Cannabis Use Disorder in the UK: Interventions and Challenges

Desklib provides past papers and solved assignments for students. This report analyzes problematic drug use and cannabis interventions in the UK.

Contents
INTRODUCTION............................................................................................................................. 1
BODY.............................................................................................................................................. 1
CONCLUSION................................................................................................................................. 6
REFERENCES...................................................................................................................................6
1

INTRODUCTION
Substance is considered as any material that is consumed mainly drugs that can be beneficial in
specific quantity to treat certain diseases but in excess are harmful for the human body and
cause effects that makes a person addicted towards its use (Roy-Byrne et al, 2014). This
assignment critically analyses the problematic drug use and its effects on human body. It
discusses the interventions that are applied to treat marijuana (cannabis) use and addiction. It
2

explores the effectiveness of these interventions and also discusses the issues that arise due to
problematic drug use. The impact of problematic drug use on individual, culture and society of
the region as well the later part of assignment highlights alternative initiatives taken in other
parts of world to overcome this drug use and addiction as well its effectiveness and modalities
to eradicate drug abuse.
BODY
Problematic drug use is defined as the habit of consuming drugs and is considered to be a
physiological medical problem that needs to be corrected medically, it is seen that problematic
drug is more a socioeconomic originated problem than a physiological one. It means the use of
drugs that can be dependent or recreational in nature (Degenhardt and Hall, 2012). Moreover
the addiction of drug and the frequency of drug taking is not the bigger problem in the
problematic drug use but more important is the kind of drug that cause problem to the health
of the individual and its excess consumption causing decline in health and wellbeing of the
individual. A person using problematic drug may face various challenges in life regarding their
social, emotional, psychological, financial and legal aspects of their life. Problem drug user
usually chooses prescribed drugs for longer duration and higher frequency. Opioids, cocaine,
acetaminophen etc. are commonly used drugs to get dependent on and that helps in causing
harmful effect to health of an individual. It was estimated that around 330445 people in UK are
using drugs including problematic use of opioids. It is also seen that 6.4 out of every 1000
people in UK are a problem drug user mostly within the age of 15 to 64 years (Bachman et al,
2013). Also as compared to graph of other countries 11 percent of people in UK at some point
of their lives have undergone problem drug use as compared to 6% ratio of other countries.
Britain is considered the worst in whole Europe regarding the use of drugs and substance
abuse. Cannabis use in UK is highest compared to any other nations globally. It is also seen that
the cocaine use in UK has increased from 1 percent in 1996 to 5 percent in 2000 that s
indicated as steepest rise in drug use in any country over past decades. In England there was
7545 hospital admission related drug misuse that was 12 percent higher to that of 2007 (Klimas
et al, 2014). There were 14,053 cases of primary drug positioning due to use of problematic
3

drug in England that is 40% higher than the rate in 2007. The statistics shows how problem drug
use is increasing in UK at an alarming rate and the concerns have risen to provide better
services and options for these people to eradicate drug misuse I UK.
Cannabis use as discussed is highest among UK that any other countries this gives a call to
discuss the reason behind the use of this drug and interventions up taken to reduce its
prevalence. Cannabis also known as marijuana is a psychoactive drug used mainly for medical
or recreational purpose. It is extracted from cannabis plant and the main psychoactive part of
this drug is tetra hydro cannabinol one of know compounds in the plant out of other 43
cannabinoids (Saitz et al, 2014). Cannabis has mental as well as physical effects as it creates a
high and stoned up feeling on administration. It also helps in change in perception, euphoric
mood and increase in appetite. Cannabis can be used for medical use but it is a dangerous drug
that can be easily got dependent on. It may have temporary and short lives side effects such as
nausea, red eye, dry mouth, short term memory loss, and feeling of anxiety and impaired
motor skills. Frequent and continuous use of cannabis may cause dependency, addiction,
retardation f mental health in teenagers, developmental defects in new born whose mother
use cannabis during pregnancy, behavioral problems, and psychosis (Moore and Fraser, 2012).
The immediate effects of cannabis include relaxation and euphoria that is the main aim of
majority of consumers. As seen the addiction to this drug is easy and dependency is normal
phenomenon. Cannabis use at first targets the dopamine mechanism of reward functioning in
brain causing euphoria and relaxation with every repeated use this drug increases its tolerance
level in the individual and the man thrives to achieve same euphoria back consumes higher
level and quantity of drug that becomes problematic in nature for his health and wellbeing.
The impact of cannabis on health of an individual is drastic and severe. As the drug has ability
to bring about mood variations and behavior changes it can elevate certain behavior and
dampen other emotions. Cannabis use can enhance short term as well as long term effects on
individual’s health. Short term effects includes drug induced anxiety disorder, drug induced
psychosis and drug induced mood disorders. Long term health implications involve depression
schizophrenia, mental retardation, emotional distress and anxiety disorder (Brick and Erickson,
4

