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Resumen
Abstract
Dating from antiquity, the Cannabis sativa plant (marihuana) of the Cannabaceae family
has been put to multiple uses: industrial, medicinal and religious. Lately, however, the
phenomenon of addiction has expanded socially and in spite of measures taken to control
it, massive consumption of marihuana has grown among Colombian youth. Objectives: To
establish an approach that is appropriate for patients addicted to marihuana and to show
different aspects related to this substance, as well as to lay significance on the mechanism
1
Médica residente de la Especialización en Toxicología Clínica, Departamento de Far-
macología y Toxicología, Universidad de Antioquia. Medellín, Colombia.
2
Médico residente de la Especialización en Medicina Interna, Departamento de Medicina
Interna, Universidad de Antioquia. Medellín, Colombia.
of action of the endocannabinoid system. Method: The article describes the generalities of
marihuana, its kinetics (absorption, distribution, metabolism and excretion), toxicology and
the effects of chronic use. Conclusions: In spite of the fact that marihuana consumption is
accepted in several countries, as its effects are considered less deleterious than those of
other substances, only by understanding the molecular mechanisms of addiction will it be
possible in the future to design pharmacological strategies that will diminish or eliminate
marihuana-related withdrawal symptoms.
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tinencia a los canabinoides. Esta esto, puede decirse que los efectos
disminución en la actividad eléctri- conductuales de este compuesto
ca se asocia con el afecto negativo, son de tipo depresor. Cuando se
disforia y síntomas distímicos cró- habla de los efectos de los cana-
nicos, que constituyen el síndrome binoides sobre el comportamiento
amotivacional que ocurre con la frente a otros individuos, se presen-
suspensión de la droga, considerada ta una dualidad entre agresividad
uno de los factores de riesgo para y apatía.
las recaídas (66). Diferentes modelos animales
La administración crónica de muestran que este compuesto
THC induce tolerancia y depen- induce un estado de agresividad.
dencia, al tiempo que produce En humanos, tras la ingestión o
neuroadaptación permanente en el inhalación de canabinoides, viene
circuito de recompensa, similar a un estado de excitación donde pre-
las inducidas por otras drogas de dominan las ideas de megalomanía.
abuso. Falta mayor investigación En cuanto a la actividad locomoto-
para evaluar otras hipótesis alter- ra, este tipo de estudios también
nativas que expliquen con mayor ha evidenciado ciertas alteraciones
alcance la conducta adictiva a la de los movimientos como la ataxia,
marihuana y las relaciones entre aunque en humanos no son tan
el sistema canabinoide y el sistema evidentes.
opioide. Por otro lado, son muchos los
órganos y sistemas que se ven afec-
Efectos nocivos del uso crónico tados, como el aparato respiratorio,
de la marihuana en el cual hay una alta incidencia de
neumopatías asociadas. Así mismo,
Al momento de plantear de forma el sistema neuroendocrino, donde
clara los efectos de los canabinoides, se observan efectos francos sobre
nos encontramos ante el problema la función sexual y reproductiva,
de que los experimentos en animales como la disminución libidinal, ciclos
no proporcionan datos extrapolables anovulatorios, oligospermia y alte-
a la especie humana, para derivar ración en la movilidad de los esper-
nuevas teorías sobre sus efectos en matozoides. En el sistema inmune,
el comportamiento y en los diferentes se suprimen respuestas humorales
órganos y sistemas. y celulares in vivo e in vitro, que
Los efectos conductuales aso- aumentan la susceptibilidad a las
ciados al consumo crónico de cana- infecciones.
binoides son complejos y dependen Se pueden incluir tres catego-
de muchas variables, como el con- rías para clasificar las consecuen-
sumidor, el ambiente de consumo y cias psiquiátricas del consumo de
la psicopatología de base. A pesar de marihuana (67):
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Escobar I., Berrouet M., González D.
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Correspondencia
Isabel Eugenia Escobar Toledo
Toxicología Clínica
Universidad de Antioquia
Calle 67 No. 53-108
Medellín, Colombia
isaescobartoledo@hotmail.com