Schaffer Library of Drug Policy

Marihuana: A Signal of Misunderstanding

Marihuana Use and Its Effects - Tolerance

US National Commission on Marihuana and Drug Abuse

Table of Contents
Introduction
I. Marihuana and the Problem of Marihuana
Origins of the Marihuana Problem
The Need for Perspective
Formulating Marihuana Policy
The Report
II. Marihuana Use and Its Effects
The Marihuana User
Profiles of Users
Becoming a Marihuana User
Becoming a Multidrug User
Effects of Marihuana on the User
Effects Related to Pattern Use
Immediate Drug Effects
ShortTerm Effects
Long Term Effects
Very Long Term Effects
Summary
III. Social Impact of Marihuana Use
IV. Social Response to Marihuana Use
V. Marihuana and Social Policy
Drugs in a Free Society
A Social Control Policy for Marihuana
Implementing the Discouragement Policy
A Final Comment
Addendum
Ancillary Recommendations
Legal and Law Enforcement Recommendations
Medical Recommendations
Other Recommendations
Letter of Transmittal
Members and Staff
Preface
History of Marihuana Use: Medical and Intoxicant
II. Biological Effects of Marihuana
Botanical and Chemical Considerations
Factors Influencing Psychopharmacological Effect
Acute Effects of Marihuana (Delta 9 THC)
Effects of Short-Term or Subacute Use
Effects of Long-Term Cannabis Use
Investigations of Very Heavy Very Long-Term Cannabis Users
III. Marihuana and Public Safety
Marihuana and Crime
Marihuana and Driving
Marihuana - Public Health and Welfare
Assessment of Perceived Risks
Preventive Public Health Concerns
Summary
Marihuana and the Dominant Social Order
The World of Youth
Why Society Feels Threatened
The Changing Social Scene
Problems in Assessing the Effects of Marihuana
Marihuana and Violence
Marihuana and (Non-Violent) Crime
Summary and Conclusions: Marihuana and Crime
Marihuana and Driving
History of Marihuana Legislation
History of Alcohol Prohibition
History of Tobacco Regulation
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The National Commission on Marihuana and Drug Abuse

Marihuana - A Signal of Misunderstanding.

Chapter II

marihuana use and its effects

Tolerance

Another important factor that determines the immediate effect of any drug is tolerance. Tolerance has two different connotations. The first, initial tolerance, is a measure of the amount of a drug which a subject must receive on first exposure to produce a designated degree of effect. A variety of innate and environmental factors contributes to initial tolerance among individuals. Different individuals require varying amounts of the drug to attain the same physical and mental effect.

The second connotation, which shall be referred to when we use the word tolerance, is that of an acquired change in tolerance. That is, within the same individual, as a result of repeated exposure to the drug, the same dose of the drug may produce a diminishing effect so that an increased amount of the drug is required to produce the same specified degree of effect.

Tolerance develops at differential rates to given effects of the same drug. If tolerance has developed to one specific effect, it has not necessarily developed to other specific effects.

By definition, the development of tolerance is neither beneficial nor detrimental. If tolerance develops rapidly to the desired mental effect of a "high" but slowly to the behavioral or physical effects, rapid increase in dose would be necessary in order to have the desired effect, and progressive behavioral and physical disruption would be seen. This is the pattern for amphetamines.

However, if tolerance develops slowly or not at all to the desired mental effects but more rapidly to the behaviorally or physically disruptive effects, no dosage increase or only a slight one would be necessary and the unpleasant and undesired effects would progressively diminish.

With regard to marihuana, present indications are that tolerance does develop to the behaviorally and physically disruptive effects, in both animals and man, especially at high frequent doses for prolonged time periods. Studies in foreign countries indicate that very heavy prolonged use of very large quantities of hashish leads to the development of tolerance to the mental effects, requiring an increase in intake to reach the original level of satisfaction. However, for the intermittent use pattern and even the moderate use pattern, little evidence exists to indicate the development of tolerance to the desired "high," although the high may persist for a shorter time period. During the Boston free-access study, no change was apparent in the level of the high produced by a relatively large dose of the drug over a 21-day period of moderate to heavy smoking.

The fact that some individuals smoke more of the drug than others may merely reflect a desire for a different level of "high." There is a tendency to develop a tolerance to the physical effects and behaviorally disruptive effects, especially the depressant effects, in heavy daily users. The development of such behavioral tolerance of this nature may explain the fact that experienced marihuana smokers describe a lower occurrence rate of undesirable drug effects. The development of tolerance may also explain why these smokers exhibit normal behavior and competent performance of ordinary tasks, while not appearing intoxicated to others even though they are at their usual level of intoxication.

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