Kalant Harold
Department of Pharmacology, Medical Sciences Building, University of Toronto, Toronto, ON, Canada M5S 1A8.
Prog Neuropsychopharmacol Biol Psychiatry. 2004 Aug;28(5):849-63. doi: 10.1016/j.pnpbp.2004.05.027.
Recent research has clarified a number of important questions concerning adverse effects of cannabis on health. A causal role of acute cannabis intoxication in motor vehicle and other accidents has now been shown by the presence of measurable levels of Delta(9)-tetrahydrocannabinol (THC) in the blood of injured drivers in the absence of alcohol or other drugs, by surveys of driving under the influence of cannabis, and by significantly higher accident culpability risk of drivers using cannabis. Chronic inflammatory and precancerous changes in the airways have been demonstrated in cannabis smokers, and the most recent case-control study shows an increased risk of airways cancer that is proportional to the amount of cannabis use. Several different studies indicate that the epidemiological link between cannabis use and schizophrenia probably represents a causal role of cannabis in precipitating the onset or relapse of schizophrenia. A weaker but significant link between cannabis and depression has been found in various cohort studies, but the nature of the link is not yet clear. A large body of evidence now demonstrates that cannabis dependence, both behavioral and physical, does occur in about 7-10% of regular users, and that early onset of use, and especially of weekly or daily use, is a strong predictor of future dependence. Cognitive impairments of various types are readily demonstrable during acute cannabis intoxication, but there is no suitable evidence yet available to permit a decision as to whether long-lasting or permanent functional losses can result from chronic heavy use in adults. However, a small but growing body of evidence indicates subtle but apparently permanent effects on memory, information processing, and executive functions, in the offspring of women who used cannabis during pregnancy. In total, the evidence indicates that regular heavy use of cannabis carries significant risks for the individual user and for the health care system.
近期研究已阐明了一些关于大麻对健康产生不良影响的重要问题。现已表明，在受伤驾驶员血液中检测到可测量水平的Δ⁹-四氢大麻酚（THC），且不存在酒精或其他药物，通过对大麻影响下驾驶情况的调查，以及使用大麻的驾驶员事故罪责风险显著更高，证明了急性大麻中毒在机动车及其他事故中的因果作用。大麻吸食者的气道出现了慢性炎症和癌前病变，最新的病例对照研究表明，患气道癌的风险增加，且与大麻使用量成正比。几项不同的研究表明，使用大麻与精神分裂症之间的流行病学联系可能意味着大麻在引发精神分裂症发作或复发中起因果作用。在各种队列研究中发现大麻与抑郁症之间存在较弱但显著的联系，但这种联系的性质尚不清楚。大量证据表明，约7% - 10%的经常使用者确实会出现行为和身体上的大麻依赖，而且早期开始使用，尤其是每周或每天使用，是未来依赖的有力预测指标。在急性大麻中毒期间，各种类型的认知障碍很容易被证实，但目前尚无适当证据来判定成年人长期大量使用大麻是否会导致持久或永久性的功能丧失。然而，少量但不断增加的证据表明，孕期使用大麻的女性所生后代在记忆、信息处理和执行功能方面受到细微但明显的永久性影响。总体而言，证据表明，经常大量使用大麻对个体使用者和医疗保健系统都有重大风险。
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