I am doing a segment with Bill O’reilly on the O’reilly factor about the potential negative side effects associated with smoking marijuana. This is a good opportunity for me to share my opinion on this matter.

According to a 2012 CBS/AP poll 1 in 10 teens smoke marijuana at least 20 times a month. This is an 80% increase since the poll began in 2008. Since the youth of our country is also our future, what will happen if the use of marijuana continues to grow through legalization? As a medical doctor, I am concerned with the health effects of widespread use of marijuana.

The IQ Factor
Aside from the physiological, psychological, and addictive effects marijuana can leave, can it also leave us less intelligent? A study out of New Zealand showed that people who began smoking marijuana heavily in their teens lost an average of 8 points in IQ between age 13 and age 38. Importantly, the lost cognitive abilities were not fully restored in those who quit smoking marijuana as adults. http://www.drugabuse.gov/publications/drugfacts/marijuana

It seems you cannot read a paper, news website or watch a news show without hearing about medical marijuana. Even NFL coach Pete Carroll, who is in New York this week to coach his Seattle Seahawks in the Super Bowl, spoke about his beliefs that the NFL should explore options such as medical marijuana to treat players. As marijuana treatment in America becomes more common, is it also dumbing us down and leaving us unable to cope?

Why are Americans in such a frenzy to use a substance that compromises their cognitive function? Does it make sense to treat a broad spectrum of problems with a drug that renders people temporarily in a haze? How does a mood-altering drug help people with their coping or self-soothing skills?

Legalizing Marijuana Use

More and more states are passing laws that will allow citizens with a doctor’s certification to obtain a marijuana card. This card will allow the patient to buy marijuana from a state-licensed seller, known as a dispensary. People most commonly smoke marijuana leaves, but you can also buy tea and baked goods (everything from pot brownies to gumdrops). The active ingredient in marijuana is THC (short for delta-9-tetrahydrocannabinol), which is quickly absorbed after smoking or ingesting pot. Within minutes, THC and the other substances in marijuana begin to take effect.

Who is Eligible and How Does it Work?

According to Barth Wilsey, MD, a pain medicine specialist at the University of California Davis Medical Center in Northern California, most patients seek medicinal marijuana cards for pain relief. However, doctors many also prescribe marijuana to treat:

  • Muscle spasms caused by multiple sclerosis
  • Nausea from cancer chemotherapy
  • Glaucoma
  • Poor appetite and weight loss caused by chronic illness, such as HIV, or nerve pain
  • Seizure disorders
  • Crohn’s disease
  • Depression
  • Anorexia
  • Anxiety

Psychological Effects of Marijuana

According to the National Institute on Drug Abuse, the main effects of marijuana on mood vary and may include euphoria, calmness, anxiety, or paranoia. Other short-term psychological effects may also occur and gradually subside after a few hours, with lasting effects up to a few days. These include:

  • Distorted sense of time

  • Paranoia

  • Magical or “random” thinking

  • Short-term memory loss

  • Anxiety and depression

Physiological EffectsThere are physiological effects as well. They include rapid heart rate, increased blood pressure, increased rate of breathing, red eyes, dry mouth, increased appetite, and delayed reaction time and cognitive function. Although these consequences gradually subside after 3-4 hours, the actual marijuana remains in your blood stream for up to 1 month.

This is Your Brain on Marijuana

In the short term, marijuana use impairs attention, concentration, perception, judgment, reaction time, thinking, memory, verbal fluency, and learning. These memory deficiencies may persist up to six weeks after the last use.

The authors concluded that some elements of executive function usually recover completely after stopping marijuana use. But the deficits most likely to persist for long periods of time include decision-making and concept formation and planning. (Crean et al., An Evidence Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions J. Addict. Med., 5: 1-8. 2011)

According to a Yale School of Medicine Psychiatry publication, “Cannabis produced dose-related impairments of immediate and delayed recall of information presented while under the influence of the drug. Learning, consolidation and retrieval of memory were all affected.” (Ranganathan M and D’Souza DC. The acute effects of cannabinoids on memory in humans: a review. Psychopharmacology, 188: 425-444, 2006).

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, published by the American Psychiatric Association, there is a class of mental disorders linked to marijuana use.

Cannabis Intoxication: Includes impaired motor coordination, anxiety, impaired judgment, sensation of slowed time, social withdrawal, and often includes perceptual disturbances

Cannabis Intoxication Delirium: Includes memory deficit, disorientation

Cannabis Induced Psychotic Disorder: Includes delusions

Cannabis Induced Psychotic Disorder: Includes hallucinations

Cannabis Induced Anxiety Disorder

Depression, Mental Illness and Marijuana

According to Dr. Gabreilla Gobbi, “Excessive cannabis use in people with depression poses a high risk of psychosis.” Young people who are genetically vulnerable to depression should be extra careful about using cannabis, as smoking cannabis leads to an increased risk of developing depressive symptoms. Several studies have linked chronic marijuana use and mental illness. High doses of marijuana can manufacture a temporary psychotic reaction (involving hallucinations and paranoia) in some users, and using marijuana can worsen the course of illness in patients with schizophrenia.

I feel the use of marijuana should be highly scrutinized and only be prescribed to patients in it’s medication form (Marinol) by qualified doctors to treat only certain illnesses including: severe nausea from chemotherapy, neuropathic pain (not headache or muscle aches) and wasting conditions found in aids and HIV. It appears the prescribed use of marijuana for pain is being abused and other alternative treatments for pain should be pursued.

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