The Dangers of Medical Marijuana

Family North Carolina Magazine—January/February 2009

By Brittany Farrell

Approximately 95 million Americans over the age of 12 have tried marijuana at least once, making it the most widely used illicit drug in the United States, according to the Department of Health and Human Services.1 Despite the federal government’s classification of marijuana as a Schedule I controlled substance, the last decade has brought increased debate regarding the possibility of legalizing the drug for medicinal purposes. While 13 American states have legalized “medical marijuana,” the medical community and government are much more hesitant to jump on the bandwagon. A host of risks are associated with marijuana use from health to legal to economic. This drug is currently illegal because of the physical, social, behavioral, and academic harm it causes.

Physical Risks

Perhaps the greatest misconception from the drug legalization community is that marijuana can treat symptoms or illnesses which themselves can be the result of marijuana use. These include respiratory illnesses, immune system complications, and poor mental health. Additionally, marijuana use is known to contribute to increased violence, traffic accidents, drug abuse, as well as poor grades and risky sexual behavior in youth. The prominent chemical in marijuana, delta-9-tetrahydrocannabinol (THC), is known to obstruct the flow of chemical neurotransmitters, which are linked to both addiction and feelings of pleasure. THC affects cannabinoid receptors specifically in the parts of the brain responsible for pleasure, memory, thought, concentration, sensory time and perception, and coordinated movement.2

Marijuana v. Tobacco
A common argument in support of the legalization of marijuana for medicinal or other purposes is that it is less harmful than currently legal tobacco products, specifically cigarettes. This claim does not hold up under scrutiny, however. Almost all concerned parties are in agreement that tobacco is detrimental to both the short¬-term and long-term health of smokers and non-smokers who have been exposed to secondhand smoke. Unlike tobacco products, marijuana damages both the physical and mental health of users, often in much worse and more permanent ways.

Smoking three or four marijuana joints a day causes the same respiratory harm of smoking a full pack of cigarette every day.3 Each joint contains between 50 and 70 percent more carcinogenic hydrocarbons than any cigarette. Marijuana also contains high levels of the enzyme known to convert hydrocarbons into malignant cells.4 Marijuana smokers inhale three to five times more tar and absorb three to five times more carbon monoxide than do tobacco smokers.5

Marijuana is considered addictive by the American Psychiatric Association. According to its Diagnostic and Statistical Manual of Mental Disorders, marijuana meets criteria necessary for substance dependence including “tolerance (needing more of the substance to achieve the same effects, or diminished effect with the same amount of the substance); withdrawal symptoms; using a drug even in the presence of adverse effects; and giving up social, occupational, or recreational activities because of substance abuse.”6 In 2002, marijuana was the substance of choice for more than 60 percent of Americans who abused or were dependent on illicit drugs.7

In sum, marijuana poses significantly more risks to respiratory health than tobacco, contains much higher amounts of harmful chemicals like tar, carcinogens, and carbon monoxide found in cigarettes, and is also addictive. To date, the U.S. Food and Drug Administration (FDA) has not approved a single medication that is smoked because smoking is considered such a crude means by which to deliver medicine. Because THC may be beneficial to the treatment of some illnesses, though, researchers continue their attempts to refine the isolation of it and to develop alternative non-smoking delivery systems. Marinol is a current example of a drug successfully made from synthetic THC to treat nausea in chemotherapy patients. According to the Institute of Medicine “there is little future in smoked marijuana as a medically approved medication.”8

Respiratory Illnesses
Marijuana causes many of the same respiratory problems as tobacco. Coughing, wheezing, chest colds, and bronchitis are outward signs of more serious internal problems. Lung inflammation, obstructed airways, and impaired function of smaller air passages make breathing difficult. More concerning are the pre-cancerous abnormalities and reduction in the defensive mechanisms of the lungs. According to a Harvard paper on the medical dangers of marijuana, there are an “unexpectedly large proportion of marijuana users among cases of lung cancer and cancers of the oral cavity, pharynx, and larynx.”9 Deterioration in lung function and the lungs’ abilities to defend against harmful substances or microorganisms raises the risk of lung infections.10

