite the fact that skunk can sometimes be incorrectly mistaken for all types of herbal cannabis).^[108][109] Extracts such as hashish and hash oil typically contain more THC than high potency cannabis flowers.^[110]

Preparations

• 

  Dried flower buds

• 

  Kief

• 

  Hashish

• 

  Tincture

• 

  Hash oil

• 

  Infusion (dairy butter)

• 

  Pipe resin

• 

  A forced-air vaporizer. The detachable balloon fills with vapors

Marijuana

Marijuana or marihuana (herbal cannabis),^[111] consists of the dried flowers and subtending leaves and stems of the female Cannabis plant.^{[112][113][114][115]} This is the most widely consumed form,^[115] containing 3% to 20% THC,^[116] with reports of up-to 33% THC.^[117] In contrast, cannabis varieties used to produce industrial hemp contain less than 1% THC and are thus not valued for recreational use.^[118]

This is the stock material from which all other preparations are derived. It is noted that cannabis or its extracts must be sufficiently heated or dehydrated to cause decarboxylation of its most abundant cannabinoid, tetrahydrocannabinolic acid (THCA), into psychoactive THC.^[119]

Kief

Kief is a powder, rich in trichomes,^[120] which can be sifted from the leaves and flowers of cannabis plants and either consumed in powder form or compressed to produce cakes of hashish.^[121] The word "kif" derives from colloquial Arabic كيف kēf/kīf, meaning pleasure.^[122]

Hashish

Hashish (also spelled hasheesh, hashisha, or simply hash) is a concentrated resin cake or ball produced from pressed kief, the detached trichomes and fine material that falls off cannabis flowers and leaves.^[123] or from scraping the resin from the surface of the plants and rolling it into balls. It varies in color from black to golden brown depending upon purity and variety of cultivar it was obtained from.^[124] It can be consumed orally or smoked, and is also vaporised, or 'vaped'.^[125] The term "Rosin Hash" refers to a high quality solventless product obtained through heat and pressure.^[126]

Tincture

Cannabinoids can be extracted from cannabis plant matter using high-proof spirits (often grain alcohol) to create a tincture, often referred to as "green dragon".^[127] Nabiximols is a branded product name from a tincture manufacturing pharmaceutical company.^[128]

Hash oil

Hash oil is a resinous matrix of cannabinoids obtained from the Cannabis plant by solvent extraction,^[129] formed into a hardened or viscous mass.^[130]

Hash oil can be the most potent of the main cannabis products because of its high level of psychoactive compound per its volume, which can vary depending on the plant's mix of essential oils and psychoactive compounds.^[131] Butane and supercritical carbon dioxide hash oil have become popular in recent years.^[132]

Infusions

There are many varieties of cannabis infusions owing to the variety of non-volatile solvents used.^[133] The plant material is mixed with the solvent and then pressed and filtered to express the oils of the plant into the solvent. Examples of solvents used in this process are cocoa butter, dairy butter, cooking oil, glycerine, and skin moisturizers. Depending on the solvent, these may be used in cannabis foods or applied topically.^[134]

Adulterated cannabis

Contaminants or adulterants may be found in marijuana or hashish. Other substances may be added to cannabis to add weight to the product (lead has been used in some cases), to increase its psychoactive effects (e.g., Phencyclidine), or as part of the cultivation and processing of the cannabis (e.g., fertilizer). Hashish obtained from "soap bar"-type sources.^[135] The dried flowers of the plant may be contaminated by the plant taking up heavy metals and other toxins from its growing environment,^[136] or by the addition of glass.^[137] In the Netherlands, chalk has been used to make cannabis appear to be of a higher quality.^[138] Increasing the weight of hashish products in Germany with lead caused lead intoxication in at least 29 users.^[139]

Despite cannabis being generally perceived as a natural product,^[140] in a recent Australian survey^[141] one in four Australians consider cannabis grown indoors under hydroponic conditions to be a greater health risk due to increased contamination, added to the plant during cultivation to enhance the plant growth and quality.

Drug dealers may "spike" or lace marijuana with other chemicals such as PCP, creating a product known as "wet marijuana"; this enhances the effects of smoking it^[142] and it can be used to make low-grade, low-potency marijuana seem more effective.

Medical use

Medical marijuana refers to the use of the Cannabis plant as a physician-recommended herbal therapy as well as synthetic^[143] THC and cannabinoids. So far, the medical use of cannabis is legal only in a limited number of territories, including Canada, Belgium, Australia, the Netherlands, Spain, and several U.S. states. This usage generally requires a prescription, and distribution is usually done within a framework defined by local laws. There is evidence supporting the use of cannabis or its derivatives in the treatment of chemotherapy-induced nausea and vomiting, neuropathic pain, and multiple sclerosis. Lower levels of evidence support its use for AIDS wasting syndrome, epilepsy, rheumatoid arthritis, and glaucoma.^[52]

History

Cannabis is indigenous to Central and South Asia.^[146] There is evidence of inhalation of cannabis smoke from the 3rd millennium BCE, namely charred cannabis seeds found in a ritual brazier at an ancient burial site in present-day Romania.^[147] In 2003, a leather basket filled with cannabis leaf fragments and seeds was found next to a 2,500- to 2,800-year-old mummified shaman in the northwestern Xinjiang Uygur Autonomous Region of China.^[148][149] Evidence of cannabis consumption was also found in Egyptian mummies dated about 950 BC.^[150][151]

