The Cannabis Chronicles: If Weed Makes A Good Time Better….

So, besides the rebound problems after a good time I discussed in my prior blog, we also have cannabis side effects.  They can be dangerous or can even neutralize the benefit sought.  Will they happen in everyone?  No. They happen in many brains –  younger brains of developing kids;  patients on psychiatric meds.  Many times I have had patients complain that their psychosis or depressive symptoms are not getting better, only to find they had not been forthcoming about their smoking weed.   Get sober, and they can start to get better.  We have folks who would go through the full intake process, knowing they were going to be tested, but still deny use on interview.

Often, new onset psychosis is due to street drug use—including cannabis.  How come? Well, it’s not due to lack of emotional fortitude.  The problem with all drugs, illegal or prescribed, that we put in our mouths, veins, lungs or noses, whether picked up at the pharmacy or on the corner, is adverse events—side effects.  We are all aware of risks with medications we buy over the counter or by prescription. Generally, they are either infrequent or of minimal inconvenience. Take diphenhydramine or Benadryl—your friendly antihistamine. It is well known to stop allergy symptoms, especially a runny nose. But it does not just go to the receptors or cells related to those. It also hits histamine receptors in the brain that affect level of alertness, making us sleepy.  That may be good for getting to sleep during an annoying flu, but, when trying to work, not so much.  Unfortunately, the receptors for histamine are all over the brain, in different regions with different functions.

This is a common occurrence with many medications and street drugs or cannabis. They are not specific enough to hit just the system where we want them to work, like the pleasure centers of the brain, not the part that causes paranoia.  We are blessed with a very efficient system that takes a limited number of receptors but makes seemingly infinite combinations, causing many different responses based on the regions where they are located. The drug goes to many different areas without a lot of specificity, leading to the effects we don’t want. Couple this with the excessive activation or change in natural transmitter activities when high, and you cause peaks and valleys of activities that, over time, impair cell functioning. The receptors don’t like this, despite you enjoying the effects. And they fight back, limiting the response in intensity and/or duration to the drug or alcohol. 

We naturally respond by using more or changing to more potent forms of the drug or changing the method of getting it to the brain.  Often, the effects after the high vanishes are the very things that subtly prompt us to use again. That “blah”, bored or washed out feeling the next day can be easily remedied by a few hits of a joint or vaporizer. Instantly, you are feeling better, even if not feeling much of a high. Then you learn an important fact. Besides making a good time better—the usual setting when most people smoke, at a party, or before/during a show – you now learn it can make a bored time better or a blah time better, or a stressed time better…. You get the picture. It starts to fuel an ever-expanding use, for reasons light and serious. It was not your initial intent, but more of your life starts to go up in smoke…