Schaffer Library of Drug Policy

Marihuana: A Signal of Misunderstanding

Acute Effects of Marijuana (Delta 9 THC) - Acute Psychoses

US National Commission on Marihuana and Drug Abuse

Table of Contents
I. Marihuana and the Problem of Marihuana
Origins of the Marihuana Problem
The Need for Perspective
Formulating Marihuana Policy
The Report
II. Marihuana Use and Its Effects
The Marihuana User
Profiles of Users
Becoming a Marihuana User
Becoming a Multidrug User
Effects of Marihuana on the User
Effects Related to Pattern Use
Immediate Drug Effects
ShortTerm Effects
Long Term Effects
Very Long Term Effects
III. Social Impact of Marihuana Use
IV. Social Response to Marihuana Use
V. Marihuana and Social Policy
Drugs in a Free Society
A Social Control Policy for Marihuana
Implementing the Discouragement Policy
A Final Comment
Ancillary Recommendations
Legal and Law Enforcement Recommendations
Medical Recommendations
Other Recommendations
Letter of Transmittal
Members and Staff
History of Marihuana Use: Medical and Intoxicant
II. Biological Effects of Marihuana
Botanical and Chemical Considerations
Factors Influencing Psychopharmacological Effect
Acute Effects of Marihuana (Delta 9 THC)
Effects of Short-Term or Subacute Use
Effects of Long-Term Cannabis Use
Investigations of Very Heavy Very Long-Term Cannabis Users
III. Marihuana and Public Safety
Marihuana and Crime
Marihuana and Driving
Marihuana - Public Health and Welfare
Assessment of Perceived Risks
Preventive Public Health Concerns
Marihuana and the Dominant Social Order
The World of Youth
Why Society Feels Threatened
The Changing Social Scene
Problems in Assessing the Effects of Marihuana
Marihuana and Violence
Marihuana and (Non-Violent) Crime
Summary and Conclusions: Marihuana and Crime
Marihuana and Driving
History of Marihuana Legislation
History of Alcohol Prohibition
History of Tobacco Regulation
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The Report of the National Commission on Marihuana and Drug Abuse

Acute Effects of Marihuana

(Delta 9 THC)


Rare cases of full-blown acute psychotic episodes precipitated by marihuana use are reported in individuals with histories of mental disorder, with marginal psychological adjustments or with poorly developed personality structures and ego defenses (Talbott, 1968; Heiman, 1968; Kaplan, 1971; Pernot, 1969; Keeler, 1968; Defer and Diehl, 1968; Wurniser et al., 1969; Allentuck and Bowman, 1942; Bromberg, 1939; Bromberg, 1934; Curtis and Wolfe, 1939; Hughes et al., 1970; Isbell et al., 1967; Keup , 1970; Keeler, 1967; Talbott and Teague, 1969 Mayor's Committee, 1944).

Marihuana intoxication may hinder the ability of these, individuals to maintain structural defenses to existing stresses, or, alternatively produce a keener awareness of personality problems or existing stresses (Smith, 1968). Psychotherapy and antipsychotic medications are useful in controlling and preventing this reaction (Weil, 1970).

Exceptionally rare reports from North America of nonspecific toxic psychosis or actite brain syndrome have occurred after extremely high drug dose consumption, although such reports are, more common in the eastern countries. These conditions are self-limited and clear spontaneously as the drug effect abates (Weil et al., 1968; Bartolucei et al. 1969 Ames, 1958; Isbell et al., 1967; Mayor's Committee, 1944; Williams et al., 1946).

Finally, marihuana intoxication may trigger delayed anxiety reactions or psychotic episodes in a small percentage of persons who have prior experience with hallucinogenic drugs (Ungerleider et al., 1968; Ungerleider, 1969; Weil et al., 1968; Favazza and Domino, 1969).

In summary, the acute psychomotor-cognitive effects of marihuana intoxication are, interesting academically to gain understanding of normal and abnormal mental function. Also, for practically determining the danger-risk factor for the individual including determination of his functional level personally, vocationally and socially in this society. The effect on personal-social-vocational function is highly individualized and difficult to predict at present.

Although reports of anxiety attacks and psychotic episodes are more frequent as marihuana use spreads, they are still exceedingly rare and their incidence appears to be decreasing as use becomes more acceptable to more diverse populations. For example, during the nine-year period of 1961 to 1969, out of 701,057 admissions to Los Angeles County Hospital, located in a, city with very high marihuana use, only three patients required hospitalization for psychic sequelae of marihuana smoking (Lundberg, et al., 1971).

In contrast, many cases are being seen in Vietnam soldiers where a extremely potent material is available and daily stresses are high, but, these probably represent only a small fraction of marihuana, users (Talbott and Teague, 1969; Talbott, 1968; Heiman, 1968).

During the, academic year 1968 and 1969, eight students were seen in the mental hygiene division of a private Eastern University student population (8,500) with acute anxiety reactions (Bialos, 1970). The frequency of marihuana-associated acute adverse, anxiety reactions requiring attention at Boston University Student Health Service (student population 20,000) is between five and seven yearly (Pillard, 1970).

In a recent survey of newly admitted patients to a large mental hospital, marihuana was the direct cause of the hospitalization in only 0.9 per thousand admissions (Keup, 1970).

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