Cannabis was also used by the ancient Hindus of India and Nepal thousands of years ago. The herb is called ganja (Sanskrit: गञ्जा, IAST: gañjā) or ganjika in Sanskrit and other modern Indo-Aryan languages.^[152][153] Some scholars suggest that the ancient drug soma, mentioned in the Vedas, was cannabis, although this theory is disputed.^[154]

Cannabis was also known to the ancient Assyrians, who discovered its psychoactive properties through the Aryans.^[155] Using it in some religious ceremonies, they called it qunubu (meaning "way to produce smoke"), a probable origin of the modern word "cannabis".^[156] The Aryans also introduced cannabis to the Scythians, Thracians and Dacians, whose shamans (the kapnobatai—"those who walk on smoke/clouds") burned cannabis flowers to induce trance.^[157]

Cannabis has an ancient history of ritual use and is found in pharmacological cults around the world. Hemp seeds discovered by archaeologists at Pazyryk suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century BCE, confirming previous historical reports by Herodotus.^[158] It was used by Muslims in various Sufi orders as early as the Mamluk period, for example by the Qalandars.^[159]

A study published in the South African Journal of Science showed that "pipes dug up from the garden of Shakespeare's home in Stratford-upon-Avon contain traces of cannabis."^[160] The chemical analysis was carried out after researchers hypothesized that the "noted weed" mentioned in Sonnet 76 and the "journey in my head" from Sonnet 27 could be references to cannabis and the use thereof.^[161] Examples of classic literature featuring cannabis include Les paradis artificiels by Charles Baudelaire and The Hasheesh Eater by Fitz Hugh Ludlow.

John Gregory Bourke described use of "mariguan", which he identifies as Cannabis indica or Indian hemp, by Mexican residents of the Rio Grande region of Texas in 1894. He described its uses for treatment of asthma, to expedite delivery, to keep away witches, and as a love-philtre. He also wrote that many Mexicans added the herb to their cigarritos or mescal, often taking a bite of sugar afterward to intensify the effect. Bourke wrote that because it was often used in a mixture with toloachi (which he inaccurately describes as Datura stramonium), mariguan was one of several plants known as "loco weed". Bourke compared mariguan to hasheesh, which he called "one of the greatest curses of the East", citing reports that users "become maniacs and are apt to commit all sorts of acts of violence and murder", causing degeneration of the body and an idiotic appearance, and mentioned laws against sale of hasheesh "in most Eastern countries".^{[162][163][164]}

Cannabis was criminalized in various countries beginning in the early 20th century. In the United States, the first restrictions for sale of cannabis came in 1906 (in District of Columbia).^[165] It was outlawed in South Africa in 1911, in Jamaica (then a British colony) in 1913, and in the United Kingdom and New Zealand in the 1920s.^[166] Canada criminalized cannabis in the Opium and Drug Act of 1923, before any reports of use of the drug in Canada. In 1925 a compromise was made at an international conference in The Hague about the International Opium Convention that banned exportation of "Indian hemp" to countries that had prohibited its use, and requiring importing countries to issue certificates approving the importation and stating that the shipment was required "exclusively for medical or scientific purposes". It also required parties to "exercise an effective control of such a nature as to prevent the illicit international traffic in Indian hemp and especially in the resin".^[167][168]

In the United States in 1937, the Marihuana Tax Act was passed, and prohibited the production of hemp in addition to cannabis. The reasons that hemp was also included in this law are disputed—several scholars have claimed that the act was passed in order to destroy the US hemp industry,^{[169][170][171]} with the primary involvement of businessmen Andrew Mellon, Randolph Hearst, and the Du Pont family.^[169][171] But the improvements of the decorticators, machines that separate the fibers from the hemp stem, could not make hemp fiber a very cheap substitute for fibers from other sources because it could not change that basic fact that strong fibers are only found in the bast, the outer part of the stem. Only about 1/3 of the stem are long and strong fibers.^{[169][172][173][174]} The company DuPont and many industrial historians dispute a link between nylon and hemp. They argue that the purpose of developing the nylon was to produce a fiber that could be used in thin stockings for females and compete with silk.^{[175][176][177]}

In New York City, there were more than 19,000 kg (41,000 lb) of marijuana growing like weeds throughout the boroughs until 1951, when the "White Wing Squad", headed by the Sanitation Department General Inspector John E. Gleason, was charged with destroying the many pot farms that had sprouted up across the city. The Brooklyn Public Library reports: this group was held to a high moral standard and was prohibited from "entering saloons, using foul language, and neglecting horses." The Squad found the most weed in Queens but even in Brooklyn dug up "millions of dollars" worth of the plants, many as "tall as Christmas trees". Gleason oversaw incineration of the plants in Woodside, Queens.^[178]

The United Nations' 2012 Global Drug Report stated that cannabis "was the world's most widely produced, trafficked, and consumed drug in the world in 2010", identifying that between 119 million and 224 million users existed in the world's adult (18 or older) population.^[179]

Society and culture

Global estimates of illegal drug users in 2013
(in millions of users)^[180]

Substance	Best estimate	Low estimate	High estimate
Amphetamine- type stimulants	33.90	13.87	53.81
Cannabis	181.79	128.48	232.07
Cocaine	17.04	13.80	20.73
Ecstasy	18.79	9.34	28.39
Opiates	16.53	12.92	20.46
Opioids	32.42	27.99	37.56

Legal status

Since the beginning of the 20th century, most countries have enacted laws against the cultivation, possession or transfer of cannabis.^[181] These laws have impacted adversely on the cannabis plant's cultivation for non-recreational purposes, but there are many regions where, under certain circumstances, handling of cannabis is legal or licensed. Many jurisdictions have lessened the penalties for possession of small quantities of cannabis, so that it is punished by confiscation and sometimes a fine, rather than imprisonment, focusing more on those who traffic the drug on the black market.

