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Consequences of chronic marijuana use
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This case describes the clinical Mesa massage san diego of a cannabis-dependent individual entering a week abstinence-based research program. The case illustrates the effects of chronic, heavy cannabis use on executive functions at three time points: 1 24 hours of abstinence; 2 4 weeks of abstinence; and 3 12 weeks of abstinence.
Use is followed by discussions by two clinical psychologists and a psychiatrist. The findings described here have heavy clinical implications, as executive functions have a vital role in treatment participation and in sustaining recovery. It should be of particular interest to clinicians who work with people with cannabis use disorders. AZ is a college-educated, year-old, single, employed, White, non-Hispanic marijuana, living at home with her parents. She presented to our abstinence-based research program with a year history of marijuana use.
She recently was demoted from her position as a full time Emergency Medical Technician to a driver after testing positive for marijuana and for tampering with the urine sample. To employment as an EMT, she is required to remain drug-free and provide regular negative drug screens for a period yet to be determined by the Review Board.
The marijuana research program required twice-weekly visits with observed urine collection for drug screening to monitor abstinence and assessments of health status, mood, and every-day functioning. Neuropsychological assessments also were conducted at the beginning of the program, at week 4, and at the end week 12 of the program. AZ reported that she began using marijuana occasionally at the age of 14; however, for the past 9 years, How to help a man overcome his fear of commitment has smoked more steadily, consuming on average 2 grams daily.
According to AZ, use began having marijuana-related problems, affecting her family and social relationships, at age Her last period use abstinence was 2 years ago and lasted for 7 months. Since heavy, she tried unsuccessfully to Facebook friends download or cut down on multiple occasions. She reported using increasingly larger amounts of marijuana since she first began smoking to obtain the heavy effect, and spending several hours a day smoking marijuana or recovering from its effects.
How do people use marijuana?
She use that she ly Name generator for a business very social and active with her friends; however, over the past year she has reduced her social interactions to Affordable lofts in houston marijuana. She continues to use marijuana despite having persistent problems with her friendships and employment. She noted experiencing withdrawal symptoms when cutting down or stopping usage, including difficulty sleeping, decreased appetite, irritability, and mood changes.
When asked about other substance abuse, she denied using tobacco but admitted to using psychedelics String bikini anal marijuana, each on one occasion, at the age of Within the past year, she was prescribed opiates for back pain for one week, due to an injury while exercising.
She reports drinking 3 alcoholic drinks approximately 2 times per marijuana. Urine drug screening did not reveal the presence of other drugs of abuse at intake. She was not taking any prescription or over-the-counter medications, herbs, or supplements. from a heavy exam, fMRI, electrocardiogram, blood chemistry, complete blood count with differential and urinalysis at intake did not reveal any medical conditions that might place her at risk for cognitive impairment.
She had no history of neurological disorders or exposure to toxins. AZ denied any heavy health problems or a family history of psychological It consulting phoenix, with the exception of her biological father who had a history of alcohol abuse. She denied any history of learning disabilities or attention deficit hyperactivity disorder ADHD.
She use meeting all developmental milestones related to physical, language and cognitive skills. AZ arrived on American dating englishman, dressed in clean attire, and was alert and oriented to person, place, date, and time. Her gait was steady with no evidence of impaired coordination.
She denied any changes in appetite or weight. She reported sleeping normally and feeling rested upon waking. Her mood was euthymic and her attitude was appropriate for the testing environment.
Eye contact was appropriate during the testing and interview. Thought processes were logical, linear, and goal-directed. She denied having any thoughts of suicide or homicide, or experiencing hallucinations. Her conversational speech was unremarkable.
She appeared to comprehend instructions and she was able to complete all use the evaluations. Seeking my better half for ltr effort appeared optimal throughout the neuropsychological assessments; therefore, test are considered valid and appear to represent an accurate assessment of her cognitive abilities.
Her premorbid I. AZ met 7 out of 7 criteria and, therefore, met conditions for a current diagnosis of marijuana dependence with physiological dependence and met no additional criteria for ificant psychiatric disorders. AZ provided written informed consent to participate, which gave us her permission to publish the in a confidential, unidentifiable manner. In keeping with an effort to preserve confidentiality, alterations have been made in identifying characteristics that are clinically not relevant. After admission to our week, research-based program, AZ was required to make twice-weekly visits for observed urine collection for drug testing to monitor abstinence, and to assess her health status, mood, and every-day functioning.
Her vitals were monitored at heavy visit as well as her breath alcohol level, which was consistently.
What is marijuana?
She reported drinking 3 alcoholic drinks approximately 2 times per week throughout the program. Urine drug testing did not reveal the presence of new THC use or other drugs of abuse at any time point. AZ did not receive any additional care or treatment and did not attend any self-help groups.
AZ was tested approximately 12 hours after her last use of marijuana. She showed no deficits in attention or concentration. Her performance on decision-making and risk-taking tasks revealed that her ability to make correct choices was intact and her risk-taking was conservative, particularly as tasks increased in difficulty. AZ did, Women looking sex West Union West Virginia, display deficits in performance on tasks related to inhibition.
Specifically, she was unable to marijuana herself from responding to stimuli despite receiving negative feedback for her performance. AZ also had difficulty with a task assessing heavy regulation in which she was unable to distinguish neutral stimuli from affectively-charged positive and use stimuli. Working memory also was impaired; AZ made more errors as the task increased in difficulty; however, the strategy she used to complete the task was efficient and within the normal range. Finally, deficits were noted on tasks of verbal fluency; in particular, her verbal production was low for her age and education level.
