Motivation and emotion/Book/2015/Cannabis and negative emotions

Overview


The focus of this chapter is on how cannabis affects negative emotions. Firstly, the chapter looks at cannabis in detail and what it is, it then focuses on the prevalence of cannabis use around the world. After which it takes an in depth look the effects of cannabis both short term and long term positive and negative effects. It then looks at the main topic of the chapter which is the effect of cannabis on negative emotion and explores negatives emotions such as; psychosis, depression, paranoia and finally anxiety. Finally, to finish off it the chapter explores how cannabis abuse can be over come with various cognitive behavioral therapies.

What is cannabis?
Cannabis is derived from the plant cannabis sativa. It grows in many tropical areas of the world, one of the major ones being Jamaica, although can be cultivated in almost any climate. The main active ingredient in cannabis are delta-9-tetrahydrocannabinol or more simply THC and Cannabidiol or CBD (Nordqvist, 2015). Cannabis has various other names such as; ganja, grass, hashish, Hemp, Mary Jane, hyrdro, marijuana, pot, reefer, weed (Anderson, 2015; Nordqvist, 2015). There are 3 main uses for cannabis: * Marijuana * Hashish * Hash oil

Marijuana is made using dried leaves from the cannabis plant, it is the least potent of the 3 cannabis products and is usually smoked by means of rolling it into joints or water pipes known as bongs. Hashish on the other hand is made from resin, a gum like secretion of the cannabis plant. It's mainly pressed into small blocks used for smoking and in some cases used in cooking. Finally, hash oil is the most potent of the 3 and is an oil acquired hashish (Anderson,2015).

Prevalence
Despite being illegal in most countries including Australia, cannabis is still the most commonly and widely used substance. In 2005 alone it was estimated that 160 million people worldwide used cannabis. As shown in figure (1) Australia is considered the country with the highest rate of cannabis use in the world. According to the Australian drug foundation, nearly half of all Australians 14 and over have used cannabis one of more times. 14.8% of 12-17 year old's have used cannabis, which is by far the most commonly used illegal substance in that age group. With cannabis being so prevalent in Australian society these days,incidences where paramedics have been needed has doubled since 2012-2013 (Ware et al, 2015). Cannabis is not only highly prevalent in Australian society it is very wide spread and is very quickly becoming the world's most commonly used drug.

As demonstrated by Sydow et al (2001),a prospective longitudinal study was conducted on cannabis use and disorders on 2446 individuals aged 14-24. The results of the study following a 42 month follow up indicated participants aged 14-17 had increased their cannabis use from their initial baseline than the older participants. Despite cannabis being highly prevalent in society it is mostly used and abused by younger individuals.

Short-term negative effects
There are numerous negative short term side effects of cannabis, these include
 * Panic and Paranoia
 * Amnesia, confusion, psychosis
 * Mania
 * Memory temporarily impaired
 * Increase in heart rate
 * Dizziness, loss of balance, feel weakened
 * Lethargic
 * Loss of concentration
 * At times slurred speech

Short-term positive effects
Despite having numerous short-term negative side effects cannabis has its fair share of positive short-term side effects as well, these include:
 * Euphoria, Intoxication
 * Relaxation and decreased anxiety
 * Talkativeness, feeling amused
 * Altered perception of time
 * Experiences intensify
 * Increased appetite

Long-term positive effects
Research has shown that there are benefits linked to smoking cannabis in the long run. Those who smoke cannabis have shown decreased levels of pain and muscular problems. Pain can be treated simply by smoking and without the use of pharmaceuticals. One of the more remarkable properties of cannabis is reducing certain types of cancers and tumors, these include:
 * Testicular
 * Glioma
 * Head and neck cancer

Cannabinoids, which are compounds found in cannabis that aid in the reduction of cancers ans tumors. In a study conducted by Rocha et al (2008) saw cancer patients undergoing chemotherapy receive cannabinoids. The purpose of giving patients the compound was to reduce nausea and vomiting caused by the chemotherapy. The study showed that patients receiving cannabinoids had reported reduced levels of nausea and vomiting. It is evident from the current study that cannabis does aid in and assist individuals with cancer.

