Cannabis: Harmful or Beneficial (Part II)

Varieties and strains

Types of cannabis

CBD is a 5-HT1A receptor agonist, which may also contribute to an anxiolytic effect.  This likely means the high concentrations of CBD found in Cannabis indica mitigate the anxiogenic effect of THC significantly.  It is often claimed that sativa strains provide a more stimulating psychoactive high while indica strains are more sedating with a body high.  However this is disputed by researchers.

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."  The three main forms of cannabis products are the flower/fruit, 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."

A 2012 review found that the THC content in marijuana had increased worldwide from 1970 to 2009.  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, 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.

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

After revisions to cannabis scheduling 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 (despite the fact that skunks can sometimes be incorrectly mistaken for all types of herbal cannabis).  Extracts such as hashish and hash oil typically contain more THC than high potency cannabis infructescences.

Preparations

·         Dried flower buds (marijuana)

·         A gram of kief

·         Hashish

·         Hash oil

·         Infusion (dairy butter)

·         Pipe residue

Marijuana

Marijuana or marihuana (herbal cannabis), consists of the dried flowers and fruits and subtending leaves and stems of the female Cannabis plant.  This is the most widely consumed form, containing 3% to 20% THC, with reports of up-to 33% THC.  This is the stock material from which all other preparations are derived. Although herbal cannabis and industrial hemp derive from the same species and contain the psychoactive component (THC), they are distinct strains with unique biochemical compositions and uses. Hemp has lower concentrations of THC and higher concentrations of CBD, which decreases the psychoactive effects.

Kief

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

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 fruits, flowers and leaves, 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.  It can be consumed orally or smoked, and is also vaporized, or 'vaped'.  The term "rosin hash" refers to a high quality solventless product obtained through heat and pressure.

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".  Nabiximols is a branded product name from a tincture manufacturing pharmaceutical company.

Hash oil

Hash oil is a resinous matrix of cannabinoids obtained from the Cannabis plant by solvent extraction,  formed into a hardened or viscous mass.  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.  Butane and supercritical carbon dioxide hash oil have become popular in recent years.

Infusions

There are many varieties of cannabis infusions owing to the variety of non-volatile solvents used.  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.

Medical use

Medical marijuana refers to the use of the Cannabis plant as a physician-recommended herbal therapy as well as synthetic 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 many 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.

History

Ancient history

Cannabis is indigenous to Central Asia and the Indian subcontinent, and its uses for fabric and rope dates back to the Neolithic age in China and Japan.  It is unclear when cannabis first became known for its psychoactive properties; some research suggests that the ancient Indian drug soma, mentioned in the Vedas, sometimes contained cannabis. This is based on the discovery of a basin containing cannabis in a shrine of the second millennium BC in Turkmenistan.

Cannabis was known to the ancient Assyrians, who discovered its psychoactive properties through the Iranians.  Using it in some religious ceremonies, they called it qunubu (meaning "way to produce smoke"), a probable origin of the modern word "cannabis".  The Iranians also introduced cannabis to the Scythians, Thracians and Dacians, whose shamans (the kapnobatai—"those who walk on smoke/clouds") burned cannabis infructescences to induce trance.  The plant was used in China before 2800 BC, and found therapeutic use in India by 1000 BC, where it was used in food and drink, including bhang.

Hindus eating bhang (c. 1790)

Cannabis has an ancient history of ritual use and is found in pharmacological cults around the world. The earliest evidence of cannabis smoking has been found in the 2,500-year-old tombs of Jirzankal Cemetery in the Pamir Mountains in Western China, where cannabis residue were found in burners with charred pebbles possibly used during funeral rituals.  Hemp seeds discovered by archaeologists at Pazyryk suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century BC, confirming previous historical reports by Herodotus.  It was used by Muslims in various Sufi orders as early as the Mamluk period, for example by the Qalandars.  Smoking pipes uncovered in Ethiopia and carbon-dated to around c. AD 1320 were found to have traces of cannabis.

Modern history

Following an 1836–1840 travel in North Africa and the Middle East, French physician Jacques-Joseph Moreau wrote on the psychological effects of cannabis use; he was a member of Paris' Club des Hashischins.[citation needed] In 1842, Irish physician William Brooke O'Shaughnessy, who had studied the drug while working as a medical officer in Bengal with the East India company, brought a quantity of cannabis with him on his return to Britain, provoking renewed interest in the West.  Examples of classic literature of the period featuring cannabis include Les paradis artificiels (1860) by Charles Baudelaire and The Hasheesh Eater (1857) by Fitz Hugh Ludlow.

