Psychiatric disorders induced by the use of opioids and cannabinoids

Opioid use disorders[edit | edit source]

Soldier sickness – morphine was freely used in wars, soldiers were then addicted (American Civil War 1861-1865, Franco-Prussian War 1870-71).

Since the early 1970s – drug mafias, heroin,
braun – Czech product, mixture of codeine opiates,
the historical shift in application is significant – from smoking, sniffing, to injection.

For more information see Substance Abuse.

Dampening, calming, euphoric effect, speed of onset according to application,
duration of effect (heroin 3–4 h, morphine 4–5 h, buprenorphine 6–8 h 48 h, methadone 12–24 h).

Acute intoxication

Apathy, depression, slowing down of psychomotor skills, disinhibition, deterioration of attention, judgement,
numbness, slurred speech, narrowing of the pupils, impaired consciousness ,
euphoria, relaxation, pleasant fatigue,
there is a risk of depression of the respiratory center, hypotension and hypothermia,
decreased GIT motility, constipation, spasms.

Harmful use

Addiction syndrome

Withdrawal status

Very often, in 4-6 hours after the last dose,
usually not life-threatening,
flu symptoms – nasal discharge, sneezing, lacrimation, pain and muscle spasms, abdominal cramps, nausea, vomiting, diarrhea, dilated pupils, piloerection, chills, tachycardia, hypertension, insomnia.

It depends on the purity of the substance, often other alkaloids – organotoxicity,
disorders of thinking, behavior (anethic states), development of a personality disorder (accentuation of negative traits), libido disorders, amenorrhea, avitaminosis, deterioration of the organism,
social problems, problems with the law,
resocialization is possible.

There are also people with minor disorders in neurotransmitters – susceptibility, more frequent occurrence of the A1-dopaminergic D2-receptor allele, very rapid habit formation.

Acute intoxication – naloxone – opiate antagonist, causes withdrawal symptoms in addicts,
treatment of withdrawal syndrome - inpatient, substitution treatment - buprenorphine, methadone, symptomatic,
withdrawal treatment - long-term comprehensive program, long-term maintenance substitution treatment - methadone, buprenorphine is also starting.

Cannabinoids are from the Indian hemp Cannabis indica, or from the seeded hemp Cannabis sativa .
The key substance in this cannabis is tetrahydrocannabinol (THC).
Cannabis contains about 0.5-11% THC in its flowers.
Hashish comes from the resinous substance produced by flowers and contains about 5x more THC than marijuana.
Smoking or oral use has a longer effect.
Excretion of THC takes a long time, t = 30 h, with chronicity it is stored, then it can be released - the so-called flashback.
The mechanism of action is complex, there are also specific receptors in the CNS .
It has significant anticonvulsant, antiemetic, hypotensive and analgesic effects.
Synthetics are used in ophthalmology to reduce pressure in glaucoma .

Cannabis sativa

dysfunctional behavior, mood changes (euphoria or anxiety ), abnormal perception (hallucinations, slowed perception, ...), deterioration of judgment, attention, depersonalization, sometimes paranoia;
inability to concentrate on demanding tasks even several days after ingestion;
typical symptoms – injected conjunctivae, increased appetite, tachycardia , dry mouth.

chronic inflammation of the lungs, fertility disorders, risk of premature birth;
long-term use – anxiety-depressive states, apathetic-abulous syndrome, schizophrenia.

exceptionally (due to slow excretion), psychomotor restlessness, irritability, nervousness, anxiety, depression .

BENEŠ, Jiří. Study materials [online]. [feeling. 2009]. < http://jirben.wz.cz >.