Marijuana "...properly being considered a 'gateway drug'."

CNS Neurol Disord Drug Targets. 2017 Apr 13. doi: 10.2174/1871527316666170413113246. [Epub ahead of print]

Cannabis; epidemiological, neurobiological and psychopathological issues: an update.

De Luca MA1, Di Chiara G1, Cadoni C2, Lecca D1, Orsolini L3, Papanti D3, Corkery J3, Schifano F3.

Author information

1

Department of Biomedical Sciences, Neuropsychopharmacology Unit, University of Cagliari, Italy Cagliari. Italy.

2

Centre of Excellence "Neurobiology of Dependence", University of Cagliari-Cagliari, Italy Cagliari. Italy.

3

Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, AL10 9AB, UK herts. United Kingdom.

Abstract

Cannabis is the illicit drug with both the largest current levels of consumption and the highest lifetime prevalence in the world. Across different countries, the prevalence of cannabis use varies according to the individual income, with the highest use reported in North America, Australia and Europe. Despite its 'soft drug' reputation, cannabis misuse may be associated with several acute and chronic adverse effects. The present article aims at reviewing several papers on epidemiological, neurobiological and psychopathological aspects of the use of cannabis. To this end, the PubMed database was examined in order to collect and discuss several papers. Cannabis intake usually starts during late adolescence/early adulthood (15-24 years) and drastically decreases in adulthood with the acquisition of working/familiar and social responsibilities. Clinical evidence supports the current socio-epidemiological alarm concerning the increased consumption among youngsters and the risks related to the onset of psychotic disorders. The mechanism of action of cannabis presents some analogies with other abused drugs, e.g. opiates. Furthermore, it has been well demonstrated that intake in adolescence may facilitate the transition to the use and/or abuse of other psychotropic drugs, hence properly being considered a 'gateway drug'. Some considerations on synthetic cannabimimetics are provided here as well. In conclusion, the highest prevalence of cannabis use and the social perception of a relatively low associated risk are in contrast with current knowledge based on biological and clinical evidence. Indeed, there are concerns relating to cannabis intake association with detrimental effects on both cognitive impairment and mental health.