Over the last few weeks I have had several young patients (and some older patients too) admit freely to smoking marijuana regularly. When asked if they have considered stopping, they answer “No, why would I stop?”
Ohio has recently legalized medical use of marijuana, and this morning I had some education on the controversy and realities of marijuana use for medical purposes. It was easier for us doctors when it was illegal, LOL!
Does marijuana have good effects? Yes, there are therapeutic reasons to use marijuana, which is the basis for legalizing the medical use. However, it’s important to realize that the medical marijuana law does NOT allow smoking pot. Legal forms include vaping, edibles, tinctures, oils and patches.
Marijuana helps patients with seizures, anxiety, post-traumatic stress disorder, chronic pain, nausea and vomiting from cancer therapy, fibromyalgia, inflammatory bowel disease, multiple sclerosis, and a host of other medical problems. Ohio’s medical marijuana program should be deployed later this year (there have been logistical problems).
Doctors have to undergo education before they can be certified to recommend medical marijuana. Marijuana can NOT be prescribed – it is a schedule I narcotic and if doctors prescribe it they will lose their DEA certification. Doctors who are certified to recommend medical marijuana use can sponsor patients to get a card which will allow them to buy marijuana at a dispensary.
We have been informed that our medical malpractice insurance carrier will not cover us if we recommend marijuana. All three large health systems in Cleveland and most (if not all) of the health systems in Ohio are in the same situation. There are almost 300 physicians in Ohio (as of today) who do have certificates to recommend. You can find the up-to-date list at this link.
What are the health risks if you do choose to use marijuana? Smoking a joint increases the heart rate and slows coordination, interferes with thinking and remembering and increases appetite. States with legal recreational marijuana use have recorded an increase in car accidents attributable to people driving while stoned. I’ve seen a number of young women who smoke marijuana regularly and complain about weight gain. (Go figure!)
Marijuana IS addictive. It is the most commonly used drug of abuse in the United States. Research has shown that 9% adult habitual users of marijuana and 17% of teenage users will become addicted. Signs of addiction include inability to stop using marijuana, continued use in spite of negative social and health consequences and difficulty maintaining relationships with others that don’t smoke pot.
Marijuana causes changes in the brain, specifically in areas related to learning and memory. It’s worse when teenagers smoke pot, because their brains are still developing. Pregnant women who use marijuana have children with higher rates of attention, learning and behavior problems. Secondhand marijuana smoke also contains THC so parents who smoke pot around their children are exposing them to an addictive substance that affects their growth and development.
While it’s not proven that marijuana use causes lung cancer, it definitely causes problems with the lungs, including cough and phlegm production and an increased risk of bronchitis. Also, most people who use marijuana also smoke tobacco, with all the risks tobacco smoking brings.
Even though use of small amounts of marijuana (the equivalent of one or two “hits” on a marijuana cigarette) can alleviate anxiety, using more actually can worsen anxiety. Marijuana users are also much more likely to develop mental disorders like schizophrenia. Teens in particular are more likely to have depression, anxiety and suicidal thoughts if they smoke pot. It’s not clear whether this is a causative relationship (i.e. do they smoke pot because they’re depressed and anxious, or the other way around).
There is also a risk of poisoning with edible marijuana products. Absorption through the GI tract is unpredictable and it can take 30 minutes to 2 hours to take effect. It is easy to over-indulge if it takes that long for the drug to make itself felt. Also, children can easily overdose if they get into marijuana edibles. In states where marijuana is legal, ER visits for accidental overdoses in children have gone up significantly.
Marijuana use is on the rise. Both adults and teens are using marijuana and have the mistaken impression that because it has been legalized for recreational and medicinal use that means it is safe. Marijuana use is NOT safe, it has real and significant health and social consequences.
QUESTION: Do you think marijuana use should be legal? Why or why not?