Marijuana Review Highlights Uncertainty Over the Effects of Its Greater Availability — Physician’s First Watch

Medical News |
June 5, 2014

Marijuana Review Highlights Uncertainty Over the Effects of Its Greater Availability

By Joe Elia

Edited by Susan Sadoughi, MD, and Lorenzo Di Francesco, MD, FACP, FHM

A New England Journal of Medicine review suggests that, with the greater availability of marijuana, patients are likely to have more questions about the drug's effects.

The authors, all from the National Institute on Drug Abuse, identify a range of associated harms — e.g., the risk for addiction, adverse effects on adolescent brain development, and impairment of motor functions. They also note that marijuana's potency has increased fourfold over the past 30 years, calling into doubt earlier findings based on less potent samples.

Marijuana's possible benefits include its anti-inflammatory effects, its effects (although transient) on intraocular pressure, and its ability, in a small study, to lessen the frequency of epileptic seizures in children.

The authors conclude with a warning that, as with the legal drugs alcohol and tobacco, marijuana's greater availability could magnify any adverse effects to a society-wide level.

Reader Comments (4)

Oleg Reznik, MD Physician, Family Medicine/General Practice, office practice

As the authors note, the study is not designed to show causality. While the hypothesis that legalized marijuana reduces opioid overuse may be true, it has not been the case in my experience with patients. Just as likely the study can be reflecting the effect of the social policies in the more "liberal" states, that may be providing more social programs for the poor and the unemployed, at the same time as liberalizing medical marijuana, etc.

John GILBERT Physician, Family Medicine/General Practice, Ireland

When a substance is illegal, it is difficult to move around without getting caught. If that substance is a drug, the more potent it is, the easier the logistics for a a given financial return. This in part explains why cannabis has been selectively grown to increase the THC content. When you meet your dealer, he does not offer a range or choice of product, you buy what he has. There is unlikely to be a warranty or after sales service.

Contrast this with an establishment selling legal products. In order to attract a broad customer base, a range of stock is held and may be offered with informed advice on choice. There is likely to be a drift away from the skunk end of the market because of the discomfiting paranoid thoughts experienced by so many of the smokers.

Let the free market rule - and tax the product according to THC content.

SHELDON BALL Physician, Geriatrics, Anvita Health

Notably absent is a discussion of use in moderation vs use in excess and the fascinating study on the effects or marijuana on pulmonary function.
Pletcher MJ et al
Association Between Marijuana Exposure and Pulmonary Function
Over 20 Years
JAMA. 2012;307(2):173-181
PMID: 22235088

Robert Owens, OD, FAAO Other Healthcare Professional, Other, Solo practitioner

This is a good reason for why medicinal cannabis should be legalized, regulated and more research conducted into the health benefits of Cbds.

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