Updated August 2024 Author : João Gama Marques What are cannabinoids? Cannabinoids are a group of substances derived from the three species of Cannabis genus: sativa, indica and ruderalis. There are many cannabinoids described in the scientific literature, the best known example is tetrahydro-cannabinol (THC) and cana-bi-diol (CBD). In general, THC is considered more harmful to mental health than CBD, which is more benign. The known species of Cannabis exist in various areas of the world. When processed, they give rise to three types of products: Cannabis, also known marijuana among other designations; Hashish, that also has other designations; Oil. These products, which can be ingested in food (for example space cakes), which can be smoked, with or without tobacco, in a cigarette, or in various types of pipe, are usually included in the group of soft drugs. Soft drugs because they are said to have less effects than so-called hard drugs. However, this idea is far from true. In many people, cannabinoids can have harmful health effects, contributing to trigger or aggravate mental disorders and psychosocial deterioration. What are the effects of cannabinoid consumption? Cannabinoid consumption is justified by its psychoactive effects, more often, by causing a feeling of well-being, ataraxia, self-centeredness and withdrawal from the outside world. The psychoactive effects of cannabinoids on the central nervous system occur initially at the level of its neuronal receptors (CB1 and CB2), with complex consequences on various neurotransmitter systems and brain areas that are effectively reflected at the level of: Humor: euphoria, irritability or depression; Affections: exaggeration or dullness; Perception: illusions or hallucinations; Thinking: overvalued or non organized ideas or delusions; Initiative: aggressiveness or adynamia syndrome; Cognition: deficits in memory and reasoning; Motricity: discoordination; Libido: decrease or disinhibition; Appetite: increased or nausea (cannabis hyperemesis syndrome); Sleep: drowsiness or hypersomnia. The effects of cannabinoid consumption are not the same for everyone. They essentially vary with: The genetic vulnerability of each one; The amount consumed; The frequency of consumption; The quality of the product consumed. Consequences of cannabinoid consumption Changes in the experience of the self often occur, from depersonalization and / or de-realization (feeling of loss of the real) to psychotic states with hallucinations (false perceptions without an object) and delusions (thoughts without logic). Cannabinoids when consumed in high doses, for prolonged periods and / or in the form of highly concentrated products can, even in people where genetic vulnerability is not obvious, contribute to the development or worsening of several mental disorders such as: Depression Schizophrenia; Drug addiction; Panic disorder; Toxic cannabis psychosis; Bipolar disorder; Personality disorder. In addition, cannabinoids are recognized as a gateway (gateway phenomenon) for the abuse and / or dependence on other extremely harmful drugs - alcohol, nicotine, amphetamine, cocaine, ketamine, phencyclidine, heroin (among others) - increasing the risk of psychosocial deterioration. Examples of psychosocial deterioration include: Adolescent who begins with social isolation and / or a drop in school performance; Young adult who begins to have marital, family and / or professional problems; Elderly adult living n a homeless situation. Cases similar to those described in which cannabinoids have not made their contribution, at a certain stage of life, to the aforementioned psychosocial deterioration are rare. Contrary to what many consumers claim, smoking cannabinoids also implies all well-known health risks regarding: Respiratory diseases, such as chronic obstructive pulmonary disease or lung cancer; Cardiovascular diseases, such as acute myocardial infarction or stroke. What about the therapeutic use of cannabinoids? Finally, we address a very controversial issue. Scientific research studies have been going over the years so that one day some cannabinoid, with supposed therapeutic properties, can be commercialized for therapeutic purposes. The promises have accumulated in terms of diseases such as glaucoma, multiple sclerosis, and even some type of epilepsy or cancer. However, we are still a long way from this reality, especially when we talk about products trafficked on the street, whose composition and percentage of THC and CBD are not known at all or controlled by any official entity. Meet the psychiatry team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
