INTRODUCTION

INTRODUCTION:
CANNABIS INDUCED PSYCHOSIS:
People use drugs or alcohol to escape, relax, or reward themselves. Over time they can make you believe that you need them to enjoy life, or that you can’t cope without them, which can gradually lead to dependence and addiction.
The drug addiction in youth today is a world-wide problem and more common than one can imagine. Teens are trying alcohol, marijuana, cigarettes, and heroin etc. even before they have turned 15. Just like any adult addict, the brain-working and neuron patterns of young drug addicts also show the same changes. Once the drugs and substance abuse take over their mind, their personality gradually begins to deform in a very strange way. Teens constitute an important part of our society. Imagining them to fall into the trap of substance abuse at such young age only points towards the seriousness of this issue.
The most common causes of drug addiction in youth are mainly an urge to experiment and experience something new. Then, there is peer pressure, lack of communication between parents and teens, low self-esteem, and a tendency towards seeking pleasure. Genetics and family history of substance abuse also contributed to drug addiction in teenagers. After trying the drugs once, the cycle goes on. It becomes an involuntary process and giving in to the harmful urges becomes a natural habit. The biggest reason behind the inability of our young ones to get out the drug addiction is denial and secrecy amongst both teens and their parents.
A long exposure to habit-forming substance abuse gives birth to poor memory, low self-confidence, serious health troubles, and even violent behaviors. The addicted teenagers are also more prone to having accidents, mood swings, poor sleep, and developing psychological disorders like schizophrenia and bipolar syndrome. The drug abuse may happen at a crucial time of their career-making and ruin the future despite having brilliant talents. The regret, however, may not always be reversible, leading to mental breakdown and suicidal tendencies in the teenagers.
ICD-10 Criteria for addiction:
An addiction must meet at least 3 of the following criteria.
1. Tolerance. Do you use more alcohol or drugs over time?
2. Withdrawal. Have you experienced physical or emotional withdrawal when you have stopped using? Have you experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.
3. Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?
4. Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
5. Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?
6. Significant time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spent a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
7. Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?
SUBSTANCE ABUSE:
Substance abuse, also known as drug abuse, is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others, and is a form of substance-related disorder. Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behavior occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well.5 In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
Signs and symptoms of substance abuse:
Depending on the actual compound, drug abuse including alcohol may lead to psychosis, health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.
Cannabis may trigger panic attacks during intoxication and with continued use, it may cause a state similar to dysthymia.22 Researchers have found that daily cannabis use and the use of high-potency cannabis are independently associated with a higher chance of developing schizophrenia and other psychotic disorders. In most cases drug induced psychiatric disorders fade away with prolonged abstinence.
DEFINITION OF DRUG INDUCED PSYCHOSIS:
Drug induced psychosis is a psychotic state caused by an excessive dose of both illegal and therapeutic drugs. This is supported by the West Australian Department of Health WADOH who defines stimulant-induced psychosis, as an episode where the use of a legal or illicit drug has caused a psychiatric illness where the reality of the patient is impaired. The impairment of the patient can also include hallucinations or delusions, which can cause additional communication problems or social interaction difficulties. The drug induced psychosis according to WADOH (2009) may also be as a result of the overuse or abuse of prescription medication, or the outcome of a history of illicit drug abuse.
CANNABIS SUBSTANCE ABUSE:
Cannabis is a genus of flowering plant that includes one or more species. The plant is believed to have originated in the mountainous regions just north-west of the Himalayas in India. Cannabis sativa male plants show evidence of selection for traits that enhance fiber production and seed-oil (for fuel) but the female plant produce seeds (for food) and flower buds that can be used as a psychoactive substance because it has higher levels of the psychoactive delta-9-tetrahydrocannabinol (THC), whereas Cannabis indica was primarily selected for drug production and has relatively higher levels of cannabidiol (CBD) and Cannabinol (CBN) than THC.
Traditional herbal cannabis contains between 1 and 15 per cent of the main psycho-active ingredient, THC. Some of the newer strains, including skunk, contain up to 20 per cent, so can be 3 times as strong as traditional cannabis. It works more quickly, and can produce hallucinations with profound relaxation and elation – along with nervousness, anxiety attacks, projectile vomiting and a strong desire to eat. They may be used by some as a substitute for Ecstasy or LSD. Recent research in Europe, and in the UK, has suggested that people who have a family background of mental illness – so probably have a genetic vulnerability anyway – are more likely to develop schizophrenia if they use cannabis as well.
There is growing evidence that people with serious mental illness, including depression and psychosis, are more likely to use cannabis or have used it for long periods of time in the past. Regular use of the drug has appeared to double the risk of developing a psychotic episode or long-term schizophrenia.
When cannabis is smoked, its compounds rapidly enter the bloodstream and are transported directly to the brain and other parts of the body. The feeling of being ‘stoned’ or ‘high’ is caused mainly by the delta-9-THC binding to cannabinoid receptors in the brain. A receptor is a site on brain cell where certain substances can stick or “bind” for a while. If this happens, it has an effect on the cell and the nerve impulses it produces. Curiously, there are also cannabis-like substances produced naturally by the brain itself – these are called endocannabinoids.
Biochemical Effects :-
The most prevalent psychoactive substance in cannabis is delta-9-tetrahydrocannabinol (commonly called ch9169-THC, or simply THC). In the past two decades, the average content of THC in marijuana sold in North America has increased from about 1% to 3-4% or more.
One of the primary effects of marijuana in humans is the disruption of short-term memory, which is consistent with the abundance of CB1 receptors on the hippocampus. The effects of THC at these receptor sites produce what is called a ‘temporary hippocampal lesion.’ 3 As a result of this lesion, several neurotransmitters like acetylcholine, norepinephrine, and glutamate, are released that trigger a major decrease in neuronal activity in the hippocampus and its inputs. The total duration of cannabis intoxication when smoked is about 1 to 4 hours.
Behavioral effects:-
It is sometimes observed, and generally stereotyped, that systematic changes in a person’s lifestyle, ambitions, motivation, and personality happen when a young person starts smoking marijuana. In fact, in many situations when people are asked to describe the personality traits of a marijuana user, they will most likely portray a person of apathy or loss of effectiveness: a person with diminished capacity or willingness to carry out complex long-term plans, endure frustration, concentrate for long periods, follow routines, or even successfully master new material. Marijuana use can just as easily be seen as the result of such a personality shift as it can be the cause of it. Regardless, studies to raise this and other questions, like the prevalence of such ‘syndrome’ in the population, and proving a biological or psychological connection of the ‘syndrome’ to substance use, have not happened. Instead, a political tug of war has ensued with each point of view claiming their own scientific research as evidence.
Similarity of symptoms:-
There is a classification of psychosis within the DSM-IV called ‘cannabis psychosis’ which is very rare. In susceptible individuals, ingestion of sufficient quantities of the drug can trigger an acute psychotic event. It should be noted that the extent of a subject’s experience with cannabis is a strong factor determining susceptibility.
A Yale research study notes that subjects administered pure delta-9-THC induced transient symptoms which resemble those of schizophrenia ‘ranging from suspiciousness and delusions to impairments in memory and attention’. There were no side effects in the study participants one, three, and six months after the study. Cannabis use appears to be neither a sufficient nor a necessary cause for psychosis. It might be a component cause, part of a complex constellation of factors leading to psychosis, or it might be a correlation without forward causality at all. Similar correlations can be drawn between cannabis usage and cancer, for instance, because those who suffer from cancer may be more likely to use cannabis due to the pain relief it provides.