Long-term negative effects
Unlike short-term effects long-term negative side effects have proven to be extremely harmful to the body, not only physically but also mentally. The main reason behind why long term is a lot more damaging than short term is because an individual can develop tolerance for the substance. Once tolerant to cannabis is can become difficult to get off it and in turn causing cannabis withdrawals. Withdrawals of long term cannabis use include:
 * Craving of cannabis
 * Trouble sleeping
 * Excessive sweating
 * Loss of weight
 * Decrease in appetite
 * And in some serious cases anxiety and depression

Long-term cannabis use also affects the brains memory and reading abilities these include; inability to concentrate, focus, retain and process information and decreased overall mental capacity (decreased math/verbal skills). In addition to having withdrawals and lack of brain functioning, the affects of cannabis extend to other parts of the body including the respiratory, reproductive and immune systems. Most common effects include:
 * Increased risk of cancer
 * Impaired immune system
 * Risk of constant lung infections
 * Panic disorder
 * Negative impact to male and female fertility
 * Coughing and wheezing
 * Altered hormones and disrupt menstruation cycles in females

Psychosis


Despite having its clear benefits cannabis use can trigger or sometimes have severe negative effects. Research conducted on the effects of cannabis use and individuals with preexisting psychotic symptoms showed that the conditions of these individuals can worsen with the use of marijuana. Even in some cases it can bring about psychotic symptoms in people who are inclined to psychosis or have a family history of it.

But what is psychosis? It is usually a group of illnesses that disrupt the everyday functioning of the brain which, in turn causes psychosis. Symptoms of this illness include; confused thinking, delusions and hallucinations. The exact causes of psychosis are not fully understood, although it is known that marijuana can trigger the first episode.

Individuals with a pre-existing psychotic disorder, cannabinoids can aggravate symptoms, trigger relapse, and have negative consequences on the course of the illness. Patients with schizophrenia can precipitate a schizophrenic episode and heavy users of cannabis have an increasingly high chance of developing schizophrenia in the near future (Thornicroft, 1990). In a study conducted by McGuire et al (1995)patients who tested positive for cannabis use via a urine test were then also tested for their potential development of psychosis. It was found from the study that recurrence or development of psychosis was as a result of genetic predisposition to schizophrenia.

Treatment to overcome or reduce the effects of cannabis include a combination of medication and community support. Their are certain medication that help restore the chemical balance in the brain which in turn reduces the symptoms. Community support programs usually involve rehabilitation and mutual support groups.

Heavy users of cannabis have high chances of developing schizophrenia which can then lead onto future complications such as psychosis.

Depression


Depression is an extremely common illness worldwide and its estimated that over 350 million people world wide suffer from it. In addition to that 800,000 people commit suicide yearly due to depression. Feelings of extreme sadness, worthlessness and hopeless are all associated with depression and it can affect anyone at anytime during their life. Although individuals who use cannabis are more susceptible to depression. There has been sufficient evidence that correlates with cannabis use and developing mental illness such as depression later in life (Moore et al, 2007).

Degenhardt et al (2003) from their study found that heavy users of cannabis are more likely to suffer from depression than individuals who don't use cannabis. In addition those with pre-existing depressive symptoms or those who have a family history of depression may trigger an onset of depression if cannabis is used. In his study Bovasso (2001)ran a study with 2 groups of people, those with depressive symptoms and those without. These participants were then required to use cannabis. At the end of the study it was found that those who had pre-existing symptoms were four times more likely to have developed depression. It is evident from the study that cannabis definitely acts as a catalyst for the onset of depression.

Paranoia
It is strongly argued whether paranoia is considered to be an emotion. Almost certainly paranoia is associated with negative emotions of feeling anxious and at times afraid. So in simpler terms what is paranoia? Its considered to be a state of mind in which an individual believes that someone is trying to harm or conspire against them. One of the most common attributes of paranoid people are that they have an inflated ego and believe that many people notice them when that might not be the case. Mild forms of paranoia are fairly common among people and tend to go away by itself. Although long-term paranoia is far more severe form of mental disorder and it's main cause it recreational drugs such as cannabis.

