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A comparison of Marijuana and Alcohol

…medicinal uses for marijuana: reducing nausea for chemotherapy patients, appetite stimulation for people with cancer and AIDS, reducing intraocular pressure in glaucoma patients, helping people with spasticity of multiple sclerosis, and much more (Voth, 1997).

After the ingestion of alcohol it moves into cell membranes and increases the fluidity. It quickly moves into the blood, passes through the blood brain barrier, and binds to GABA-A, which causes cells to become hyperpolarized, decreasing the number of action potentials occurring in the brain. Another way that alcohol affects the GABA systems is by inhibiting the downregulation of GABA, which functions to increase the alcohol related effects. The main psychoactive effect of alcohol is as a CNS depressant, but alcohol also has other effects. Most areas become less active, but some areas of the brain become more active since the inhibitors of those areas are now inhibited. It can cause people to feel uninhibited, relaxed, cheerful, warm, social, talkative, dizzy, confused, disorganized, uncoordinated, and more. (Chastain, 2006).

The effects of marijuana are mediated by cannabinoid receptors linked to G proteins. There are two known types of cannabinoid receptors, and possibly more. CB1 receptors are responsible for the psychoactive effects of marijuana, and are found mostly in the brain, with especially high densities in the hippocampus, cerebellum, and striatum. Marijuana causes users to experience distorted perception of the senses, loss of coordination, decrease in memory and learning skills, decrease in problem solving, and sometimes anxiety and paranoia (Van Vliet, 2000).

Alcohol exerts most of its effects through GABA, but also activates other neurotransmitter systems. It has also been shown that alcohol increases dopamine transmission in the mesolimbic pathway, and that dopamine release will produce reinforcement for the behavior, and possibly addiction. Dopamine release to the nucleus accumbens causes the downstream activation of opioid receptors, and feeling of pleasure. Alcohol also reduces the effectiveness of glutamate activity, especially at NMDA receptors (Chastain, 2006). Marijuana on the other hand exerts its effect mainly through CB1 receptors. CB1 receptor activation is known to affect cognition and memory, motor functions, pain perception, appetite, mood, and more. After a CB1 receptor is engaged multiple intracellular pathways are activated, one of which activates the G protein Gi resulting in inhibition of the enzyme adenylate cyclase, leading to less production of the second messenger cyclic AMP. CB1 activation also affects potassium ion channels, calcium channels, protein kinase A and C, Raf-1, ERK, JNK, and more (Van Vliet, 2000).

Alcohol and marijuana vary considerably on their addiction potential. Alcohol has a moderately high addiction potential. It is considered physically and psychologically addictive. Alcohol withdrawal is one only a few types of drug withdrawals that can kill you. After someone has drank alcohol for a long period of time their brain adapts to having excess amounts of GABA receptor activation, which is inhibitory. If the person quits drinking they can die from having an excess level of excitatory glutamate neurotransmitters. People continue to argue about how addictive marijuana is. Marijuana does not cause severe withdrawals, although heavy users report irritability, sleeplessness, and anxiety if they don’t use for an extended period of time. However most marijuana smokers do not consider themselves addicted; many marijuana smokers only use the drug occasionally, and report few or no cravings (Chastain, 2006).

The typical alcoholic and marijuana smoker are quite a bit different. Alcohol is consumed and accepted in society by people 21 and over in the US, 18 and older in most countries. Alcoholics come in all genders, ages, and classes. One thing many alcoholics share in common is the use of alcohol as a mechanism for dealing with stress, when something stressful happens in their lives they turn to alcohol as a coping mechanism. People tend to drink more when they reach legal drinking age, and first have the opportunity to go out in public drinking. One group of people who typically consume a lot of alcoholic beverages is college students. Alcoholics who are older might suffer from korsokoff’s disease, where they tend to fabricate stories which they perceive as real themselves. The typical marijuana smoker is often portrayed as a lazy, unemployed, with long hair, a tie-dye shirt, watching TV, with a bag of chips or some kind of munchies. Similar to alcohol abusers it is difficult to define a typical marijuana smoker. Most marijuana smoker are young. Nine out of ten marijuana smokers are less than 40 years old. Most marijuana smokers are in college, working, or in high school. Some people use marijuana to relieve symptoms of serious diseases or conditions. Some use marijuana to cope with issues, or to relax, or for other reasons. The typical marijuana user is different depending on which group of marijuana users you are talking about (Infofacts).

