Cannabis use and disorder: Pathogenesis and pharmacology
- David A Gorelick, MD, PhD
David A Gorelick, MD, PhD
- Professor of Psychiatry
- University of Maryland School of Medicine
Cannabis (also called marijuana) is the most commonly used illegal psychoactive substance worldwide . Its psychoactive properties are primarily due to one cannabinoid: delta-9-tetrahydrocannabinol (THC); THC concentration is commonly used as a measure of cannabis potency .
The legal status of cannabis use, for medical as well as recreational purposes, varies internationally as well as across the United States. The potency of cannabis has increased significantly around the world in recent decades, which may have contributed to increased rates of cannabis-related adverse effects. Cannabis use disorder develops in approximately 10 percent of regular cannabis users, and may be associated with cognitive impairment, poor school or work performance and psychiatric comorbidity such as mood disorders and psychosis.
The pathogenesis and pharmacology of cannabis use and cannabis use disorder in adults are reviewed here, as are synthetic cannabinoids. The medico-legal context, epidemiology, comorbidity, and health consequences of cannabis use and cannabis use disorder in adults are discussed separately as are the clinical manifestations, course, assessment, diagnosis, and treatment of cannabis use disorder. Acute cannabis intoxication is also reviewed separately. (See "Cannabis use and disorder: Epidemiology, comorbidity, health consequences, and medico-legal status" and "Cannabis use and disorder: Clinical manifestations, course, assessment, and diagnosis" and "Treatment of cannabis use disorder" and "Cannabis (marijuana): Acute intoxication".)
Slang terms used for cannabis include Aunt Mary, BC bud, blunt (cannabis within tobacco), boom, chronic, dope, gangster, ganja, grass, hash, herb, hydro, indo, joint (cannabis cigarette), kif, Mary Jane, mota, pot, reefer, roach, sinsemilla, skunk, smoke, weed, and yerba . Synthetic cannabinoids have street or “brand” names that include synthetic weed, legal high, spice, K2, Blaze, RedX Dawn, Paradise, Demon, Black Magic, Spike, Mr. Nice Guy, Ninja, Zohai, Dream, Genie, Sence, Smoke, Skunk, Serenity, Yucatan, Fire, and Crazy Clown .
The cannabis plant contains more than 100 unique terpenophenolic compounds known as (phyto)cannabinoids, most of which have not been fully characterized scientifically . Its psychoactive properties are primarily due to one cannabinoid: delta-9-tetrahydrocannabinol (THC); THC concentration is commonly used as a measure of cannabis potency .
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