In some areas where cannabis use has been historically tolerated, some new restrictions have been put in place, such as the closing of cannabis coffee shops near the borders of the Netherlands,^[182] closing of coffee shops near secondary schools in the Netherlands and crackdowns on "Pusher Street" in Christiania, Copenhagen in 2004.^[183][184]

Some jurisdictions use free voluntary treatment programs and/or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution. More recently however, many political parties, non-profit organizations and causes based on the legalization of medical cannabis and/or legalizing the plant entirely (with some restrictions) have emerged.

In December 2012, the U.S. state of Washington became the first state to officially legalize cannabis in a state law (Washington Initiative 502) (but still illegal by federal law),^[185] with the state of Colorado following close behind (Colorado Amendment 64).^[186] On January 1, 2013, the first marijuana "club" for private marijuana smoking (no buying or selling, however) was allowed for the first time in Colorado.^[187] The California Supreme Court decided in May 2013 that local governments can ban medical marijuana dispensaries despite a state law in California that permits the use of cannabis for medical purposes. At least 180 cities across California have enacted bans in recent years.^[188]

In December 2013, Uruguay became the first country to legalize growing, sale and use of cannabis.^[189] However, as of August 2014, no cannabis has yet been sold legally in Uruguay. According to the law, the only cannabis that can be sold legally must be grown in the country by no more than five licensed growers, and these have yet to be selected; in fact the call for applications did not go out until August 1, 2014.^[190] In the elections of October 2014, there is a significant chance that lawmakers opposed to legal cannabis will come to control the legislature, and the law will be repealed before it has fully taken effect.^{[191][192][193]}

On October 17, 2015, Australian health minister Sussan Ley presented a new law that will allow the cultivation of cannabis for scientific research and medical trails on patients.^[194] In December 2015, it was reported that the Canadian government had committed to legalizing cannabis, but at that time no timeline for the legalization was set out.^[195]

Usage

In 2013, between 128 and 232 million people used cannabis (2.7% to 4.9% of the global population between the ages of 15 and 65).^[17]

United States

In 2015, almost half of the people in the United States have tried marijuana, 12% have used it in the past year, and 7.3% have used it in the past month.^[18] Daily marijuana use amongst US college students has reached its highest level on record rising from 3.5% in 2007 to 5.9% in 2014 and has surpassed daily cigarette use.^[196]

In the US, men are over twice as likely to use marijuana as women and 18-29 year-olds are six times more likely to use as over 65-year-olds.^[23] In 2015, a record 44% of the US population has tried marijuana in their lifetime, an increase from 38% in 2013 and 33% in 1985.^[23]

Economics

Production

It is often claimed by growers and breeders of herbal cannabis that advances in breeding and cultivation techniques have increased the potency of cannabis since the late 1960s and early '70s, when THC was first discovered and understood. However, potent seedless cannabis such as "Thai sticks" were already available at that time. Sinsemilla (Spanish for "without seed") is the dried, seedless inflorescences of female cannabis plants. Because THC production drops off once pollination occurs, the male plants (which produce little THC themselves) are eliminated before they shed pollen to prevent pollination. Advanced cultivation techniques such as hydroponics, cloning, high-intensity artificial lighting, and the sea of green method are frequently employed as a response (in part) to prohibition enforcement efforts that make outdoor cultivation more risky. It is often cited that the average levels of THC in cannabis sold in United States rose dramatically between the 1970s and 2000, but such statements are likely skewed because of undue weight given to much more expensive and potent, but less prevalent samples.^[197]

"Skunk" refers to several named strains of potent cannabis, grown through selective breeding and sometimes hydroponics. It is a cross-breed of Cannabis sativa and C. indica (although other strains of this mix exist in abundance). Skunk cannabis potency ranges usually from 6% to 15% and rarely as high as 20%. The average THC level in coffee shops in the Netherlands is about 18–19%.^[198]

Price

The price or street value of cannabis varies widely depending on geographic area and potency.^[199]

In the United States, cannabis is overall the number four value crop, and is number one or two in many states including California, New York and Florida, averaging $3,000/lb.^[200][201] It is believed to generate an estimated $36 billion market.^[202] The United Nations Office on Drugs and Crime claims in its 2008 World Drug Report that typical U.S. retail prices are $10–15 per gram (approximately $280–420 per ounce). Street prices in North America are known to range from about $40 to $400 per ounce, depending on quality.^[203]

The European Monitoring Centre for Drugs and Drug Addiction reports that typical retail prices in Europe for cannabis varies from €2 to €20 per gram, with a majority of European countries reporting prices in the range €4–10.^[204]

Distribution

Marijuana vending machines for selling or dispensing cannabis are in use in the United States and are planned to be used in Canada.^[205]

