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Abuse of Cannabinoids

Year 2017, Volume: 17 Issue: 4, 293 - 299, 20.12.2017
https://doi.org/10.17098/amj.364169

Abstract

Cannabis sativa, also known as Indian
hemp or cannabis, which has been used for centuries for therapeutic and
pleasure purposes, contains compounds called cannabinoids. Tetrahydrocannabinol
which has psychoactive effect is the key component of this plant. Cannabis
(marijuana), which has sedative, cognitive dysfunction, short-term memory
impairment, deterioration in time perception effects has been widely used for
many years as a drug and pleasurable substance. In recent years, synthetic
cannabinoids produced in the laboratory have been used increasingly. These
highly potent addictive compounds have been synthesized under the name
"JWH substances" in the 1990s by John William Huffman et al.
Nowadays, known as substances such as "Bonzai, Spice, K2 Jamaican
Gold" are obtained by dissolving synthetic cannabinoids in a solvent and by
spraying them on various herbal mixtures. These substances are marketed in the
form of cigarettes, pipes or tea and cause serious incidents resulting in
poisoning or death. Cannabinoids are also found endogenously in the human body
and play a role in the regulation of various physiological events such as the
immune system, appetite, pain, pleasure, mood and memory. Endogenous
cannabinoids are arachidonic acid metabolism products. Endogenous cannabinoids
such as 2-arachidonyl glycerol (2-AG) and anandamide (arachidonyl ethanolamide)
act by binding to cannabinoid receptors (CB1 and CB2).

Cannabinoids are not only used abusively, but also for the treatment of various
diseases or alleviation of symptoms. Today, there are FDA-approved cannabinoid
analogues to reduce nausea and vomiting in cancer chemotherapy, to increase appetite
in AIDS patients, and to aid in

the treatment of chronic pain. There are also studies showing that regulation
of the cannabinoid system may be beneficial in neurodegenerative diseases,
postmenopausal osteoporosis, cancer, obesity, diabetes, liver diseases,
cardiometabolic complications and alcohol-drug addiction.