Excessive use of cannabis causes paranoid thoughts which in turn can trigger an episode of psychosis. The link between cannabis and paranoid thoughts were tested by Freeman and Freeman (2014) in their study. 121 volunteers were selected for the study all of which had used cannabis in the previous month and had experienced a degree of paranoia. The participants were divided into 2 groups on one which received a dosage of THC which is the main active ingredient in cannabis and the other group received a placebo. It was found from the study that half of those who had received the THC experienced paranoia whereas only 30% of those in the placebo group experienced it. It is clearly evident from the study that despite only receiving a small dosage of THC the chances of paranoia are dramatically increased. In a similar study conducted by ware et al (2003) subjects who had previously used cannabis were recruited and asked to partake in a survey. After completion of the survey it was found that majority of participants had experienced paranoia whether it was mild or severe due to cannabis smoking.

Paranoia can be extremely difficult for an individual as it can lead to other major mental disorders such as anxiety.

Anxiety
Anxiety is a major form of mental illness that affects thousands of individuals a year. Many people think anxiety is feelings of stress or worry. Feelings of anxiety are really common when under stress, though those feelings subside once the stressful situation is gone. Anxiety is much more than feeling stressed or worried, it's where the anxious feelings don't go away even after the stressor has been removed. It becomes difficult for an individual to cope with anxiety and eventually disrupts their daily functioning. It is estimated that in the US alone 15.7 million people yearly suffer from anxiety disorders (Pierre, 2002). One of the biggest contributors to anxiety is cannabis abuse.

Though is it proven that cannabis increases the risk of anxiety? Patton (2002) conducted a study addressing that exact question. His sample contained 1,601 students from high schools around Australia. The anxiety levels of the students were measured. It was found that the students who had used cannabis had higher rates of anxiety than those who didn't. In addition to that daily users of cannabis were found to be at risk of developing more severe mental illnesses such as depression in the future. In a similar study conducted on university students by Tounier et al (2003) in relation to developing anxiety due to smoking marijuana found that those who regularly smoked or used cannabis increased their chances of developing anxiety which in turn could lead to psychosis.

The theory of planned behaviour
This Theory was first originated in 1980 by Ajzen and Fishbein, it suggests that behavioural intent is the key component of the theory and that the intentions are influenced by the attitude that the behaviour will have the expected outcome and the evaluation by the individual of the dangers or rewards of the outcome (Conner &Norman, 1996).

There are 3 concepts to TPB; attitude towards behaviour, subjective norms and perceived behavioural control all of which influence an individual’s attitudes and that in turn predicts a behaviour. Attitude relates to an individual’s beliefs about a desired behaviour, subjective norm is what a significant other thinks of the behaviour and whether that impacts you, and finally perceived behavioural control is how easy it is to perform the behaviour (Ajzen, 1991).

Relating this to cannabis use individuals attitudes towards cannabis use are influenced by external forces such as peer pressure and in some cases the media. Perceived behavioural control on cannabis use shows how easy it is these days to get your hands on illegal substances. On the other hand, individuals who use cannabis do it without the knowledge of a significant other as they fear their actions will not be supported. Therefore the TBP does explain the intentions behind cannabis use and abuse.

Treatments
Addiction and abuse to marijuana is similar to other substance abuse although the long term implications are less severe. Those who seek advice and help with their marijuana abuse are those individuals who have used and abused the substance for nearly every days for more than 10 years, these individuals other wise known as 'pot heads'. Those that do have an abuse problem suffer from other psychiatric disorders such as; psychosis, depression, anxiety and paranoia. Medications and available behavioral therapies are the most common form of help sought out by individuals. Although, these days medication for substance abuse especially that of cannabis is seen as a last resort, behavioral therapies are proven to be most effective.

Cognitive-behavioral therapy
Cognitive behavioral therapy (CBT) is a form of psychotherapy that teaches individuals to identify and correct their behavior in order to better themselves and over come their drug abuse. It not only focuses on helping overcome substance abuse it also helps better manage and eventually eliminate any other problems that may be arose from taking drugs.