Gateway drug

The Gateway Hypothesis states that cannabis use increases the probability of trying "harder" drugs. The hypothesis has been hotly debated as it is regarded by some as the primary rationale for the United States prohibition on cannabis use.^[206][207] A Pew Research Center poll found that political opposition to marijuana use was significantly associated with concerns about health effects and whether legalization would increase marijuana use by children.^[208]

Some studies state that while there is no proof for the gateway hypothesis,^[209] young cannabis users should still be considered as a risk group for intervention programs.^[210] Other findings indicate that hard drug users are likely to be poly-drug users, and that interventions must address the use of multiple drugs instead of a single hard drug.^[211] Almost two-thirds of the poly drug users in the "2009/10 Scottish Crime and Justice Survey" used cannabis.^[212]

The gateway effect may appear due to social factors involved in using any illegal drug. Because of the illegal status of cannabis, its consumers are likely to find themselves in situations allowing them to acquaint with individuals using or selling other illegal drugs.^[213][214] Utilizing this argument some studies have shown that alcohol and tobacco may additionally be regarded as gateway drugs;^[215] however, a more parsimonious explanation could be that cannabis is simply more readily available (and at an earlier age) than illegal hard drugs. In turn alcohol and tobacco are easier to obtain at an earlier point than is cannabis (though the reverse may be true in some areas), thus leading to the "gateway sequence" in those individuals since they are most likely to experiment with any drug offered.^[206]

An alternative to the gateway hypothesis is the common liability to addiction (CLA) theory. It states that some individuals are, for various reasons, willing to try multiple recreational substances. The "gateway" drugs are merely those that are (usually) available at an earlier age than the harder drugs. Researchers have noted in an extensive review, Vanyukov et al., that it is dangerous to present the sequence of events described in gateway "theory" in causative terms as this hinders both research and intervention.^[216]

Research

Cannabis research is challenging since the plant is illegal in most countries.^{[217][218][219][220][221]} Research-grade samples of the drug are difficult to obtain for research purposes, unless granted under authority of national governments.

There are also other difficulties in researching the effects of cannabis. Many people who smoke cannabis also smoke tobacco.^[222] This causes confounding factors, where questions arise as to whether the tobacco, the cannabis, or both that have caused a cancer. Another difficulty researchers have is in recruiting people who smoke cannabis into studies. Because cannabis is an illegal drug in many countries, people may be reluctant to take part in research, and if they do agree to take part, they may not say how much cannabis they actually smoke.^[223]

Footnotes

^ a: Weed,^[224] pot,^[225] grass,^[226] and herb^[227] are among the many other nicknames for cannabis as a drug.^[228][229]
^ b: Sources for this section and more information can be found in the Medical cannabis article

See also

• Cannabinoid hyperemesis syndrome
• Nederwiet
• Hemp

References

External links

Look up marijuana in Wiktionary, the free dictionary.

Wikimedia Commons has media related to Cannabis.

• Wiktionary Appendix of Cannabis Slang

Cannabis plant, Cannabis marijuana General Autoflowering cannabis Cannabis indica ruderalis sativa Difference between C. indica and C. sativa Cannabis flower essential oil Cultivation Synthetic cannabis Thai stick Cannabis strains Pure indica G-13 indica phenotype Hybrid Indica with subset strains BC Bud Blueberry Kush Northern Lights Pure sativa Acapulco Gold Malawi Gold Hybrid Sativa with subset strains Charlotte's Web Diesel Haze Jack Herer Skunk Sour Sour Diesel Usage General Marijuana Anonymous (MA) Medical cannabis History of medical cannabis Religious and spiritual use Chalice Hemp Hanfparade Hempcrete List of hemp diseases Hemp for Victory Hemp Industries Association Hemp jewelry Hemp oil The Emperor Wears No Clothes Preparations Kief Charas Tincture Extracts by potency Hash oil Bubble hash Hashish Consumption Bhang Cannabis foods Cannabis smoking Cannabis tea Vaporizing Phytocannabinoids Cannabidiol (CBD) Tetrahydrocannabinol (THC) Effects Cannabis in pregnancy Effects of cannabis Endocannabinoid system Long-term Dependence Culture 420 Cannabis Culture (magazine) Films High Times Cannabis Cup Cannabis culture Music Head shop Pro-Cannabis organizations ACT AMMA ASA Buyers Club CCRMG CLEAR CRC DPA FCA GMM LEAP MAPS MPP NCIA NORML SAFER Social Club SSDP SCC Use demographics Adult lifetime use by country Annual use by country Politics General Bootleggers and Baptists Drug testing Global Marijuana March Legality Legality by country Legal and medical status Legal history in the United States Marijuana Control, Regulation, and Education Act Marihuana Tax Act of 1937 Major legal reforms UK: Return to class B Uruguay: Law No. 19172 USA: Decriminalization of non-medical use Places that have decriminalized non-medical use Removal from Schedule I of the Controlled Substances Act Politicians and parties Cannabis political parties List of British politicians who have acknowledged cannabis use List of U.S. politicians who admit to cannabis use Lawsuits and legal cases ADPF 187 Gonzales v. Raich Kyllo v. United States (thermal imaging) Media KBUD Category Portal

