Encyclopedia of drugs, alcohol, & addictive behavior Vol 3 (M-R)

438 Pages·2009·9.58 MB·English

by  Kranzler

VOLUME
3
Encyclopedia of
Drugs, Alcohol & Addictive Behavior
Third Edition
HENRY R. KRANZLER & PAMELA KORSMEYER
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/14/20089:31AMPage3
ENCYCLOPEDIA OF
DRUGS, ALCOHOL
& ADDICTIVE
BEHAVIOR
THIRD EDITION
Volume 3
M–R
Pamela Korsmeyer and Henry R. Kranzler
EDITORSINCHIEF
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage1
M
n
offenses. These harsh laws set off a chain reaction.
MANDATORY SENTENCING. Man- Between 1978 and 1981, forty-nine states enacted
datorysentencinglawsprovidethatpeopleconvicted mandatory sentencing laws. Every state and the
of particular crimes receive particular sentences. federal government enacted mandatory sentencing
Examples include laws specifying that people con- lawsduring the1980s. In2007,over one hundred
victedofsellingheroinorcocainewithin1,000yards separate mandatory minimum penalty provisions
ofaschoolreceiveatleastathree-yearprisontermor were contained in federal criminal statutes.
thatpeopleconvictedofsellingmorethanfouroun-
Apartfromspecificoffensesthatcarrymandatory
ces of heroin or cocaine receive at least a five-year
sentences, state and federal sentencing guidelines
prisonterm.The latter are referredto as mandatory
mandated that judges impose minimum sentences
minimum sentences. Some mandatory sentencing
based on the crime committed, aggravating factors,
lawsrequirelifesentences.AMichiganlaw,forexam-
and the criminal history of the defendant. These
ple,whichtheU.S.SupremeCourtupheldagainsta
guidelinesincreasedpunishmentforcriminaloffenses
claimthatmandatorylifesentencesconstitute‘‘cruel
andlimitedjudicialdiscretioninsentencingbyiden-
andunusualpunishment’’inviolationoftheEighth
tifyingthepunishmentrequireduponconvictionfor
Amendment to the U.S. Constitution, required life
aparticularoffense.Manyofthesestatuteseliminated
sentences without possibility of parole for people
or greatly restrictedparole for prison inmates. Con-
convicted of possessing more than 650 grams of
gress passed the Sentencing Reform Act of 1984
cocaine(Harmelin v.Michigan, 49 Cr.L. 2350[6/
(SRA),whicheliminatedparoleforfederalprisoners
27/91]).AnAlabamalawrequiredlifesentencesfor
andreducedtheamountoftimeoffgrantedforgood
peoplewho,havingpreviouslybeentwiceconvicted
behavior.TheSRAalsoestablishedtheU.S.Sentenc-
offelonies,areconvictedofathirdfelony.Lawslike
ingGuidelinesCommissionanddirectedittocreatea
Alabama’s are sometimes called habitual offender or
new sentencing system. In 1987, the commission’s
predicatefelonylaws.
guidelinesbecameeffective.
The popularity of sentencing guidelines in the
ENACTMENT OFMANDATORY
SENTENCING LAWS United States marked a rejection of indeterminate
An unprecedented number of mandatory sentenc- sentencing. Under indeterminate sentencing, judges
inglawswereenactedduringthe1970sand1980s. setmaximumlengthsofprisonsentences,andsome-
Most involve drugs, firearms, or both. New York, time minimums, but parole boards decide when a
under Governor Nelson Rockefeller, was the first prisonerwillbereleased.Incontrast,theFederalSen-
state to enact mandatory sentences. Known as the tencingGuidelinesshiftthefocusinsentencingfrom
Rockefeller drug laws, these acts imposed manda- theoffendertotheoffense.Theguidelinescategorize
tory 15-year and life sentences for certain drug offenses and identify the sentence required upon
1
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage2
MANDATORY SENTENCING
conviction. Judges are allowed to increase or thatareundulyharsh.Theythinkthatjusticerequires
decrease sentences, which are called departures, thatsentencesbeindividualizedtofitthecircumstan-
onlyiftheyhavegoodreasonsandcitethesereasons cesoftheoffenderandofthecrime.Theyalsothink
into the trial record. Upward departures are easy to that sentences should vary depending on considera-
achieve,asjudgesareallowedtoconsiderallrelevant tionssuchaswhethertheoffenderwasaringleaderor
conduct.Thisconductcanincludethecircumstances afollower;whethertheoffenderplayedamajorrole
surroundingthecrime,offensesthatwerecommitted oraminorone;whetherheorshewasmotivatedby
atthesametimeasthechargedoffensebutwerenot greed or poverty; whether a seller of drugs was an
charged, prior convictions, and acts for which the addict raising money to support a drug habit or a
defendantwaspreviouslytriedbutacquitted.Federal professional drug dealer; and whether the quantity
judges have a more difficult time decreasing a sen- involvedwaslargeorsmall.Alawrequiringthatany-
tence. A downward departure is acceptable if the oneconvictedofsellingmorethanasmallamountof
defendantacceptsresponsibilityforthecrimeorcom- heroin receive a five-year prison sentence ignores all
mitted the crime to avoid a more serious offense. suchdistinctions.
