1. 藥物濫用 M arijuana 賴滄海 教授 01-04-2008

2. Marijuana Learning objectives Statistics of Marijuana useStatistics of Marijuana use Effects of Marijuana useEffects of Marijuana use Medical use of MarijuanaMedical use of Marijuana

3. Marijuana plant

4. History of Marijuana use Book of Drugs (Shen Nung, 2737 B.C.)Book of Drugs (Shen Nung, 2737 B.C.) To treat gout, malaria, gas pain and absent mindedness To treat gout, malaria, gas pain and absent mindedness Scythians (600 B.C.)Scythians (600 B.C.) Burned the tops of the plant to produce a narcotic smoke Burned the tops of the plant to produce a narcotic smoke Greeks (1st Century)Greeks (1st Century) made into intoxicating cakes made into intoxicating cakes

5. IndiaIndia An essential part of indian religious ceremonies for thousand of years An essential part of indian religious ceremonies for thousand of years Assyrian (650 B.C.)Assyrian (650 B.C.) Described the plant “Azulla” that was used for making rope and cloth and was consumed to experience euphoria Described the plant “Azulla” that was used for making rope and cloth and was consumed to experience euphoria France (19th Century)France (19th Century) Napoleon’s troops brought hashish to France from Egypt Napoleon’s troops brought hashish to France from Egypt

6. Types of drugs used in the past month. Aged 12 or older in 2003

7. Marijuana Use Reported in 2003 by Americans During Lifetime, Past Year, and Past Month, According to Age

8. Major factors affecting marijuana use Mass mediaMass media Parental role modelParental role model Perceived riskPerceived risk AvailabilityAvailability Peer pressurePeer pressure

9. Major factors affecting marijuana use Age, gender, family background and religious beliefsAge, gender, family background and religious beliefs Social and interactional factorsSocial and interactional factors Setting ; type of community and neighborhoodSetting ; type of community and neighborhood Attitudinal factors: self-esteem. level of security, maturation levelAttitudinal factors: self-esteem. level of security, maturation level

10. Gateway Drugs Drugs that often lead to the use of more serious drugs. For example, alcohol, tobacco and marijuana are commonly believed to be gateway drugs.Drugs that often lead to the use of more serious drugs. For example, alcohol, tobacco and marijuana are commonly believed to be gateway drugs.

11. Different Views of Marijuana As a recreational drugsAs a recreational drugs Time wasted while intoxicated with marijuanaTime wasted while intoxicated with marijuana Americans in 1930 “ Assassin of youth”Americans in 1930 “ Assassin of youth” Jamaican called it a holy plantJamaican called it a holy plant

12. Effects of marijuana use The HighThe High Subjective Euphoric EffectsSubjective Euphoric Effects Driving performanceDriving performance Critical thinking skillsCritical thinking skills Amotivational SyndromeAmotivational Syndrome

13. The High dry mouth, red eye, some loss of coordination and balance, slower reaction time, euphoria dry mouth, red eye, some loss of coordination and balance, slower reaction time, euphoria

14. Subjective Euphoric Effects relaxation and tranquilityrelaxation and tranquility heightened sensitivity to sound, taste and emotionalityheightened sensitivity to sound, taste and emotionality hallucinogenic highhallucinogenic high relieves boredomrelieves boredom

15. Driving performance Impairs motor coordination, reaction time, sensory perceptions and glare recoveryImpairs motor coordination, reaction time, sensory perceptions and glare recovery 90minutes after use, 94 ﹪ failed a test drive90minutes after use, 94 ﹪ failed a test drive Smokers were over represented in fatal highway accidentsSmokers were over represented in fatal highway accidents Deficit persisted for sometime after the highDeficit persisted for sometime after the high

16. Critical thinking skills Impairs critical skills related to attention, memory and learningImpairs critical skills related to attention, memory and learning Impairs alertness, coordination and reaction time effects last for at least 24 hoursImpairs alertness, coordination and reaction time effects last for at least 24 hours Such as sustaining attention, shifting attention, and in registering, organizing and using informationSuch as sustaining attention, shifting attention, and in registering, organizing and using information

17. Amotivational syndrome Lack of motivation and leads to reduced productivity apathy, poor short term memory, difficulty in concentration,Lack of motivation and leads to reduced productivity apathy, poor short term memory, difficulty in concentration, Disinterest in pursuing goalsDisinterest in pursuing goals

18. Tolerance and Dependence Tolerance developed rapidly with repeated useTolerance developed rapidly with repeated use Frequent high doses of THC can produce mild physical dependenceFrequent high doses of THC can produce mild physical dependence

19. Withdrawal Symptoms IrritabilityIrritability Sleep disturbancesSleep disturbances Weight lossWeight loss Loss of appetiteLoss of appetite SweatingSweating Gastrointestinal upsetsGastrointestinal upsets

20. Medical use of marijuana Reduction in intraocular （ eye ） pressure Anti asthmatic (bronchodilation) Muscle relaxant Anti seizure Anti depressant Analgesic (migraine, childbirth) Appetite stimulant

21. Physiological effects of Marijuana use Damage to the lungDamage to the lung CNS （ Altered perceptions ）CNS （ Altered perceptions ） Respiratory SystemRespiratory System laryngitis, pharyngitis, bronchitis asthma-like conditions, cough, hoarseness,dry mouth laryngitis, pharyngitis, bronchitis asthma-like conditions, cough, hoarseness,dry mouth Cardiovascular SystemCardiovascular System vasodilation, increased blood pressure, heart rate vasodilation, increased blood pressure, heart rate binding to hemoglobin binding to hemoglobin

22. Physiological effects of Marijuana use Reproduction AphrodisiacReproduction Aphrodisiac decreased amount of testosterone decreased amount of testosterone decreased number of sperm decreased number of sperm blocks ovulation blocks ovulation

23. Inhalants Volatile SubstancesVolatile Substances Gasoline, freon, butane, propane, aerosol, toluene, Gasoline, freon, butane, propane, aerosol, toluene, AnestheticsAnesthetics ether, chloroform, halothane, nitrous oxide, amyl nitrites ether, chloroform, halothane, nitrous oxide, amyl nitrites

24. Danger of Inhalant Abuse 1.Sudden sniffing death syndrome (SSDS) characterized by serious cardiac arrhythmia 2.Direct physical damage to the heart, lung, liver,brain and bone marrow 3.Choking on vomitus, asphyxiation, suffocation 4.Falls or accidents involving impaired driving under the influence of inhalants

25. Signs of inhalant abuse Uncoordinated and disoriented and appear drunkenUncoordinated and disoriented and appear drunken Red and watery eyeRed and watery eye Slurred speechSlurred speech Nausea, headachesNausea, headaches NosebleedsNosebleeds Rashes around the nose and mouthRashes around the nose and mouth