Marijuana treatment and prevention services

What is it?

Marijuana, or Cannabis, refers to the dried leaves, flowers, stems, and seeds from the hemp plant Cannabis sativa, which contains the psychoactive (mind-altering) chemical delta-9-tetrahydrocannabinol (THC), as well as other related compounds. This plant material can also be concentrated in a resin called hashish or a sticky black liquid called hash oil. THC is believed to be the main chemical ingredient that produces the psychoactive effect.

Other Words for Marijuana

People Blunt, dope, ganja, grass, herb, joint, bud, Mary jane, pot, reefer, green, trees, smoke, skunk, weed, hash, tea, cronic, loud.

How is it used?

People smoke marijuana in hand-rolled cigarettes (joints) or in pipes or water pipes (bongs). They also smoke it in blunts—emptied cigars that have been partly or completely refilled with marijuana. To avoid inhaling smoke, more people are using vaporizers. These devices pull the active ingredients (including THC) from the marijuana and collect their vapor in a storage unit. A person then inhales the vapor, not the smoke. This also does not produce the same identifiable smell of marijuana.

Users can mix marijuana in food (edibles), such as brownies, cookies, or candy, or brew it as a tea. A newly popular method of use is smoking or eating different forms of THC-rich resins.

Marijuana extracts

Marijuana extracts have high a concentration THC, up to 99% in some cases. Extracts can be referred to in several ways including:

  • Hash Oil or Honey Oil: a gooey liquid
  • Wax or Budder: a softer solid, almost like lip balm
  • Shatter- a very thin, hard, amber-colored solid, almost like an ultra-thin peanut brittle

These extracts can deliver extremely large amounts of THC to users, and their use has sent some people to the emergency room. Another danger is in preparing these extracts, which usually involves butane (lighter fluid). A number of people who have used butane to make extracts at home have caused fires and explosions and have been seriously burned.

Short-term effects

When a person smokes marijuana, THC quickly passes from the lungs into the bloodstream. The blood carries the chemical to the brain and other organs throughout the body. The body absorbs THC more slowly when the person eats or drinks it. In that case, the user generally feels the effects after 30 minutes to 1 hour, depending on the level of TCH in the strain.

THC acts on specific brain cell receptors that ordinarily react to natural THC-like chemicals in the brain. These natural chemicals play a role in normal brain development and function.

Marijuana over-activates parts of the brain that contain the highest number of these receptors. This causes the “high” that users feel. Other effects include:

  • Altered senses (for example, seeing brighter colors)
  • Altered sense of time
  • Changes in mood
  • Impaired body movement
  • Difficulty with thinking and problem-solving
  • Impaired memory

Long-term effects

Marijuana also affects brain development. When marijuana users begin using as teenagers, the drug may reduce thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions. Marijuana’s effects on these abilities may last a long time or even be permanent.

Other Health Effects: Physical

  • Breathing problems.
  • Increased heart rate.
  • Problems with child development during and after pregnancy.

Other Health Effects: Mental

Long-term marijuana use has been linked to mental illness in some users, such as:

  • Temporary hallucinations—sensations and images that seem real though they are not
  • Temporary paranoia—extreme and unreasonable distrust of others
  • Worsening symptoms in patients with schizophrenia (a severe mental disorder with symptoms such as hallucinations, paranoia, and disorganized thinking)
  • Marijuana use has also been linked to other mental health problems, such as depression, anxiety, and suicidal thoughts among teens. However, study findings have been mixed.

Is marijuana addictive?

Yes marijuana can be addictive. The myth about marijuana not being addictive stems from how the body processes it. Marijuana is fat-soluible and is stored in the fat cells. This is why it can be detected in a person’s system for about a month. Because of this, the withdrawl is very different than from other substances like alcohol. Marijuana withdrawl is very slow and experience symptoms similar to someone who is in the process if quitting smoking.

Treatment options

Long-term marijuana users trying to quit report withdrawal symptoms that make quitting difficult. These include:

  • Grouchiness
  • Sleeplessness
  • Decreased appetite
  • Anxiety
  • Cravings

Behavioral support has been effective in treating marijuana addiction. Examples include therapy and motivational incentives (providing rewards to patients who remain substance free). No medications are currently available to treat marijuana addiction. However, continuing research may lead to new medications that help ease withdrawal symptoms, block the effects of marijuana, and prevent relapse.

Laws and Policies

State-level laws and policies on marijuana use (for recreational or medical use) have changed over the past decade; however it remains an illegal substance (Schedule I drug) under federal law. Therefore, a person can be charged with an OWI for marijuana use just as her or she can be charged with an OWI for alcohol use.

As state laws continue to change, the Department of Justice issued a guidance regarding marijuana enforcement – 2013 for federal prosecutors regarding marijuana enforcement under the Controlled Substance Act.

Position on Legalization and Use of Medical Marijuana

While no one knows for sure how the issues related to marijuana will play out, we do know that we are entering a critical period in our country. The majority of Americans, as the votes have attested around the country, are in favor of increased access to marijuana. They support decriminalization, medical marijuana, and legalization. This is problematic when considered in the context of the major surveys of young people that are conducted annually.  Data shows that use of marijuana in our young people is on the upward trend while use of every other illicit drug is on the decline. At the same time that marijuana use in our young people is on an upward trend, their perception of risk is declining.

Among illicit substance use, marijuana is the most commonly used substance in the US by a wide margin, with more than 47% (close to 5 out of 10) of Americans age 12 or older having used marijuana during their lifetime.

