What to take with marijuana to prevent drowsiness

Side effects: acute and long-term (5/7)

There are also individual aspects: the dose required for the psychoactive effects of cannabis to occur differs from person to person. Medicines with the active ingredients dronabinol, nabilone or THC can lead to the same side effects.

Even if the effects of cannabis as a drug and cannabis as medicine are in principle the same, findings cannot simply be transferred. This is related to the proportion of cannabinoids and the question of regulated use. In addition, the use of cannabis as a drug is often linked to the use of other illegal drugs and legal addictive substances such as alcohol and nicotine.

A distinction is made between acute side effects and those that can occur after long-term use. Without specific therapy, all acute adverse effects generally disappear within hours to one to three days.

Acute side effects

The effects of cannabis are mostly experienced as pleasant and relaxing. The perception changes, the sensitivity to pain decreases and an increased sense of well-being ("high" feeling) occurs. But the feeling can also give way to negative feelings.

The acute side effects of cannabis range from moodiness to depression, anxiety or panic, hallucinations or a feeling of loss of control. In addition, the acute psychoactive effects of cannabinoids can cause poor memory, reduced psychomotor or cognitive performance and impaired perception of temporal processes. Typical after cannabis use are, for example, thought disorders, which are mainly expressed in fleeting thinking.

Common physical side effects of cannabinoids include fatigue, dizziness, tachycardia (racing heart), drop in blood pressure, dry mouth, slurred speech, reduced tearing, muscle relaxation, and increased appetite. Rare undesirable side effects are also nausea and headaches.

The effect of cannabinoids on the blood vessels can increase the risk of heart attacks in pre-stressed people. In individual cases, cardiac ischemia or heart attacks have occurred after the use of cannabis.

However, there have been no reports of life-threatening complications or even deaths following the medical use of cannabis. Even after cannabis poisoning, there were no deaths.

Side effects after long-term use

After taking cannabis for a long time - even within weeks, sometimes even days - what is known as tolerance usually develops.

The effects on the psyche, the impairment of the psychomotor function or the effects on the cardiovascular system decrease. The effects on the endocrine system, intraocular pressure or against nausea are also reduced. This development of tolerance is one of the reasons why cannabis can be addictive. Those who consume cannabis in very high quantities over a long period run the risk of becoming psychologically dependent.

This may be insignificant during therapy for a serious illness, but withdrawal symptoms are still problematic. How intense withdrawal symptoms occur depends on the duration of consumption. They are similar to those that occur when someone suddenly quits smoking. These include insomnia, restlessness, irritability, decreased appetite, drooling, increased perspiration or diarrhea.

Risk of "cannabis psychosis"

In rare cases, prolonged use of cannabis can lead to schizophrenic psychosis. This is undoubtedly one of the most serious side effects and affects people who are predisposed to such mental disorders. Cannabis can therefore lead to a schizophrenic illness or to the onset of psychosis earlier.

This "cannabis psychosis" has been known for a long time. Current data suggest that cannabis use can double the risk of schizophrenia in adults. When used therapeutically, such disorders as well as the development of dependency have so far only rarely been observed.

Cannabinoids can also affect both male and female sex hormones. In women, cycles without ovulation have been described in individual cases, and in men impaired sperm formation.

Further consequences of the long-term use of medical cannabis cannot yet be assessed on the basis of the current study situation.

Cannabis and fitness to drive

Due to the effects described, cannabis consumption can impair the ability to drive. In principle, anyone who drives a car under the influence of cannabis is committing a crime and, among other things, loses their driver's license.

In this context, however, it is questionable how to deal with patients who receive cannabis as medicine. In April 2017, the federal government announced that cannabis patients are allowed to take part in road traffic if they are not restricted in their ability to drive. Conversely, this means that patients taking medicinal cannabis are not allowed to drive a car if they have not consumed the cannabis properly or if they cannot drive the vehicle safely.