Follow the Science

On Legalization of Recreational Marijuana, by Dr. Charles Morgan, MD

With the New York State Legislature seriously considering legislation to legalize marijuana for recreational, adult use in New York, I submit the following thoughts for readers' consideration.

The coronavirus pandemic has resulted in people acknowledging more than ever the importance of scientific knowledge. We now hear from all directions statements like, "What does the science tell us?" Some of our leading politicians commonly say, "Follow the science." At the same time, we are hearing some of these same politicians in New York state call for the legalization of marijuana. That being the case, one might ask what the science tells us about marijuana and THC, the main psychoactive compound in cannabis.

Here are some of the scientifically proven facts:

Cannabis is much more potent today than in the past. In 1995, the content of THC in the marijuana plant was about 4%. Not only has the amount of THC increased in the plant, but the average amount of THC in products sold in dispensaries can vary from about 17.7% to 23.2%. Concentrated products may contain over 75% THC.

Detrimental effects of cannabis start before birth. THC crosses the placenta and gets into breast milk, resulting in fetal growth retardation, low birth weight and premature birth.

Use of cannabis in adolescents predisposes them to the use of other drugs in later life as well as decreased academic achievement and increased dropout rates from school.

In addition, use of cannabis by adolescents is associated with increased rates of suicide and later development of serious mental illness, such as schizophrenia, especially in those who are predisposed. Even though cannabis is commonly thought of as "mellowing one out," it is actually associated with an increase in anxiety disorders.

The percentage of eighth- and 10th-graders who used cannabis daily increased significantly between 2017 and 2019, with a significant increase in those vaping cannabis in middle and high school students.

When people who have a history of trauma use cannabis, they actually have an increased risk of developing PTSD.

Although some proponents of legalization have stated that cannabis can help some mental disorders, the American Psychiatric Association says, "There is no current scientific evidence that cannabis is in any way beneficial for the treatment of any psychiatric disorder. Current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders."

Use in adolescence can result in decreased IQ and other intellectual impairments which may be long lasting and persistent.

Adverse effects do not just result from smoking marijuana. In fact, edibles, which can be a form that THC takes when legalized, have a higher concentration of THC and result in more emergency room visits than marijuana that is smoked.

Multiple studies have shown that cannabis use impairs motor function, judgment and reaction time, all of which need to be intact to safely operate a motor vehicle. Blood levels of THC and impaired driving have been shown to be directly related. It has even been associated with fatal automobile crashes.

The American Lung Association has stated that marijuana use clearly damages the lungs, and the American Heart Association's Scientific Statement says that marijuana use leads to cardiovascular disease.

According to the American Society of Addiction Medicine, surveys indicate that between 9.3% and 30.6% of Americans who use cannabis have cannabis use disorder or addiction to cannabis, and 23% of these have severe addiction.

Although various entities have touted marijuana's therapeutic effects for various medical conditions, the National Academies of Science, Engineering and Medicine found substantial evidence for effectiveness only for chemotherapy-induced nausea and vomiting, spastic multiple sclerosis and chronic pain. But other scientific studies showed that the benefits for neuropathic pain might be outweighed by the harm done by the use of cannabis. (Epidiolex is approved to treat specific seizures and contains a high concentration of cannabidiol, the other major component of cannabis.)

In 2017, the American Journal of Public Health published an article stating, "The most effective way to avoid any risks of cannabis use is to abstain from use."

A study by the Pew Charitable Trusts in 2019 indicated that tax revenue from legalizing marijuana has proven to be unreliable in states that have done so and that other sources of revenue should be relied on for the long haul.

The American Academy of Family Physicians states the following about marijuana and its legalization: "The Academy's policy on marijuana possession for personal use opposes the recreational use of marijuana. 'However,' the policy notes, 'the AAFP supports decriminalization of possession of marijuana for personal use. The AAFP recognizes the benefits of intervention and treatment for the recreational use of marijuana, in lieu of incarceration, for all individuals, including youth.' The policy also states that the Academy 'recognizes that several states have passed laws approving limited recreational use and/or possession of marijuana. Therefore, the AAFP advocates for further research into the overall safety and health effects of recreational use, as well as the effects of those laws on patient and societal health.'"

Several other medical professional organizations have addressed the issue of marijuana use and legalization, including the American Academy of Pediatrics, the American Academy of Addiction Psychiatry and the others mentioned in this article. None of them has outright recommended the legalization of marijuana, although some, like the American Society of Addiction Medicine, have strong recommendations for states that choose to legalize marijuana. All recommend that it not be used recreationally and that even for medical use, we need to be doing more research. All recommend that treatment and prevention efforts be strengthened and recommend against allowing people's lives to be ruined by such things as possession charges.

Certainly there is more to say about marijuana and there are more scientific facts. Hopefully elected officials in New York state will follow their own admonitions to "follow the science" when they consider legalizing marijuana.

Once opioids were touted to be without adverse effects, and being critical of their use was unpopular, and even criticized. Now we are suffering because of the opioid epidemic, with countless deaths of our loved ones. It turns out that the science never supported the level of prescriptions that were written in the country.

Let's not have a repeat of the opioid crisis. More thought is needed as we approach the issue of legalization of marijuana. The revenue generated by taxes on the substance may not be likely to be worth the cost to us and our children. And science has a lot to say. We should be asking the legislators if they've followed the science and then insist that they do so.

This article used the following sources which deserve credit for the facts presented. You can go to these sources, too, to learn more about this issue.

This article references numerous sources, which readers can access on St. Joseph's website at www.stjoestreatment.org under "About Us," then click "Follow the Science article."

---

Dr. Charles Morgan is interim medical director of St. Joseph's Addiction Treatment and Recovery Centers, based in Saranac Lake.