CHAPTER 15
MARIJUANA
A. Preparations from Cannabis
The extensive and intricate historical relationship between humans and Cannabis
remains a topic of scholarly debate, with fundamental inquiries such as the quantity and
nomenclature of species yet to be conclusively determined. The botanical and cultural
history of Cannabis can be comprehensively examined to identify three distinct
categories of human utilization. These include the use of Cannabis for the production of
fiber, which is utilized in the creation of ropes and cloth. Additionally, the plant has been
used for nonpsychoactive medical purposes. Finally, the use of Cannabis has been
primarily focused on its psychological effects. It is plausible to hypothesize that a
knowledgeable American residing in the initial phase of the 20th century would have
been cognizant of hemp as a plant utilized for rope production, cannabis as a scarcely
utilized medicinal commodity, and marijuana as a variant of a mind-altering cigarette,
without comprehending that these would eventually be legally categorized as a solitary
species, namely Cannabis sativa. The classification of Cannabis into a single species has
been a topic of controversy, as there exists a longstanding tradition of differentiating
between two primary types of Cannabis. Historically, Cannabis sativa was predominantly
grown for the purpose of producing hemp fiber and seeds. The plant exhibited a tall and
slender growth habit, reaching a height of 18 feet, and demonstrated a comparatively low
level of psychoactive potency. Cannabis indica was historically cultivated in China and
India for its fiber and seeds, as well as its psychoactive properties. This strain of cannabis
typically grows to a more compact height of only 2 or 3 feet. At present, there is a
widespread cultivation of both C. sativa and C. indica with the aim of optimizing their
psychoactive properties, leading to the creation of numerous hybrid varieties. The
concept that C. sativa is more stimulating and C. indica is more sedating is widely
promoted by both users and commercial producers. However, there is limited scientific
evidence to support these purported differences.
The resin of the cannabis plant contains varying concentrations of delta-9-
tetrahydrocannabinol (THC), which is the primary psychoactive compound. The amount
of resin produced by different parts of the plant varies. The female plant's flowers exhibit
the highest concentration of psychoactive compounds, which are predominantly present
in trichomes, minute hair-like structures. Consequently, the psychoactive potency of
diverse products derived from the plant will exhibit significant variations. The seeds,
which are abundant in oil that is abundant in essential amino acids, have been utilized as
a source of nourishment for both humans and domesticated animals. It is noteworthy that
these seeds lack any psychoactive properties. Cigarettes derived from marijuana leaves
may contain a minimal amount of 1 percent THC, while those obtained from the
flowering tops of specific strains may possess a THC concentration of approximately 30
percent. Through the process of mechanically separating or detaching the minute hair-like
structures known as trichomes and compressing them, a highly concentrated substance
known as hashish can be produced, which can contain as much as 65 percent
tetrahydrocannabinol (THC) by mass. Cultivators have developed a high level of
proficiency in the process of strain selection and the elimination of male plants before
pollination, resulting in the production of seedless flowers (sinsemilla) from female
plants with increased yield. The implementation of artificial lighting cycles has been
observed to stimulate the process of flowering, thereby leading to a rise in the output of
the most potent psychoactive constituents of the plant.
Due to the poor solubility of THC in water, various organic solvents have been
employed by individuals over time to extract THC from plant material. A conventional
technique entailed immersing the botanical matter in ethanol, which subsequently
underwent filtration and evaporation, resulting in a condensed substance commonly
known as "hash oil." The utilization of liquid butane as an extraction agent is known to
offer expedited and optimized extraction outcomes. However, it is important to note that
this method poses a significant risk due to the combustible nature of butane during its
evaporation process. Currently, numerous industrial extraction facilities employ liquid
carbon dioxide (CO) as a means of generating oils or other derivatives, such as "budder,"
"wax," or "shatter," which boast THC concentrations that can reach as high as 70 to 80
percent. The concentrated forms are primarily utilized by subjecting them to heat within
specifically engineered pipes, followed by inhalation of the resulting vapors. Solutions
suitable for utilization in vaporization pens are also accessible. Incorporation of plant
matter into baked goods, such as cookies or brownies, is a common practice to facilitate
the ingestion of cannabis through the oral route. Moreover, extracts have the potential to
be integrated into a variety of comestible items such as hard or chewy confectioneries,
chocolate confections, carbonated beverages, and numerous other edible commodities.