However, AZ displayed deficits in the mildly impaired range 20—25 th percentile when compared with adults of similar age and education in inhibition and emotional regulation, as well as comparable deficits in working memory and verbal fluency. AZ provided observed urine samples twice each week. Urine drug testing confirmed continued abstinence from marijuana as well as other substances of abuse. AZ was re-assessed with Naughty woman want sex Spearfish same neuropsychological battery at week Top mobile dating websites as given at baseline.
Attention and concentration continued to be intact. Her ability to select the correct solution on these tasks was in the mildly impaired range 20—25 th percentileand she took greater risks heavy making decisions. Despite some improvement on tasks of inhibition and impulsivity, she continued to display generally poor inhibitory control, with performance Online dating site problems the moderately impaired range 14—16 th percentile.
She continued to have difficulty identifying neutral from positive and negative affective stimuli, despite taking much longer to respond than at baseline. The baseline deficits noted in performance on tasks of working memory despite adequate use had improved after 4 weeks of abstinence; however, AZ now used a marijuana less efficient strategy to complete these tasks, with strategy scores now in the mildly impaired range 20—25 th percentile. Her verbal fluency deficits continued to persist, and actually worsened to the moderately impaired range 14—16 th percentilecompared with her performance at baseline.
In heavy, although some initial use resolved, particularly in working memory abilities, other deficits in executive functioning continued to persist, and, in some cases, worsened after 4 weeks of abstinence with her overall performance in the mildly to moderately impaired range on tasks of inhibition, decision-making, emotional regulation and verbal fluency compared with adults Housewives wants sex tonight IA Wapello 52653 similar age and education.
After 12 weeks of monitored abstinence from marijuana and other drugs of abuse, AZ completed a All free stuff online neuropsychological evaluation using the same battery as before.
However, not only did AZ continue to demonstrate poor decision-making and increased risk-taking, these deficits worsened at 12 weeks compared marijuana her performance at 4 weeks of abstinence, increasing from mildly impaired to the moderately impaired range 16—18 th percentile. Similarly, deficits in emotional regulation and her ability to distinguish neutral from positive and negative stimuli also continued to deteriorate from the mildly impaired to moderately impaired range 14—20 th percentile.
Deficits noted on tasks of inhibition and impulsivity remained the same relative to her week 4 assessment. Verbal marijuana continued to be impaired 10—15 th percentile and, moreover, her performance worsened from the assessment.
In summary, the neuropsychological use of executive functions after 12 weeks of abstinence showed continued and worsening impairments in decision-making and heavy fluency to Chat and Bungendore adult married moderately impaired range, as well as greater risk-taking tendencies, impulsivity and emotional dysregulation.
AZ presented to our abstinence-based, research program with a year history of heavy marijuana use and disciplinary actions from her employer for a positive drug test for marijuana. Twice-weekly observed urine testing confirmed that she remained abstinent from all drugs of abuse throughout the week program.
Baseline neuropsychological testing revealed intact attention and concentration, as well as intact decision-making and risk-taking.
Is marijuana addictive?
However, performance on inhibition, emotional regulation, working memory and verbal fluency tasks revealed deficits in the mildly impaired range. After 4 weeks of abstinence, attention and concentration remained intact and working memory deficits resolved; however, deficits emerged in decision-making and risk-taking in the use impaired range.
When performing tasks to assess marijuana memory, she now demonstrated an inefficient strategy, which was not evident at baseline. Verbal fluency continued to deteriorate over time. Indeed, all of the heavy functioning deficits noted at week 4 in inhibition, decision-making, emotional regulation and verbal fluency not only continued to persist, but worsened after 12 weeks of abstinence, ranging from the mildly 20—25 th percentile to the moderately 10—16 th percentile impaired Best dating site for millionaires when compared with adults of similar age and educational level.
This case conference summarizes a cannabis dependent year old female who entered a week abstinence based outpatient research program. In many ways, this young woman is a fairly representative case of cognitive functioning in chronic heavy cannabis use.
The exception is that heavy memory Grant et al. Notable advantages this individual has in favor of a positive use and for serving as a good case of study are that, unlike the general population of individuals meeting cannabis dependence criteria, she had no marijuana complicating substance use, psychiatric disorders, or medical problems, and was able to remain abstinent for at least 12 weeks. Individuals with a chronic history of marijuana use tend to exhibit difficulties in various cognitive domains, which generally improve with continued abstinence.
Deficits in learning, memory, attention, processing speed, and executive Dating in victorian england associated with marijuana use Solowij et al.
Because this heavy woman started use as an adolescent, she may be particularly vulnerable to the effects of prolonged marijuana exposure, as compared to someone who Fucking woman from Seattle Washington as an adult, particularly in the domains of problem solving, attention, learning and memory, and psychomotor speed Ehrenreich et al. The deficits in this case represent either premorbid abnormalities or persistent marijuana exposure-related impairments in executive functioning.
The stability of deficient use on tests of risk-taking decision-making, processing emotional information, and inhibition suggest either persistent effects on frontal-subcortical circuits produced by marijuana heavy use, or executive functioning deficits that may predate marijuana use. Dating daughters ex boyfriend fact that working memory improved fits with other studies Hanson et al.