Prosecutors often successfully challenge decreases in
Opponents also complain that mandatory sen-
sentencesonappeal.
tencing laws adversely affect court operations.
Mandatorysentencinglawshavelongbeencon- Because prosecuting attorneys decide what charges
troversial. The American Law Institute, an associa- to file in each case, mandatory sentencing laws shift
tion of lawyers, judges, and law professors that power from the judge to the prosecutor. Most
created the Model Penal Code, a model law on crimes are not covered by mandatory sentencing
which the criminal laws of nearly half the states are laws. Typically, for example, trafficking in drugs is
patterned, opposes enactment of mandatory sen- subject to mandatory penalties, but possession of
tencinglaws.SodoestheAmericanBarAssociation. drugs is not. Since nearly every drug trafficker also
Many U.S. federal judges favored repeal of federal possessesdrugs,prosecutorscandecidewhichcharge
laws calling for mandatory sentences in drug cases. to file; a trafficking charge ties the judge’s hands; a
possession charge gives the judge discretion.
Despitethis opposition, ittooka U.S. Supreme
Court decision rather than an act of Congress to Another objection is that mandatory penalties
reduce the absolutism of the federal guidelines. In remove much of the defendant’s incentive to plead
2005 the Court ruled that the guidelines violated guilty and thus increase the frequency of trials and
theSixthAmendmentbecauseanyfactthatincreases lengthenthetimerequiredtoresolvecases.Inmost
thepenaltyfora crimebeyondtheprescribed statu- courts, 85 to 95 percent of convictions result from
tory maximum must be submitted to a jury and guiltypleas.Manyresultfrompleabargains,inwhich
proved beyond a reasonable doubt. The sentencing theprosecutoragreeseithertodismisssomecharges
guidelines violated this principle because judges or to approve a particular sentence if the defendant
couldincreasesentencesbyapplyingaggravatingfac- pleads guilty. If mandatory penalties remove incen-
torsthatthejuryneverconsidered.Havingmadethe tives from plea bargains, then trials, backlogs, and
guidelines advisory, the Court also ruled that the delaysincrease.Yetanotherobjectionisthatmanda-
guidelines must still be consulted by judges to help tory sentencing laws sometimes result in deceptive
them fashion valid sentences. If a sentence is chal- practices on the part of judges. To avoid imposing
lengedonappeal,thefederalcourtsmustdetermine sentences that they believe are too severe, judges
ifthesentencewasreasonable.Thisdecisionhassetin sometimes ignore the mandatory sentence law and
motionchallengestostatesentencingguidelines. imposesomeothersentenceoracquitdefendantsof
crimesthatbearmandatorypenalties.
Inthecontextofdruglaws,thecontroversyover
OBJECTIONS TO MANDATORY
SENTENCING LAWS disparate mandatory minimum sentencesfor dealers
Opponents of mandatory sentencing laws oppose of crack and powder cocaine raged from the late
themforavarietyofreasons.Manyjudgesandlawyers 1980s until 2007. Under a 1986 federal law, one
believe that mandatorysentencinglaws are arbitrary gramofcrackis equivalentto100 gramsofpowder
and sometimes require judges to impose sentences cocaine.TheU.S.SentencingGuidelineCommission
2 ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage3
MANDATORY SENTENCING
adoptedthis ratio when it revised itsguidelines that affectsguiltypleas, trialrates, andcourtdelays,but
year.However,in1988Congressamendedthelawto theyregardthoseproblemsasapriceworthpaying.