Differences in genetics of Cytochrome P450 (CYP450) enzymes relate to a person’s addiction potential for alcohol. There are two CYP450 enzymes that relate to alcohol metabolism, they are alcohol dehydrogenase (ADH), and aldehyde dehydrogenase (ALDH). The enzyme ADH converts alcohol in the body to aldehyde. Aldehyde is a toxic metabolite of alcohol, it doesn’t have any psychoactive properties, and is responsible for some of the sickness and hangover experienced after drinking. ALDH is the enzyme that breaks down and converts aldehyde to harmless carboxylic acids. Genetics determine levels of both enzymes; some peoples’ enzymes work faster or slower to break down alcohol. Women genetically have 50% less ADH than men, meaning when they drink they will have the psychoactive drug in their systems longer and get more intoxicated from the same amount of alcohol. The speed of the ALDH enzymes influences how much sickness someone experiences, the severity of hangovers, and how toxic alcohol is for an individual. People who have a slow ADH and fast ALDH are more likely to become addicted than someone with fast ADH enzymes, and slow ALDH enzymes, which is the least likely type of person to become an alcoholic. Besides the genetics I mentioned above, there are social, cultural, and psychological things that contribute to a person becoming addicted (Crabb, 2004). Much less information is available on how someone become addicted to marijuana. The underlying neurobiology is what makes someone likely to become addicted, but the specific biology, links to personality types or traits have not been established. Some typical environmental influences that increase the changes of someone using drugs include: availability of the drug, and use among peers. The first step in addiction is using and liking of the drug. After someone has used a drug for a period of time they may begin to become dependent on it whenever they experience stress or problems in life, this process can lead to psychological dependence for marijuana (Jones, 1981).

The occurrence of binge drinking for adults aged 18 to 25 was 41.8% in past 30 days. Heavy alcohol use was reported by 14.7% of 18 to 25 year olds over the past 30 days (Office, 2007). An estimated 17 million people did heavy drinking in the last 30 days. Over 100,000 deaths are linked to alcohol each year. Many of the deaths are from automobile accidents. Half of all fatal automobile accidents involve alcohol (Nels, 2001). Almost 15 Million Americans use marijuana at least once in the past month. Everyday about 6000 Americans try marijuana for the first time. An estimated 41% of Americans have tried marijuana, and the rates might be higher since people are reluctant to report using an illegal drug. There isn’t very much information about the negative effects of marijuana on society, health care, families, etc (Infofacts).

For Alcohol the most important neuroadaptations relate to GABA and glutamate. When someone uses alcohol it activates GABA (inhibitory) receptors. The brain adapts to this by increasing the levels of glutamate (excitatory) to balance out the high GABA levels. If someone who is a chronic alcohol user stops there will be an imbalance of excitatory over inhibitory activation. It the imbalance is large enough the person can go into seizure and could die. If an alcoholic goes to treatment they will often be given barbiturates (inhibitory) to keep from having seizures while their high levels of glutamate activation are slowly decreased over a period of time. Marijuana neuroadaptations aren’t nearly as dangerous as they are for alcohol. Chronic marijuana use will lead to decreased amounts of CB1 and CB2 receptors. After the person stops using marijuana they will temporarily have less CB1 and CB2 activation than someone who never used marijuana. They will have less activation of all the various things that the CB1 and CB2 G proteins activate, they will experience marijuana withdrawals (Van Vliet, 2000).

Marijuana withdrawal symptoms include irritability, sleeplessness, sweating, nausea, tremors, loss of motivation, depression, and weight loss. Marijuana withdrawal symptoms are not considered very severe compared to withdrawals from most other psychoactive drugs. Alcohol withdrawal on the other hand can be very serious, leading to seizures and death in some cases. Alcoholics during withdrawal will often be shaky since they have excess excitatory glutamate. They can have trouble sleeping, eating, experience nausea, headaches, anxiety, confusion, disorientation, hallucinations, or delirium tremors. The extent of alcohol withdrawal relates to how much alcohol they typically consumed and for how long a period of time they consumed that much alcohol (Jones, 1981).

Withdrawal symptoms for alcohol are typically treated with barbiturates. Alcohol and barbiturates are both depressants, both are cross tolerant with each other. Barbiturates are given to the person to slowly decrease the levels of glutamate so that the person does not have a seizure. Alcohol is not given to the person because they have associations and cues tied to alcohol that aren’t to barbiturates. If the person was given alcohol to drink it would make them want more and cause them psychological distress, which barbiturates hopefully won’t do. Barbiturates are also used to decrease the severity of withdrawal symptoms for addicts who aren’t at risk for seizures. Cravings can be managed with drugs, addicts are taught to avoid high risk situations, and in some programs they have mentors to talk to, phone numbers to call for support, and other techniques to use. Abstinence is supported by teaching coping skills, risk assessment, and utilizing long term support groups, contact with sponsors, and use of online support programs (Mayo-Smith, 2004). Marijuana withdrawal is typically not severe enough to warrant taking drugs to combat withdrawals. There are not very many techniques designed to treat marijuana withdrawal symptoms. Most marijuana users are advised to do things like exercise in order to manage cravings, although there are cognitive behavioral therapy techniques designed for marijuana addiction. Sometimes anti-anxiety medication is prescribed to help people experiencing marijuana withdrawal. Abstinence is supported through support groups, high risk situation avoidance, learning of coping skills, online support groups, and more (Jones, 1981).