B. History
The first known mention of Cannabis can be traced back to a pharmacological
manuscript authored by the Chinese emperor Shen Nung in 2737 BC. He referred to the
psychoactive properties of Cannabis as a euphoriant and dubbed it the "Liberator of Sin."
The individual suggested the utilization of the aforementioned substance for medicinal
purposes such as addressing conditions such as female weakness, gout, rheumatism,
malaria, beriberi, constipation, and absent-mindedness. By the year AD 1000, the
utilization of the plant for social purposes had disseminated to the regions of the Middle
East and North Africa. During this era in the Eastern Mediterranean region, a mythos
emerged concerning a religious faction that engaged in politically motivated homicide.
The term "hashishiyya" was utilized by a particular group, which eventually led to the
evolution of the word "assassin." In the year 1299, Marco Polo recounted the narrative he
had been informed of regarding this particular assemblage and its principal figure. The
narrative possessed all the essential elements that have historically contributed to the
longevity of a story, including but not limited to, elements of mystery, homicide,
sexuality, substance abuse, and enigmatic territories. The narrative of this collective and
its undertakings has been recounted through various means throughout the years, with
one such instance being the inclusion of a tale inspired by it in Boccaccio's Decameron.
The narratives of this particular cohort, in conjunction with the recurrent allusion to the
potency and marvels of hashish in The Arabian Nights, were extensively disseminated
throughout Europe throughout the course of time.
During the early 1900s, there was a restricted level of public attention towards
cannabis and its consumption. During the initial years of the 1920s, a limited number of
citations in the popular press documented the utilization of a substance referred to as
marijuana by individuals of Mexican American descent. However, there was no
widespread apprehension among the general public at that time. During the latter part of
the 1920s, a sequence of articles linking marijuana and criminal activity were published
in newspapers located in the southern region. Consequently, the general populace
developed a curiosity towards this novel pharmaceutical substance. During the mid-
1930s, Harry Anslinger exhibited a significant level of interest in marijuana. Between
1930 and 1962, Anslinger held the position of commissioner at the U.S. Bureau of
Narcotics, an entity situated within the Department of the Treasury. The Department of
the Treasury was tasked with the coordination of enforcement endeavors pertaining to a
number of significant drug laws, such as the Harrison Act of 1914 and the 18th
Amendment that established Prohibition. Following the repeal of the 18th Amendment in
December 1933, marijuana became a primary focus of law enforcement agents tasked
with combating narcotics. Consequently, Anslinger's bureau would assume a prominent
position. With the aim of persuading the American populace of his competence,
Anslinger utilized his authoritative position to promote the perils of marijuana and
advocate for the enactment of federal laws prohibiting its consumption, distribution, and
trade.
The enactment of the Marijuana Tax Act was an inevitable outcome. A limited
number of witnesses provided testimony, with the exception of law enforcement
personnel. The birdseed industry successfully lobbied for a modification to the relevant
legislation, thereby enabling them to legally import sterilized Cannabis seed for
incorporation into their product. During the hearing, an individual affiliated with the
American Medical Association (AMA) provided testimony in a personal capacity, rather
than as a representative of the organization, in opposition to the proposed legislation.
Broadly speaking, medical practitioners exhibited a sense of displeasure towards the
oversight exercised by the Bureau of Narcotics, with certain individuals expressing a
desire to maintain their ability to utilize marijuana for medicinal objectives. Several
medical practitioners were reluctant to link traditional Cannabis-based remedies with the
novel and unfamiliar drug known as marijuana. The legislative measure was ratified in
the month of August and subsequently enforced on the first day of October in the year
1937. The Harrison Act of 1914 established a regulatory framework for the law that is
characterized by its emphasis on taxation. The federal legislation did not prohibit
Cannabis or its derivatives; rather, it imposed levies on the cultivator, supplier, vendor,
and purchaser, and created significant administrative hurdles that effectively precluded
any involvement with Cannabis. Furthermore, the Bureau of Narcotics formulated a
standardized legislation that was adopted by numerous states. The legislation pertaining
to marijuana, commonly known as the uniform law, explicitly designates C. sativa as the
botanical species whose foliar matter is prohibited. Subsequently, the defense counsel in
certain legal proceedings contended that the seized substance had originated from C.
indica, thereby rendering it non-illicit. Typically, the specimens procured by law
enforcement or submitted as evidence in legal proceedings lack distinguishing features
between species, as they are either absent or have been eradicated through the processes
of desiccation and compression. Due to the ubiquitous presence of cannabinoids across
various species, it is difficult to ascertain the specific species of the majority of
confiscated marijuana. Presently, the extant federal and standardized regulations pertain
exclusively to Cannabis.
