Marijuana
|
Marijuana (leaves and tops of plants), Hashish (hard
chunks or cubes of dried cannabis resin and compressed flowers), Hashish Oil
(viscous extract from hashish) |
|
|
Routes |
·
Smoking (inhaling), oral ingestion (cooked or
baked in foods), rarely injected |
|
Safe Limits |
·
There is no known safe limit for use in
pregnancy. Studies on this topic generally have many confounders |
|
Harmful Effects |
·
Neonatal effects: no significant effect on
birth parameters, no congenital anomalies ·
Obstetrical complications: no consistent
association with antenatal/intrapartum
complications ·
Possible neurobehavioural
effects in neonate: increased tremors, exaggerated startles and sleep
disturbances (decreased total quiet sleep at 1 month, which continued at 3
years of age) ·
Long-term effects: increased hyperactivity,
inattention, and impulsivity from school age (6 years) to adolescence;
increased delinquency and externalizing problems ·
Acute non-lymphoblastic
leukemia associated with prenatal marijuana exposure (documented in one
study) |
|
Symptoms of Intoxication |
·
Increased heart rate ·
Impaired performance on psychomotor tasks and
other forms of cognitive impairment |
|
Symptoms and Signs of
Withdrawal with Chronic Daily Use |
·
Mild symptoms and signs: irritability,
insomnia, anorexia - resolve within days ·
Moderate symptoms and signs: anxiety,
irritability - may continue for weeks |
|
Withdrawal Management |
·
No specific therapy |
|
Management of Dependence |
·
Reduce amount if unable to quit |
|
Breastfeeding |
·
Marijuana is transferred into breast milk and
may cause lethargy, poor feeding, and neurobehavioural
effects in infant; abstinence from marijuana use is recommended while
breastfeeding |