establishmandatoryminimumsentencesforcocaine
Proponentsofmandatorysentencinglawsmake
dealing. Thus, selling five grams of crack cocaine is
four arguments. First, they argue that the laws
punishablebyamandatoryminimumsentenceoffive
allow legislators to assure citizens their concerns
years.Toreceivethesamesentencefortraffickingin
are being taken seriously. Second, they assert that
powdercocaine,adefendantwouldhavetosell500
harsh mandatory sentencing laws deter offenders
grams. This resulted in longer prison sentences for
from committing crimes. Third, they claim that
small-timecrackdealersthanforcocainewholesalers.
certaincrimesaresoseriousthatpeoplewhocom-
Thefederallawandsimilarstatelawshavebeenchal-
mit them should be severely punished and that
lenged as violations of equal protection, as African
legislators should insist judges impose severe pen-
Americans have been charged with more crack
alties in such cases. Fourth, they contend that
cocaine offenses than whites. Similarly, whites have
mandatory sentencing laws are a device for assur-
beenchargedwithsellingpowdercocainemoreoften
thanAfricanAmericans. ingthatoffenderswhocommitthesamecrimewill
receive the same penalty.
These legal arguments met with little success.
By the mid-1990s, the U.S. Sentencing Guideline
Commission sought to reduce the disparity in sen- RESEARCH ON MANDATORY
tencing. Finally, in 2007 the commission modified SENTENCING LAWS
the guidelines, reducing the sentence range for Evaluations of mandatory sentencing laws offer
first-time offenders possessing five grams or more greater support to their opponents than to their
ofcrackcocaineto51to63months.Theoldrange supporters. Studies on the deterrent effect of man-
was 63to 78months. Thenew range for first-time datorysentencinglawsconcludeeitherthatpassage
offenders possessing at least 50 grams is 97 to 121 of such laws has no deterrent effect or that they
months in prison, decreasing from 121 to 151 have a modest deterrent effect that soon disap-
months. A commission analysis estimated that pears.Researchonhowmandatorysentencinglaws
changing the crack guidelines would reduce the affect court operations shows that such laws do
size of the federal prison population by 3,800 in shift power from judges to prosecutors, do some-
fifteen years. The commission also asked Congress times result in lower guilty plea rates and higher
torepealthemandatoryprisontermforsimplepos- trial rates, often cause case processing delays, and
session and increase the amount of crack cocaine frequentlyresultinimpositionofsentencesthatthe
requiredtotriggerfive-yearandten-yearmandatory judges and lawyers involved believe are harsher
minimumprisonterms.Thecommissioncontended than the defendant deserves. All of these conclu-
this was a way to focus on major drug traffickers. sions were reached by the evaluators of the Rock-
efeller Drug Laws in New York State in the mid-
ARGUMENTSFOR MANDATORY 1970s, yet the laws remain on the books despite
SENTENCING LAWS widespread criticism.
Supporters of mandatory sentences are not
The conclusions of earlier research were con-
troubled by the harshness of the laws or the fact
firmed by the most ambitious and sophisticated
that they shift power from the judge to the prose-
cutor. One of the goals of such laws is to assure study of mandatory penalties ever completed: a
that the mandated sentence will be imposed report on mandatory penalties in the U.S. federal
whether the judge agrees with the sentence or courts by the U.S. Sentencing Commission. That
not. Supporters are troubled by deceptive efforts study concluded that people convicted of crimes
of judges (and sometimes of prosecutors) to avoid subject to mandatory penalties were two and one-
applying them. They argue that judges are wrong half times more likely to be convicted after trials
to try to circumvent mandatory sentences, that if (30% of convictions) than are other federal defen-
legislatures pass laws, judges should enforce them dants (12.5%). The study found that ‘‘mandatory
whether or not they agree with them. Finally, sup- minimums transfer sentencing power from the court
porters say they regret that mandatory sentencing to the prosecutor,’’ that ‘‘honesty and truth in
ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION 3
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage4
MARIJUANA (CANNABIS)
sentencing’’ are compromised by prosecutors’ and
judges’ efforts to work around mandatory sentences,
and that ‘‘lack of uniform application [of mandato-
ries] creates unwarranted disparity in sentencing.’’
