Kannabis ile İlişkili Bozukluklar
Özet
Kannabis (esrar), kenevir bitkisinden elde edilen ve psikoaktif etkilere neden olan bir maddedir. Son yıllarda değişen yasalar ve yasallaşma süreçleri, bu ürünlerin ulaşılabilirliğini ve yoğun kullanım oranlarını artırmıştır. Kannabis içeriğinde 550'den fazla kimyasal bileşik barındırır; en önemli bileşenleri öfori ve psikotropik etkilerden sorumlu tetrahidrokannabinol (THC) ile terapötik etkileri olan kannabidioldür (CBD). Maddenin düzenli veya kronik kullanımı; bilişsel işlevlerde bozulma, bağımlılık, anksiyete, depresyon, bipolar bozukluk seyrinde kötüleşme ve özellikle yatkınlığı olan bireylerde şizofreni dahil kronik psikoz riskinde artış gibi ciddi ruhsal ve fiziksel sağlık sorunlarıyla ilişkilendirilmiştir. Kannabis Kullanım Bozukluğu (KKB) tanısı DSM-5 kriterlerine göre klinik sıkıntı ve işlevsellik kaybına yol açan belirtilerle konulmakta ve şiddeti bu belirti sayısına göre belirlenmektedir. Akut zehirlenme vakalarında bilişsel bozulma, taşikardi, halüsinasyon gibi semptomlar görülürken; kullanımın bırakılması durumunda ise öfke, uyku sorunları ve terleme gibi yoksunluk belirtileri ortaya çıkabilmektedir. Günümüzde KKB tedavisi için FDA onaylı bir ilaç bulunmamakta, bu nedenle bilişsel davranışçı terapi ve motivasyon arttırıcı terapi gibi psikososyal müdahaleler ilk seçenek olarak uygulanmaktadır. İlaç tedavilerinde ise gabapentin ve N-asetilsistein (NAC) gibi ajanlar üzerine yapılan klinik çalışmalar bazı umut verici sonuçlar sunmaktadır.
Cannabis is a substance obtained from the hemp plant that causes psychoactive effects. In recent years, changing laws and legalization processes have increased the accessibility and intensive use rates of these products. Cannabis contains more than 550 chemical compounds, the most important components of which are tetrahydrocannabinol (THC), responsible for euphoria and psychotropic effects, and cannabidiol (CBD), which has therapeutic effects. Regular or chronic use of the substance has been associated with serious mental and physical health problems, such as impaired cognitive functions, addiction, anxiety, depression, worsening in the course of bipolar disorder, and an increased risk of chronic psychosis, including schizophrenia, especially in vulnerable individuals. The diagnosis of Cannabis Use Disorder (CUD) is made according to DSM-5 criteria with symptoms leading to clinical distress and loss of functionality, and its severity is determined by the number of these symptoms. While symptoms such as cognitive impairment, tachycardia, and hallucinations are observed in acute intoxication cases, withdrawal symptoms such as anger, sleep problems, and sweating may occur when use is discontinued. Currently, there is no FDA-approved medication for the treatment of CUD; therefore, psychosocial interventions such as cognitive behavioral therapy and motivational enhancement therapy are applied as the first-line option. In pharmacological treatments, clinical studies on agents such as gabapentin and N-acetylcysteine (NAC) offer some promising results.
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