The enactment of the Marijuana Tax Act yielded a remarkable impact. There was
a noticeable decrease in the incidence of violent crimes perpetrated while under the
influence of marijuana in a short span of time. The drug experienced a significant surge
in price, coinciding with the onset of war. Approximately five years following the
enactment of the relevant legislation, the cost of a marijuana cigarette, colloquially
referred to as a "reefer," had escalated by a factor of 6 to 12, ultimately reaching a cost of
approximately one dollar. In 1938, subsequent to the enactment of the law, Mayor
Fiorello LaGuardia of New York City made a request to the New York Academy of
Medicine to conduct a study on the potential long-term effects of marijuana usage on its
consumers.
C. Pharmacology
The chemical composition of Cannabis is intricate, and the process of isolating
and extracting its active constituent remains challenging in contemporary times.
Marijuana comprises over 500 chemical compounds, with approximately 100 of them
being exclusive to the Cannabis plant, and are referred to as cannabinoids. Delta-9-
tetrahydrocannabinol (THC), which was synthesized and isolated in 1964, is widely
recognized as the most pharmacologically potent compound among them. Nevertheless, it
is plausible that additional cannabinoids could potentially contribute to the
comprehensive impacts. Cannabidiol (CBD) has garnered significant interest as a non-
psychoactive cannabinoid with demonstrated efficacy as an anticonvulsant medication.
Additionally, when administered concurrently with THC, CBD appears to mitigate some
of the psychoactive effects of THC. While the majority of research has focused on THC
and CBD, a cursory online inquiry utilizing the term "cannabinoid" will uncover
assertions and conjectures regarding the conceivable therapeutic advantages of no less
than eight additional phytocannabinoids derived from plants. Advocates of medical
marijuana contend that the advantages of utilizing the plant may not be fully encapsulated
by any individual isolated chemical compound, such as THC, owing to the occurrence of
entourage effects. These effects are generated by a blend of not only cannabinoids but
also terpenes, which are oils produced by various plant species. The odors of cannabis
plants are primarily attributed to the terpenes present in them.
Upon inhalation, tetrahydrocannabinol (THC) undergoes rapid absorption into the
bloodstream and preferentially targets the brain before being subsequently redistributed
to other bodily tissues. Notably, within a half-hour timeframe, a significant portion of
THC is eliminated from the brain. The concurrent manifestation of peak mood-altering
and cardiovascular effects typically transpires within a span of 5 to 10 minutes. When
consumed orally, the absorption of THC is gradual and inefficient, resulting in less than
20% of the compound reaching the brain. This is attributed to the extensive metabolic
processes that occur in the liver. The aforementioned route of administration entails a
delay of 60 to 90 minutes before the peak effects of the drug are observed. The half-life
of THC is approximately 19 hours, while its metabolites, which include at least 45
compounds, are predominantly synthesized in the liver. The primary metabolite, 11-
hydroxy-delta-9-THC, has a half-life of 50 hours. Following a period of seven days, it is
possible for approximately 25 to 30 percent of the tetrahydrocannabinol (THC) and its
metabolites to persist within the human body. The complete elimination of a substantial
amount of THC and its metabolites may require a duration of 2 to 3 weeks.
For a considerable period, researchers endeavored to discover a crucial element
that could assist them in unraveling the enigma of marijuana's impact on the central
nervous system. The process of identifying and purifying THC was deemed an essential
measure. In 1988, researchers achieved a noteworthy advancement by devising a method
to detect and quantify binding sites that exhibit high specificity and selectivity for THC
and its associated compounds in the brains of rats. As a consequence, there was a
proliferation of research efforts aimed at creating and evaluating marijuana analogues
with increased potency. An additional outcome was the unearthing in 1992 of an
endogenous compound that elicits effects similar to those of marijuana in animals upon
administration.