Thus, on the major empirical issues about
which opponents and supporters of mandatory
penalties disagree, the great weight of the evidence
supports opponents’ views. Empirical evidence,
however, cannot refute supporters’ normative
claims that mandatory penalties should be enacted
to assure citizens that their concerns about crime
are taken seriously or that certain crimes deserve
severe punishment and that mandatory sentencing
laws should be enacted to increase the likelihood
thatsuchpunishmentswillbeimposed.Opponents
of mandatory penalties do not necessarily disagree
that lawmakers should try to respond to citizens’
concerns or that some crimes deserve harsh penal-
Figure1.Marijuana.ILLUSTRATIONBYGGSINFORMATIONSERVICES.
ties;theydobelievethatmandatorypenaltiesarean GALE,CENGAGELEARNING
ineffective way to achieve those goals. In addition,
thecosts oflongsmall-term incarceration continue
world to refer to the various psychoactive products
to take large bites out of state revenues as correc-
derived from the Cannabis sativa plant that are
tionalagenciesstruggletohousethesteadyflowof
used by humans to alter their state of mind. Slang
prisoners convicted of drug crimes.
terms for marijuana and other psychoactive prod-
SeealsoCivilCommitment;DrugLaws,Prosecutionof; ucts derived from Cannabis sativa change over
LegalRegulationofDrugsandAlcohol;Treatment time but some stable and more current terms
AccountabilityforSaferCommunities(TASC). include: weed, pot, herb, grass, reefer, Mary Jane,
dagga, bhang, Aunt Mary, skunk, boom, gangster,
BIBLIOGRAPHY kif, ganja, hashish, and hash oil. Cannabis remains
AmericanLawInstitute.(1962).Modelpenalcode(proposed in the early twenty-first century the most widely
officialdraft).Philadelphia:TheInstitute. used illicit substance in the United States and in
most other developed countries that regulate mar-
Gray,Madison.(2007,August17).Mandatorysentencing:
ijuana. Between the late 1960s and 2008, mari-
stalled reform. Time. Available from http://www.
time.com/. juana use has generated continued controversy
regardingitsaddictivepotential,healthconsequen-
U.S.SentencingCommission.(2007).Cocaineandfederal
ces, potential for medical use, and legal status.
sentencingpolicy.Washington,DC:U.S.Government
PrintingOffice.
THECANNABISPLANT
MICHAELTONRY
Cannabis sativa grows easily throughout the
REVISEDBYFREDERICKK.TONRY(2009)
tropics, subtropics, and temperate regions. It can
alsogrowincolderclimateswithashortenedgrow-
ing season. As of 2008 it was grown in most states
n
across the United States. Once established, the
MARIJUANA (CANNABIS). Marijuana plantcanreseedandspread.Marijuanacomesfrom
is the most common name used in the United the dried flowering tops (buds or heads), leaves,
States for the Cannabis sativa plant, which is one and stems of the harvested plant. The primary
variety of the cannabis or hemp plant family. Can- mind-altering ingredient in cannabis is delta-9-
nabis is the more appropriate scientific term and tetrahydrocannabinol (THC).The THC concentra-
the more common term used throughout the tion (strength of the marijuana) partially depends
4 ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage5
MARIJUANA (CANNABIS)
upon growing conditions and the genetics of the drug’s history offers a collage of medicinal, agricul-
plant. Generally, THC concentration is greatest in tural,industrial,religious,cultural,andpoliticaltales,
the buds, then the leaves, and finally the stems eachofwhichcanbetracedbackovermanycenturies.
and seeds. Sophisticated growing techniques and Inhis1980book,Marihuana:TheFirstTwelveThou-
breedingofalternativegeneticstrainshaveresulted sandYears,ErnestAbelnotes:
in producing more potent marijuana, with poten-
Armies and navieshave usedittomakewar, men
cies of that confiscated in the first decade of the
andwomentomakelove.Huntersandfishermen
twenty-first century by legal authorities in the
havesnaredthemostferociouscreatures,fromthe
United States and of other samples tested in the
tigertotheshark,initsherculeanweave.Fashion
Netherlandsrangingfromapproximately2percent designershavedressedthemostelegantwomenin
to more than 20 percent. its supple knit. Hangmenhave snapped the necks
of thieves and murderers with its fiber. Obstetri-
Hashish or hash is another way that Cannabis
cians have eased the pain of childbirth with its
sativaispreparedforuse.Hashconsistsofdriedcan-
leaves. Farmers have crushed its seeds and used
nabisresinandcompressedflowers.ItsTHCconcen- theoilwithintolighttheirlamps.Mournershave
trationisusually2to8percent,butcangetashighas thrown its seeds into blazing fires and have had
10to15percent.ExtractingTHCfromhashormar- their sorrow transformed into blissful ecstasy by
thefumesthatfilledtheair.