Immunosuppressant
Advocates of “medical marijuana” see a role for marijuana in the treatment of nausea among chemotherapy patients and loss of appetite among AIDS patients. The most glaring problem with this claim is that marijuana is an immunosuppressant that weakens natural immune mechanisms, including so called “killer cells” and T-cells, which are primarily responsible for fighting infection and are already deficient in persons with either of these conditions. The same Harvard paper discussing the medical dangers of marijuana use found that marijuana may in fact “accelerate the progression of HIV to full-blown AIDS and increases the occurrence of infections,” which are especially dangerous to patients with weakened immune systems as a result of AIDS or chemotherapy.11

A single joint a day can so damage the cells in the bronchial passages that they are unable to protect against inhaled microorganisms making it more difficult for immune cells in the lungs to fight fungi, bacteria, and tumor cells.12 A Columbia University study found that smoking one marijuana cigarette every other day for a year resulted in a white-blood-cell count 39 percent lower than normal.13 This significant drop is likely fatal for patients with already weakened immune systems. There is no wisdom is prescribing marijuana for patients who cannot afford another attack on their immune system.

Mental Health
Despite claims that marijuana is less harmful than cocaine, heroin, and alcohol, it exhibits similar brain changes as each of these other substances.14 Cognitive impairment, distorted perception, memory loss, trouble with thinking and problem solving, difficulty learning, anxiety, panic attacks, depression, social withdrawal, paranoia, and hallucinations are just the beginning of the mental health complications presented by marijuana use.15 These symptoms can last as long as six weeks after the last use of the drug. Ironically, panic attacks are one of the conditions marijuana advocates are experimentally treating with the drug.

The American Psychiatric Association is so concerned about this aspect of mental health that the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV contains a complete section for mental disorders connected to marijuana use. These categories include “Cannabis Intoxication (consisting of impaired motor coordination, anxiety, impaired judgment, sensation of slowed time, social withdrawal…); Cannabis Intoxication Delirium (memory deficit, disorientation); Cannabis Induced Psychotic Disorder, Delusions; Cannabis Induced Psychotic Disorder, Hallucinations, and Cannabis Induced Anxiety Disorder.”16 Addiction and psychiatric disorders often occur together, according to the American Society of Addiction Medicine. Research on the effect of marijuana on mental health points to the same conclusion.

Youth
Due to the overwhelming data on the especially adverse impact of marijuana use on youth, even supporters of the drug do not want kids using it.17 Still, 42 percent of American high school students had used marijuana at least once, according to the 2001 Youth Risk Behavior Surveillance System.18 Smoking marijuana is one of the worst things youth can do. There is a clear relationship between academic performance and drug use. Students with a D average are four times as likely to have recently used marijuana as students with an A average.19 Poor performance in school takes the form of “deficits in mathematical skills and verbal expression,” as well as memory-retrieval processes.20

By lowering inhibitions about drug use and exposing youth to the drug culture which encourage use of other drugs, marijuana truly does act as a “gateway drug” for adolescents. The Journal of the American Medical Association reported a study of 300 sets of twins that showed that the twins who used marijuana were four times more likely to go on to use cocaine or crack cocaine and were five times more likely to use such hallucinogens as LSD.21 Drug use among adolescents also leads to dependence triple the incidence of dependence among adults.22

Marijuana use leads to more reckless lifestyles for adolescents. Smokers of the drug are three times as likely to consider committing suicide.23 A 2003 Canadian study reported approximately 20 percent of students drive within an hour of using marijuana.24 Even moderate doses of marijuana slow reaction time, distort perception, and impair motor skills. Finally, youths who use marijuana tend to have more unprotected sex with more partners beginning at a younger age.

