Cannabis and the concept of “Drugs”

Is cannabis a drug? To properly frame the issue, a hint to the definition of the concept of “drugs” is essential.

From a pharmacological point of view, it is a drug “Any chemical, natural or artificial, that modifies the psychology or mental activity of human beings” (J. Delay). This definition includes, in addition to drugs commonly considered as such, alcoholic beverages, tobacco, tea, coffee, many vegetables and all those pharmaceutical products that are commonly called “psychotropic drugs” (sedatives, sleeping pills, analgesics, stimulants, etc. )

From a legal point of view, a series of substances are considered “drugs” (or rather “narcotics”), the use of which is supposed to be particularly harmful to the individual and / or society. In common use, the definition of drug refers, rather than to a series of substances, to an abstract image of “substance that gives pleasure, but enslaves the individual and ultimately destroys him”

This intertwining of definitions, creates  confusion in that the term “drug” is generally used without defining it, and the criteria and contents of the different definitions are exchanged between them. In the specific case of cannabis, this type of argument is still quite common:

Cannabis is a drug because the law defines it as such; drugs are addictive because this corresponds to the conventional definition of the concept of “drug”; so cannabis is addictive.

Confusion is increased by the expression “narcotic substances”, which is the legal-police-bureaucratic synonym of the term “drug”. In pharmacology, “drugs”, in fact,  indicates an action that is typical of opiates, but is absolutely not applicable to other illegal substances, such as cannabis, cocaine and hallucinogens.

Going back to the initial question: ” Is Cannabis a drug?”, We can say that:

a) In the pharmacological sense of the term, cannabis causing changes in mental activity falls into the category of drugs, like many other substances universally widespread in our culture, such as alcohol, tobacco, coffee, etc.

b) In the legal sense, cannabis is a drug because it is included in the list of “narcotic” substances

c) Compared to the conventional image of “drug” as a enslaving and destructive substance, cannabis is not a drug, as its pharmacological characteristics are completely different from the most dangerous drugs such as heroin, cocaine and so on.

In light of these considerations, it seems justified to affirm both that cannabis is a “drug” if it is clear that all substances that have certain pharmacological characteristics, including “legal” ones, fall in this category, and that cannabis is a “non-drug “if we mean “drugs” only those substances that are actually dangerous from a medical and social point of view.

Physical effects

The immediate physical effects of cannabis intoxication on the body are limited. The most frequent reported effect is an increase in pulse rate. In the field of circulatory function, there have also been  noticed a slight increase in systolic  pressure at rather strong doses; in normal subjects there are no significant changes to the electrocardiogram.

Another frequent effect is the redness of the ocular conjunctiva and the reduction of the pressure of intraocular fluids (which can be used for the treatment of glaucoma). Finally, the reduction of salivation and the feeling of “dry mouth” are also typical of cannabis use.

Muscle strength tends to decrease with heavy doses of cannabis. Nonetheless, in countries where use is traditional, cannabis is consumed to reduce physical labor fatigue (probably because it affects the psychological component of fatigue).

As for the effects from excessive doses, the “lethal toxicity”, that is the possibility of killing the consumer, is exceptionally low:

Few, if any, cases of human death are directly attributable to overdose of cannabis. Although several death cases have been attributed to cannabis in older literature, those cases have not been clearly documented and the actual role of cannabis in the event was ambiguous and questionable.

According to Mikuriya, the lethal dose (calculated on rats) amounts to about 150 grams of THC, which is 40,000 times an effective dose. While not citing Mikuriya’s study, from the lethal toxicity point of view, cannabis must be considered one of the safest substances that today are used as a medicine.

However, it is possible that cannabis may react with other drugs taken simultaneously and increase their toxicity. Among the chronic consequences (i.e. due to prolonged use) the main ones are lung disorders (chronic bronchitis and emphysema) similar to those caused by the use of tobacco.

Tolerance and dependence

Tolerance

Until a few years ago it was believed that cannabis did not give tolerance. A tolerance to the main effects of cannabis does not normally occur in humans who make moderate or intermittent use but there is growing evidence that a certain degree of tolerance develops with prolonged use.

According to a study by Perez-Reyes et al. presented at the conference of the New York Academy of Science (NYAS), the use of cannabis for 4 years at an average of 493 cigarettes per year does not determine any tolerance.