ijuanausingfilteringandpurificationprocessesprodu-
ceshashoil,anditsconcentrationofTHCcanrange In the United States, approximately 30 canna-
from20to60percent. bis preparations, including Chlorodyne, a concoc-
tion of morphine and cannabis, were marketed in
USING CANNABIS the1930s.Superiormedicationseventuallybecame
Themostpopularwaytousecannabisandhashisby available, and the drug was removed from the U.S.
smoking(inhaling)itinpipesorrollingitincigarette PharmacopoeiaandNationalFormularyin1941.
papers(joints,reefers,doobies,spliffs).Waterpipesor
Periodically,commissionsofinquiry,forexam-
bongs(atypeofpipe)arealsousedbecausetheycool
ple, the 1925 Panama Canal Zone Committee and
the smoke and there is not as much marijuana lost
the 1944 Mayor’s Committee on Marihuana (The
through smoke that escapes when a standard pipe is
LaGuardia Committee), were formed to assess the
used. Another method for smoking that has become
degreeofriskposedtopublichealthbyrecreational
commonisrollingcannabisintoanemptiedcigarcas-
cannabisuse.Amovementgrewtoprohibitcanna-
ing. This product is usually called a blunt, and has
bispossession,andby1937,whenthefederalMar-
becomepopularbecauseitlookslikealegalsubstance,
ijuanaTaxActwaspassed,allstateshadbannedthe
itcanbere-liteasily,andsomepeoplereportenjoying
drug. The Vietnam antiwar movement saw a sub-
the effect of the mixture of marijuana and tobacco.
stantial increase in the drug’s popularity, particu-
Notethatthetermspliffalsocanbeusedtorefertoa
cigarette that is a mixture of marijuana and tobacco. larly among young adults in the United States. In
Hashisalsotypicallysmokedinsomeformofapipe, reaction to the long prison terms being imposed
andhashoilisusuallyusedbyaddingafewdropstoa for possession, the National Commission on Mar-
cigaretteortothemixtureinapipe.Also,theoilcanbe ihuana and Drug Abuse recommended in 1972
heated by itself and the vapors inhaled. Marijuana or that cannabis possession be decriminalized. In that
hashcanalsobetakenorally(eaten),andusuallyeating decade a number of states replaced prison terms
hasinvolvedcookingorbakingitinfoods(e.g.,brow- with either civil penalties or misdemeanor fines.
nies).Wheneaten,theonsetoftheeffectsisdelayedby While cannabis remained classified under federal
aboutanhourbecausethedrugneedstobeabsorbed law as having high risk and no accepted medical
through the stomach, but the effects can last several use,the last decades of thetwentieth century sawa
hourslonger. number of states enacting laws designed to protect
patients from prosecution if a physician recom-
HISTORY mended use of cannabis. In 1999 the Institute on
The use of cannabis as a medicine dates back to the Medicine released a comprehensive report on the
thirdmillenniumBCEinChina,andtothesecondand status of marijuana as a recreational drug and its
firstmillenniaBCEinIndiaandancientAssyria.This potential for use as a medicine.
ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION 5
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage6
MARIJUANA (CANNABIS)
CHEMISTRY / PHARMACOLOGY effectsofeatingmarijuanaareusuallynotfeltforabout
Cannabissativacontainsover400chemicalsubstan- thirty to sixty minutes, and they peak 120 to 240
ces. The compounds responsible for most direct minutes after ingestion. The direct effects of smoked
effectsarecalledcannabinoids,andover66suchcan- marijuana may persist for approximately four to six
nabinoidshavebeenidentified.Thethreemostabun- hours;effectsfollowingoralconsumptionmaylastsix
dant are cannabidiol, tetrahydrocannabinol (THC), to eight hours. The slow release of THC from fatty
andcannabinol.Delta-9-THCisthecompoundthat tissues produces low levels of THC metabolites for
causesthemostnotableeffectsofcannabis.Cannabi- many days but no significant effects appear to be
diol and cannabinol do not appear to have strong causedbysuchrelease.Nonetheless,storageandslow
psychoactive properties, but it is thought that they releasefromfattytissuesresultinTHCbeingdetect-
maymodifytheeffectsofTHC.Theproportionsof ableinurineforlongperiodsoftime(uptoamonth)
thesecannabinoidscanvaryamongstrainsandcanbe followingitsingestion.