Legal Implications

The legal obstacles posed by the legalization of marijuana for medical purposes arise primarily as a result of a discrepancy between federal and state law and logistical difficulties in enforcing and regulating standards. The Comprehensive Drug Abuse Prevention and Control Act of 1970 established marijuana as a Schedule I controlled substance. Substances under this category are illegal to possess, distribute, or use and “are categorized as such because of their high potential for abuse, lack of any accepted medical use, and absence of any accepted safety for use in medically supervised treatment.”25 The 13 states that have “legalized” marijuana for medical or other purposes have done nothing more than attempt to provide a small defense for anyone caught with marijuana in those states. Federal law still considers marijuana an illegal substance and law enforcement officials can and will charge citizens accordingly, regardless of state law. The British Medical Association in 2004 voiced “extreme concern” that efforts to downgrade the criminal status of marijuana would give the public a false sense of security about the safety of the drug when, “in fact, it has been linked to greater risk of heart disease, lung cancer, bronchitis, and emphysema” among other conditions.26

Despite proponents’ arguments that the legalization of marijuana would allow for better government regulation and increased revenue through taxation, legalization has done little more than add to the problems of law enforcement in states like California. Marijuana has to be grown somewhere. Public lands like national forests and parks have become breeding grounds for massive crop growth and organized crime. This poses a serious threat to the security of citizens and tourists in these areas. It is common for illegal Asian and South American nationals to be hired by drug cartels as armed guards with orders to shoot anyone threatening this major cash crop, especially rival cartels and including law enforcement officers. These lands are enticing because they are “free and accessible, crop ownership is hard to document, and because growers are immune to asset forfeiture laws.”27 However, there is a substantial threat to public safety, when playgrounds and natural recreation areas for families and children are caught in the midst of a gang fight over territory for growing this unhealthy and illegal drug.

Quality control is a serious concern when considering any medication, but is even more of a concern for a substance with the number and diversity of health risks associated with marijuana. So far, no state has been able to fashion a law that sufficiently allows for regulation of the quality of the drug before being given to patients because it is so easy for individuals to grow and exchange small or large quantities of marijuana undetected. Because marijuana is illegal in the United States, even in states that wish to treat it as legal, doctors are not able to prescribe it like a typical drug with dosage instructions. This means that there is no control over the consumption of the drug by anyone from legitimate patients to addicted users. As the Office of National Drug Control Policy points out, “medicines are not approved in this country by popular vote,” but that is exactly how marijuana has come to be not only debated but used as a legitimate medicine.28

Economic Drain

The impacts on the physical and mental health of users of marijuana lead to lower school and job performance, thereby robbing both the individual and society of the fruits of their labor. Additionally, the negative health impacts result in additional strain on an already stretched and expensive health care system.

However, the production and distribution of marijuana itself requires high opportunity costs. In California, individual growers or drug cartels buy or rent houses for the expressed purpose of using them to grow large quantities of marijuana, thereby making the homes unlivable and virtually worthless after the crop is harvested. In addition, these cartels already “smuggle hundreds of undocumented Mexican nationals” to help grow, guard, harvest, and distribute the drug. This practice directly contributes to the hotly debated issue of illegal immigration and its costs to the American public.29

Faulty Advertising

Proponents of legalizing marijuana have a dirty little secret about their motives. The movement is not merely an effort to legalize marijuana for legitimate medical use. Many organizations like the Drug Policy Alliance, the National Organization for the Reform of Marijuana Laws, and the Lindesmith Center do not deny using “medical marijuana” as “a stalking horse for drug legalization” more generally and beginning with marijuana.30

The “medical marijuana” movement targets youth through pro-drug messages on television, in movies, in books and magazines, and in music. The White House Office of National Drug Control Policy asserts that “More often than not, the culture glamorizes or trivializes marijuana use and fails to portray the harm it can cause.”31 The internet, where young people disproportionately spend their time, is especially rife with websites touting the wonders of marijuana, selling kits to beat drug tests, and advertising marijuana for sale.32

What is so dangerous is that the pot of today is not the pot of the 1960s or 1970s. The average amount of THC has jumped from less than one percent to over six percent in the last 30 years. Some samples have been found to contain THC levels reaching 33 percent.33 Because of this increased potency, users today face more damage that is done faster and with significantly less exposure to marijuana.