At the same NYAS conference, a study by Jones et al. shows that cannabis used orally gives tolerance, but it runs out “surprisingly quickly”; this means, in concrete terms, that a suspension of use for 20-48 hours would be sufficient to obtain the same effects with the dosage equal to the initial one.

In conclusion, it can be said that the existence of a certain level of tolerance seems to have been demonstrated, but has not yet been clearly quantified: this implicitly indicates that we are faced with a considerably lower tolerance than that caused by other substances.

In the initial stages of use, a phenomenon of reverse tolerance has been demonstrated: with the same doses, the subjective effects of cannabis are more pronounced in “novice” consumers (ie those who have limited experience, or no experience of the use of the substance).

This phenomenon has not been clarified. It could be linked to THC metabolism; it seems more likely that it depends on the fact that consumers are progressively improving their ability to exploit and recognize the psychological effects of the substance.

Addiction

Regarding the existence of a physical dependence, the scientific documentation is almost unanimous in denying that the suspension of the use (even very intense and frequent) of cannabis can cause a definite and evident “withdrawal syndrome”.

One of these studies found a withdrawal syndrome (irritability, sleep disturbances, decreased appetite, sweating, tremors, nausea, vomiting and diarrhea) in subjects undergoing doses of 210 mg. of THC per day orally, with dosing at constant intervals of 4 hours (therefore also at night) for periods varying between 21 and 42 days.

To clarify the pharmacological significance of this experiment, remember that continuity of administration is an essential factor for the establishment of addiction; on the other hand, under normal conditions cannabis is smoked, and therefore the effects disappear in less time;

Finally, even the most avid consumers stop using during sleep. The experiment therefore concerns a situation completely different from the normal circumstances of use. Whether and how cannabis causes psychic addiction is a complex problem, since it is not easy, as we have seen, to give this term a precise meaning.

Medical use

Cannabis has been used for centuries as a medicine, and is still used in traditional medicine in some countries such as India.

In western medicine, cannabis was used as a pain reliever, calming and anticonvulsant until the turn of the last  century; subsequently it was replaced by synthetic opium derivatives (morphine and heroin) which, being industrially produced, were more stable and more certainly measurable until they disappeared from the pharmacopoeia (list of authorized drugs) USA in 1941.

A Mikuriya study found the following therapeutic effects: 1) analgesic-hypnotic,  2) appetite stimulant, 3) antiepileptic and antispasmodic, 4) antineuralgic,  5) antidepressant, 6) antiasthmatic, 7) accelerator of childbirth, 8) local anesthetic, 9) birth pain reliever, 10) antibiotic for local use only (especially for gram-positive germs)

An editorial by the official body of the US  Association of Anesthesiology found that cannabis, and in particular synthetic THC, appears particularly promising for possible therapeutic uses for the following reasons:

a) peculiarity of the pharmacological effects

b) absence of physical dependence

c) extraordinarily low toxicity, and lack of depressive action on the respiratory centers

It is interesting to note how, paradoxically, the “extraordinarily low toxicity” of cannabis has been demonstrated by the very numerous researches which aimed to demonstrate the opposite, to justify the illegality of the use of this substance.Among the possible therapeutic uses of cannabis there are:

1) Treatment of glaucoma (the use of cannabis in fact causes a decrease in endo-ocular pressure);

2) Treatment of lack of appetite, nausea and vomiting in cancer patients undergoing chemotherapy;

3) Treatment of bronchial asthma (for the specific action of THC to dilate the respiratory tract)

Reasons for use

Judging from the available literature, it seems that very few scholars have made an effort to understand the reasons for starting, and possibly continuing, the use of cannabis in countries where this substance is not part of the customs and traditions.

On this topic we report the results of an investigation by J.S. Hochman out of 400 students from the University of Los Angeles (UCLA) carried out in 1970. The validity of Hochman’s investigation is naturally linked to the era and the area in which it took place, and it would be arbitrary to give it universal meaning. We also believe that, pending further contributions, the responses of UCLA students have at least an indicative value.

The experimenters, or those who used cannabis only once during the investigation, amounted to 21% of the total number of UCLA students. Occasional consumers (up to three times a week for less than two years) were 26% of the total. Regular consumers (more than three times a week for more than two years) 3.5%. Among non-consumers, 78% had the intention of trying cannabis.

Some fundamental data emerge from this study:

1) The main motivation for all groups can be defined as “hedonistic” (having fun, feeling good, seeing the beautiful side of things)

2) Equally important are the motivations related to personal relationships (being with friends, closer relationship with someone, understanding others, communicating, sex)

3) Motivations of a more strictly cultural nature (curiosity, changing perspectives of life, creative inspiration, unity with the world) have a secondary impact, which also tends to increase in regular consumers.

