Nestoros Joannis N, Vakonaki Elena, Tzatzarakis Manolis N, Alegakis Athanasios, Skondras Markos D, Tsatsakis Aristidis M
Department of Clinical Psychology, Scientific Director, Synchronal Amphiaraia University of Crete Spin-off Company, Heraklion, Crete, Greece.
Laboratory of Toxicology, Medical School, University of Crete, Heraklion, Crete, Greece.
Am J Addict. 2017 Jun;26(4):335-342. doi: 10.1111/ajad.12529. Epub 2017 Mar 17.
The purpose of this study was to evaluate the extent of short-term memory impairment and schizophrenia-like symptoms in heavy and systematic cannabis users and the association between the severity of abuse and the longevity of its persistent symptoms after refraining from such use.
A complete psychiatric examination and a psychometric evaluation were performed in 48 solely cannabis users. Additionally, head hair samples were analyzed and the detected cannabinoids levels were correlated with the psychometric findings.
A total of 33.3% (n = 16) of the total examined cannabis users were currently imprisoned. The years of abuse ranged from 1 to 35 years and the median daily dose was 5.84.4 gr and 4.84.0 gr for prisoners (n = 16) and non prisoners (n = 32), respectively. A total of 39.6% of the users experienced hallucinations (mostly auditory), 54.2% experienced delusions (mostly ideas of reference and persecution), 85.4% had organic brain dysfunction in a test addressing visual-motor functioning and visual perception skills, and all users (100%) were found to have organic brain dysfunction in a test of visual memory immediate recall. The cannabinoid metabolite levels in the hair samples were consistent with the reported history of substance abuse and total grams of consumption for the participants below 35 years old (p < .001). Statistically elevated cannabinoids levels were observed in users with auditory hallucinations compared to users without any hallucinations (p = .019).
The existence of hallucinations, delusions, and organic brain dysfunction in heavy cannabis users seems to be associated with cannabinoid levels in hair. The continuation of persistent symptoms 3 months after the discontinuation of cannabis abuse, was a remarkable finding.
We provide evidence that chronic and heavy cannabis abuse results in long-lasting brain dysfunction in all users and in long-lasting schizophrenia-like psychotic symptoms in more than half of all users. These findings suggest a reevaluation of the current classification of cannabis as a "soft narcotic" which erroneously, therefore, is typically considered harmless. (Am J Addict 2017;26:335-342).
本研究旨在评估重度及长期大麻使用者的短期记忆损害程度和类精神分裂症症状，以及滥用严重程度与其停止使用后持续症状时长之间的关联。
对48名仅使用大麻的使用者进行了全面的精神检查和心理测评。此外，对头发样本进行了分析，并将检测到的大麻素水平与心理测评结果相关联。
在所有接受检查的大麻使用者中，共有33.3%（n = 16）目前被监禁。滥用年限从1年到35年不等，囚犯（n = 16）和非囚犯（n = 32）的日均剂量中位数分别为5.84.4克和4.84.0克。共有39.6%的使用者出现幻觉（主要是听觉幻觉），54.2%的使用者出现妄想（主要是牵连观念和被害妄想），在一项针对视觉运动功能和视觉感知技能的测试中，85.4%的使用者存在器质性脑功能障碍，而在一项视觉记忆即时回忆测试中，所有使用者（100%）均被发现存在器质性脑功能障碍。头发样本中的大麻素代谢物水平与35岁以下参与者报告的药物滥用史和总消费克数一致（p <.001）。与无任何幻觉的使用者相比，有听觉幻觉的使用者中观察到统计学上大麻素水平升高（p = 0.019）。
重度大麻使用者中幻觉、妄想和器质性脑功能障碍的存在似乎与头发中的大麻素水平有关。停止大麻滥用3个月后持续症状的存在是一个显著发现。
我们提供的证据表明，慢性重度大麻滥用会导致所有使用者出现持久的脑功能障碍，超过半数使用者出现持久的类精神分裂症性精神病症状。这些发现表明，需要重新评估目前将大麻归类为“软性麻醉品”的做法，因为这种归类错误地认为大麻通常无害。（《美国成瘾杂志》2017年；26:335 - 342）