Cannabinoids Phytocannabinoids Alkylamides Caryophyllene CBC CBCV CBD CBDV CBG CBGM CBGV CBL CBDL CBN CBV Epigallocatechin gallate Gallocatechol Perrottetinene Serinolamide A THC THC-C4 THCA THCV Yangonin Active metabolites: 8,11-DiOH-THC 11-COOH-THC 11-OH-THC Endocannabinoids Arachidonoyl ethanolamide (AEA; anandamide) 2-Arachidonoylglycerol (2-AG) 2-Arachidonyl glyceryl ether (2-AGE; noladin ether) 2-Oleoylglycerol (2-OG) N-Arachidonoyl dopamine (NADA) N-Arachidonylglycine (NAGly) 2-Arachidonoyl lysophosphatidylinositol (2-ALPI) N-Arachidonoyl serotonin (AA-5-HT) Docosatetraenoylethanolamide (DEA) Lysophosphatidylinositol (LPI) Oleamide Oleoylethanolamide (OEA) Palmitoylethanolamide (PEA) RVD-Hpα Stearoylethanolamide (SEA) O-Arachidonoyl ethanolamine (O-AEA; virodhamine) Synthetic cannabinoids Classical cannabinoids (dibenzopyrans) A-40174 A-41988 A-42574 Ajulemic acid AM-087 AM-411 AM-855 AM-905 AM-906 AM-919 AM-926 AM-938 AM-2389 AM-4030 AMG-1 AMG-3 AMG-36 AMG-41 Dexanabinol (HU-211) DMHP Dronabinol HHC HU-210 HU-243 JWH-051 JWH-133 JWH-139 JWH-161 JWH-229 JWH-359 KM-233 L-759,633 L-759,656 Levonantradol (CP 50,5561) Menabitan Nabazenil Nabidrox (Canbisol) Nabilone Nabitan Naboctate O-224 O-581 O-774 O-806 O-823 O-1057 O-1125 O-1191 O-1238 O-2048 O-2113 O-2365 O-2372 O-2373 O-2383 O-2426 O-2484 O-2545 O-2694 O-2715 O-2716 O-3223 O-3226 Parahexyl Pirnabine THC-O-acetate THC-O-phosphate Non-classical cannabinoids Cannabicyclohexanol CP 47,497 (C6)-CP 47,497 (C9)-CP 47,497 CP 55,244 CP 55,940 HU-308 HU-320 HU-331 HU-336 HU-345 HU-910 Nonabine O-1376 O-1422 O-1601 O-1656 O-1657 O-1660 O-1871 SPA-229 Tinabinol 2-Isopropyl-5-methyl-1- (2,6-dihydroxy-4-nonylphenyl)cyclohex-1-ene Benzoylindoles 1-Butyl-3-(2-methoxybenzoyl)indole 1-Butyl-3-(4-methoxybenzoyl)indole 1-Pentyl-3-(2-methoxybenzoyl)indole AM-630 AM-679 AM-694 AM-1241 AM-2233 GW-405,833 (L-768,242) Pravadoline RCS-4 WIN 54,461 Naphthoylindoles AM-1220 AM-1221 AM-1235 AM-2201 AM-2232 CHM-081 EAM-2201 FUB-JWH-018 JWH-007 JWH-015 JWH-018 JWH-019 JWH-073 JWH-081 JWH-098 JWH-116 JWH-122 JWH-149 JWH-164 JWH-182 JWH-193 JWH-198 JWH-200 JWH-210 JWH-398 JWH-424 MAM-1220 MAM-2201 Naphthoylindazoles THJ-018 THJ-2201 Pyrrolobenzoxazines WIN 55,212-2 Naphthylmethylindoles JWH-175 JWH-176 JWH-184 JWH-185 JWH-192 JWH-194 JWH-195 JWH-196 JWH-197 JWH-199 Phenylacetylindoles Cannabipiperidiethanone JWH-167 JWH-203 JWH-249 JWH-250 JWH-251 JWH-302 RCS-8 Indole-3-carboxamides 5F-ADBICA 5F-NNE1 5F-PCN 5F-SDB-006 AB-FUBICA AB-PICA ADBICA ADB-FUBICA APICA CUMYL-BICA CUMYL-PICA CUMYL-5F-PICA FDU-NNE1 MDMB-CHMICA MMB-2201 NNE1 PX-1 Org 28312 Org 28611 SDB-006 STS-135 UR-12 (MN-25) Indole-3-carboxylates 5F-PB-22 FDU-PB-22 FUB-PB-22 QUCHIC (BB-22) QUPIC (PB-22) NM-2201 Tetramethylcyclo- propanoylindoles 5Br-UR-144 5Cl-UR-144 A-796,260 A-834,735 FUB-144 UR-144 XLR-11 XLR-12 Indazole-3- carboxamides 5Cl-APINACA 5F-ADB 5F-ADB-PINACA 5F-AMB 5F-APINACA 5F-CUMYL-PINACA 5F-EMB-PINACA AB-CHMINACA AB-FUBINACA AB-FUBINACA 2-fluorobenzyl isomer AB-PINACA ADB-CHMINACA ADB-FUBINACA ADB-PINACA ADAMANTYL-THPINACA ADSB-FUB-187 AMB-CHMINACA AMB-FUBINACA APINACA (AKB48) APP-FUBINACA CUMYL-PINACA CUMYL-THPINACA EMB-FUBINACA FUB-APINACA MDMB-FUBINACA MDMB-CHMINACA MN-18 PX-2 PX-3 Tetramethylcyclo- propanoylindazoles FAB-144 Naphthoylpyrroles JWH-030 JWH-147 JWH-307 JWH-369 JWH-370 Eicosanoids AM-883 AM-1346 ACEA ACPA Methanandamide (AM-356) O-585 O-689 O-1812 O-1860 O-1861 Pyrazolecarboxamides 5F-AB-FUPPYCA AB-CHFUPYCA AB-CHMFUPPYCA Others 4-HTMPIPO 5F-PY-PICA 5F-PY-PINACA 5F-3-pyridinoylindole A-836,339 A-955,840 Abnormal cannabidiol AB-001 BzODZ-EPyr AM-1248 AM-1714 AZ-11713908 BAY 38-7271 BAY 59-3074 BIM-018 CB-13 CB-86 CBS-0550 FUBIMINA GSK-554,418A GW-842,166X JTE 7-31 LASSBio-881 LBP-1 Leelamine MDA-7 MDA-19 MEPIRAPIM NESS-040C5 NMP-7 O-889 O-1269 O-1270 O-1399 O-1602 O-2220 PF-03550096 PSB-SB-1202 PTI-1 PTI-2 QMPSB S-444,823 SER-601 Tedalinab URB-447 VSN-16 WIN 56,098 Allosteric CBR ligands Org 27569 Org 27759 Org 29647 RTI-371 Pregnenolone Endocannabinoid enhancers (inactivation inhibitors) 4-Nonylphenylboronic acid AM-404 Arachidonoyl serotonin Arvanil BIA 10-2474 Biochanin A CAY-10401 CAY-10429 Genistein IDFP JNJ 1661010 JNJ-42165279 JZL184 JZL195 Kaempferol LY-2183240 MK-4409 O-1624 O-2093 Oleoylethanolamide (OEA) Olvanil Palmitoylethanolamide (PEA) PF-04457845 PF-622 PF-750 PF-3845 PHOP URB-447 URB-597 URB-602 URB-754 VDM-11 Anticannabinoids (antagonists/inverse agonists/antibodies) AM-251 AM-281 AM-630 AM-1387 AM-4113 AM-6527 AM-6545 BML-190 Brizantin (Бризантин) CAY-10508 CB-25 CB-52 CB-86 Dietressa (Диетресса) Drinabant (AVE1625) Hemopressin Ibipinabant (SLV319) JTE-907 LH-21 LY-320,135 MDA-77 MJ-15 MK-9470 NESS-0327 NIDA-41020 O-606 O-1184 O-1248 O-1918 O-2050 O-2654 Otenabant (CP-945,598) PF-514273 PipISB PSB-SB-487 Rimonabant (SR141716) Rosonabant (E-6776) SR-144,528 Surinabant (SR147778) Taranabant (MK-0364) TM-38837 VCHSR See also: Cannabinoidergics (cannabinoids by pharmacology) List of: AM cannabinoids JWH cannabinoids Designer drugs § Synthetic cannabimimetics