modifiedbybreeding,resultingincannabiswithdif-
WhenTHCentersthebrain,itactivatestherelease
ferenteffectsandvaryingpotencies.
of dopamine, a neurotransmitter, which is important
TheeffectsofTHCresultfromitsabilitytoacti- because dopamine release is associated with the
vatereceptorsonthesurfaceofspecificcellsinthebrain rewarding properties of most drugs and thus may
and body. In the late 1980s it was discovered that contribute to repeated use and perhaps addiction.
humansandanimalshaveanendogenouscannabinoid Marijuana’s actions include a wide range of fairly
system,indicatingthatTHCinteractswithanaturally diverse effects. Indeed, it is difficult to classify mari-
occurring system in the body. Two specific types of juana into other common drug categories. In most
cannabinoidreceptorshavebeenidentified(theCB1 classification systems, marijuana is either placed in its
andCB2receptors).CB1receptorsarelocatedprimar- owncategoryorincludedwiththehallucinogens.
ilyonnervecellsinthebrainandspinalcord,aswellas
Although wide variation in the effects of mar-
in some tissues outside the brain. CB2 receptors are
ijuanaisobservedbasedonanindividual’sprevious
locatedmostlyoncellsoftheimmunesystemanddo
experiencewiththedrug,thedosesmokedorcon-
notappeartobepresentinthebrain.Anendogenous
sumed, and the current smoking environment, the
cannabinoid, anandamide, has also been identified.
early effects are usually more stimulating in nature:
The role of the cannabinoid system has only begun
feeling high or a mild euphoria; increased silliness,
to be explored. The effects of cannabinoids known
laughter, and talkativeness; having altered percep-
fromanimalandhumanexperimentsincludeappetite
modulation, pain relief, impairment of memory and tual experiences that include a distorted sense of
the control of movements, and reductions in body time and more intense experiences of hearing
temperature and in the activity of the gut. Research music,seeingcolors,watchingmoviesortelevision,
oncannabinoidpharmacologycontinuestogrowrap- and eating. Some of the effects might not be
idlyintheearlytwenty-firstcentury,andpromisesto pleasant. The most commonly reported unpleasant
facilitatetheunderstandingoftheroleofendogenous effects are anxiety, panic reactions, fear of going
cannabinoidsandtheeffectsofcannabis. crazy,anddepression.Atveryhighdoses,theexpe-
rience may seem more intense, and one may even
feel a sense of depersonalization or experience
DIRECT EFFECTS AND
delusions (beliefs not based in reality) or hallucina-
PSYCHOPHARMACOLOGY
Approximately30percentoftheTHCisdeliveredinto tions (seeing or hearing things that are not there).
the blood stream when cannabis is smoked. A lower These more extreme unpleasant psychological
proportionofTHCisabsorbedaftertakingcannabis effects are usually felt by infrequent users who are
bymouthbecauseTHCismetabolizedintheliver,but less familiar with the effects of marijuana or by
itsmetaboliteisalsopsychoactiveandthuslikelypro- people who have eaten or smoked more marijuana
longsitseffects.THCisdistributedwidelythroughout than they are used to. Also, using marijuana with a
thebodyviathebloodstreamandisstoredprimarilyin higher THC concentration or that is laced with
fattytissues.Theeffectsofsmokingmarijuanaarefelt other substances can cause such effects. These
withinminutes,withmaximaleffectstypicallyexperi- experiences are typically short-lived and stop when
enced thirty to ninety minutes after smoking. The thehighobtainedfrommarijuanaends.