References

  • 1. Drummer O, Odell M. The Forensic Pharmacology Of Drugs Of Abuse. 1. Baskı London-Great Britain: Arnold; 2001.
  • 2. Agar E. The role of cannabinoids and leptin in neurological diseases. Acta Neurol Scand 2015;132:371-80.
  • 3. Hollister LE. Health aspects of cannabis. Pharmacol Rev 1986;38:1-20.
  • 4. Pertwee RG. Pharmacology of cannabinoid CB1 and CB2 receptors. Pharmacol Ther 1997;74:129-80.
  • 5. Gaoni Y, Mechoulam R. Isolation, structure and partial synthesis of an active constituent of hashish. J Am Chem Soc 1964;86:1646-7.
  • 6. Howlett AC, Barth F, Bonner TI et al. International Union of Pharmacology XXVII. Classification of cannabinoid receptors. Pharmacol Rev 2002;54:161-202.
  • 7. Ameri A. The effects of cannabinoids on the brain. Prog Neurobiol 1999;58:315-48.
  • 8. Hirst RA, Lambert DG, Notcutt WG. Pharmacology and potential therapeutic uses of cannabis. Br J Anaesth 1998;81:77-84.
  • 9. Hazekamp A, Ware MA, Müller-Vahl KR, Abrams D, Grotenhermen F. The medicinal use of cannabis and cannabinoids—an international cross-sectional survey on administration forms. J Psychoactive Drugs 2013;45(3):199-210.
  • 10. Devane WA, Breuer A, Sheskin T, Jarbe TUC, Eisen MS, Mechoulam R. A novel probe for the cannabinoid receptor. J Med Chem 1992;35:2065-9.
  • 11. Tellioğlu T, Tellioğlu Z. Tıbbi esrar psikiyatrik bozuklukların tedavisinde kullanılabilir mi? Klinik Psikofarmakoloji Bülteni 2012;22:98-109.
  • 12. Castellanos D, Thornton G. Synthetic cannabinoid use: recognition and management. J Psychiatr Pract 2012;18:86-93.
  • 13. Çınar R, Gündüz-Çınar Ö. Kannabinoid tip 1 reseptör (CB1) ve terapötik yaklaşımlara genel bakış-2. Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2012;1:149-54.
  • 14. WhitingPF, WolffRF, DeshpandeSve ark. Cannabinoids for Medical Use A Systematic Review and Meta-analysis.JAMA 2015;313(24):2456-73.
  • 15. Abood ME, Martin BR. Neurobiology of marijuana abuse. Trends Pharmacol Sci 1992;13:201-6.
  • 16. Dewey WL. Cannabinoid pharmacology. Pharmacol Rev 1986;38:151-78.
  • 17. Pertwee RG. The central neuropharmacology of psychotropic cannabinoids. Pharmacol Ther 1988;36:89-261.
  • 18. Smith JP, Sutcliffe OB, Banks CE. An overview of recent developments in the analytical detection of new psychoactive substances (NPSs). Analyst 2015;140(15):4932-48.
  • 19. Huffman J, Dai D, Martin B, Compton D. Design, synthesis and pharmacology of cannabimimetic indoles. Bioorg Med Chem Lett 1994;4:563-6.
  • 20. Yeni Nesil Psiko-aktif Maddeler Sempozyumu. 26 Kasım 2013. İstanbul. http://www.atk.gov.tr/psikoakifmaddeler.pdf, Erişim tarihi:03.11.2017.
  • 21. Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B ve ark. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manage 1995;10:89-97.
  • 22. Vardakou I, Pistos C, Spiliopoulou C. Spice drugs as a new trend: mode of action, identification and legislation. Toxicol Lett 2010;197:157-62.
  • 23. Kumar RN, Chambers WA, Pertwee RG. Pharmacological actions and therapeutic uses of cannabis and cannabinoids. Anaesthesia 2001;56:1059-68.
  • 24. Leirer VO, Yesavage JA, Morrow DG. Marijuana carry-over effects on aircraft pilot performance. Aviat Space Environ Med 1991;62:221-7.
  • 25. Buckley NE, McCoy KL, Mezey E, Bonner T, Zimmer A, Felder CC ve ark. Immunomodulation by cannabinoids is absent in mice deficient for the cannabinoid CB(2) receptor. European journal of pharmacology 2000;396:141-9.
  • 26. Zimmer A, Zimmer AM, Hohmann AG, Herkenham M, Bonner TI. Increased mortality, hypoactivity, and hypoalgesia in cannabinoid CB1 receptor knockout mice. Proc Natl Acad Sci USA 1999;96:5780-5.
  • 27. Galiegue S, Mary S, Marchand J, Dussossoy D, Carriere D, Carayon P ve ark. Expression of central and peripheral cannabinoid receptors in human immune tissues and leukocyte subpopulations. Eur J Biochem 1995;232:54-61.
  • 28. Ryberg E, Larsson N, Sjogren S, Hjorth S, Hermansson NO, Leonova J ve ark. The orphan receptor GPR55 is a novel cannabinoid receptor. British J Pharmacol 2007;152:1092-101.
  • 29. Gurney SMR, Scott KS, Kacinko SL, Presley BC, Logan BK. Pharmacology, toxicology, and adverse effects of synthetic cannabinoid drugs. Forensic Sci Rev 2014;26:53-78.
  • 30. Pertwee RG. Pharmacology of cannabinoid receptor ligands. Curr Med Chem 1999;6:635-64.
  • 31. Hajos N, Freund TF. Distinct cannabinoid sensitive receptors regulate hippocampal excitation and inhibition. Chem Phys Lipids 2002;121:73-82.
  • 32. McCarberg BH, Barkin RL. The future of cannabinoids as analgesic agents: a pharmacologic, pharmacokinetic, and pharmacodynamic overview. Am J Ther 2007;14:475-83.
  • 33. Ashton JC, Wright JL, McPartland JM, Tyndall JD. Cannabinoid CB1 and CB2 receptor ligand specificity and the development of CB2-selective agonists. Curr Med Chem 2008;15:1428-43.
  • 34. Wintermeyer A, Moller I, Thevis M, Jubner M, Beike J, Rothschild MA ve ark. In vitro phase I metabolism of the synthetic cannabimimetic JWH-018. Anal Bioanal Chem 2010;398:2141-53.
  • 35. Croxford JL, Yamamura T. Cannabinoids and the immune system: potential for the treatment of inflammatory diseases? J Neuroimmunol 2005;166:3-18.
  • 36. Herkenham M, Lynn AB, Johnson MR, Melvin LS, de Costa BR, Rice KC. Characterization and localization of cannabinoid receptors in rat brain: a quantitative in vitro autoradiographic study. J Neurosci 1991;11:563-83.
  • 37. Munro S, Thomas KL, Abu-Shaar M. Molecular characterization of a peripheral receptor for cannabinoids. Nature 1993;365:61-5.
  • 38. Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet 2003;42:327-60.
  • 39. Bozkurt M. Sentetik kannabinoidler: artık herkesin sorunu. Psikiyatride Güncel 2014;4:165-177.
  • 40. Cohen J, Morrison S, Greenberg J, Saidinejad M. Clinical presentation of intoxication due to synthetic cannabinoids. Pediatrics 2012;129(4):e1064-67.
  • 41. Zimmermann US, Winkelmann PR, Pilhatsch M, Nees JA, Spanagel R, Schulz K. Withdrawal phenomena and dependence syndrome after the consumption of “spice gold”. Dtsch Arztebl Int 2009;106:464-7.
  • 42. Derungs A, Schwaninger AE, Mansella G, Bingisser R, Kraemer T, Liechti ME Symptoms, toxicities, and analytical results for a patient after smoking herbs containing the novel synthetic cannabinoid MAM-2201. Forensic Toxicol 2013;31:164-71.
  • 43. Forrester MB, Kleinschmidt K, Schwarz E, Young A. Synthetic cannabinoid exposures reported to Texas poison centers. J Addict Dis 2011;30:351-8.
  • 44. Bloom JW, Kaltenborn WT, Paoletti P, Camilli A, Lebowitz MD. Respiratory effects of non-tobacco cigarettes. Br Med J (Clin Res Ed) 1987;295:1516-8.