Cannabis propaganda from 1935

Cannabis was criminalized in various countries beginning in the 19th century. The British colonies of Mauritius banned cannabis in 1840 over concerns on its effect on Indian indentured workers; the same occurred in British Singapore in 1870.  In the United States, the first restrictions on sale of cannabis came in 1906 (in District of Columbia).  Canada criminalized cannabis in The Opium and Narcotic Drug Act, 1923, before any reports of the use of the drug in Canada, but eventually legalized its consumption for recreational and medicinal purposes in 2018.

Cannabis indica fluid extract, American Druggists Syndicate (pre-1937)

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".  In the United States in 1937, the Marihuana Tax Act was passed, and prohibited the production of hemp in addition to cannabis.

In 1972, the Dutch government divided drugs into more- and less-dangerous categories, with cannabis being in the lesser category. Accordingly, possession of 30 grams (1.1 oz) or less was made a misdemeanor.  Cannabis has been available for recreational use in coffee shops since 1976.  Cannabis products are only sold openly in certain local "coffeeshops" and possession of up to 5 grams (0.18 oz) for personal use is decriminalized, however: the police may still confiscate it, which often happens in car checks near the border. Other types of sales and transportation are not permitted, although the general approach toward cannabis was lenient even before official decriminalization.

In Uruguay, President Jose Mujica signed legislation to legalize recreational cannabis in December 2013, making Uruguay the first country in the modern era to legalize cannabis. In August 2014, Uruguay legalized growing up to six plants at home, as well as the formation of growing clubs, and a state-controlled marijuana dispensary regime.

As of October 17, 2018 when recreational use of cannabis was legalized in Canada, dietary supplements for human use and veterinary health products containing not more than 10 parts per million of THC extract were approved for marketing; Nabiximols (as Sativex) is used as a prescription drug in Canada.

The United Nations' World Drug Report stated that cannabis "was the world's most widely produced, trafficked, and consumed drug in the world in 2010", and estimated between 128 million and 238 million users globally in 2015.

Society and culture

Legal status

Since the beginning of the 20th century, most countries have enacted laws against the cultivation, possession or transfer of cannabis.  These laws have impacted adversely on cannabis cultivation for non-recreational purposes, but there are many regions where 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 had been historically tolerated, new restrictions were instituted, such as the closing of cannabis coffee shops near the borders of the Netherlands, and closing of coffee shops near secondary schools in the Netherlands.  In Copenhagen, Denmark in 2014, mayor Frank Jensen discussed possibilities for the city to legalize cannabis production and commerce.

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. 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 such countries as China and Thailand.

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), with the state of Colorado following close behind (Colorado Amendment 64).  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.  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.

In December 2013, Uruguay became the first country to legalize growing, sale and use of cannabis.  After a long delay in implementing the retail component of the law, in 2017 sixteen pharmacies were authorized to sell cannabis commercially.  On June 19, 2018, the Canadian Senate passed a bill and the Prime Minister announced the effective legalization date as October 17, 2018.  Canada is the second nation to legalize the drug.

In November 2015, Uttarakhand became the first state of India to legalize the cultivation of hemp for industrial purposes.  Usage within the Hindu and Buddhist cultures of the Indian subcontinent is common, with many street vendors in India openly selling products infused with cannabis, and traditional medical practitioners in Sri Lanka selling products infused with cannabis for recreational purposes and well as for religious celebrations.  It was criminalized in the Indian subcontinent by the Dutch and then the British. India and Sri Lanka have allowed cannabis to be taken in the context of traditional culture for recreational/celebratory purposes and also for medicinal purposes.

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 trials on patients.

On October 17, 2018, Canada legalized cannabis for recreational adult use making it the second country in the world to do so after Uruguay and the first G7 nation. The Canadian Licensed Producer system aims to become the Gold Standard in the world for safe and secure cannabis production, including provisions for a robust craft cannabis industry where many expect opportunities for experimenting with different strains.  Laws around use vary from province to province including age limits, retail structure, and growing at home.

As the drug has increasingly been seen as a health issue instead of criminal behavior, marijuana has also been legalized or decriminalized in: Czech Republic, Colombia, Ecuador, Portugal, South Africa and Canada.  Medical marijuana was legalized in Mexico in mid-2017; legislators plan to legalize its recreational use by late 2019.

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).  Cannabis is by far the most widely used illicit substance.

