In an episode of the hit NBC television series The West Wing – a show that follows the day-to-day of a fictional democratic President and his cabinet – the surgeon general makes a remark about marijuana legalization during an online chat. “I can tell you that marijuana poses no greater public health risk than nicotine or alcohol and doesn’t show the same addictive qualities as heroin and LSD,” the surgeon general claims. Without political support from congress, the President on this fictionalized TV Show asks for the surgeon general’s resignation.
At the time of the airing of the episode in the early 2000s, popular opinion in the United States was in line with the president’s move to fire the surgeon general regarding marijuana use and the impact her words had on the public. However, like marriage equality before it, marijuana legalization has turned quickly in the American cultural milieu. In fact, the state of Nevada, which passed marijuana legalization in November, will initiate state recreational cannabis sales on July 1, 2017 according to the Nevada Tax Commission as reported at The Daily Beast. This comes in record time as many other states – seven total and the District of Columbia – have passed similar expansive measures that take years to set-up and regulate. Before long, nationwide legalization may be standing at the doorstep of the Supreme Court.
With the rapid change in public opinion and the onslaught of legalization, it is paramount to understand: the potential risk factors marijuana poses for users; changes in the law related to regulating the drug; and ways parents and health experts, schools and communities can engage in open discourse about this issue.
To begin, marijuana is a mind-altering drug. According to the National Institute on Drug Abuse (NIDA), the main psychoactive chemical in marijuana, responsible for most of the intoxicating effects that people seek, is delta-9-tetrahydrocannabinol or THC. NIDA reports that the “high” caused by THC have other effects, including: “altered senses and time, changes in mood, impaired body movement, difficulty with thinking, problem solving and impaired memory.”
With evident mind-altering effects from using marijuana, researchers and scientists have performed various research studies to understand the long-term effects of the drug on the brain and body. For example, adolescents experimenting with the drug for the first time, may experience negative effects later in life. A recent study published at Tel Aviv University titled “Cannabis Use in Adolescence Linked to Schizophrenia” found that “smoking pot or using cannabis in other ways may serve as a catalyst for schizophrenia (a disorder caused by an imbalance in the brain’s chemical reactions) in individuals already susceptible to this disorder.” And a recent controversial article published in Great Britain’s the Daily Mail by Dr. Max Pemberton, a British medical doctor, journalist and author, who works full time as a psychiatrist in the National Health Service, links marijuana use to violent behavior.
“Regular use has been found to double the risk of a psychotic episode or of developing schizophrenia,” writes Pemberton. Back in the United States, where legalization takes hold of new states with each passing election, recent data shows the use of marijuana is on the rise amongst youth in states like Colorado and Washington where it is legal, and is climbing elsewhere as well. A study from Monitoring the Future, an organization that commissioned researchers at the University of Michigan and paid for by NIDA, to look at substance abuse in young adults, found that 51% of college-aged students (19-22) in 2015 used marijuana for the first time, an uptick from 41% in 2014 and shows the highest percentage rate of use in Monitoring the Future’s 36-year-long look at this demographic and substance abuse.
Though usage is up due to legalization and a turn in public opinion, lawmakers and government agencies are grappling with a wide range of new products and uses for THC with unforeseen consequences. Legalization has seen the rise of “synthetics” or marijuana-related products that are synthetically made in a lab. According to a report by the Hazelden Betty Ford Institute for Recovery Advocacy, synthetic marijuana may contain “THC concentrations of up to 80 percent,” which is much higher than average levels in regular marijuana. Because of this higher potency, the report found that individuals who use synthetic cannabis were “30 times more likely to visit an emergency unit than those who use traditional forms of cannabis.” The report also looked at a recent study of high school students who use synthetic marijuana, which found an “increased risk for using other drugs such as cocaine, heroin and ecstasy; getting into a physical fight; having unprotected sex; and riding with intoxicated drivers, compared with those who used marijuana only.” And since new synthetics become available in the market each year, it’s difficult for lawmakers to keep up with informing the public of the potentially dangerous effects of these products.
In addition to synthetics, lawmakers are seeing a rise in “dabbing,” the practice of consuming the vapors of marijuana extract, a highly potent waxy substance. This rise in potency has health experts concerned for the effects it has on cognitive function. “Not only is the method of production explosive (the New York Fire Department have reports that link fires to local production of dabbing substances), but the use has serious physical and psychological side effects,” says James J. Hunt, special agent in charge of the Federal Drug Enforcement Administration’s New York division to the New York Times.
So why the shift to dabbing? Not only does the substance contain a much higher concentration of THC for a bigger high (dabbing can have a concentration of up to 80%); it boasts an edge – a new wave – over plain old pot. As one teenager interviewed for the New York Times about dabbing puts it, “marijuana is the beer of THC, as dabbing is to vodka.”
Marijuana legalization is also seeing changes in the law related to drug-impaired driving. Lawmakers are working to maintain safety and protection for drivers on the road as marijuana-related traffic incidents rise. According to the Governors Highway Safety Association report on drug-impaired driving, “in experimental settings, marijuana impairs psychomotor skills and cognitive functions associated with driving, including vigilance, time and distance perception, lane tracking, motor coordination, divided attention tasks, and reaction time.”
As such, the report found that in Colorado, where marijuana has been legal since 2012, “the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive was 4.5% in the first 6 months of 1994, 5.9% in the first 6 months of 2009, and 10% at the end of 2011.” And in California (where marijuana has been decriminalized since 2011) the research shows that “there was no change in THC positive driving among weekend nighttime drivers, but there was a significant increase in crash fatalities involving cannabinoids.” Still, since much of this research is new and legalization is in its infancy, the writers of the report qualify their findings with: “for many drugs the relationship between a drug’s presence in the body, its effect on driving, and its effects on crash risk are complex, not understood well, and vary from driver to driver.”
Even though impairment from marijuana use alone on drivers can be difficult to decipher, what is known is that drug combinations (such as marijuana with alcohol) is particularly risky. The Governors report found that the combination of marijuana and alcohol “dramatically impaired driving performance” and that “use of alcohol and marijuana together produces significantly higher blood concentrations of THC than just marijuana use.”
Despite these alarming trends, public opinion in favor of marijuana use continues to rise. “The percentage of adults and adolescents who believe regular use of marijuana poses ‘no risk’ tripled from 5% in 2004 to 15.3% in 2014,” reports the Substance Abuse and Mental Health Services Administration (SAMSHA). As such, it may take quite some time before researchers and clinicians, lawmakers and educators can inform the public enough to create an awareness about the changes marijuana legalization is having on its users.
Though there is controversy surrounding this issue, researchers on the matter explain, “we believe strongly in the paramount importance of educating the public about the dangers and potentially addictive dynamics of all drugs, including marijuana.” On the flip side, though researchers who authored the Hazelden Betty Ford Center white paper on the topic “oppose the use of marijuana as a “medicine” unless it has been approved by the U.S. Food and Drug Administration (FDA), we still understand the cannabis plant has some medicinal qualities and support further research.” Therefore, it is up to our communities to raise awareness, ask questions, and be proactive about voicing concerns that come out of the administration and distribution of such a drug.
As America wrestles with the changing landscape of marijuana use, informing the public is a top priority for many. Dr. Amelia Arria, Associate Professor and Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, is at the forefront of doing just that. She urges researchers to “look at patterns of high-potency cannabis and new routes of administration so we can more thoroughly understand the impact of marijuana on our society.” Public campaigns – such as the ones used to raise awareness about drunk driving and the health risks associated with nicotine in cigarettes seen in the 1960s and 70s – may be the best way to keep our roads and communities safe.