Physicians and healthcare systems, as sources of credible public health information, have a responsibility to share both potential risks and unexpected consequences of the legalization of marijuana.
Marijuana has had a complex effect on health according to a recent New England Journal of Medicine (NEJM) article entitled, “Cannabis-Related Disorders and Toxic Effects.”
The easy access to marijuana has led to exacerbations of chronic health conditions, particularly mental health disease. It is difficult to fully quantify the worsening of psychosis, anxiety, depression, and other mental health diseases, but easy access to marijuana and other narcotics makes a bad condition worse. Without question, the combination of marijuana plus alcohol increases the risk of motor vehicle accidents more than either substance used alone.
Currently, all but three states (Idaho, Kansas, and Nebraska) have some form of legalized cannabis product. Emergency room treatment for marijuana intoxication was rare until the laws changed. Now patients appear in emergency departments with anxiety, panic attacks, public intoxication, vomiting, and other symptoms of marijuana use.
Safer medications are already on the market for all medical uses for marijuana. Ameliorating the side effects of cancer and chemotherapy can be accomplished without medical marijuana. The same is true for glaucoma and seizure disorders. But the financial rewards for marijuana purveyors are astounding, which surely contributes to their tenacity.
“The 2018 Farm Bill removed cannabis plants containing less than 0.3% THC from the jurisdiction of the Controlled Substances Act and defined them as hemp. The CBD products now widely available in the United States are presumably derived from hemp,” according to the NEJM article referenced above.
The unforeseen harm of the increased production and distribution of marijuana includes anxiety, panic attacks, paranoia, and psychotic symptoms such as hallucinations, delusions, and cyclic vomiting syndrome. Cyclic vomiting syndrome—which presents with severe abdominal pain, vomiting, and unusual sweating—is now more prevalent.
Potential overdoses increase by using edible forms. Smoked marijuana reaches a peak between 30 and 90 minutes, whereas the edible form peaks at 3 hours. This delayed effect from the oral form can seduce a user into ingesting additional amounts due to the delayed reaction—and thus can lead to an overdose. One of the worst unforeseen negative outcomes is children inadvertently ingesting edible marijuana in the form of cookies, candy (gummy bears), or baked goods.
Overdosing, widespread distribution, impairment of cognitive function, addictive potential, loss of self-control, and worsening of mental illness are all negative influences of marijuana. Currently, no specific antidote for cannabis intoxication exists. Close observation in a safe, quiet environment with supportive reassurance is recommended.
Concerningly, the financial gain for the growers, sellers, and distributors of marijuana will perpetuate the continued use. Meanwhile, let’s stay informed as we consider the welfare of our entire community.