Contingency management
The main focus of contingency management is to reinforce the an individual with positive rewards when the desired behavior is achieved and removing a stimulus as punishment if a desired behavior is not achieved. The principles of contingency management are that of operant conditioning, that is changing a behavior by the use of reinforcement until the desired behavior is achieved. So how does this apply to substance abuse?

When substance abusers are sent to contingency management programs many clinicians use a technique called confrontation and when the patients fail to comply with the rules of the program they get discharged. This is a from of negative reinforcement in most cases in works in favor of the clinicians and patients do follow rules and complete the program. A form of positive reinforcement that is sometimes used in these programs is patients who are allowed to take home methadone, for more severe case of drug abuse. This is where the trust worthiness of the patients are tested. Like the negative reinforcement most of the time this technique is successful (Petry, 2002).

Motivational enhancement therapy
Motivational enhancement therapy (MET) is thought to be the most self-initiated therapy. It's based the concepts of motivational psychology and the main focus is to invoke rapid internal change in the individual. Unlike most therapy that guides the an individual every step through recovery, MET aims to utilize the clients own sense of motivation to get over their substance abuse.

MET comprises of 4 individual sessions. The first two sessions concentrate on feedback from the initial assessment, plans for the client, and motivation that’s needed for change. The 2 final sessions, which happens half way through the program and a final one at the end, give a chance for the therapist to reinforce motivation, inspire revaluation, and provide an unbiased opinion on their process of change.

Conclusion
Marijuana or otherwise known as cannabis is plant that grows really well in tropical climates. It is quickly growing to be one of the most widely used drugs in the world among teenagers. There are various short term and long term negative and positive side effects with cannabis use. Although, the negative effects it has on emotions outweigh those of positive. It causes psychosis which is as a result of a group of mental illnesses, in addition to that it also causes depression which is a fast growing mental illness in the world. Furthermore it contributes to paranoia and anxiety. There are ways to seek help if an individual is seen as having substance abuse associated with cannabis there are various therapies such as CBT, contingency management and MET which offer help. With individuals being exposed to drugs such as cannabis from a very young age it is vital to be educated on the negative consequences associated with cannabis use and how it may affect a person later in life.



{What is another name for cannabis?
 * type=""}

- Marijuana - Ganja - Kush + All of the above
 * Cannabis has a variety of street

{In 2005 how many individuals worldwide used cannabis?
 * type=""}

+ 150 million - 200 million - 125 million - 100 million
 * There were approximately 150 million people worldwide

{What are some short term negative side effects of cannabis use?
 * type=""}

- Temporary blindness - Hallucinations - Loss in weight + Mania, Loss of concentration, slurred speech, lethargic
 * There are various short term negative side effects associated with cannabis use

{What are some positive long term effects of cannabis?
 * type=""}

+ Helps with prevention of certain types of cancer - Helps with concentration - Improves memory - Assists with appetite
 * Prevents certain types of cancer, such as testicular, glioma and head and neck cancer

{Schizophrenia can lead to?
 * type=""}

- Depression - Anxiety + Psychosis - Paranoia
 * Leads to psychosis

{How many people worldwide suffer from depression?
 * type=""}

- 200 million - 375 million - 300 million + 350 million
 * 350 million people worldwide suffer from depression each year and 800,000 commit suicide because of it

{What is the cause of paranoia?
 * type=""}

+ Excessive use of recreational drugs - Using cannabis once - It's just a state of mind - None of the above
 * Excessive use of recreational drugs such as cannabis

{How many individual suffer from anxiety in the U.S.?
 * type=""}

- 20 million - 14 million - 34 million + none of the above
 * none of the above 15.7 million people in the U.S. suffer from anxiety

{What is the most effective treatment for cannabis abuse?
 * type=""}

+ Behavioral therapies - Medication - Interventions - Shock Therapy
 * Behavioral therapies, such as cognitive behavioral therapy, contingency management and motivational enhancement therapy.