4) The impact of the motivation most commonly attributed to consumers of the stereotypical image (escape reality) is poor and tends to decrease in regular consumers.

The absolute predominance of the motivations listed in the first three points configures a motivational framework that has impressive analogies with the social use of alcohol that is traditional in our culture (drinking to be together, to communicate, to have fun, to relax).

The use of cannabis arises mainly in the context of social-recreational use and, secondarily, in the experimental one.

It should also be noted that there are substantial differences between the answers given by the different groups. For some reasons (such as “curiosity” and “escape from reality”) there is an attenuation of motivation;

For most other reasons there is a sort of geometric progression, from which it appears that the interest in use strengthens and finds new reasons: it is in fact evident that the groups of occasional and habitual consumers attach much importance to more than a motivation. On a superficial analysis, this could lead one to think that the use of cannabis causes in itself (i.e. due to the pharmacological effect of the substance) a change in the existential and cultural attitude of consumers.

Psychological effects

A key feature of the psychological effects of cannabis is variability. According to Tart, the effects of cannabis are largely potential effects, in the sense that they only manifest themselves if a series of individual and environmental variables, extraneous to the substance, act in a certain way.

Consequently, research based on laboratory investigations (such as those carried out on cannabis users closed in the laboratory night and day) are partially reliable, as they do not reproduce the usual conditions of use.

To give an overall picture of the psychological effects, the most valid source is that of direct testimony of consumers on their experiences in the normal psychological and environmental context. On this basis, numerous statistics have been elaborated, based either on the free answers of the subjects interviewed, or on the answers to forms with a series of questions set by the researchers.

Effects can be grouped into four categories:

1) Perception of the environment

2) Interpersonal relationships

3) Mental processes

4) Perception of subjectivity.

The most common effects in the field of sensory perceptions are:

• perception of subtle qualities in sounds;

• spatial separation of sound sources (in other words the possibility of experiencing music in a dimension of space)

• transformations of sounds into visual images

• perception of particular shapes and meanings in visual materials that normally appear insignificant

• A sharper perception of the contours, of the colors, of the third dimension

• Greater ease to visual imagination connected with thoughts and readings

• Increase in tactile, olfactory and gustatory perceptions (the flavors of foods are particularly appreciated).

The change in perceptions caused by cannabis has been treated by several writers. Here are two passages in which some of the most typical effects are described in an exemplary way. So Baudelaire describes the effects on music:

Musical notes become numbers, and if your mind has some aptitude for mathematics, melody, harmony, while retaining its voluptuous and sensual character, it transforms into a vast arithmetic operation, in which numbers generate the numbers, and you follow the phases and the generation with an inexplicable ease and agility equal to that of the performer “.

And here’s what W. Benjamin writes about visual perceptions:

The people we deal with … have a marked tendency to transform themselves a little, I would not say to become strangers, but not to remain familiar and to look like strangers in a certain sense “.

Spatiotemporal references

Perceptions cannot be considered in the abstract, but in the context of two fundamental coordinates: space and time. In the normal state, these coordinates are considered immutable, therefore practically ignored. Among the effects of cannabis there is precisely that of modifying these parameters: the perception of space and time can be different than in normal conditions.

Distances seem either longer or shorter: space can be transformed to the point of having the sensation of “floating in an infinite space”. The perception of slowed down time is marked, it is connected with the decrease in ties with the past and the future, and with that particular feeling of “being inside” the present moment and the place in which we find ourselves, which is commonly defined by the here-and-now formula.

Interpersonal relationships

Cannabis significantly changes the individual’s attitude towards others, in an overall positive way (not surprisingly it is used mainly collectively), with possible negative consequences.

The most frequent effects are the following:

• Difficulty playing the conventional social role;

• Tendency to be less rowdy on holidays;

• Tendency to play very childish or particularly sophisticated games;

• Greater group solidarity

Cannabis appears to act as an enhancer  of interpersonal relationships at low or moderate intoxication levels. At higher levels, cannabis can have two completely different effects.

The consumer can become less sociable and withdraw from the group to fully appreciate his inner experiences. But on the other hand, he can also continue his contact with the group, and in this case he will be able to feel this contact as particularly profound, up to the sensation of flowing into others.