North Carolina Status

Thus far, the state of North Carolina has avoided much consideration or debate on the subject of “medical marijuana.” However, during the 2008 short session of the NC General Assembly, House Bill 2405—LRC Study/Alternative Medicines was introduced by Representative Earl Jones (D–Guilford). Introduced a mere 12 days after the Office of National Drug Control Policy (ONDCP) issued its report, “Teen Marijuana Use Worsens Depression: An Analysis of Recent Data Shows ‘Self-Medicating Could Actually Make Things Worse,” the bill asked the Legislative Research Commission to study the “possible public benefits of allowing marijuana or its chemical equivalent to be used for medicinal purposes.”34 This despite the fact that the ONDCP report found that “using marijuana can worsen depression and lead to serious mental health disorders, such as schizophrenia, anxiety, and even suicide.”35 The bill never made it out of committee and therefore died. Similar bills have been filed in previous sessions but were not considered.

North Carolina should continue to heed the warnings regarding the physical, social, behavioral, and academic harm caused by marijuana and refuse to give credence to opportunistic individuals. There is no such thing as “medical marijuana” and North Carolina should refuse to jeopardize the health and safety of all her citizens by abiding by federal law which has classified marijuana as a dangerous Schedule I substance for good reasons.


Endnotes:

  1. National Survey on Drug Use and Health 202: National Findings. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), 2003.
  2. Herkenham, M et al. Cannabinoid receptor localization in the brain. Proceedings of the National Academy of Sciences of the United States of America. 87:1932-1936, 1990.
  3. D. P. Tashkin, “Pulmonary Complications of Smoked Substance Abuse,” Western Journal of Medicine 152 (no. 5) (1990): 525-530; cited in White House Office of National Drug Control Policy, Marijuana Myths & Facts, 9.
  4. National Institute on Drug Abuse, “NIDA Info Facts: Marijuana”: 3.
  5. Wu, TC et al. Pulmonary hazards of smoking marijuana as compared with tobacco. New England Journal of Medicine. 318(6):347-351, 1988.
  6. DSM–IV–TR. American Psychiatric Association, 2000; cited in White House Office of National Drug Control Policy, Marijuana Myths & Facts, 7.
  7. National Survey of Drug Use and Health 2002. SAMHSA, 2003.
  8. “Marijuana and Medicine: Assessing the Science Base,” Institute of Medicine, 1999; cited in U.S. Department of Justice Drug Enforcement Administration, Exposing the Myth of Medical Marijuana.
  9. “Health_Concerns: What Are The Medical Dangers Of Marijuana Use?” Berkman Center for Internet & Society. Harvard University Law School. 18 Nov. 2008. http://cyber.law.harvard.edu/evidence99/marijuana/Health_1.html
  10. Nuttall, SL; Raczi, JL; Manney, S; Thorpe, GH; Kendall, MJ. Effects of smoking and cannabis use on markers of oxidative stress in exhaled breath condensate. Division of Medical Sciences, University of Birmingham, Birmingham, UK, 2003.
    National Institute of Drug Abuse, “Smoking Any Substance Raises Risk of Lung Infections” NIDA Notes, Volume 12, Number 1, January/February 1997.
    “Health_Concerns”
  11. “Health_Concerns”
  12. “Health_Concerns”
  13. Dobson, Dr. James, “Marijuana Can Cause Great Harm” Washington Times, February 23, 1999.
  14. Rodriguez de Fonseca, F et al. Activation of corticotrophin-releasing factor in the limbic system during cannabinoid withdrawal. Science. 276(5321):2050-2064, 1997.
    Diana, M et al. Mesolimbic dopaminergic decline after cannabinoid withdrawal. Proceedings of the National Academy of Sciences of the United States of America. 95 (17): 10269-10273, 1998.
  15. Pope, HG and Yurelun-Todd, D. The residual cognitive effects of heavy marijuana use in college students. Journal of the American Medical Assocation. 275(7): 521-527, 1996.
