Cannabis produces euphoria and relaxation, perceptual alterations (including time distortion, and impaired short-term memory and attention), and intensification of ordinary sensory experiences, such as eating and listening to music.(2) The most common unpleasant psychological effects are anxiety and panic reactions.(2) These may be reported by naive users and they are a common reason for discontinuing use.(2)
Cannabis produces dose-related impairments in cognitive and behavioural functions that may potentially impair driving an automobile or operating machinery. (6) Chronic psychological effects of cannabis use Cannabis dependence
For much of the 1970s cannabis was not regarded as a drug of dependence because of the apparent absence of tolerance and withdrawal symptoms, and a lack of persons seeking help to stop their cannabis use. There is now evidence that animals and humans develop tolerance to the effects of THC, (1) with some heavy users experiencing withdrawal symptoms on the abrupt cessation of cannabis use.(7) During the 1980s and 1990s there was an increase in the number of persons in the United States, Australia, and Europe seeking help to stop their cannabis use.(2)
There is clinical and epidemiological evidence that a cannabis-dependence syndrome occurs in heavy chronic users of cannabis who report problems in controlling their cannabis use, but who continue despite experiencing adverse personal and social consequences. (8)
The lifetime prevalence of cannabis abuse and dependence (as defined in DSM-IIIR) in the United States has been estimated at 4.4 per cent of adults. (9) Similar estimates have been obtained in New Zealand and Australia.(2) The risk of becoming dependent on cannabis seems to have more similarities with that for alcohol than with that for nicotine or the opioids, with around 10 per cent of those who ever use cannabis meeting criteria for dependence at some point in their lives. (29)
It is not clear how cannabis dependence is best managed. Stephens and Roffman (19 have reported controlled trials of cognitive-behavioural relapse prevention and social support. They found rates of abstinence at 12 months of around only 30 per cent, but the rates of use had substantially declined among those who continued to use cannabis.
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