Cannabinoids

Rx Name: Marinol (Dronabinol)
Street Names: Marijuana. Dope, weed, hemp, hash, grass, pot

Marinol (Dronabinol) represents a chemically synthesized THC=Marijuana. Available as Rx in Capsules. FDA approval for TX of chemotherapy-induced nausea and for appetite stimulation in the treatment of AIDS-related anorexia. It has psychoactive effects so patients are warned not to drive, operate complex machinery or engage in hazardous activity

Pharmacology:
Marijuana represents a mixture of the dried, flowering tops and leaves from the cannabis plant, Cannabis sativa. Contains a class of compounds known as cannabinoids. The principle psychoactive agent in cannabinoids is delta-9-tetrahydrocannabinol (THC). As a hallucinogen, it affects the mind causing a euphoria or "high", followed by drowsiness. Impairs concentration, learning and perceptual skills. Time, color and spatial perceptions are altered for 3-5 hours. Loss of coordination and judgment can last 24-48 hours for which the person is consciously unaware. Metabolites stored in fatty tissue that accounts for its slow excretion. Thus a positive urine drug test can result more than 30 days after it is stopped.

Daily use does not confirm an addict as it is easily stopped, having no significant addiction needs unlike those drugs that cannot be voluntarily controlled in causing addiction such as cocaine.

Diagnosis:
Urine: Screening immunoassay detects multiple metabolites of THC while the GC/MS specifically identifies and quantitates THCA. Standard lab cut-off level is 50 ng/ml, but it can be varied from 20 to 100 ng/ml, at the employer’s request in non DOT cases. The assay can be falsely positive as metabolites from other drugs can cross-react with the antibodies used in the immunoassays. Therefore, confirmation for a positive THC always must be established by a GC/MS lab confirmation test. Passive exposure to Marijuana smoke will not result in a positive THC urine test.
Hair: very small amounts THC are deposited into hair, thus HHS proposed 1pg/mg cut-off value for screening and 0.05 pg/mg as THCA cut-of confirmation by GC/MS. As such, infrequent users of THC will be missed with hair analysis..
Oral Fluid: only elicits THC that is deposited within oral cavity before it is swallowed (in salvia) or absorbed into the blood. THC is not transferred from blood to the oral cavity with 2 ng/ml cutoff in GC/MS lab confirmation. Positive THC confirms use of THC within 24 hours or less. Kissing some who is smoking Marijuana will not reveal a positive +THC test after 30-60 minutes, so always wait one hour before oral testing.
Blood: Can have high peak plasma concentrations of 100-200 ng/mg on recent usage but rapid elimination occurs so may be negative in 24-48hour.

Phencyclidine (PCP)

Rx Name: no other name
Street Names: PCP, Angel Dust, Love Boat

Pharmacology:
Intoxication begins several minutes after consumed. Major effects decline after 4-6 hours with 24 hours before returning to "normal". Unpredictable bizarre effects can not be predicted such as agitation, schizophrenic type personality changes. Physical findings Nystagmus, HVD, tachycardia, severe impairment of physical and mental abilities ever after one dose. It is lipid soluble like THC, so excretion is longer, up to 30+ days in chronic use. Ingestion acid solution like Cranberry juice enhances rate of excretion. Benadryl and Dextromorphan can cause false + assay reports but GC/MS determination confirms its existence.

Illicit Use:
Used for its "high metal effects" which are bizarre and in combination with other drugs to enhance their effect, such as Cocaine and THC. Can be smoked, eaten, snorted or injected IV.

See also other drug categories

• Stimulants
• Narcotics/Analgesics/Opiates
• Depressants/Sedatives/Hypnotics