    J.S. Brook, et al., “The Effect of Early Marijuana Use on Later Anxiety and Depressive Symptoms,” NYS Psychologist (2001): 35-39; cited in White House Office of National Drug Control Policy, Marijuana Myths & Facts, 9.
  16. DSM–IV–TR. American Psychiatric Association, 2000; cited in Health_Concerns: What Are the Medical Dangers of Marijuana Use?
  17. For example: “Walters is correct in suggesting that marijuana, like other drugs, is not for kids,” Keith Stroup, founder and executive director of the National Organization for the Reform of Marijuana Laws (NORML), and Paul Armentano, NORML senior policy analyst, in Letters to the Editor, The Washington Post, May 4, 2002, in response to “The Myth of ‘Harmless’ Marijuana,” by ONDCP Director John Walters, The Washington Post, May 1, 2002.
    “Cannabis consumption is for adults only. It is irresponsible to provide cannabis to children,” Principles of Responsible Cannabis Use, the National Organization for the Reform of Marijuana Laws (April 11, 2003; www.norml.org)
  18. Grunbaum, J et al. Youth Risk Behavior Surveillance—United States, 2001. Surveillance Summaries, June 28, 2002, MMWR 2002. 51(No. SS­4): 1­64.
  19. The National Household Survey on Drug Abuse (NHSDA) Report: Marijuana use among youths. Based on data from the 2000 NHSDA SAMHSA, July 19, 2002.
  20. Block, RI and Ghoneim, MM. Effects of chronic marijuana use on human cognition. Psychopharmacology. 110(1­2):219­228, 1993.
  21. White House Office of National Drug Control Policy, “What Americans Need to Know about Marijuana,” 9.
  22. Cannabis Youth Treatment Randomized Field Experiment, preliminary report. U.S. Department of Health and Human Services, 2002.
  23. Greenblatt, J. Adolescent self­reported behaviors and their association with marijuana use. Based on data from the National Household Survey on Drug Abuse, 1994­1996 SAMHSA, 1998.
  24. Adlaf, et al. Drinking, cannabis use and driving among Ontario students. Canadian Medical Association Journal. 168, March 2003. http://www.cmaj.ca/cgi/content/full/168/5/565
  25. Gonzales v. Raich, supra, 125 S. Ct. at page 2204. 2005.
  26. “Doctors’ Fears at Cannabis Change,” BBC News, January 21, 2004.
  27. Intelligence Brief: National Drug Threat Assessment, Marijuana Update, August 2002, Document ID: 2002­J0403­002. http://www.usdoj.gov/ndic/pubs1/1335/
    National Drug Intelligence Center, Oklahoma Drug Threat Assessment (October 2002), Washington Drug Threat Assessment (February 2003).
    Marijuana Eradication, Santa Barbara County (CA) Sheriff ’s Department press release, August 18, 2003.
  28. White House Office of National Drug Control Policy, Marijuana Myths & Facts, 12.
  29. National Drug Intelligence Center, Massachusetts Drug Threat Assessment April 2001.
    Annex E, California State Threat Assessment FY 2004, Drug Enforcement Administration.
  30. White House Office of National Drug Control Policy, Marijuana Myths & Facts, 12.
    Wren, Christopher, “Small but Forceful Coalition Works to Counter U.S. War on Drugs,” New York Times, 2 January 2000.
  31. White House Office of National Drug Control Policy, Marijuana Myths & Facts, 17.
  32. White House Office of National Drug Control Policy, Marijuana Myths & Facts, 1.
  33. Marijuana Potency Monitoring Project, report No. 83. University of Mississippi, 2003.
  34. House Bill 2405, LRC Study/Alternative Medicines. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=2007&BillID=H2405
  35. Teen Marijuana Use Worsens Depression: An Analysis of Recent Data Shows “Self-Medicating” Could Actually Make Things Worse, Office of National Drug Control Policy Executive Office of the President, May, 2008, page 1.

Brittany Farrell is a research associate with the North Carolina Family Policy Council.

Copyright © 2009. North Carolina Family Policy Council. All rights reserved.