Marijuana and alcohol are both very commonly used drugs. Alcohol is a more dangerous drug in many ways than marijuana, yet alcohol is legal and marijuana illegal. Alcohol shows much more addiction potential than marijuana, and has a lot more severe withdrawal symptoms than marijuana. The withdrawal symptoms from alcohol can kill you, while marijuana will simply make you irritable. 100,000 people a year die from alcohol related deaths. The number of deaths marijuana contributes to is unknown, but it is considered to be considerably less than 100,000 people a year. Alcohol, in the process of being metabolized, is broken down into aldehyde, which is toxic to the body; marijuana does not contain anything that is toxic and doesn’t get metabolized into any toxic metabolites. One of the most dangerous things about marijuana is related to the fact that most people smoke it, and smoke is never good for your body. Marijuana is useful for treating the symptoms of a number of serious medical conditions, therefore it is beneficial for patients that marijuana is now available for medicinal use in many states. Written for web420.com Psychedelic Blog by Robert Stigers.

References

9,000-Year History of Chinese Fermented Beverages Confirmed by Penn Museum Archaeochemist. Retrieved May 18, 2008, from The University of Pennsylvania Museum web site: http://www.museum.upenn.edu/new/research/Exp_Rese_disc/masca/jiahu/jiahu.shtml

Crabb, David W., et al (2004). Overview of the role of alcohol dehydrogenase and aldehyde dehydrogenase and their variants in the genesis of alcohol-related pathology. Proceedings of the Nutrition Society. 63, 49-63.

Chastain, G. (2006). Alcohol, neurotransmitter systems, and behavior. The Journal of general psychology. 133 (4): 329–35.

Ericson, Nels. (2001). Substance Abuse: The Nation’s Number One Health Problem. US Dept. Of Justice Newsletter. 17.

Gillman, W. M., et al. (1995). Relationship of alcohol intake with blood pressure. Hypertension. 25, 1106-1110.

Hong-En Jiang., et al. (2006). A new insight into Cannabis sativa (Cannabaceae) utilization from 2500-year-old Yanghai tombs, Xinjiang, China. Journal of Ethnopharmacology. 108 (3): 414 – 422.

Infofacts: Marijuana. (n.d.). Retrieved May 18, 2008, from http://www.nida.nih.gov/infofacts/marijuana.html

Jones, R., et al. (1981). Clinical relevance of cannabis tolerance and dependence. Journal of Clinical Pharmacology. 21: 143-152.

Kopper, L., et al. (2005). Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies. Diabetes Care. 28, 719-725.

La Porte, R., et al. (1985). Coronary heart disease and total mortality. Recent developments in Alcoholism. 3, 157-163.

Lipton, R. I. (1994). The effect of moderate alcohol use on the relationship between stress and depression. American Journal of Public Health. 84(12), 1913-1917.

Mayo-Smith, Michael F., et al. (2004). Management of Alcohol Withdrawal Delirium: An Evidence Based Practice Guideline. Arch Intern Med. 164(13):1405-1412.

Office of Applied Studies. (2007). Results from the 2007 National Survey on Drug Use and Health: National Findings” Retrieved may 28, 2008, from http://www.oas.samhsa.gov/nsduh/2k7nsduh/2k7Results.cfm

Rudgley, Richard (1998). Lost Civilizations of the Stone Age. New York: Free Press. 145 – 148.

Van Vliet, B., et al. (2000). CB1 Receptor Mediated Effects on Brain Neurotransmitter Systems European Neuropsychopharmacology. (10) 3, 182-183.

Voth, Eric A., Schwartz, Richard H. (1997). Medicinal Applications of Delta-9-Tetrahydrocannabinol and Marijuana. Annuals of Internal medicine.126 (10): 791-798.

6 Comments

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  1. It’s a shame I came across this so late, I’ll have to finish it in the morning. I think it could be improved with citations for the technical information, but even without it I enjoy it thus far.

  2. I just added the references to the end of the second page, and put the citations back in the paper. I had deleted all that stuff because the formatting was all messed up, but it’s fixed now. Smile

  3. Very nicely written, but there’s one thing I was curious about. I heard that the chemicals from aspartame, found in most sugar free products, when mixed with alcohol neutralizes the acid which normally would sit in your digestive tract for a long period of time.

  4. I just wanted to say, the actual amount of deaths due to marijuana is 0. No one has ever died from it, you can’t die from it.

    Also, I just wanted to comment about marijuana “addiction”, this really depends on the person. It is very different from alcohol because marijuana itself does not have addictive qualities, but your mind and body obviously can become addicted to anything you overindulge with like that.

    very good article

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