Data suggests that 9% (about 1 in 10) of adults and 17% (about 1 in 6) of adolescents who use marijuana develop an addiction to it.

Both sides of the debate typically choose not to acknowledge data that does not support their platform. Marijuana is neither harmless nor evil, but as long as both sides of the debate continue to distort the facts to their side, the real problems will never be addressed and misunderstandings will remain.

In this current environment related to changes in perceptions about marijuana, Prairie Ridge feels strongly that our position on use and legalization of medical marijuana needs to be based on solid evidence and a reliance on science and research as it relates to the dangers and potential benefits of medical marijuana use.

Prairie Ridge holds the position that current recommendations on changing policies related to marijuana are often ahead of the research into the effects of marijuana, both positive and negative.  Our rush to legalize or medicalize marijuana ahead of quality research places our population at risk.

Cutting edge cannabinoid research is taking place on a daily basis.

Marijuana is made up of more than 60 different related chemicals called cannabinoids.  The two main cannabinoids, or active ingredients, in marijuana are delta 9-tetrahydrocannabinol, also called THC, and cannabidiol, or CBD. THC and CBD are responsible for the effects we typically associate with marijuana.

There are many other cannabinoids, and some may prove to play important roles as medication.   It is our hope that ongoing research will continue to focus on other cannabinoids that can be helpful without the dangers of smoking and psychoactive effects.  Current research on cannabinoids has resulted in two receiving approval by the US Food and Drug Administration for treatment of nausea and appetite stimulation.  There is also some evidence that they can be effective in treating chronic pain, long-lasting pain that does not respond well to treatment, and neuropathic pain, pain from specific nerves that often leads to coldness or burning.  They have also shown promise in the treatment of muscle spasticity, or tightness, associated with MS.  Research is currently ongoing regarding the use of cannabidiol oil in the treatment of seizure disorders, as well.

In several states, marijuana has been approved for a variety of debilitating illnesses, including cancer, glaucoma, HIV, Hepatitis C, ALS, Crohn’s, Parkinson’s and MS. Not all of these have evidence to indicate effectiveness. Additionally, physicians are not limited to prescribing medical marijuana to these 8 conditions.

An example of the above includes the following:  While many people have spoken about the potential of cannabinoids as a treatment for ALS (also known as Lou Gehrig’s disease), and multiple states include ALS on their list of illnesses that can be treated with medical marijuana, there has only been one randomized clinical trial on using cannabinoids to treat ALS, and the results were not positive.

In instances where it may make sense to consider its use, no doctor would recommend smoking it. Since no FDA approved medication is smoked, medical marijuana should not be smoked. If a person is relying on medical marijuana for legitimate medical purposes, then they should be able to ingest the marijuana and wait to feel the effects in the same way we wait to feel the effect of ibuprofen.

Another problem with current medical marijuana laws is the amount of marijuana allowed. In Massachusetts, a doctor is permitted to recommend 10 ounces, or even more, per 60 days. This is an enormous amount. The heavy users in current clinical trials smoke an average of a half-ounce per week. One ounce of marijuana makes 56 joints. This amount of marijuana lends itself to heavy use, addiction and black market sales.

It is assumed having so much marijuana is a likely contributor in a recent study that found Colorado medical marijuana ending up in the hands of adolescents who are in treatment for substance abuse. It’s hard to resist selling the extra.

Where do we go from here?  What we need is evidence-based public policy that is supported by, and not ahead of, the science.

While the science does not provide strong support for use of medical marijuana as it is used to date, medical marijuana programs are still feasible. Rather than having the distribution of medical marijuana blossom into a billion-dollar industry, a much smaller program should be the goal. Colorado passed an amendment allowing medical marijuana in 2000. By 2011 Denver had more dispensaries than it did Starbucks coffee shops.

In the book, Marijuana: The Unbiased Truth about the World’s Most Popular Weed, Kevin P. Hill, M.D. documents studies that he and his team are currently conducting that require approvals from the Food and Drug Administration, the National Institute on Drug Abuse, and the McLean Hospital Institutional Review Board, and they have to take numerous steps, both in the way they conduct the studies and with the paperwork they are required to complete, to reduce risk of harm to participants. They accept the extra steps because they understand the importance of them. These extra steps take time and slow the pace of research. Unfortunately, State after state has implemented medical marijuana regulations with serious flaws due to their rush to pass and implement these laws, putting people at risk.

Based on the above information, the position of Prairie Ridge on legalization and use of medical marijuana is as follows:

  1. Prairie Ridge supports ongoing research into the potential medical benefits of marijuana.  We support the movement toward making marijuana a Schedule II drug for the purposes of making funding more available for this research.
  2. Prairie Ridge does not support use of marijuana for any non-FDA approved purposes.
  3. Prairie Ridge does not support marijuana that is smoked due to the significant health consequences associated with smoking it.
  4. Prairie Ridge does not support use of marijuana with high psychoactive content that increases the likelihood of impairment and addiction.

As with any other potential substance of abuse, Prairie Ridge believes that anyone struggling with addiction to marijuana deserves to be able to access treatment in a dignified and supportive environment.  In addition, Prairie Ridge reserves the right to change and/or update this position statement as new research and evidence becomes available that would suggest the value of different options and responses.

For additional information on current research and policy, we would refer the reader to Dr. Kevin Hill’s book, Marijuana:  The Unbiased Truth about the World’s Most Popular Weed.


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