Kannabinoidlerin Kötüye Kullanımı

Year 2017, Volume: 17 Issue: 4, 293 - 299, 20.12.2017
https://doi.org/10.17098/amj.364169

Abstract

Yüzyıllardır tedavide
ve keyif verici amaçla kullanılan Hint keneviri veya esrar adıyla bilinen
“Cannabis sativa”, içeriğinde kannabinoidler denilen bileşenleri
barındırmaktadır. Psikoaktif etkili tetrahidrokannabinol (THC), bu bitkinin
temel bileşenidir. Sedasyon, kognitif

disfonksiyon, kısa süreli hafızada bozulma, zaman değerlendirmesinde değişiklik
gibi etkileri olan esrar bitkisi (marihuana) yıllardır uyuşturucu ve keyif
verici olarak yaygın biçimde kullanılmaktadır. Son yıllarda ise laboratuvar
ortamında üretilen sentetik kannabinoidler (SK), giderek artan bir biçimde
kullanıma girmiştir. Bağımlılık potansiyeli oldukça yüksek olan bu bileşikler
1990'lı yıllarda John William Huffman ve arkadaşları tarafından “JWH maddeleri”
adıyla sentezlenmiştir. Günümüzde “Bonzai, Spice, K2, Jamaican Gold” gibi isimlerle
bilinen maddeler, sentetik kannabinoidlerin bir solventte çözülüp çeşitli
bitkisel karışımlara püskürtülmesiyle elde edilmiştir. Bu maddeler sigara, pipo
ya da çay şeklinde pazarlanmakta ve zehirlenme veya ölümle sonuçlanan ciddi
vakalara neden olmaktadır. Kannabinoidler insan vücudunda endojen olarak da
bulunur ve immün sistem, iştah, ağrı, zevk hissi, duygu durum ve hafıza gibi
çeşitli fizyolojik olayların düzenlenmesinde rol oynar. Endojen kannabinoidler
araşidonik asit metabolizması ürünleridir. 2-araşidonil gliserol (2-AG) ve
anandamid (araşidonil etanolamid) gibi endojen kannabinoidler kannabinoid
reseptörlerine (CB1 ve CB2) bağlanarak etki gösterir. Kannabinoidler kötüye
kullanılan maddelerden olmasının yanı sıra çeşitli hastalıkların tedavisinde
veya semptomların hafifletilmesinde de kullanılmaktadır. Günümüzde kanser
kemoterapisinde bulantı ve kusmayı azaltmak, AIDS hastalarında iştahı artırmak
ve kronik ağrı tedavisine yardımcı olmak amacıyla FDA tarafından onaylanmış
kannabinoid analogları bulunmaktadır. Ayrıca kannabinoid sistemin
regülasyonunun nörodejeneratif hastalıklarda, postmenopozal osteoporoz, kanser,
obezite, diyabet, karaciğer hastalıkları, kardiyometabolik komplikasyonlar,
alkol-ilaç bağımlılığı gibi hastalıklarda faydalı olabileceğini gösteren
çalışmalar bulunmaktadır.

