Desmitificación del uso medicinal de la marihuana: argumentos médicos, científicos y sociales en contra de su legalización

  • Martín Nizama-Valladolid Universidad Peruana Cayetano Heredia. Lima, Perú

Abstract

El consumo de marihuana es un tema controversial, aún más con la intensa campaña global para legalizarlo, argumentando sus beneficios medicinales; ocultándose sus efectos adictivos. El presente trabajo explica cómo esta droga afecta la estructura y funcionamiento del sistema nervioso. Los neurotransmisores involucrados en el proceso adictivo como la dopamina, involucrada con la sensación de placer, los receptores cannabinoides CB1 y CB2 con mayor distribución en el sistema nervioso central y periférico, respectivamente, los cuales además están asociados a alteraciones de la motivación y habilidades cognitivas. Hay variada información que refuerza la asociación entre el uso de marihuana y el debut o recaída de los trastornos psiquiátricos. La APA (American Psychiatry Association) considera que la marihuana no es beneficiosa para el tratamiento de trastornos psiquiátricos, además advierte que su uso afecta el neurodesarrollo.

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Author Biography

Martín Nizama-Valladolid, Universidad Peruana Cayetano Heredia. Lima, Perú
Dirección Ejecutiva de Investigación, Docencia y Atención Especializada de Adicciones del Instituto Nacional de Salud Mental “Honorio Delgado- Hideyo Noguchi”. Lima, Perú. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima, Perú. Facultad de Medicina de San Fernando; Universidad Nacional Mayor de San Marcos. Lima, Perú. Médico Psiquiatra. Médico especialista en Adicciones. Doctor en medicina. Docente.

References

National Institute on Drug Abuse. Marijuana [Internet]. Bethesda: NIDA; 2017 [citado el 3 de agosto de 2017]. Disponible en: https:// www.drugabuse.gov/publications/research-reports/marijuana/ marijuana-addictive

Volkow ND, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;371(9):879.

Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, et al. Cannabinoids for medical use. JAMA. 2015;313(24):2456- 73.

Cannabis Farmacología. En: Lorenzo P, Ladero JM, Leza JC, Lizasoain I. Drogodependencias. Farmacología, patología, psicología, legislación. 3ra edición. Editorial Médica Panamericana, 2009. p. 303-14.

Hernandez S, Sotelo J. Argumentos para el debate sobre la legalización de la marihuana en México. Entreciencias. 2013;1(2):169-76.

Coomber R. Assessing the real dangers of illicit drugs: risk analysis as the way forward? Addict Res. 1999;7(2):85-90.

Lachenmeier D, Rehm J. Comparative Risk Assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach. Sci Rep. 2015;5:8126.

Hall W, Degenhardt L. Adverse health effects of non-medical cannabis use. Lancet. 2009;374(9698):1383-91.

Grotenhermen F. Los cannabinoides y el sistema endocannabinoide. Cannabinoids. 2006;1(1):10-4.

Preedy V, editor. Neuropathology of drug addictions and substance misuse. Foundations of understanding, tobacco, alcohol, Cannabinoids and Opioids. Volume 1. San Diego, United States: Academic Press; 2016.

Battistella G, Fornari E, Annoni JM, Chtioui H, Dao K, Fabritius M, et al. Long-term effects of Cannabis on brain structure. Neuropsychopharmacology. 2014;39(9):2041-8.

Zalesky A, Solowij N, Yücel M, Lubman DI, Takagi M, Harding IH, et al. Effect of long-term cannabis use on axonal fibre connectivity. Brain. 2012;135(Pt 7):2245-55.

Hadland SE, Knight JR, Harris SK. Medical marijuana: review of the science and implications for developmental-behavioral pediatric practice. J Dev Behav Pediatr. 2015 Feb-Mar;36(2):115-23.

Solowij N, Battisti R. The chronic effects of cannabis on memory in humans: a review. Curr Drug Abuse Rev. 2008;1(1):81-98.

Crippa JA, Zuardi AW, Martín-Santos R, Bhattacharyya S, Atakan Z, McGuire P, et al. Cannabis and anxiety: a critical review of the evidence. Hum Psychopharmacol. 2009;24(7):515-23.

Moreira FA, Grieb M, Lutz B. Central side-effects of therapies based on CB1 cannabinoid receptor agonists and antagonists: focus on anxiety and depression. Best Pract Res Clin Endocrinol Metab. 2009;23(1):133-44.

D’Souza DC, Abi-Saab WM, Madonick S, Forselius-Bielen K, Doersch A, Braley G, et al. Delta-9-tetrahydrocannabinol effects in schizophrenia: Implications for cognition, psychosis, and addition. Biol Psychiatry. 2005;57(6):594-608.

Alvarez-Jimenez M, Priede A, Hetrick SE, Bendall S, Killackey E, Parker AG, et al. Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res. 2012;139(1-3):116-28.

Dumas P, Soaud M, Bouafia S, Gutknecth C, Ecochard R, Dalery J, et al. Cannabis use correlates with schizotypal personality traits in healthy students. Psychiatry Res. 2002;109(1):27-35.

Davis L, Uezato A, Newell JM, Frazier E. 2008. Major depression and comorbid substance use disorders. Curr Opin Psychiatry. 2008;21(1):14-8.

Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61(8):807-16.

Zaman T, Rosenthal RN, Renner JA, Kleber HD, Milin R. Position Statement on Marijuana as Medicine. APA Official Actions. Arlington: American Psychiatric Association: 2013.

Sanchis-Segura C, Cline BH, Marsicano G, Lutz B, Spanagel R. Reduced sensitivity to reward in CB1 knockout mice. Psychopharmacology (Berl). 2004;176(2):223-32.

Ferguson DM, Horwood LJ, Beautrais AL. Cannabis and educational achievement. Addiction. 2003; 98(12):1681-92

Lynskey M, Hall W. The effects of adolescent cannabis use on educational attainment: a review. Addiction. 2000;95(11):1621-30.

National Institute on Drug Abuse. La marihuana. ¿Cómo afecta el uso de marihuana el rendimiento en la escuela, el trabajo y la vida social? [Internet]. Bethesda, Maryland: NIDA; 2015 [citado 22 feb 2017]. Disponible en: https://www.drugabuse.gov/es/ publicaciones/serie-de-reportes/la-marihuana/cuales-son-losefectos- de-la-marihuana-en-el-rendimiento-escolar-en-el-

Macleod J, Oakes R, Copello A, Crome I, Egger M, Hickman M, et al. Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies. Lancet. 2004;363(9421):1579-88.

Silins E, Horwood LJ, Patton GC, Fergusson DM, Olsson CA, Hutchinson DM, et al. Young adult sequelae of adolescent cannabis use: an integrative analysis. Lancet Psychiatry. 2014;1(4):286-93.

Fergusson DM, Boden JM. Cannabis use and later life outcomes. Addiction. 2008;103(6):969-76.

Brook JS, Lee JY, Finch SJ, Seltzer N, Brook DW. Adult work commitment, financial stability, and social environment as related to trajectories of marijuana use beginning in adolescence. Subst Abus. 2013;34(3):298-305.

Gruber AJ, Pope HG, Hudson JI, Yurgelun-Todd D. Attributes of long-term heavy cannabis users: a case-control study. Psychol Med. 2003;33(8):1415-22.

Mead A. The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law. Epilepsy Behav. 2017; 70(Pt B):288-91.

González M, Ricardo A. Marihuana: beneficios vs grandes riesgos. Reflexiones sobre las tendencias legalizadoras. Anales de la Academia de Ciencias de Cuba. 2016;6(2):1-17.

Broder LE, Lean NL, Hilsenbeck SG. A randomized blinded clinical trial comparing delta – 9 – tetrahydrocannabinol (THC) and hydroxyzine (HZ) as antiemetic’s (AE) for cancer chemotherapy

Mc Cabe M, Smith FP, Macdonald JS, Woolley PV, Goldberg D, Schein PS. Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy. Invest New Drugs 1988;6(3):243-6. (CT). Proc Am Assoc Cancer Res. 1982;23:514.

Mack A, Joy J. Marijuana as Medicine? The Science Beyond the Controversy. Washington (DC): National Academies Press (US); 2000.

Veen ND, Selten JP, van der Tweel I, Feller WG, Hoek HW, Kahn RS. Cannabis use and age at onset of schizophrenia. Am J Psychiatry. 2004;161(3):501-6.

De Jesus E, Rodwick BM, Bowers D, Cohen CJ, Pearce D. Use of dronabinol improves appetite and reverses weight loss in HIV/AIDS infected patients. J Int Assoc Physicians AIDS Care (Chic). 2007;6(2):95-100.

Koppel BS, Brust JC, Fife T, Bronstein J, Youssof S, Gronseth G, et al. Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014;82(17):1556-63.

Hancox RJ, Shin HH, Gray AR, Poulton R, Sears MR. Effects of quitting cannabis on respiratory symptoms. Eur Respir J. 2015;46(1):80-7.

Zhang LR, Morgenstern H, Greenland S, Chang SC, Lazarus P, Teare MD, et al. Cannabis smoking and lung cancer risk: pooled analysis in the International Lung Cancer Consortium. Int J Cancer 2015;136(4):894-903.

Kempker JA, Honig EG, Martin GS. The effects of cannabis exposure on expiratory airflow. A study of adults who participated in the U.S. National Health and Nutrition Examination Study. Ann Am Thorac Soc. 2015;12(2):135-41.

O’Connell BK1, Gloss D2, Devinsky O. Cannabinoids in treatmentresistant epilepsy: A review. Epilepsy Behav. 2017;70(Pt B):341-8.

Levin FR, Mariani JJ, Pavlicova M, Brooks D, Glass A, Mahony A, et al. Dronabinol and lofexidine for cannabis use disorder: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend. 2016;159:53-60.

Food and Drug Administration [Internet]. Hampton, Virginia: FDA; c2017 [citado el 14 de febrero de 2017]. Disponible en: https://www.fda.gov/

Published
2017-11-02
How to Cite
1.
Nizama-Valladolid M. Desmitificación del uso medicinal de la marihuana: argumentos médicos, científicos y sociales en contra de su legalización. Acta Med Peru [Internet]. 2017Nov.2 [cited 2024Nov.19];34(3):231-6. Available from: https://amp.cmp.org.pe/index.php/AMP/article/view/410
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SPECIAL ARTICLES