Cannabis acute and chronic effects – the dutch experience

Abstract

Introduction: Historically, the policy on cannabis use in The Netherlands differs from that in many other countries. It is prudent to evaluate this policy at regular intervals, and in 2008 the Dutch Coordination Centre for the Assessment and Monitoring of drugs (CAM) performed a risk assessment on cannabis use in the Netherlands. This includes health risks, and risks related to public order and involvement of organized crime. Special attention was paid to the risks of cannabis with high THC concentrations, the role of cannabis in the development of psychiatric disorders, and the observed increase in addiction care demands.Results: The acute toxicity of cannabis is low. Acute effects include nausea, vomiting, hypotension, tachycardia, “stoned” feeling and drowsiness. Cannabis users smoking cigarettes containing high THC doses (up to 69mg), mixed with tobacco, showed linear relationships between THC dose and THC serum concentration. There is large inter-individual variability in THC Cmax, mainly related to differences in THC absorbed fraction and possibly to differences in metabolism. Heart rate, cognitive and psychomotor impairment, and subjective effects increase with increasing THC dose. Cannabis use is associated with impaired memory function, but the mechanism needs further clarification, as does the question of recovery of memory function. Cannabis use can contribute to the onset of psychotic disorders, especially in vulnerable and young individuals who have already experienced psychotic symptoms or have a family history of psychotic disorders. It has been associated (although not consistently) with a slight increase in the risk for depression. Some cannabis users become dependent. At present, there is lack of scientific evidence that high THC dose contributes to the increased demand of addiction care.Conclusion: Increased awareness in young people on the health risks associated with the use of cannabis is necessary.