Cannabis-related disorders
Cannabis-Related Disorders
This section includes problems that are associated with substances that are derived from the cannabis plant (cannabinoids) and chemically similar synthetic compounds. When the upper leaves, tops, and stems of the plant are cut, dried, and rolled into cigarettes, the product is usually called marijuana or bhang. Hashish is the dried, resinous exudate that seeps from the tops and undersides of cannabis leaves; hashish oil is a concentrated distillate of hashish. In recent years, another high-potency form of cannabis, sensimilla, has been produced in Asia, Hawaii, and California. Cannabinoids are usually smoked, but they may be taken orally, usually mixed with tea or food. The cannabinoid that has been identified as primarily responsible for the psychoactive effects of cannabis is delta-9-tetrahydrocannabinol (also known as THC, or delta-9-THC), a substance that is rarely available in a pure form. The cannabinoids have diverse effects in the brain, prominent among which are actions on CB1 and CB2 cannabinoid receptors that are found throughout the central nervous system. Endogenous ligands for these receptors, anandamide and N-palmitoethanolamide, behave essentially like neurotransmitters. The THC content of the marijuana that is generally available varies greatly. The THC content of illicit marijuana has increased significantly since the late 1960s from an average of approximately 1%-5% to as much as 10%-15%. Synthetic delta-9-THC has been used for certain general medical conditions (e.g., for nausea and vomiting caused by chemotherapy, for anorexia and weight loss in individuals with acquired immunodeficiency syndrome [AIDS]).
This section contains discussions specific to the Cannabis-Related Disorders. Texts and criteria sets have already been provided to define the generic aspects of Substance Dependence (p. 192) and Substance Abuse (p. 198) that apply across all substances. The application of these general criteria to Cannabis Dependence and Abuse is provided below. However, there are no unique criteria sets for Cannabis Dependence or Cannabis Abuse. A specific text and criteria set for Cannabis Intoxication is also provided below. Symptoms of possible cannabis withdrawal (e.g., irritable or anxious mood accompanied by physiological changes such as tremor, perspiration, nausea, change in appetite, and sleep disturbances) have been described in association with the use of very high doses, but their clinical significance is uncertain. For these reasons, the diagnosis of cannabis withdrawal is not included in this manual. The Cannabis-Induced Disorders (other than Cannabis Intoxication) are described in the sections of the manual with disorders with which they share phenomenology (e.g., Cannabis-Induced Mood Disorder is included in the "Mood Disorders" section). Listed below are the Cannabis Use Disorders and the Cannabis-Induced Disorders.
Cannabis Use Disorders
- 304.30 Cannabis Dependence (see p. 236)
- 305.20 Cannabis Abuse (see p. 236)
Cannabis-Induced Disorders
- 292.89 Cannabis Intoxication (see p. 237) Specify if: With Perceptual Disturbances
- 292.81 Cannabis Intoxication Delirium (see p. 143)
- 292.11 Cannabis-Induced Psychotic Disorder, With Delusions (see p. 338)
Specify if: With Onset During Intoxication - 292.12 Cannabis-Induced Psychotic Disorder, With Hallucinations (see p. 338) Specify if: With Onset During Intoxication
- 292.89 Cannabis-Induced Anxiety Disorder (see p. 479)
Specify if: With Onset During Intoxication - 292.9 Cannabis-Related Disorder Not Otherwise Specified (see p. 241)