One of the most prevalent physiological responses noted subsequent to the
consumption of marijuana or THC-laden edibles is a rise in heart rate. Persistent acute
outcomes of inhaled cannabis include ocular redness and desiccation of the oral cavity
and pharynx. With the exception of bronchodilation, the impact of acute marijuana
exposure on pulmonary function, as assessed by conventional pulmonary tests, is
minimal. Prolonged and intense use of marijuana may result in notable and less easily
reversible decline in pulmonary function.
At some juncture, a minority of cannabis users, specifically less than 10%, may
develop an addiction to the substance. The magnitude of this numerical value may vary
based on one's viewpoint or pre-existing convictions regarding cannabis. It may be
informative to note that approximately 15% of individuals who consume alcohol and one-
third of those who smoke tobacco are susceptible to developing addiction over the course
of their lifespan. In terms of relative comparison, assuming equal circumstances,
marijuana exhibits a lower propensity for abuse in comparison to the two legally
obtainable psychoactive substances. Tetrahydrocannabinol (THC) is widely considered to
be the primary psychoactive constituent of cannabis, which is believed to be responsible
for the drug's consumption. To clarify, the removal of THC from marijuana would result
in a significant decrease in the number of individuals who partake in its consumption.
Empirical evidence derived from laboratory experiments indicates that marijuana is
extensively self-administered by young individuals, and that the self-administration of
marijuana is contingent upon the concentration of THC. It is preferred to consume
marijuana cigarettes with a higher concentration of THC as opposed to those with a lower
concentration of THC. The results of this study validate the significance of THC in the
sustenance of self-administration of marijuana. Additionally, the outcomes imply that the
administration of THC alone, such as through oral intake of THC capsules, may have
rewarding or reinforcing effects. In a particular research, proficient cannabis users were
provided with multiple chances to self-administer oral THC capsules or to obtain a
monetary reward of $2.
There are several noteworthy discoveries from the aforementioned investigation
that merit discussion. The findings of the study indicate that the participants exhibited a
preference for selecting money over capsules on multiple occasions. Additionally, they
showed a greater inclination towards selecting drug-containing capsules over placebo.
Furthermore, the participants demonstrated a higher tendency to select THC capsules
during social or recreational periods as opposed to non-social or non-recreational periods.
The aforementioned observations suggest that the potential for abuse of oral THC is
limited, and individuals who have prior experience with marijuana can easily differentiate
the effects related to THC. Furthermore, the act of self-administering cannabis is subject
to the influence of social factors.
Certain individuals have posited that a prerequisite for novice cannabis consumers
to encounter favorable subjective effects linked to cannabis usage, such as elation and a
sense of being under the influence, is to undergo a cognitive process that involves
acquiring the ability to identify and comprehend the psychoactive effects generated by
smoked cannabis. The effects of marijuana in experienced users have been thoroughly
characterized, although there is ongoing debate regarding this matter. Typically,
proficient cannabis users indicate elevated levels of euphoria, intoxication, relaxation,
appetite, and arousal subsequent to consuming marijuana. The aforementioned effects
reach their maximum intensity within a timeframe of 5 to 10 minutes and have a duration
of approximately 2 hours. It is commonly observed that these effects are contingent upon
the concentration of THC. The subjective effects as reported by individuals who smoke
marijuana infrequently are comparable to those of regular smokers, albeit more
pronounced. This is due to the fact that infrequent smokers possess a lower tolerance to
the effects associated with marijuana. Moreover, when exposed to elevated levels of
THC, occasional smokers may experience adverse outcomes, including but not limited to
mild paranoia and hallucinations. The peak subjective effects of oral THC have been
observed to be comparable to those induced by smoked marijuana, albeit with a distinct
temporal pattern, as evidenced by heart rate. The maximum subjective effects manifest
approximately 90 minutes after oral consumption and may persist for multiple hours. As
per the prevailing perspective in the field of drug abuse research, a crucial determinant of
a drug's potential for abuse is the speed with which its effects manifest. The likelihood of
a drug being abused increases proportionally with the speed at which its effects are
manifested. This could potentially explain the restricted abuse liability of orally
administered THC.
