The ongoing debate about the use of marijuana as a medicinal therapy and recreational drug continues to rage in the halls of power and the public square, but, surprisingly, there is also a continuing back-and-forth among physicians and the scientific community. Despite its presence in Western society since the 19th
century, there is still a dearth of authentic and reliable science on its health effects. It remains a proscribed substance in 26 of the U.S. states; it is available as a medicinal in the other states, with four allowing recreational use.
Among the medical community, the most likely answer to the question, "Is marijuana safe?" is most likely "It depends" On the spectrum of detrimental substances it probably ranks close to alcohol. In terms of lethality, marijuana is less dangerous than alcohol, but because it also impairs reflexes and decision making, it can contribute to unsafe situations which can produce fatalities.
Also like alcohol, marijuana has potentially catastrophic health effects if used for an extended period. If smoked, marijuana may produce similar effects to tobacco smoking including diminished lung function and cardiopulmonary issues. Research has also shown that prolonged use can induce hallucinations, paranoia and schizophrenia, as well as diminish cognitive ability.
Despite these serious health detriments and condemnations from medical authorities like the American Medical Association and the American Society of Addiction Medicine, a growing number of states are legalizing it. The prevailing justification for medical marijuana is its efficacy in relieving some forms of chronic pain, mental health conditions and nausea.
Unfortunately, this pretext is largely anecdotal. There is no authoritative study that can confirm that cannabis does produce these effects. Because of federal laws restricting use of marijuana, there is a paucity of scientific research that physicians can use to support a cannabis-based therapy.
A recent study published in JAMA found that most of 79 randomized trials were unreliable because the trial sizes were not statistically significant. The meta-data suggests that while there is some evidence that cannabinoids could remediate nausea, pain and sleep disturbances, they could also produce serious side effects like nausea, vomiting, dizziness and hallucinations. The authors of the JAMA study recommended a larger, more definitive trial.
In addition to the questionable science, there is a serious, almost criminal, lack of standardization in the production of cannabis medical products. A study by Professor Ryan Vandrey of Johns Hopkins School of Medicine reports that of 75 marijuana dispensary products tested, only 17 percent were accurately labeled. Physicians already lack reliable dosage recommendations, causing many to resort to trial and error protocols, so the lack of packaging information in many foods and medicines exacerbates the murkiness of prescribing marijuana.
In spite of a more accepting American populace and political establishment, there may be issues with widespread use of marijuana, even in a controlled medical setting. Without considerably more research into the effects of marijuana use and additional oversight of production and distribution, it is still unclear if marijuana poses considerable health risks.
Article written by:
Robert Moghim, M.D.
CEO, Health Carousel Locum Tenens