Jeffrey J. Prager
Increasing prevalence of recreational cannabis use among the young population has stimulated debate on the possible effects of acute and longterm use. Cannabinoids derived from herbal cannabis interact with endogenous cannabinoid systems in the body. Actions on specific brain receptors cause dose-related impairments of psychomotor performance with implications for car and train driving, airplane piloting and academic performance. Other constituents of cannabis smoke carry respiratory and cardiovascular health risks similar to those of tobacco smoke. Cannabis is not, as widely perceived, a harmless drug but poses risks to the individual and to society. Herbal cannabis contains over 400 compounds including over 100 cannabinoids, which are aryl-substituted meroterpenes unique to the plant genus Cannabis. The pharmacology of most of the cannabinoids is largely unknown but the most potent psychoactive agent, (Δ9-tetrahydrocannabinol Δ9-THC, or THC), has been isolated, synthesised and much studied. Other plant cannabinoids include Δ8-THC, cannabinol and cannabidiol. These and other cannabinoids have additive, synergistic or antagonistic effects with THC and may modify its actions when herbal cannabis is smoked. Synthetic cannabinoids such as nabilone and others are also available for therapeutic and research purposes. Non-cannabinoid constituents of the plant are similar to those found in tobacco (with the exception of nicotine). Cannabinoids are present in the stalks, leaves, flowers and seeds of the plant, and also in the resin secreted by the female plant. The THC content varies tremendously between different sources and preparations of cannabis. Over the past 20 years, sophisticated cultivation (such as hydroponic farming) and plant-breeding techniques have greatly increased the potency of cannabis products. In the ‘flower power’ days of the 1960s and 1970s an average reefer contained about 10 mg of THC. Now a joint made out of skunkweed, netherweed and other potent s
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