The impact of cannabis on cognitive functioning has been a subject of extensive
scrutiny in both mainstream media and scholarly publications over an extended period,
yet a consensus has yet to be reached. Regrettably, numerous deliberations concerning
this subject contribute to the perplexity as they neglect to distinguish between the
immediate (acute) and prolonged (chronic) impacts of cannabis. Moreover, they neglect
to take into account the individual's past usage of marijuana. Temporary disruptions in
various domains are observed in infrequent users following acute administration of
smoked marijuana. These disruptions include increased time required to complete
cognitive tasks, decreased performance on immediate recall tasks, increased premature
responding, decreased performance on tracking tasks, and disrupted performance on tasks
requiring participants to reproduce computer-generated patterns, indicating disrupted
visuospatial processing and loss of sustained concentration or vigilance. The impact of
marijuana on the cognitive abilities of individuals who consume it frequently is
comparatively less pronounced due to the development of tolerance. However, certain
adverse cognitive effects have been documented. A persistent observation is the
deceleration of cognitive functioning, which is evident even among individuals who
consume the substance on a routine basis. The aforementioned phenomenon could
potentially yield noteworthy behavioral implications in situations that necessitate intricate
operations to be executed within a restricted time frame, such as specific occupational
duties and the handling of machinery and vehicles.
The phenomenon of increased food consumption, commonly referred to as the
"munchies," following the consumption of marijuana is a well-known occurrence. The
available literature indicates that both marijuana and oral THC have a significant impact
on food intake, as evidenced by numerous studies. The aforementioned discoveries
served as the foundation for at least one therapeutic application of drugs derived from
cannabis, namely, the promotion of appetite (refer to "Therapeutic Applications of
Cannabis"). An inquiry that has garnered comparatively less scholarly scrutiny is: What
accounts for the relatively low prevalence of obesity among individuals who engage in
chronic marijuana use? There has been speculation regarding the development of
tolerance towards the food-intake-enhancing impact of cannabis-based medications.
However, no empirical evidence has been found to substantiate this claim. There is
currently a lack of empirical research on the average weight of individuals who
chronically use marijuana, thus precluding any definitive conclusions on the matter. It is
plausible that chronic marijuana users exhibit a higher likelihood of being overweight on
average. It is plausible that the majority of cannabis consumption takes place during
adolescence, as evidenced by data obtained from nationwide surveys. This may be
attributed to the heightened metabolic rate and activity levels of individuals during this
developmental stage. This could potentially mitigate the increase in body weight resulting
from the consumption of marijuana.
Marijuana has been found to have a consistent impact on verbal behavior,
specifically in the area of speech production. Studies have demonstrated that the
administration of stimulant drugs, such as amphetamines, and moderate consumption of
alcohol can lead to an increase in verbal interactions. Marijuana exhibits distinct
characteristics. Multiple studies have indicated that marijuana use leads to an increase in
nonverbal social interactions, while simultaneously resulting in a significant decrease in
verbal communication.
During the early 1900s, a diverse range of Cannabis preparations were accessible
for medicinal purposes. The enactment of the Marijuana Tax Act in 1937 led to the
removal of medicines containing cannabis from the market. Additionally, in 1941,
Cannabis was eliminated from both The National Formulary and The U.S.
Pharmacopoeia. The medical employment of Cannabis experienced a reduction well in
advance of 1937, and the legislation did not eradicate a therapeutically utilized substance
that was in current use. There were four contributing factors that led to the decrease in the
rate of prescription of this particular plant. One significant advancement was the creation
of novel and improved pharmaceuticals for a wide range of medical conditions. The
second factor pertained to the variability observed in the medicinal formulations of
Cannabis that were accessible. Thirdly, the active component exhibits insolubility in
aqueous solutions, thereby rendering it unsuitable for injectable formulations. Finally,
when administered orally, it exhibits an atypically prolonged delay in the initiation of its
effects.
Simultaneously, additional scholars were evaluating the impacts of orally
administered delta-9-tetrahydrocannabinol (THC) and inhaled cannabis for the alleviation
of nausea and vomiting induced by specific pharmaceuticals employed in the
management of cancer. Consistent findings from the studies indicated that treatments
derived from cannabis exhibited greater efficacy compared to both placebo and
alternative antiemetic medications. The year 1985 marked the approval of oral
tetrahydrocannabinol (THC) by the Food and Drug Administration (FDA) for the purpose
of alleviating nausea in patients undergoing cancer chemotherapy. The pharmaceutical
substance is commonly known as dronabinol in its generic nomenclature, while its
proprietary designation is Marinol. In 1993, the drug dronabinol, which contains oral
tetrahydrocannabinol (THC), was granted approval as an appetite-stimulant for
individuals diagnosed with acquired immunodeficiency syndrome (AIDS). The Food and
Drug Administration has granted approval for two specific uses of oral THC, namely,
alleviating nausea and vomiting that arise from cancer chemotherapy and stimulating
appetite in individuals with AIDS.