Cannabinoidergics Receptor (ligands) CB1 Agonists (abridged; see here for more): 2-AG 2-AGE (noladin ether) 11-Hydroxy-THC α-Amyrin β-Amyrin AB-CHMINACA AM-1172 AM-1220 AM-1221 AM-1235 AM-2201 AM-2232 Anandamide Arvanil AZ-11713908 Cannabinol CB-13 CP 47,497 CP 55,940 Dimethylheptylpyran DEA ECG EGCG Epicatechin Gallocatechol (gallocatechin) Honokiol HU-210 JWH-007 JWH-015 JWH-018 JWH-073 Kavain L-759,633 Levonantradol Menabitan Nabilone Nabitan NADA O-1812 Oleamide Serinolamide A THC (dronabinol) UR-144 WIN 55,212-2 Yangonin Antagonists: AM-251 AM-6545 Cannabidiol Cannabigerol Drinabant Falcarinol (carotatoxin) Hemopressin Ibipinabant LY-320,135 MK-9470 NESS-0327 O-2050 Otenabant PF-514273 PipISB Rimonabant Rosonabant Surinabant Taranabant THCV TM-38837 VCHSR Virodhamine Antibodies: Brizantin (Бризантин) Dietressa (Диетресса) Unknown/unsorted: MAFP CB2 Agonists: 2-AG 2-AGE (noladin ether) 3,3'-Diindolylmethane 4-O-Methylhonokiol α-Amyrin β-Amyrin A-796,260 A-834,735 A-836,339 AM-1172 AM-1221 AM-1235 AM-1241 AM-2232 Anandamide AZ-11713908 Cannabinol Caryophyllene CB-13 CBS-0550 CP-55,940 GW-405,833 (L-768,242) GW-842,166X HU-308 JTE 7-31 JWH-007 JWH-015 JWH-018 JWH-73 JWH-133 L-759,633 L-759,656 Magnolol MDA-19 Nabitan NADA PF-03550096 S-444,823 SER-601 Serinolamide A UR-144 Tedalinab THC (dronabinol) THCV Tetrahydromagnolol Virodhamine Antagonists: 4-O-Methylhonokiol AM-630 BML-190 Cannabidiol Honokiol JTE-907 SR-144,528 WIN 54,461 WIN 56,098 GPR18 Agonists: Abnormal cannabidiol ACPA AM251 Anandamide Cannabidiol NADGly THC (dronabinol) O-1602 Antagonists: CID-85469571 O-1918 GPR55 Agonists: 2-AGE (noladin ether) 2-ALPI Abnormal cannabidiol AM-251 CID1011163 CID1252842 CID1792579 CP 55,940 GSK-494581A Lysophosphatidylinositol ML-184 ML-185 ML-186 O-1602 Oleoylethanolamide Palmitoylethanolamide THC (dronabinol) Antagonists: Cannabidiol CID-16020046 ML-191 ML-192 ML-193 O-1918 PSB-SB-487 PSB-SB-1202 PSB-SB-1203 Tetrahydromagnolol GPR119 Agonists: 2-Oleoylglycerol Anandamide APD668 AR-231,453 AS-1269574 MBX-2982 N-Oleoyldopamine Oleoylethanolamide Olvanil PSN-375,963 PSN-632,408 Transporter (modulators) eCBTs Inhibitors: 5'-DMH-CBD AM-404 AM-1172 Arachidonoyl serotonin Arvanil Cannabidiol Guineensine LY-2183240 O-2093 OMDM-2 Paracetamol (acetaminophen) SB-FI-26 UCM-707 URB-597 VDM-11 WOBE490 WOBE491 WOBE492 Enzyme (modulators) FAAH Inhibitors: 4-Nonylphenylboronic acid AACOCF3 AM-404 Arachidonoyl serotonin BIA 10-2474 Biochanin A Genistein IDFP JNJ-1661010 JNJ-42165279 JZL-195 Kaempferol LY-2183240 MAFP Palmitoylisopropylamide Paracetamol (acetaminophen) PF-3845 PF-04457845 PF-750 SA-47 SA-57 TAK 21d TC-F 2 UCM710 URB-597 Activators: PDP-EA MAGL Inhibitors: ABX-1431 IDFP JJKK 048 JW 642 JZL-184 JZL-195 JZP-361 KML 29 MAFP MJN110 NAM Pristimerin URB-602 ABHD6 Inhibitors: JZP-169 JZP-430 KT182 KT185 KT195 KT203 LEI-106 ML294 ML295 ML296 UCM710 WWL-70 ABHD12 Inhibitors: Betulinic acid Maslinic acid MAFP Oleanolic acid Orlistat (tetrahydrolipstatin) Ursolic acid Others Precursors: Phosphatidylethanolamine NAPE Diacylglycerol Others: 2-PG (directly potentiates activity of 2-AG at CB1 receptor) ARN-272 (FAAH-like anandamide transporter inhibitor) See also: Cannabinoids (cannabinoids by structure)

