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Chapter 3 - Flies in the Ointment

Cannabinoid Deficiency and the Reality of Addiction

from Section 1 - The Science of Marijuana and the Brain

Published online by Cambridge University Press:  31 March 2020

Timmen L. Cermak
Affiliation:
Private Practice of Psychiatry and Addiction Psychiatry, California
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Summary

The topic of marijuana addiction is emotionally charged. The two aspects of addiction—withdrawal symptoms unique to marijuana and alterations in the brain’s reward mechanism common to all addictive drugs—must be approached separately. THC’s stimulation of CB1 receptors causes a homeostatic reduction of receptor density, called downregulation. When THC stimulation wanes, the resultant relative lack of receptors leads to a transient deficiency of endocannabinoid activity. Hirnoven found a 20% reduction in endocannabinoid receptors in the cortex of individuals regularly using marijuana requiring 4 weeks of abstinence to be reversed. The effects of cannabinoid deficiency outlined by Budney include withdrawal symptoms of restlessness, anxiety, insomnia, boredom and irritability. Relapse to marijuana use often occurs to abort withdrawal symptoms. The influx of dopamine in the reward center (nucleus accumbens) caused by excessive cannabinoid stimulation is the sine qua non for addiction and leads to a neurologically based increase in the salience of marijuana. Modification of reward mechanisms increases the motivation to use marijuana to the point that cognitive rationality is clouded and denial is produced.

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Publisher: Cambridge University Press
Print publication year: 2020

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  • Flies in the Ointment
  • Timmen L. Cermak
  • Book: From Bud to Brain: A Psychiatrist's View of Marijuana
  • Online publication: 31 March 2020
  • Chapter DOI: https://doi.org/10.1017/9781108653428.005
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  • Flies in the Ointment
  • Timmen L. Cermak
  • Book: From Bud to Brain: A Psychiatrist's View of Marijuana
  • Online publication: 31 March 2020
  • Chapter DOI: https://doi.org/10.1017/9781108653428.005
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Flies in the Ointment
  • Timmen L. Cermak
  • Book: From Bud to Brain: A Psychiatrist's View of Marijuana
  • Online publication: 31 March 2020
  • Chapter DOI: https://doi.org/10.1017/9781108653428.005
Available formats
×