Current Studies & Articles

Cannabis is Not a Benign Drug
With the continued relaxation of societal norms regarding marijuana use, as manifest by its legalization, even for recreational purposes, in several states with more to come, it seems timely to re-evaluate the risk associated with the use of cannabis. And that is exactly what the doctors at the University of Pittsburgh Medical Center have done (http://www.upmcphysicianresources.com/cme-course/upmc-svnergies-fall-2013). Dr. Douaihy writes that currently there is “a little-informed or misinformed general public with no clear knowledge of what risk and harm is associated with cannabis use.” The following draws highlights from Dr. Douaihy’s article.

Smoked cannabis reaches the brain almost instantly, where a “high” is produced lasting from one to four hours. A few minutes into the instance of use the heart rate increases, the bronchial passages dilate, and the eyes redden. In this context feelings of euphoria and relaxation ensue, followed by sleepiness as the high passes, although some users become anxious and even paranoid. Synthetic cannabinoids, such as “K2” or “Spice” produce much the same effects.

While the effects of a single episode of cannabis use are typically mild and reversible, chronic use is associated with negative effects on mental processes that cause negative educational, occupational, and interpersonal outcomes. An especially vulnerable group are adolescents, in whom cannabis is associated with dropping out of school, unemployment, welfare dependency, and an overall feeling of dissatisfaction with life. Even more worrisome is the observation that these effects on mental processes ‘may not completely reverse with abstinence from cannabis.

Although data regarding the direct effects of cannabis use on the risk of developing a mental disorder are somewhat uneven, it is clear that anxiety disorders and cannabis use are linked. It is also clear that in individuals vulnerable to schizophrenia, cannabis use is associated with earlier age of onset, an increased risk of an acute event, and those who continue to use cannabis throughout their illness have more frequent hospitalizations, poorer overall functional outcomes, and are more prone to relapse into psychosis.

While people who seek help for cannabis use may not represent the typical user, it is instructive to observe what motivates them to get treatment; in particular, negative psychosocial consequences of use, interpersonal problems, diminished productivity, and loss of self-control. Also, their attempts to stop using results in an abstinence syndrome — characterized by irritability, anger, hostility, anxiety, depressed mood, craving for the drug, appetite disturbance, and insomnia — which can last from one the three weeks.

Whether the use of cannabis serves as a “gateway” to other drug of abuse has been debated. However, the best data and most sophisticated analysis confirms that this is in fact so. Indeed, the risk of illicit drug initiation was 21 times higher amongst cannabis experimenters and 124 times higher amongst daily cannabis abusers relative to non-users. Further, it has been averred that cannabis use is “safer" than alcohol use, yet cannabis use was linked to an increase in motor vehicle accidents, even after accounting for other variables; and the risk of crash involvement was increased as frequency and potency of cannabis use increased. Finally, the rate of emergency department visits and hospital admissions related to cannabis use has paralleled the rise in potency of cannabis.

In summary, cannabis is linked to addiction, impaired mental processes, motor skills deficits, respiratory and cardiovascular problems, and an increased risk of psychosis. For all these reasons, it must be concluded that cannabis is not a benign drug.
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