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Galen College of Nursing *
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Nursing
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Apr 29, 2024
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Cannabis Use Disorder: Clinical Profile and Treatment Approaches
1. Diagnostic Criteria for Cannabis Use Disorder
Cannabis Use Disorder (CUD) is characterized by a problematic pattern of cannabis use leading to clinically significant impairment or distress as manifested by at least two of the following criteria within a 12-month period (according to the DSM-5):
Cannabis is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects. Craving, or a strong desire or urge to use cannabis.
Recurrent cannabis use results in a failure to fulfill major role obligations at work, school, or home.
Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
Important social, occupational, or recreational activities are given up or reduced because of cannabis use. Recurrent cannabis use in situations in which it is physically hazardous.
Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
Tolerance, as defined by either of the following: a need for markedly increased amounts of cannabis to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of cannabis.
Withdrawal, as manifested by either the characteristic withdrawal syndrome for cannabis or cannabis (or a closely related substance) is taken to relieve or avoid withdrawal symptoms (Patel & Marwaha, 2019).
2. Street Names of Cannabis
Common street names for cannabis include Weed, Pot, Grass, Herb, Ganja, Mary Jane, Bud, Green, Reefer, Trees, and Dope.
3. Methods of Use
Cannabis can be used in various forms, including:
Smoking: Includes joints, blunts, pipes, and bongs.
Vaporizing: Using vaporizers to inhale cannabis vapors.
Oral ingestion: Through edibles such as cookies, brownies, and candies.
Topical application: In creams and oils absorbed through the skin.
Dabbing: Smoking highly concentrated cannabis (dabs) using a special rig.
4. Symptoms of Intoxication
While under the influence of cannabis, individuals might exhibit:
Altered senses (e.g., seeing brighter colors)
Altered sense of time (slowing down)
Mood changes (elevated mood, relaxation)
Impairment in body movement
Difficulty with thinking, problem-solving, and memory
Hallucinations and paranoia (especially with high doses)
(Archie & Cucullo, 2019)
5. Withdrawal Symptoms
Symptoms of withdrawal from cannabis may include but are not limited to:
Irritability
Mood and sleep difficulties
Decreased appetite
Restlessness
Various forms of physical discomfort
Cravings for cannabis
6. Treatment Recommendations
First-line Treatment Options:
Behavioral therapies such as Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and Contingency Management (CM) are considered first-line treatments for CUD.
FDA-Approved Medications:
There are currently no FDA-approved medications specifically for the treatment of Cannabis Use
Disorder. However, off-label medications such as gabapentin have shown promise in reducing symptoms. (National Institute on Drug Abuse, 2020).
Mechanism of Action for Gabapentin:
Gabapentin is thought to work by affecting GABA neurotransmitter release and reducing neuronal excitability, which may help alleviate withdrawal symptoms and reduce cannabis use (Lile et al., 2023).
Common Side Effects of Gabapentin:
Dizziness
Fatigue
Visual disturbances
Ataxia
Weight gain
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