2013). Marijuana works in a discrete manner by producing effects like a regulator that is
already produced in human body and is known as endocannabinoids. Endocannabinoids is the
substance in human body responsible to regulate change sin brain and cause different functions
in body, when the cannabis works in same way as this endocannabinoids in brain they produce
same effects as the natural substance. The increased production of such symptoms is not good
for health and that is why cannabis smoker start experiencing memory issues and bad mental
health. Marijuana hits the hippocampus in brain that is the region that is responsible for short
term memory. The use of this drug prevents the human rain to temporarily not learn new
things and not create new memories that is why the consumer experience short term memory
loss. This is same reason why cannabis user also develops false and imaginary memories due to
chronic use and is usually considered to be suffering from schizophrenia. Researches also show
that regular use of cannabis causes decline in cognitive functioning in later life stages and also
alters their thinking form and thought process (Klingemann et al, 2012).
Use of cannabis on regular basis also alters the production and levels of dopamine in body that
is a neurotransmitter responsible for attention, concentration and feelings in human brain.
Other than mental health issues the marijuana cause to human body there are other physical
health implications also. Smoking marijuana causes exposure to lot of toxic chemicals and this
can affect respiratory tract of the smoker. It is seen that regular user of cannabis has frequent
cough, breathing issues, and produce more mucus from their respiratory tracts. Cannabis
enters blood stream through the lungs and cause increase in heart rate by 50 beats per minute
and for an existing heart patient this can be a greater risk and life threatening condition
(Aldridge, Measham and Williams, 2013). The researches show that in young individual heat
attack risk will be increased due to regular cannabis use even without any other possible
markers for risk present. It also has evidence regarding enhancing risk towards acute coronary
syndrome. Risk of addiction of cannabis is one in ten users yet the risk is pretty high as statistics
shows wide range of user in UK. Relationship between cannabis and testicular cancer is also
noted by some of the studies. Other disease that is prominent in regular pot smoker is the gum
diseases as it is seen that there is a correlation between periodontal gum disease and cannabis
use.
5

Marijuana is an illegal drug usually everywhere in the world including USA. The regular use of
this drug can impact the family of the user in severe manner as it can financially cause problems
to the family. The amount of money spent for possessing and using the drug can be handsome
and can affect every member in the household pretty well. The money used for this drug can be
used for other household activities and expenses and this can affect the overall functioning of
the family (Rubino and Parolaro 2014). Even the marijuana consumption and utilization is illegal
if the family member is caught doing so he can be arrested and jailed that will lead the family to
undergo court trials and expenses and other mental and physical issues. Mentally it can affect
the family in devastating manner. Physically the person may not spend time with his family due
to the use of drug in excess and the behavior changes caused by it.
Use of drugs and cannabis also affects individual’s social life including school, education and
social wellbeing. The use of marijuana has severed social implications including failure in school
and decline in work performances (Henry, Knight and Thornberry, 2012). Marijuana user usually
is involved in workplace incidents and loses their jobs due to it. It also affects the perception of
society towards the user and judgment of them. Its effect on memory and learning abilities can
affect the teenagers and people studying in school and college. It also is responsible for
producing weird behavior changes including poor relationships with family and peers. Even the
workers at different workplaces are affected differently as people involved in high
concentration work being marijuana dependent are more likely t produce errors and failure due
to obvious memory effects caused by the drug (Ferentzy, Wayne Skinner and Matheson, 2013).
The global survey showed that people receiving and seeking treatment of any drug abuse in
world is mainly for cannabis. It is seen that after alcohol treatment people who seek treatment
for addiction and dependency is for cannabis use. The overall number of cannabis user seeking
help has increased in past two decades since 1990s in majority of developed and some
developing countries (Malchow et al, 2013). In 2012 around 110000 people from total who
enrolled in drug treatment programme in Europe reported to be seeking treatment for
cannabis. 36% of all illicit drug use is alone conserved to cannabis use globally.
6