It should be noted that this intensification of relationships can be completely negative if real relationships with certain people or environments are bad; in this case they can undergo a rather unpleasant amplification. Among the most frequently described effects, we recall those of experiencing greater contact with the partner during intercourse. Overall, it seems that cannabis is not an aphrodisiac in the true sense of the word, that is, something that induces sexual arousal, but rather to make the sexual act more attractive if the impulse is already present.

Mental processes:

One of the most typical effects of cannabis is to weaken the “immediate memory” (ie the memory related to very recent events), to the point of forgetting the beginning of the conversation. What happens during the intoxication period can be forgotten, or perfectly remembered (the difference depends on unknown psychological factors).

The effects of cannabis on attention are complex and contradictory. To put it in a nutshell, we think that some fundamental aspects should be underlined:

• The modification and the overall enhancement of sensory perceptions tend to result in a type of attention that has increased in intensity but with a decreased range of extension: like vision through a tunnel, but with the contents of the tunnel enlarged; hence the tendency to deal with one thing at a time, such as listening to music or talking, instead of listening and speaking at the same time as is typical in the normal state.

• At low and medium dosages, the increase in the “here and now” sensation can help to focus on certain intellectual stimuli (reading, studying, reflections); at high dosages, the increased speed of mental processes can make it difficult to focus attention on a predetermined subject.

• The effect of cannabis also affects the quality of attention, in the sense that attention in the state of intoxication can preferably be attracted by subjects and stimuli other than those that  in the normal state are considered to be priorities.

Intellectual activity

At low levels of intoxication, there is often the feeling of being able to carry out more intense than normal intellectual activity; at high levels, however, the performance is lower. Other frequent effects: easy acceptance of contradictions; appreciation of the more subtle humor, perception of different and profound meanings in things that appear to be taken for granted in conditions of normality, a tendency to introspection, wandering thoughts, lively and spontaneous associations, a feeling of increased imagination and creativity.

Emotions

The most commonly reported effect is that of an improvement in mood: relaxation, serenity, tendency to laugh. Another typical effect is the amplification of emotions. There is also a greater sensitivity of the bodily components of the emotion.

Perception of subjectivity

This expression defines the way in which consumers perceive themselves during intoxication, both from a somatic and psychic point of view. We therefore distinguish somatic subjectivity from psychological subjectivity.

A) Somatic subjectivity – From this point of view, the most typical effects are: tendency not to move, relaxation, laziness, sometimes lethargy, but also hyper dynamism. When consumers move, they often feel that they are doing it in a particularly fluid and coordinated way.

It increases the perception of bodily processes; the body can, on the other hand, be completely forgotten if attention is paid elsewhere; pain tolerance higher or lower than normal to the extent that attention is focused  on the painful point or elsewhere.

B) Psychological subjectivity – Consumers report the following phenomena more frequently: childish attitude, in the sense of greater availability for new experiences and wonder; feeling of freedom, lack of inhibitions, greater self-confidence, less detachment between oneself and the outside world (in the sense of greater participation in the outside world).

2 thoughts on “Cannabis and the concept of “Drugs””

  1. I really enjoyed this, but very little is mentioned about cannabis and mental health. Wondering what you thoughts are?.
    I’m a mental health professional and have used cannabis for nearly 30 years. I have an interest in how substance misuse can impact on and exacerbate mental illness. I do not believe that cannabis causes mental illness at all, but it’s become clear to me after 20 years of practice that some people are more vulnerable to experiencing mental illness and should really stay away from cannabis, and cannabis can exacerbate existing mental illnesses, in my opinion. This is particularly the care for first onset psychosis where people are displaying prodromal symptoms. But it’s a very complex issue, anyone who says drugs makes can make you mentally ill is seriously oversimplifying it or are just plain wrong.
    I have to say I’m very sceptical about the commercialization of cannabis, particularly in the US. I see hundreds and thousands of posts on Instagram all the time pushing the benefits of cannabis for health including mental health…. You’ll be hard pushed to find anything that points to consumers being made aware of the potential risks that all drugs, including pharmaceutical drugs carry.
    I love cannabis, i have since I was 16, it’s brought me lots of fun and good times.

    Reply
    • Hello and thank you for your nice words and interesting comment. You will probably be able to find what you are looking for (cannabis and mental health) in the next post(s). We’re planning on publishing more on this subject. We agree with what you say that cannabis can make things worse in mentally “vulnerable” people. All the best, TLT

      Reply

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