6 ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage7
MARIJUANA (CANNABIS)
Subsequent effects of use are more relaxing, across all regions of the United States with minimal
and individuals may become more introspective, variance, although some states have significantly
with thought or concentration requiring more higherratesofusethanothers.Prevalenceofuseacross
effort,andmemoryandpsychomotortasksbecom- majorethnicandracialgroupsissimilar,thoughthere
ing more difficult. Common physiological effects issomeindicationofslightlyhigherratesamongAfri-
include increased pulse rate, reddening of the eyes, can Americans, American Indians, and those who
dry mouth, thirst and hunger, and drowsiness. claimmembershipintwoormoreraces.
With repeated and regular use, tolerance to
many of marijuana’s effects can develop, which
ADVERSE HEALTH,COGNITIVE,
meanstheusermaytakemoremarijuanatoachieve AND BEHAVIORALCONSEQUENCES
an effect or feel less effect when using the same Much remains unknown about cannabis. Moreover,
amount of marijuana. Different degrees of toler- proving that the drug’s use causes specific adverse
ance develop for different effects of marijuana. For effects, rather than their simply co-occurring with
example, tolerance to the increase in heart rate can those effects or perhaps being an attempt at self-
develop rapidly. Whether substantial tolerance medicationtoamelioratethoseeffects,isanongoing
develops to feeling euphoric is debated. challengeincannabisresearchwithhumans.Alterna-
tiveexplanationscanandshouldbeconsideredviable
Awithdrawalsyndromecanoccurinmanypersons
until well-controlled research necessitates their being
whohavebeenusingmarijuanaheavilyforasubstantial
ruledout.Thiscaveatnotwithstanding,thefindingsto
periodoftime.Thesymptomsofthiswithdrawalsyn-
date warrant mention of the following potential
dromeappearsomewhatsimilartothatdescribedwith
adverseconsequences.
tobacco smokers. The most common symptoms
reported are: irritability/anger, restlessness, nervous-
Personal Development. The possibility that can-
ness,sleepdifficulties,vividdreams,andnausea,crav-
nabis use contributes to disturbances in normal
ing, and depressed mood. These symptoms typically
adolescentdevelopmentisofconsiderableconcern.
appearwithintwotofourdaysafterstoppingregular
Frequent cannabis use by adolescents is correlated
useandmaylasttwotothreeweeks.
withsuchnegativepsychosocialoutcomesaspoorer
academic performance, truancy, and dropping out
EPIDEMIOLOGY
of school. Teens who initiate use earlier are at
Cannabis remains the most widely used illicit sub-
higher risk of developing dependence. There are
stanceinmostdevelopedcountriesthatregulateits
mixedfindingsconcerningthesuggestionthatcan-
use, and its rate of use is also increasing in devel-
nabis may interfere with normal adolescent brain
oping countries. In the United States, it is esti-
development.
mated that 98 million people (39 percent) have
used the drug; 15 million (6 percent) are currently
Cognitive Function. Although the findings are
using it (i.e., at least once in the past month); and
mixed, some studies indicate that heavy and long-
3.1millionareusingcannabisdaily.Cannabisuseis
term cannabis use impairs memory and executive
most prevalent among adolescents and young
functioning, with these consequences persisting
adults aged sixteen to twenty-five. Approximately
after cannabis use has ceased. Moreover, there is
34percentofhighschoolseniorsand28percentof
evidencethattheonsetofusebeforeagesixteenor
sophomoreshaveused marijuana at least once,and
seventeen respectively predicts poorer performance
daily use approximates 6 percent and 4 percent
in tasks requiring focused attention and lower
among seniors and sophomores, respectively.
verbal IQ in adulthood.
Although illegal in the United States, marijuana is
readily accessible; approximately 40 percent of
Affective and Psychotic Disorders. Brief psy-
eighth graders, 73 percent of tenth graders, and
choticepisodesthatmimicschizophreniformdisorders
86percentoftwelfthgradersreportthattheyknow
can occur following cannabis consumption and are
where to get marijuana.
