Cannabis (marijuana, hashish)

and Martina Feichter, medical editor and biologist

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

Cannabis (Latin for hemp) has a millennia-old tradition as a useful and medicinal plant. It is also one of the oldest known intoxicants. Its psychoactive effect was first used in India, in the context of cultic acts. In Europe, where hemp played an important role in fiber production as a cultivated plant, the intoxicating effect of certain varieties became known in the 19th century. Consumption spread particularly in the 1970s.

In Germany today, cannabis is by far the most commonly used illegal drug. Overall, it ranks third among the most popular psychoactive substances after alcohol and tobacco.

The cannabis plant

There are different types of hemp family, one of which is cannabis, each with male and female specimens (hermaphroditic forms are rare). Only the female plants of Cannabis sativa contain enough of the main psychoactive ingredient tetrahydrocannabinol (THC) to cause intoxication. THC and the other intoxicating ingredients (cannabinoids) are in the resin of the glandular hair.

There are three different cannabis products:

• Marijuana (grass, pot): the chopped and dried female flowers of the plant
• Hashish (shit, dope): the pressed, often stretched resin
• Hashish oil (oil from the resin) or hemp oil (oil from the seeds)

The mean THC content is 6.8 percent for hash and 2 percent for marijuana. The THC content in hashish oil can be up to 30 percent. In general, however, the THC content can vary greatly depending on the type of plant, cultivation area and method as well as processing of the plants. For example, greenhouse varieties of marijuana can contain up to 20 percent THC.

Cannabis is smoked (pure or together with tobacco), chewed or mixed with food or drinks (e.g. biscuits, tea).

In addition to cannabis, which is used as an illegal drug, there are also hemp varieties that are grown quite legally for fiber production. However, only varieties with a maximum THC content of 0.2 percent may be used for this.

The cannabis high

Mechanism of action

Cannabis sativa contains more than 60 different cannabinoids. The so-called delta-9-tetrahydrocannabinol (THC) is ascribed the greatest psychoactive effect.

The exact mechanism of action of cannabis is not yet fully understood.However, researchers have found special cannabinoid receptors in the brain as well as in other parts of the body. THC and the other intoxicating hemp ingredients bind to it and develop their relaxing and mood-enhancing effect. Other effects are

• a heightened perception (hearing, seeing)
• an increased need for communication
• a way of thinking that is more rich in associations and more imaginative

But cannabis can also trigger unpleasant effects:

• depressed mood
• Restlessness
• excitement
• Anxiety and panic reactions
• Confusion with paranoid to paranoid delusions

Experts suspect that the psychoses, depression and anxiety disorders of some cannabis users can be traced back to an underlying predisposition, i.e. a genetic susceptibility to mental disorders.

The effects of cannabis use and how strong they are depend on several factors. These include, for example, the type of consumption (smoked, eaten), the amount of active ingredient ingested, the basic mood and the psychological stability of the person concerned.

Onset of action

Anyone who smokes cannabis will notice the effect of the intoxication almost immediately. It reaches its peak after about a quarter of an hour. After 30 to 60 minutes it slowly subsides; it has completely subsided after two to four hours.

Drug intoxication unfolds much more slowly when someone eats or drinks cannabis. Because if the body absorbs THC through the stomach, it takes longer than if it goes directly into the blood via the lungs. The effects set in 30 minutes to two hours after consumption and can last up to twelve hours or (rarely) longer. The onset of action cannot be precisely foreseen. It depends, for example, on what and how much you ate beforehand.

The consequences

Acute risks from the consumption of cannabis mainly affect the psyche: Paranoia, hallucinations, "bad trips", memory gaps and other negative sensations can arise. Palpitations, nausea and even circulatory collapse are also possible. Cannabis poses a short-term health hazard due to its heart rate-increasing effect. The drug is therefore dangerous for those with heart disease.

Overall, the sometimes very unpredictable effect is problematic. First-time cannabis users in particular do not know how their body and mind will react to it.

Long-term use of cannabis has psychological, social and physical consequences, although some risks are controversial. It is considered certain that smoking cannabis products damages the respiratory tract (especially if tobacco is also mixed in). The lung function is impaired and the risk of lung cancer increases because cannabis smoke contains more carcinogenic substances than a comparable amount of tobacco smoke!

During puberty, hemp may interfere with development. The consequences in pregnancy and on the newborn are unclear. It has been proven that cannabis use worsens mental performance (attention, concentration, ability to learn) over the long term. According to current knowledge, however, permanent brain damage does not occur.

There is so far no scientific evidence for the often described "amotivational syndrome" that is said to result from prolonged, heavy use of cannabis. It is understood to mean a permanent state of listlessness, indifference and general disinterest, which is also reflected in a neglect of the external appearance.

Compared to other drugs, cannabis has a low potential for mental and physical addiction. On a corresponding scale, hemp is roughly comparable to alcohol and nicotine.

In the long run, however, a psychological and slight physical dependence can develop with cannabis.

Supporters and opponents

The consumption of cannabis is one of the most controversial topics of our time. The struggle to legalize the intoxicant divides the public. If the proponents see cannabis as a rather light relaxant, the opponents stick to their opinion that cannabis is the number one "gateway drug".

In medicine, cannabis is used, among other things, as an appetite stimulator and mood enhancer, as well as for pain relief (e.g. in severe cancer, epilepsy, multiple sclerosis, AIDS).

Cannabis as a drug

Since March 2017, doctors have been able to legally prescribe cannabis flowers and extracts by prescription. This is permitted for patients with serious illnesses, provided that the cannabis preparations, in the opinion of the doctor, are:

• significantly relieve symptoms
• positively influence the course of the disease

This can be the case, for example, for the treatment of pain and spasticity, for severe loss of appetite and nausea, for example in the course of cancer therapy, or for chronic diseases such as multiple sclerosis.

Tags:  desire to have children pregnancy alternative medicine