Marijuana in today’s world is on verge of social acceptance as people think it does not harm
hem physically or by any means. This is not the case with every individual and smoking or
consuming marijuana is as harmful as other drugs. People have started realizing the value of life
and seeking help for their dependency and addiction towards cannabis. As seen in the
statistical review the rate of people seeking help for quitting drug misuse including cannabis
have increased over last decade (Hester et al, 2015).
The marijuana use disorder is usually treated in the similar manner as other drug use disorder.
The people dependent on marijuana use usually consume it regularly for long period and have
attempted to quit it couple of times with high rate of relapse. The studies have suggested
concrete evidence related to cognitive behavioral therapy for the marijuana use disorder. Some
of the widely used behavioral treatments that have shown promising results, cognitive behavior
therapy is a psychoanalytic therapy that teaches individual to correct the problematic behavior
by achieving back self-control stop the drug usage and help self to correct the correlated issues.
Motivational enhancement therapy is the treatment modality that design intervention that
brings rapid, internal motivation for the individual it does not aim to treat the person but it
aims to develop that internal urge to get involved in the treatment. Individual himself start to
have that emotional contentment for withdrawing the use of drug and getting the treatment
for his better health. Contingency management is the therapy that encourages individual to
achieve a desired behavior and when the patient achieves the behavior desired the rewards are
given for contingency and continuous positive outcomes (Galanter, Kleber and Brady, 2014).
FDA currently has not approved any pharmacological interventions for marijuana use disorder.
Usually medications may be helpful in treating the symptoms o withdrawal that is sleep
problems, anxiety and psychosis. Other than the therapies that are discussed for marijuana use
disorder social support therapy is also found equivalent to these discussed interventions. Even
combined therapies are proved to be highly beneficial in this treatment. It is proved that
motivation enhancement therapy and cognitive behavior therapy are most effective together in
reducing the cannabis use in adolescents with improving psychiatric conditions the drug has
caused in them.
7

No medicinal treatment is proved to be adequate for cannabis withdrawal and has not been
approved by any of the countries. Buspirone is the medication that has shown great efficacy in
marijuana withdrawal till date. Studies also showed that dronabinol, the COMT inhibitor
entacapone, and lithium may be researched more to be effective in use for cannabis use
disorder (Gates, Copeland, Swift and Martin, 2012). Some clinical trials have also shown that
fatty acid amide hydrolase (FAAH) inhibitors such as URB597, nicotinic alpha7 receptor
antagonists such as methyllycaconitine (MLA) and endocannabinoid-metabolizing enzymes, can
also be used to treat this problematic drug use. Cannabis drug disorder is so prevalent
nowadays that new interventions that too medicinal in nature are required to provide better
and effective care. These medications are required to be researched on with more efficiency
and scope to provide better evidence for their benefit in the problematic drug use. Most of the
cases of cannabis use relapse due to the withdrawal syndrome it has during withdrawal. The
pharmacological treatment if provided for symptomatic relief during this syndrome will be
beneficial in reducing the cases of relapses and helps in reducing the prevalence of cannabis
use in UK (Davis et al, 2015).
CONCLUSION
Problem drug use as defined is the condition when the prescription drug or any other drug that
is usually used in medical interventions is used in excess quantity and has severe health
8

