Marijuana is a typical plant source, which is renowned for its psychological effects rather it’s hallucination effects in past. Gradually different research revealed that Marijuana has a potential pharmacological effects also.
To controlling the abuse of Marijuana due its hallucinating effect, Marijuana was categorized as Scheduled I Drug in the year 1970. In further research revealed that THC, which is chemically known as delta-9-tetrahydrocannabinol is the active ingredient of Marijuana and contributes psychological and medicinal effects. In 1966, the THC was synthesized and US FDA provided approval in 1985. (1)
Mechanism of action of Marijuana
Marijuana exerts its effects by interacting with the definite endogenous cannabinoid receptors, which are termed as CB1 receptor and CB2 receptor. CB1 receptor is present in human at brain and peripheral nervous system, whereas CB2 receptor is present is in the spleen and other immune cells.
Therefore, marihuana does not act through opioid receptors. Cannabinoid receptors are not responsible for breathing cessation as opioid receptors, therefore the chances of fatal outcome even at overdose of marijuana is less than the other narcotic drugs. But there is a debate of overdose of marijuana and fatal effects. (2)
Pharmacokinetics of Marijuana
After inhalation of Marijuana smoke, it directly reaches to the lungs, and quickly penetrate into the systemic circulation and though blood it cross the blood brain barrier and reached to brain within few minutes. The bioavailability is less in oral intake in comparison with inhalation, almost 25 to 30% less dose is obtainable in blood stream due to fast pass metabolism in the hepatic system.
The onset of effect also delayed and provide prolonged effect due to delayed excretion from the body. The duration of effect varies from 7 days to 30 days, as the half life of the marijuana is one week, but it may take a month for complete elimination. Therefore, the effect of marijuana in the body may attain for several days to month. (2)
‘Greening out’ Effect of Marijuana
‘Greening out’ effect is also known as short term marijuana overdose effects. It is very rare that brief overdose effect does not cause fatal outcome or any enduring disability, but new experience holders have greater risk than the habitual users. The following are the included symptoms of overdosing of the marijuana in the physiological system:
- short-term frights, thoughts of paranoia and anxiety
- Breath rate decreases
- Dilation of pupil
- Nausea and vomiting
- Increased heart rate (tachycardia)
- Uncontrollable shivering
- Cold sensitivity increase
- Hallucinations and decentralized
Usually the above mentioned symptoms may lasts for minutes to hours. In case of severity of the symptoms raise up, require immediate medical attention. Sometimes combination of the chemicals or drugs with marijuana can provide serious health issues even at the temporary overdosing. (3)
How to Treat Marijuana Overdose Symptoms
Usually after a few hours, the temporary overdosing effects of marijuana goes away in its own way. The following management reduce the discomfort of the affected person:
- Close monitoring
- Keep hydrated by providing sufficient fluid
- Complete rest
- Breathing difficulty related problem should be immediately take care of by providing artificial oxygen supply.
- Pallor, tachycardia (increased heart rate) and unresponsiveness need additional medical support and may patient need to shift in medical care facility settings like hospital.
- Healthcare staffs need to apply allied treatment on controlling the aggravate the symptoms. They can provide anti-anxiety, anti-arrhythmic and antihypertensive medications to control anxiety, irregular heart beat and increased blood pressure. Fluid can be administered via intravenous route to control the dehydration and prevents further shock. (3)
Controversy in regards of fatal outcome
Rarely, marijuana overdose can cause fatal outcome. THC, the active ingredient of marijuana is not considered as fatal substance, which can alone contribute death.
Usually, it is suspected that in combination with other toxic chemicals with marijuana or co-morbidity of the individual subject usually responsible for fatal outcome. It is identified that maximum dose of THC alone is required to provide fatal outcome as it is a comparatively lower potency in comparison with other fatal toxic substance. this can be explained by following examples:
The exceeding dose of alcohol in 5 to 10 times than the normal drinking dose is considered as fatal dose, whereas marijuana needs 1000 times exceeded dose to provide killing effect. Therefore, alcohol is more fatal than the marijuana.
The therapeutic index of marijuana is 40,000:1, which can be explained as death can be occur after taking marijuana, when the dose is exceeded 40,000 more than the normal amount, whereas morphine has therapeutic index 70:1 ratio.
Scientists, who support that marijuana is not provided fatal effects, as animal study shows 3000mg/kg body weight cannot reached to lethal dose. Lethal dose is indicated by LD-50 and this can be defined as very small animals like mice or rats can take maximum 1000mg / kg body weight and that can cause death. In human study, it is analyzed that 4 pound marijuana is not provide fatal effect on 63 kilograms human, though the study is continuing to identify the severe adverse effects of marijuana at different dose limit.
But other than this report, several other case reports expected that high dose of marijuana may have fatal effect, though direct conclusive report is not yet develop. (3,4,5,6)
- SUMAIYA KABIR; 20 Medical Benefits of Marijuana You Probably Never Knew; Retrieve from: http://www.lifehack.org/articles/lifestyle/20-medical-benefits-marijuana-you-probably-never-knew.html
- HEATHERASHTON (2001); Pharmacology and effects of cannabis: a brief review; The British Journal of Psychiatry Feb 2001, 178 (2) 101-106; DOI: 10.1192/bjp.178.2.101; Retrieve from: http://bjp.rcpsych.org/content/178/2/101
- Can You Overdose On Marijuana?, New Health Guide; Retrieve from: http://www.newhealthguide.org/Can-You-Overdose-On-Marijuana.html
- Hunter Stuart; Here’s Why Those ‘Marijuana Deaths’ Don’t Change The Debate On Weed (2014); Retrieve from: http://www.huffingtonpost.com/entry/marijuana-deaths_n_4868209.html?section=india
- Kim Bellware (2015); Here’s How Many People Fatally Overdosed On Marijuana Last Year; Retrieve from: http://www.huffingtonpost.com/entry/marijuana-deaths-2014_us_56816417e4b06fa68880a217?section=india
- Can You Overdose on Marijuana? Retrieve from: http://www.leafscience.com/2014/08/26/can-you-overdose-on-marijuana/
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