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MARIJUANA (p.6)

  • 9.

    Tolerance & Dependence Tolerance does occur via:

    • a.

      down-regulation (# & sensitivity) of cannabinoid RSs

    • b.

      with synthetic agonists, see rapid RS “internalization” process (RS protein taken back into cell?)

When d/c MJ --- w/d effects (so dependence does occur)

restlessness insomnia anorexia

irritability

anxiety

agitation

depression

nausea, abdominal cramping

increased sleep disturbances drug craving

w/d effects begin about 2 days after d/c…why so long? w/d effects last about 4-6 days

As with other drugs, user often uses MJ + other drugs User often has co-morbid Sxs of w/d that are a combination of MJ w/d plus w/d from other drugs

10. Clinical Uses of THC dronabinol (Marinol) – synthetic THC increase appetite (e.g. in anorexic cancer pts) decrease nausea, vomiting (e.g. in chemotherapy pts) decrease muscle spasms (e.g. MS pts) decrease pain (e.g. MS, cancer, RA) suppress IS (e.g. RA, MS pts) decrease intraocular pressure (e.g. glaucoma pt) decrease glutamate release (e.g. post-stroke pts, head trauma)

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