D. Causes for Concern
Empirical evidence from diverse human laboratory and clinical investigations
indicates that an abrupt discontinuation of smoked marijuana or oral delta-9-THC intake
for several days can result in the manifestation of an abstinence syndrome. Although
cannabinoid withdrawal is not considered to be life-threatening, the associated symptoms
can be uncomfortable and distressing. Withdrawal symptoms associated with marijuana
use in habitual users may encompass adverse mood states such as anxiety, restlessness,
depression, and irritability, as well as sleep disturbances, reduced appetite, and, in certain
instances, aggressive conduct. The aforementioned symptoms have been observed to
manifest within 24 hours of discontinuing cannabinoid use and endure for a duration
ranging from 4 to 12 days, contingent upon the degree of an individual's dependence on
marijuana. The majority of individuals who use marijuana do not exhibit withdrawal
symptoms and do not fulfill the diagnostic criteria for cannabis use disorder as outlined in
the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The
aforementioned discoveries serve as a reminder that consistent utilization of marijuana
(or any other psychoactive substance) can elicit a range of outcomes, encompassing both
favorable and unfavorable consequences.
The physiological impacts of marijuana, specifically the elevation in heart rate,
have not been deemed as a health hazard. There is a growing concern among researchers
that the aging population of marijuana users may be at risk of adverse health effects,
particularly those with pre-existing conditions such as hypertension, cardiovascular
disease, or atherosclerosis, who may be vulnerable to the potential harms associated with
smoking marijuana. The potential lethal dose of THC has not been subjected to
comprehensive research in animals, and there have been no documented cases of human
fatalities resulting from marijuana "overdoses". Therefore, it appears that marijuana
overdose is not a significant concern in terms of public health.
Considerable apprehension has been expressed regarding the potential enduring
consequences of persistent cannabis consumption on pulmonary function or susceptibility
to pulmonary ailments such as carcinoma and emphysema. The majority of research
examining the relationship between marijuana smoking and chronic respiratory
symptoms, such as cough, phlegm, wheezing, and breathlessness, has demonstrated a
positive correlation between smoking and symptoms of chronic bronchitis, particularly
cough and phlegm. However, there appears to be no significant association between
smoking and shortness of breath. The most severe and incapacitating manifestation of
progressive pulmonary illness is dyspnea. Furthermore, a majority of individuals who
engage in marijuana consumption also partake in tobacco cigarette smoking. Upon
adjusting for tobacco usage, the previously observed positive association between
marijuana smoking and chronic bronchitis symptoms loses its statistical significance.
This implies that the act of smoking marijuana in isolation does not pose a substantial
threat for the emergence of pulmonary ailments.
To mitigate the potential pulmonary toxicity linked to smoking cannabis, certain
individuals have adopted the practice of vaporizing the substance. The term "vaping"
pertains to the process of vaporizing substances, such as cannabis products, through the
application of heat to liquid, oil, or plant material. This results in the release of an
aerosolized mixture of water vapor and active ingredients, such as THC or CBD, which is
subsequently inhaled. This mode of delivery circumvents the process of combustion of
the material and the consequent inhalation of smoke, which comprises carbon monoxide
and other potentially hazardous combustion byproducts. Initial indications propose that
the act of vaporizing cannabis is linked with a reduced incidence of respiratory
symptoms. However, there is a dearth of rigorously controlled research studies that have
systematically explored this matter among individuals who smoke cannabis.
An additional behavioral issue linked to cannabis intoxication is the possibility of
heightened anxiety or panic response. Similar to numerous adverse experiences involving
hallucinogenic substances, the typical response is characterized by apprehension
regarding the loss of agency and the possibility of prolonged deviation from the baseline
state. While individuals may present themselves for emergency medical care due to
anxiety induced by cannabis and may receive sedatives or tranquilizers, the optimal
approach is likely to employ "talking down" techniques. This involves reminding the
individual of their identity and surroundings, reassuring them that the reaction is
transient, and providing assurance that the situation will resolve. To mitigate adverse
reactions following the consumption of cannabis, it is advisable to consume smaller
doses, particularly for individuals with limited exposure to cannabis-derived products.