Analgesics (N02A, N02B) Opioids Opiates/opium Codeine# Morphine# Opium Laudanum Paregoric Semisynthetic Acetyldihydrocodeine Benzylmorphine Buprenorphine Desomorphine Diacetylmorphine (heroin) Dihydrocodeine Dihydromorphine Ethylmorphine Hydrocodone Hydromorphinol Hydromorphone Nicocodeine Nicodicodeine Nicomorphine Oxycodone Oxymorphone Synthetic Alphaprodine Anileridine Butorphanol Dextromoramide Dextropropoxyphene Dezocine Fentanyl Ketobemidone Levorphanol Meptazinol Methadone Nalbuphine Pentazocine Pethidine Phenazocine Piminodine Piritramide Propiram Tapentadol Tilidine Tramadol Anilines Acetanilide‡ Bucetin‡ Butacetin‡ Paracetamol (acetaminophen)# Parapropamol‡ Phenacetin‡ Propacetamol‡ NSAIDs Propionates Fenoprofen Flurbiprofen Ibuprofen# Ketoprofen Naproxen Oxaprozin Oxicams Meloxicam Piroxicam Acetates Diclofenac Indometacin Ketorolac Nabumetone Sulindac Tolmetin COX-2 inhibitors Celecoxib Etoricoxib Lumiracoxib Parecoxib Rofecoxib ‡ Valdecoxib ‡ Fenamates Meclofenamic acid Mefenamic acid Salicylates Aspirin (acetylsalicylic acid)# (+paracetamol/caffeine) Benorylate Diflunisal Ethenzamide Magnesium salicylate Salicin Salicylamide Salsalate Wintergreen (methyl salicylate) Pyrazolones Aminophenazone‡ Ampyrone Metamizole (dipyrone) Nifenazone Phenazone Propyphenazone Others Glafenine Cannabinoids Cannabidiol Cannabis Nabilone Nabiximols Tetrahydrocannabinol (dronabinol) Channelergics Calcium blockers Gabapentin Gabapentin enacarbil Pregabalin Ziconotide Sodium blockers Carbamazepine Lacosamide Local anesthetics (e.g., cocaine, lidocaine) Mexiletine Nefopam Tricyclic antidepressants (e.g., amitriptyline#) Potassium openers Flupirtine Myorelaxants Carisoprodol Chlorzoxazone Cyclobenzaprine Mephenoxalone Methocarbamol Orphenadrine Others Camphor Capsaicin Clonidine Ketamine Menthol Methoxyflurane Nefopam Proglumide Tricyclic antidepressants (e.g., amitriptyline#) #WHO-EM ‡Withdrawn from market Clinical trials: †Phase III §Never to phase III