References

  • 1. Drummer O, Odell M. The Forensic Pharmacology Of Drugs Of Abuse. 1. Baskı London-Great Britain: Arnold; 2001.
  • 2. Agar E. The role of cannabinoids and leptin in neurological diseases. Acta Neurol Scand 2015;132:371-80.
  • 3. Hollister LE. Health aspects of cannabis. Pharmacol Rev 1986;38:1-20.
  • 4. Pertwee RG. Pharmacology of cannabinoid CB1 and CB2 receptors. Pharmacol Ther 1997;74:129-80.
  • 5. Gaoni Y, Mechoulam R. Isolation, structure and partial synthesis of an active constituent of hashish. J Am Chem Soc 1964;86:1646-7.
  • 6. Howlett AC, Barth F, Bonner TI et al. International Union of Pharmacology XXVII. Classification of cannabinoid receptors. Pharmacol Rev 2002;54:161-202.
  • 7. Ameri A. The effects of cannabinoids on the brain. Prog Neurobiol 1999;58:315-48.
  • 8. Hirst RA, Lambert DG, Notcutt WG. Pharmacology and potential therapeutic uses of cannabis. Br J Anaesth 1998;81:77-84.
  • 9. Hazekamp A, Ware MA, Müller-Vahl KR, Abrams D, Grotenhermen F. The medicinal use of cannabis and cannabinoids—an international cross-sectional survey on administration forms. J Psychoactive Drugs 2013;45(3):199-210.
  • 10. Devane WA, Breuer A, Sheskin T, Jarbe TUC, Eisen MS, Mechoulam R. A novel probe for the cannabinoid receptor. J Med Chem 1992;35:2065-9.
  • 11. Tellioğlu T, Tellioğlu Z. Tıbbi esrar psikiyatrik bozuklukların tedavisinde kullanılabilir mi? Klinik Psikofarmakoloji Bülteni 2012;22:98-109.
  • 12. Castellanos D, Thornton G. Synthetic cannabinoid use: recognition and management. J Psychiatr Pract 2012;18:86-93.
  • 13. Çınar R, Gündüz-Çınar Ö. Kannabinoid tip 1 reseptör (CB1) ve terapötik yaklaşımlara genel bakış-2. Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2012;1:149-54.
  • 14. WhitingPF, WolffRF, DeshpandeSve ark. Cannabinoids for Medical Use A Systematic Review and Meta-analysis.JAMA 2015;313(24):2456-73.
  • 15. Abood ME, Martin BR. Neurobiology of marijuana abuse. Trends Pharmacol Sci 1992;13:201-6.
  • 16. Dewey WL. Cannabinoid pharmacology. Pharmacol Rev 1986;38:151-78.
  • 17. Pertwee RG. The central neuropharmacology of psychotropic cannabinoids. Pharmacol Ther 1988;36:89-261.
  • 18. Smith JP, Sutcliffe OB, Banks CE. An overview of recent developments in the analytical detection of new psychoactive substances (NPSs). Analyst 2015;140(15):4932-48.
  • 19. Huffman J, Dai D, Martin B, Compton D. Design, synthesis and pharmacology of cannabimimetic indoles. Bioorg Med Chem Lett 1994;4:563-6.
  • 20. Yeni Nesil Psiko-aktif Maddeler Sempozyumu. 26 Kasım 2013. İstanbul. http://www.atk.gov.tr/psikoakifmaddeler.pdf, Erişim tarihi:03.11.2017.
  • 21. Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B ve ark. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manage 1995;10:89-97.
  • 22. Vardakou I, Pistos C, Spiliopoulou C. Spice drugs as a new trend: mode of action, identification and legislation. Toxicol Lett 2010;197:157-62.
  • 23. Kumar RN, Chambers WA, Pertwee RG. Pharmacological actions and therapeutic uses of cannabis and cannabinoids. Anaesthesia 2001;56:1059-68.
  • 24. Leirer VO, Yesavage JA, Morrow DG. Marijuana carry-over effects on aircraft pilot performance. Aviat Space Environ Med 1991;62:221-7.