implications with chronic excess use. This problem drug use is increasing at an alarming rate in
UK. This has presented as severe economic as well as societal issues in current times. Cannabis
use is so common in UK that around 6.4 people over every 1000 people in UK are regular
cannabis consumer. It has shown therapeutic effects on human body but in controlled dosage.
Excess use of cannabis has psychological as well as physical effects on human health. It
deteriorates mental abilities and even cognitive functioning in some cases. Physical effects also
include cardiovascular disease risk, risk towards cancer and other comorbid diseases.
Psychological effects include mental retardation, psychosis, change in behavior, schizophrenia,
anxiety disorder etc. the interventions provided for cannabis use disorder includes
psychological methods including cognitive behavior therapy, motivation enhancement therapy
etc. that shows good effects for the withdrawal procedure. There is scope for more research in
the area of pharmacological interventions for cannabis use disorder. Some of the substances
are found beneficial in treating this problem and can be studied more to provide better and
effective treatment modalities for the disorder.
REFERENCES
Aldridge, J., Measham, F. and Williams, L., 2013. Illegal leisure revisited: Changing patterns of
alcohol and drug use in adolescents and young adults. Routledge.
Bachman, J.G., Wadsworth, K.N., O'Malley, P.M., Johnston, L.D. and Schulenberg, J.E.,
2013. Smoking, drinking, and drug use in young adulthood: The impacts of new freedoms and
new responsibilities. Psychology Press.
Brick, J. and Erickson, C.K., 2013. Drugs, the brain, and behavior: The pharmacology of drug use
disorders. Routledge.
9

Davis, M.L., Powers, M.B., Handelsman, P., Medina, J.L., Zvolensky, M. and Smits, J.A., 2015.
Behavioral therapies for treatment-seeking cannabis users: a meta-analysis of randomized
controlled trials. Evaluation & the health professions, 38(1), pp.94-114.
Degenhardt, L. and Hall, W., 2012. Extent of illicit drug use and dependence, and their
contribution to the global burden of disease. The Lancet, 379(9810), pp.55-70.
Ferentzy, P., Wayne Skinner, W.J. and Matheson, F.I., 2013. Illicit drug use and problem
gambling. ISRN Addiction, 2013.
Galanter, M., Kleber, H.D. and Brady, K. eds., 2014. The American Psychiatric Publishing
textbook of substance abuse treatment. American Psychiatric Pub.
Gates, P., Copeland, J., Swift, W. and Martin, G., 2012. Barriers and facilitators to cannabis
treatment. Drug and alcohol review, 31(3), pp.311-319.
Henry, K.L., Knight, K.E. and Thornberry, T.P., 2012. School disengagement as a predictor of
dropout, delinquency, and problem substance use during adolescence and early
adulthood. Journal of youth and adolescence, 41(2), pp.156-166.
Hester, M., Ferrari, G., Jones, S.K., Williamson, E., Bacchus, L.J., Peters, T.J. and Feder, G., 2015.
Occurrence and impact of negative behaviour, including domestic violence and abuse, in men
attending UK primary care health clinics: a cross-sectional survey. BMJ open, 5(5), p.e007141.
Klimas, J., Cullen, W., Field, C.A. and Problem Alcohol/Drug Use Guideline Development Group,
2014. Problem alcohol use among problem drug users: development and content of clinical
guidelines for general practice. Irish journal of medical science, 183(1), pp.89-101.
Klingemann, H., Sobell, L.C., Barker, J., Blomqvist, J., Cloud, W., Ellinstad, T., Finfgeld, D.,
Granfield, R., Hodgings, D., Hunt, G. and Junker, C., 2012. Promoting self-change from problem
substance use: Practical implications for policy, prevention and treatment. Springer Science &
Business Media.
10

Malchow, B., Hasan, A., Fusar-Poli, P., Schmitt, A., Falkai, P. and Wobrock, T., 2013. Cannabis
abuse and brain morphology in schizophrenia: a review of the available evidence. European
archives of psychiatry and clinical neuroscience, 263(1), pp.3-13.
Moore, D. and Fraser, S., 2013. Producing the “problem” of addiction in drug
treatment. Qualitative Health Research, 23(7), pp.916-923.
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I.I., Maynard,
C., Atkins, D.C., Graves, M.C. and Joesch, J.M., 2014. Brief intervention for problem drug use in
safety-net primary care settings: a randomized clinical trial. Jama, 312(5), pp.492-501.
Rubino, T. and Parolaro, D., 2014. Cannabis abuse in adolescence and the risk of psychosis: a
brief review of the preclinical evidence. Progress in Neuro-Psychopharmacology and Biological
Psychiatry, 52, pp.41-44.
Saitz, R., Palfai, T.P., Cheng, D.M., Alford, D.P., Bernstein, J.A., Lloyd-Travaglini, C.A., Meli, S.M.,
Chaisson, C.E. and Samet, J.H., 2014. Screening and brief intervention for drug use in primary
care: the ASPIRE randomized clinical trial. Jama, 312(5), pp.502-513.
11