generally short-lived. Such episodes are more likely
As with other drugs of abuse, cannabis is used following heavy consumption. In those who are sus-
more often by males than females. Cannabis is used ceptible to schizophrenia, cannabis use increases the
ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION 7
EncyclopediaofDrugs,Alcohol&AddictiveBehavior,3rdEdition,Vol3-Finals/10/13/200820:48PMPage8
MARIJUANA (CANNABIS)
likelihoodofanacuteepisode,anearlierrelapse,more potentialforharmofcannabisaddiction.Aswithother
frequent hospitalization, and poorer psychosocial substances,includingalcoholandtobacco,asubsetof
functioning.Thereisalsoevidencethatheavycannabis individualswhotrytocontinuetousecannabiseven-
usecanbeacontributingfactorinthedevelopmentof tuallydevelopswhatislabeledasdependenceoraddic-
psychotic illness in those without such a predisposi- tion.Itisestimatedthat9percentofthosewhohave
tion, although conclusions concerning this relation- used marijuana at least once meet the diagnostic cri-
shipremaincontentious. teria for cannabis dependence, which compares to
approximately15 percentfor cocaine, 24 percentfor
There appears to be a small but significant risk
heroin, and 32 percent for tobacco cigarettes. More
ofmajordepressionoccurringinyoungadultswho
frequentmarijuanauseresultsingreaterriskfordevel-
arecurrentcannabisusers.Earlyonsetandfrequent
opingdependence,andinheavieruserstheproportion
use may increase the risk of both anxiety and
meeting dependence criteria may be as high as 50
depression in young adulthood.
percent. Between 1992 and 2002, the prevalence of
marijuana use disorders among adults increased
RespiratorySystem. Heavycannabissmokershave
despite a stabilization of overall rates of marijuana
agreaterriskofchroniccough,chronicsputumpro-
use,andboththeratesofuseandprevalenceofdisor-
duction,wheezing,andepisodesofacutebronchitis
dersincreasedamongadolescents.Itappearsthatthe
thannonsmokers.Additionally,cannabissmokersare
risk of developing cannabis dependence is elevated
at an increased risk of such infectious diseases as
(one in six or seven) for users who first use the drug
pneumonia.Bronchialbiopsiesgiveevidenceofpre-
at a young age. Compared with adults, adolescent
cancerouspathologicalchangessuggestiveofanele-
cannabis users qualify for a diagnosis of dependence
vatedriskofrespiratorytractcancers.OneNewZea-
withalowerfrequencyandquantityofcannabiscon-
land population-based case control study in adults
sumption.Cannabisdependenceasreportedbythose
fifty-fiveyearsofageandyoungerfoundthattherisk
seekingtreatmentbecauseofmarijuana-relatedprob-
of lung cancer increased 8 percent for each year of
lemsappearshighlysimilartoothersubstancedepend-
cannabis smoking. In contrast, a large case control
ence disorders, although it is usually less severe than
survey in California found no association between
mostothers.
cannabisuseandthesetypesofcancer.
Cardiovascular System. For individuals with
TREATMENT
cardiovascular disease, increased stress on the heart TreatmentadmissionsintheUnitedStatesforprimary
due to the effects of cannabis on the circulatory cannabisabusemorethandoubledbetween1993and
system may increase the risk of chest pain, heart 2003, and similar trends have been observed in such
attack, or stroke. othercountriesasAustralia.Thereisincreasedrecog-
nitionthatcannabisisadrugthatcanleadtoaddiction
Driving. Due to cognitive and psychomotor
and significant negative consequences in a subset of
impairments when high, drivers who have con-
thosewhouseit.Thisawarenesshasledtothedevelop-
sumed cannabis are at a modestly increased risk of
mentofcannabis-specificinterventionsandtreatment
accidents.
materials paralleling those used with other substance
use disorders. These advances have increased the
Fetal Development. Subtle disturbances of brain
acceptability of seeking and providing treatment for
developmentmayresultincognitiveimpairmentin
cannabis dependence, and consequently the number
the offspring of women who use cannabis during
of individuals seeking help has increased. Types of
pregnancy. The impairment may not appear until
treatments shown to be effective include: motiva-
preschool or school age.
tional enhancement therapy, cognitive-behavioral
treatments,contingencymanagement,andvarious
DEPENDENCE (ADDICTION) behavioralfamily-basedtreatments(foradolescents).
Althoughtheconceptofdependenceoraddictionin However, as with treatment for other substance use
relation to cannabis has been questioned by some, disorders, many individuals do not respond well
diagnostic, epidemiological, laboratory, and clinical to these interventions; hence, there is a continued
studiesclearlyindicatetheexistence,importance,and need to develop more effective treatment options.
8 ENCYCLOPEDIA OF DRUGS, ALCOHOL & ADDICTIVE BEHAVIOR, 3RD EDITION