  • 25. Buckley NE, McCoy KL, Mezey E, Bonner T, Zimmer A, Felder CC ve ark. Immunomodulation by cannabinoids is absent in mice deficient for the cannabinoid CB(2) receptor. European journal of pharmacology 2000;396:141-9.
  • 26. Zimmer A, Zimmer AM, Hohmann AG, Herkenham M, Bonner TI. Increased mortality, hypoactivity, and hypoalgesia in cannabinoid CB1 receptor knockout mice. Proc Natl Acad Sci USA 1999;96:5780-5.
  • 27. Galiegue S, Mary S, Marchand J, Dussossoy D, Carriere D, Carayon P ve ark. Expression of central and peripheral cannabinoid receptors in human immune tissues and leukocyte subpopulations. Eur J Biochem 1995;232:54-61.
  • 28. Ryberg E, Larsson N, Sjogren S, Hjorth S, Hermansson NO, Leonova J ve ark. The orphan receptor GPR55 is a novel cannabinoid receptor. British J Pharmacol 2007;152:1092-101.
  • 29. Gurney SMR, Scott KS, Kacinko SL, Presley BC, Logan BK. Pharmacology, toxicology, and adverse effects of synthetic cannabinoid drugs. Forensic Sci Rev 2014;26:53-78.
  • 30. Pertwee RG. Pharmacology of cannabinoid receptor ligands. Curr Med Chem 1999;6:635-64.
  • 31. Hajos N, Freund TF. Distinct cannabinoid sensitive receptors regulate hippocampal excitation and inhibition. Chem Phys Lipids 2002;121:73-82.
  • 32. McCarberg BH, Barkin RL. The future of cannabinoids as analgesic agents: a pharmacologic, pharmacokinetic, and pharmacodynamic overview. Am J Ther 2007;14:475-83.
  • 33. Ashton JC, Wright JL, McPartland JM, Tyndall JD. Cannabinoid CB1 and CB2 receptor ligand specificity and the development of CB2-selective agonists. Curr Med Chem 2008;15:1428-43.
  • 34. Wintermeyer A, Moller I, Thevis M, Jubner M, Beike J, Rothschild MA ve ark. In vitro phase I metabolism of the synthetic cannabimimetic JWH-018. Anal Bioanal Chem 2010;398:2141-53.
  • 35. Croxford JL, Yamamura T. Cannabinoids and the immune system: potential for the treatment of inflammatory diseases? J Neuroimmunol 2005;166:3-18.
  • 36. Herkenham M, Lynn AB, Johnson MR, Melvin LS, de Costa BR, Rice KC. Characterization and localization of cannabinoid receptors in rat brain: a quantitative in vitro autoradiographic study. J Neurosci 1991;11:563-83.
  • 37. Munro S, Thomas KL, Abu-Shaar M. Molecular characterization of a peripheral receptor for cannabinoids. Nature 1993;365:61-5.
  • 38. Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet 2003;42:327-60.
  • 39. Bozkurt M. Sentetik kannabinoidler: artık herkesin sorunu. Psikiyatride Güncel 2014;4:165-177.
  • 40. Cohen J, Morrison S, Greenberg J, Saidinejad M. Clinical presentation of intoxication due to synthetic cannabinoids. Pediatrics 2012;129(4):e1064-67.
  • 41. Zimmermann US, Winkelmann PR, Pilhatsch M, Nees JA, Spanagel R, Schulz K. Withdrawal phenomena and dependence syndrome after the consumption of “spice gold”. Dtsch Arztebl Int 2009;106:464-7.
  • 42. Derungs A, Schwaninger AE, Mansella G, Bingisser R, Kraemer T, Liechti ME Symptoms, toxicities, and analytical results for a patient after smoking herbs containing the novel synthetic cannabinoid MAM-2201. Forensic Toxicol 2013;31:164-71.
  • 43. Forrester MB, Kleinschmidt K, Schwarz E, Young A. Synthetic cannabinoid exposures reported to Texas poison centers. J Addict Dis 2011;30:351-8.
  • 44. Bloom JW, Kaltenborn WT, Paoletti P, Camilli A, Lebowitz MD. Respiratory effects of non-tobacco cigarettes. Br Med J (Clin Res Ed) 1987;295:1516-8.
There are 44 citations in total.