United States

Between 1973 and 1978, eleven states decriminalized marijuana.  In 2001, Nevada reduced marijuana possession to a misdemeanor and since 2012; several other states have decriminalized and even legalized marijuana.

In 2015, almost half of the people in the United States had tried marijuana, 12% had used it in the past year, and 7.3% had used it in the past month.  In 2014, daily marijuana use amongst US college students had reached its highest level since records began in 1980, rising from 3.5% in 2007 to 5.9% in 2014 and had surpassed daily cigarette use.

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.  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.

Marijuana use in the United States is three times above the global average, but in line with other Western democracies. Forty-four percent of American 12th graders have tried the drug at least once, and the typical age of first-use is 16, similar to the typical age of first-use for alcohol but lower than the first-use age for other illicit drugs.

Economics

Production

Sinsemilla (Spanish for "without seed") is the dried, seedless (i.e. parthenocarpic) infructescences 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, thus inducing the development of parthenocarpic fruits gathered in dense infructescences. 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.

"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%.

The average levels of THC in cannabis sold in the United States rose dramatically between the 1970s and 2000.  This is disputed for various reasons, and there is little consensus as to whether this is a fact or an artifact of poor testing methodologies.  According to Daniel Forbes writing for slate.com, the relative strength of modern strains are likely skewed because undue weight is given to much more expensive and potent, but less prevalent, samples.  Some suggest that results are skewed by older testing methods that included low-THC-content plant material such as leaves in the samples, which are excluded in contemporary tests. Others believe that modern strains actually are significantly more potent than older ones.

Price

The price or street value of cannabis varies widely depending on geographic area and potency.  Prices and overall markets have also varied considerably over time.

In 1997, cannabis was estimated to be overall the number four value crop in the US, and number one or two in many states, including California, New York, and Florida. This estimate is based on a value to growers of ~60% of retail value, or $3,000 per pound ($6,600/kg).

In 2006, cannabis was estimated to have been a $36 billion market.  This estimate has been challenged as exaggerated.  The UN World Drug Report (2008) estimated that 2006 street prices in the US and Canada ranged from about US$8.8 to $25 per gram (approximately $250 to $700 per ounce), depending on quality.  Typical U.S. retail prices were $10–15 per gram (approximately $280–420 per ounce).

In 2017, the U.S. was estimated to constitute 90% of the worldwide $9.5 billion trade in cannabis.

After some U.S. states legalized cannabis, street prices began to drop. In Colorado, the price of smokable buds (infructescences) dropped 40 percent between 2014 and 2019, from $200 per ounce to $120 per ounce ($7 per gram to $4.19 per gram).

The European Monitoring Centre for Drugs and Drug Addiction reports that typical retail prices in Europe for cannabis varied from €2 to €20 per gram in 2008, with a majority of European countries reporting prices in the range €4–10.

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.  A Pew Research Center poll found that political opposition to marijuana use was significantly associated with concerns about the health effects and whether legalization would increase marijuana use by children.

Some studies state that while there is no proof for the gateway hypothesis, young cannabis users should still be considered as a risk group for intervention programs.   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.  Almost two-thirds of the poly drug users in the 2009-2010 Scottish Crime and Justice Survey used cannabis.

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.   Studies have shown that alcohol and tobacco may additionally be regarded as gateway drugs; 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 typically easier to obtain at an earlier age 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.

A related 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 that it is dangerous to present the sequence of events described in gateway "theory" in causative terms as this hinders both research and intervention.

Research

Cannabis research is challenging since the plant is illegal in most countries.  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.  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.

A 2015 review found that the use of high CBD-to-THC strains of cannabis showed significantly fewer positive symptoms such as delusions and hallucinations, better cognitive function and both lower risk for developing psychosis, as well as a later age of onset of the illness, compared to cannabis with low CBD-to-THC ratios.  A 2014 Cochrane review found that research was insufficient to determine the safety and efficacy to using cannabis to treat schizophrenia or psychosis.  As of 2017, the molecular mechanisms for the anti-inflammatory and possible pain relieving effects of cannabis are under preliminary research.

By country

Uruguay and Canada are the only countries that have fully legalized the consumption and sale of recreational cannabis nationwide.  In the United States, 11 states and the District of Columbia have legalized the recreational use of cannabis – though the drug remains illegal at the federal level.  Laws vary from state to state when it comes to the commercial sale. Court rulings in Georgia and South Africa have led to the legalization of cannabis consumption, but not legal sales. A policy of limited enforcement has also been adopted in many countries, in particular Spain and the Netherlands where the sale of cannabis is tolerated at licensed establishments.