("Smoking high-potency marijuana may cause psychiatric disorders."
FoxNews.com. February 17, 2015.)
I recently attended a presentation in Huntington, West Virginia by Sam Quinones, author of Dreamland: The True Tale of America's Opiate Epidemic. During the question/answer session of the event, a young man asked Quinones how he felt about legalization.
When explaining his position on legalizing marijuana, Quinones answered that a possible compromise would be to limit the potency by voting for legalization of pot with a low THC content. He used an analogy to alcohol and the difference between 6% beer and much higher proof alcoholic spirits to emphasize the effect of the apparent intoxicating effects.
This was the first time I had heard of such a proposal to legalizing marijuana. The more I thought about it, the more sense this simple compromise made to me. Let me explain why I think legalization without specific controls is dangerous and why I have since have found Quinones's idea to be a more responsible solution than no-holds-barred legalization.
Thinking About THC
The intoxicating chemical in marijuana is tetrahydracannabinol, or THC. While a handful of growers are finessing strains to provide a medical benefit without the high, the majority aim to push THC content as high as it will go according to government data. Most people want pot to simple get high.
The most potent strains have a THC content of around 25%, according to testing commissioned by the organizers at High Times magazine. But at the University of Mississippi, in a laboratory that tracks the potency of marijuana seized by federal law enforcement officers, they've found even higher levels -- as high as 37%, according to Dr. Mahmoud ElSohly, the director of the Marijuana Potency Project.
Since 1972, ElSohly says, the average THC content of marijuana has soared from less than 1% to 3 to 4% in the 1990s, to nearly 13% today.
"You really have to be careful," he says. "The danger of this high-potency material is not with the experienced marijuana smokers, but young people who really don't know what they're smoking. They don't know what to expect, and before they know it, they've inhaled too much."
(Caleb Hellerman. "Is super weed, super bad?" CNN. August 09, 2013.)
Of course, for most people, getting "altered" is the whole point of ingesting marijuana. They seem to be breaking any envelope to get higher and higher. A growing number of young people are giving up joints and even Cannabis Cup-quality buds to get high inhaling the smoke from concentrated oils with a THC content of 50% or more.
Virtually everyone knows the risk of overdose with marijuana is far less serious than with cocaine or heroin. But certain behaviors -- like driving -- can be deadly if you're acutely intoxicated.
"The risk is not that you'll stop breathing or that you'll die," says Dr. Julie Holland, a psychiatrist in New York who studies the history and science of cannabis. "The risk is that you'll become very altered and disoriented, and you can get anxious and panicky in that situation."
The only cure is a few hours of waiting, and reassurance.
Visits to the hospital related to marijuana are more frequent than many suspect. More than 455,000 patients entered emergency rooms with marijuana in their system in 2011, a 19% increase from just two years earlier according to government statistics.
The figure represents all patients with marijuana in their system, whether or not the ER visit is related to the drug. But most experts agree that along with showing an increase in usage, those numbers also indicate an increase in marijuana-related problems.
"There's an increase in psych admissions," says Dr. Stuart Gitlow, a psychiatrist who estimates that upwards of 1 in 100 people using high-THC marijuana experience psychotic symptoms. As president of the American Society for Addiction Medicine, Gitlow also worries about the long-term impact.
(Caleb Hellerman. "Is super weed, super bad?" CNN. August 09, 2013.)
THC In Colorado?
The THC content found in Colorado marijuana is considered to be the highest in the world, so residents there believe keeping these products out of the hands of Colorado youth is more important than ever.
There, Fresh Baked, which sells recreational marijuana in Boulder, offers “Green Crack” with a THC content of about 21 percent and “Phnom Penh,” with about 8 percent. The level in a concentrate called “Bubble Hash” is about 70 percent; cartridges for vaporizers, much like e-cigarettes, range from 15 to 30 percent THC.
Smartcolorado.org says while there is irrefutable research on how marijuana at 2-5% THC levels permanently impacts the developing brain, there has yet to be any research conducted on what the specific health and safety implications are for youth, or even adults, from consuming marijuana at the THC levels (ranging up to 90%) of the marijuana being sold today.
Smartcolorado claims the confusion over the type of marijuana sold in pot shops and the marijuana used to make “Charlotte’s Oil” for kids suffering from uncontrollable seizures only serves to cloud two very different and important issues. The marijuana used to help children with seizures contains almost no THC but is high in CBD (Cannabidiol), the chemical believed to contain medicinal properties.
Smartcolorado contends it is extremely unfortunate when the health and well-being of one group of children is inappropriately used to prevent us from protecting the rest of Colorado children and teenagers.
("The Potency." smartcolorado.org. 2015)
Actual Studies To Consider
Though proponents of marijuana legalization claim it will be useful to stimulate appetite, quiet pain, soothe anxiety, and even reduce epileptic seizures, research on the drug is very tightly restricted, so few reliable studies have tested these medical claims.
Studies do support the fact that short-term use of the drug impairs thinking and coordination. In long-term studies, teens who smoke marijuana have exhibited lower IQs later on, as well as suffering structural differences in their brains, though scientists debate whether this is an effect of the drug or a result of habitual pot smokers seeking out less intellectually stimulating pursuits.