Details

Subjects Health Care Administration
Journal Section Reviews
Authors

Halil Kara

Publication Date December 20, 2017
Published in Issue Year 2017 Volume: 17 Issue: 4

Cite

APA Kara, H. (2017). Abuse of Cannabinoids. Ankara Medical Journal, 17(4), 293-299. https://doi.org/10.17098/amj.364169
AMA Kara H. Abuse of Cannabinoids. Ankara Med J. December 2017;17(4):293-299. doi:10.17098/amj.364169
Chicago Kara, Halil. “Abuse of Cannabinoids”. Ankara Medical Journal 17, no. 4 (December 2017): 293-99. https://doi.org/10.17098/amj.364169.
EndNote Kara H (December 1, 2017) Abuse of Cannabinoids. Ankara Medical Journal 17 4 293–299.
IEEE H. Kara, “Abuse of Cannabinoids”, Ankara Med J, vol. 17, no. 4, pp. 293–299, 2017, doi: 10.17098/amj.364169.
ISNAD Kara, Halil. “Abuse of Cannabinoids”. Ankara Medical Journal 17/4 (December 2017), 293-299. https://doi.org/10.17098/amj.364169.
JAMA Kara H. Abuse of Cannabinoids. Ankara Med J. 2017;17:293–299.
MLA Kara, Halil. “Abuse of Cannabinoids”. Ankara Medical Journal, vol. 17, no. 4, 2017, pp. 293-9, doi:10.17098/amj.364169.
Vancouver Kara H. Abuse of Cannabinoids. Ankara Med J. 2017;17(4):293-9.