Psychoactive substance-related disorder (F10–F19, 291–292; 303–305) General SID Substance intoxication / Drug overdose Withdrawal Substance-induced psychosis SUD Substance abuse Physical dependence / Substance dependence Alcohol SID Diseases Neurological disorders Alcoholic hallucinosis Alcohol withdrawal Fetal alcohol spectrum disorder (FASD) Fetal alcohol syndrome (FAS) Korsakoff's syndrome Wernicke–Korsakoff syndrome Wernicke's encephalopathy Digestive system Alcoholic hepatitis Alcoholic liver disease Nervous system Alcohol-related dementia Alcoholic hallucinosis Hangover Cardiovascular system Alcoholic cardiomyopathy Alcohol flush reaction SUD Alcoholism Alcohol dependence Alcohol abuse Opioids SID Opioid overdose SUD Opioid dependence Caffeine SID Effect of caffeine on memory Caffeine-induced sleep disorder SUD Caffeine addiction Cannabis SID Effects of cannabis Long-term effects of cannabis SUD Cannabis dependence Sedative / hypnotic benzodiazepine: SID Benzodiazepine overdose Benzodiazepine withdrawal SUD Benzodiazepine misuse Benzodiazepine dependence barbiturate: SID Barbiturate overdose SUD Barbiturate dependence Cocaine SID Cocaine intoxication SUD Cocaine dependence Stimulants SID Stimulant psychosis SUD Amphetamine dependence Hallucinogen SID Hallucinogen persisting perception disorder Tobacco SID Nicotine poisoning Nicotine withdrawal Volatile solvent Inhalant abuse: Toluene toxicity Multiple Poly drug use

Recreational drug use Major recreational drugs Depressants Barbiturates Benzodiazepines Carbamates Ethanol (Alcoholic beverages) Gabapentinoids GHB Kava Nonbenzodiazepines Quinazolinones Opioids Buprenorphine (Suboxone · Subutex) Codeine Desomorphine (Krokodil) Dextropropoxyphene (Darvocet · Darvon) Fentanyl Diamorphine (Heroin) Hydrocodone Hydromorphone (Dilaudid) Methadone Mitragyna speciosa (Kratom) Morphine (Opium) Oxycodone Stimulants Amphetamine Arecoline (Areca) Betel Caffeine (Coffee Energy drinks Tea) Cathinone (Khat) Cocaine (Coca) Ephedrine (Ephedra) MDPV Mephedrone Methamphetamine Methylone Methylphenidate Nicotine (Tobacco) Theobromine (Cocoa) Entactogens MDA MDMA (Ecstasy) 2C-* series alpha-Methyltryptamine 6-APB (Benzofury) Hallucinogens Psychedelics Bufotenin Psychoactive toads Vilca Yopo DMT (Ayahuasca) LSA LSD-25 Mescaline Peruvian Torch Peyote San Pedro Psilocybin / Psilocin (Psilocybin mushrooms) Dissociatives DXM Inhalants Nitrous oxide alkyl nitrites poppers amyl nitrite Ketamine MXE Muscimol (Amanita muscaria) PCP Salvinorin A (Salvia divinorum) Deliriants Atropine and Scopolamine Atropa belladonna Datura Hyoscyamus niger Mandragora officinarum Dimenhydrinate Diphenhydramine Cannabinoids JWH-018 THC (Cannabis Hashish Hash oil) Oneirogens Calea zacatechichi Silene capensis Drug culture Cannabis (marijuana) 420 Cannabis cultivation Cannabis smoking Legal history of cannabis in the United States Legality of cannabis Marijuana Policy Project Medical cannabis NORML Religious and spiritual use of cannabis Stoner film Caffeine Coffee break Coffeehouse Latte art Tea house Psychedelic Art Drug Era Experience Literature Music Therapy Ethanol (alcohol) Drinking culture Music Nightclub Pub crawl Beer culture Beer festival Bartending Happy hour Hip flask Oktoberfest Other Club drug Counterculture of the 1960s Dance party Drug paraphernalia Drug tourism Entheogen Hippie Mary Joy Party and play Poly drug use Rave Self-medication Sex and drugs Whoonga Drug production and trade Drug production Coca production in Colombia Drug precursors Opium production in Afghanistan Rolling meth lab Drug trade Illegal drug trade in Colombia Issues with drug use Abuse Date rape drug Effects of cannabis Addiction Dependence Prevention Opioid replacement therapy Rehabilitation Responsible use Drug-related crime Fetal alcohol spectrum disorder Illegal drug trade Long-term effects of cannabis Neurotoxicity Overdose Passive smoking (of tobacco or other substances) Legality of drug use International 1961 Narcotic Drugs 1971 Psychotropic Substances 1988 Drug Trafficking Council of the European Union decisions on designer drugs State level Drug policy Decriminalization Prohibition Supply reduction Policy reform Demand reduction Drug Policy Alliance Harm reduction Law Enforcement Against Prohibition Liberalization (Latin America) Students for Sensible Drug Policy Transform Drug Policy Foundation Drug policy by country Australia Canada Germany India Netherlands Portugal Slovakia Sweden Switzerland Soviet Union United States Just Say No Office of National Drug Control Policy School district drug policies California Colorado Maryland Virginia Other Arguments for and against drug prohibition Capital punishment for drug trafficking Designer drug Drug court Drug harmfulness Drug possession Drug test Mexican Drug War Narc Politics of drug abuse War on Drugs Zero tolerance Lists of countries by... Alcohol legality Alcohol consumption Anabolic steroid legality Cannabis legality Annual use Lifetime use Cigarette consumption Cocaine legality Cocaine use Methamphetamine legality Opiates use Psilocybin mushrooms legality Salvia legality

Authority control NDL: 00562994 NKC: ph122639