Still, evidence of long-term effects is building. A study released in 2012 showed that teenagers who were found to be dependent on pot before age 18 and who continued using it into adulthood lost an average of eight I.Q. points by age 38. In 2013, Dr. Hans Breiter, professor of psychiatry and behavioral sciences at Northwestern’s medical school, and his colleagues also saw changes in the nucleus accumbens among adults in their early 20s who had smoked daily for three years but had stopped for at least two years.
They had impaired working memories as well. “Working memory is key for learning,” Dr. Breiter said. “If I were to design a substance that is bad for college students, it would be marijuana.”
(Abigail Sullivan Moore. "This Is Your Brain on Drugs.
The New York Times. October 29, 2014.)
Marijuana use has been linked to mental illnesses such as schizophrenia, according to NIDA. While studies may differ about whether causes these illnesses, most conclude use can make them much worse.
In fact, a recent study published in the journal Lancet Psychiatry has linked smoking strong, high-potency marijuana to an increased risk of developing psychiatric disorders.
Study authors from the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, analyzed about 800 people ages 18 to 65. According to a news release, at the beginning of the study, 410 of those patients had reported a first episode of psychosis and 370 healthy patients were used as a control.
After examining their marijuana use, researchers observed that compared to those who never smoked, study participants who tried the stronger variety of marijuana had a threefold increased risk of developing psychosis. Those who used the potent pot every day had a fivefold increased risk of developing psychosis.
“Skeptics still claim that this is not an important cause of schizophrenia-like psychosis. This paper suggests that we could prevent almost one-quarter of cases of psychosis if no one smoked high-potency cannabis,” senior researcher Sir Robin Murray, a psychiatric research professor at King’s College, said in the news release.
("Smoking high-potency marijuana may cause psychiatric disorders."
FoxNews.com. February 17, 2015.)
Abigail Sullivan Moore also reported that high-THC marijuana is associated with paranoia and psychosis, according to The New England Journal of Medicine. Concerns over increasing potency, and rising usage among the young, is giving new urgency to research.
“We have seen very, very significant increases in emergency room admissions associated with marijuana use that can’t be accounted for solely on basis of changes in prevalence rates,” said Nora D. Volkow, director of the National Institute on Drug Abuse and a co-author of the THC study.
“It can only be explained by the fact that current marijuana has higher potency associated with much greater risk for adverse effects.”
(Nora D. Volkow, M.D., Ruben D. Baler, Ph.D., Wilson M. Compton, M.D., and Susan R.B. Weiss, Ph.D. "Adverse Health Effects of Marijuana Use." N Engl J Med 370. June 5, 2014.)
It's unclear whether marijuana is a gateway drug to more serious substances. Yet, studies show that people who use marijuana are more likely to later abuse other drugs. But scientists aren't sure of the reason. It's possible that marijuana, like alcohol and nicotine, "prime the brain for a heightened response to other drugs," Volkow wrote.
Higher potency may simply accelerate addiction. “You don’t have to work so hard to get high,” said Alan J. Budney, a researcher and professor at Dartmouth’s medical school. “As you make it easier to get high, it makes a person more vulnerable to addiction.” Among adults, the rate is one of 11; for teenagers, one of six.
(Abigail Sullivan Moore. "This Is Your Brain on Drugs.
The New York Times. October 29, 2014.)
The effects of chronic marijuana use on the brain may depend on age of first use and duration of use, according to researchers at the Center for Brain Health at The University of Texas at Dallas.
In a paper published November 10, 2014, in Proceedings of the National Academy of Sciences (PNAS), researchers for the first time comprehensively describe existing abnormalities in brain function and structure of long-term marijuana users with multiple magnetic resonance imaging (MRI) techniques. Findings show chronic marijuana users have smaller brain volume in the orbitofrontal cortex (OFC), a part of the brain commonly associated with addiction, but also increased brain connectivity.
“To date, existing studies on the long-term effects of marijuana on brain structures have been largely inconclusive due to limitations in methodologies,” said Dr. Filbey. “While our study does not conclusively address whether any or all of the brain changes are a direct consequence of marijuana use, these effects do suggest that these changes are related to age of onset and duration of use.”
(Francesca M. Filbey et.al. "Long-term effects of marijuana use on the brain."
Center for BrainHealth. PNAS. 2014.)
So, in conclusion, I come back to the remarks by Sam Quinones. As I consider Issue 3 in Ohio sponsored by a group named Responsible Ohio that would legalize the recreational use of marijuana in the Buckeye State, I believe the proposal is not at all "responsible" in that it opens the door for high-potency cannabis.
The easy availability of high-potency marijuana poses too many health risks to the general public. Proponents want to deny this, and they portray pot as a non-addictive, safe substance that will be used legally only by responsible adults. Although the comparison is "apples and oranges," I have heard Purdue claim this about a painkiller than caused a national health epidemic -- OxyContin.
In no way am I suggesting legalized marijuana has the same potential for destruction as the aforementioned prescription opiate. I am saying present research confirms marijuana high in THC is a dangerous product for recreational consumption.
You may consider the comparison to the alcoholic content of beer and liquor to be a false analogy; however, voting "yes" for Issue 3 will open the door for yet another vice -- like drinking alcohol and smoking cigarettes -- that offers little value other than getting wasted to those who seek the strongest substance to accomplish the deed.
Why not vote down Issue 3 and make better proposals that limit THC ... even if you support recreational pot? Think about it.
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