Tag: Marijuana

Marijuana appears to offer several benefits…and risks
Sanjay Gupta writes for CNN.com about his change of heart on the benefits of marijuana, notwithstanding its risks. In traveling the world, Gupta spoke directly to people for whom marijuana was the only treatment that offered relief. He also learned that the proportion of older adults using marijuana in the US is growing more rapidly than any other age cohort.

Gupta is clear that marijuana is not a cure-all. But, for example, it sometimes can prevent seizures in children. Still, it does not work to offer relief to everyone. What’s worse, marijuana can contribute to falls, which often land older adults in the emergency room.

Until 1996, cannabis was illegal in every state for all purposes. Today, marijuana is legal in 38 states as well as the District of Columbia. Some of the remaining states make it a crime to possess marijuana, even for medicinal purposes. The federal government still treats marijuana as a “Schedule 1 substance,” with no accepted medical use and a likely chance of abuse.

Apparently, federal law notwithstanding, many older adults use marijuana daily to address sleep issues, pains, anxiety and depression. They tend to like it better than anti-depressants, opioids and sleeping pills.

Marijuana could reduce the number of prescription drugs older adults take. Today, three in 10 older adults take at least five prescription drugs daily.

Gupta says that our bodies actually produce cannabis and have cannabinols receptors. Our endocannabinoid system balances our body, but it weakens as we age. That’s why older adults tend to struggle more with sleep and pain and mood.

If you are thinking that you’d like to try cannabis, Gupta suggests you start with a low dose and take it slowly. There are more than 100 cannabinols, so we don’t generally have a good idea of how any particular cannabis you take will affect you. All we know is that it could give you a very good night’s sleep.

Here’s more from Just Care:
August 31, 2023
Almost all states permit the sale of products containing the principal psychoactive ingredient in weed
You might not know it, but even if you live in a state in which weed is illegal, you likely can legally enjoy drinks containing weed’s primary psychoactive ingredient, delta-9 THC. At one bar in Missouri, Eric Berger reports for Kaiser Health News that customers were getting buzzed on a drink containing delta-9 THC.

Many believe that so long as a drink contains less than .3 percent by volume of the delta-9 THC, it can be sold most places. How? If it comes from hemp and not weed. Federal law, they argue, restricts delta-9 THC by volume but otherwise allows it if it is derived for hemp.

Of course, there’s a big issue here. Selling marijuana is illegal under federal law. And, people who sell marijuana in states where it’s legal must deal with paying taxes and abiding by regulations. But, these rules don’t apply to hemp. A 2018 law, pushed by Mitch McConnell to help farmers, delisted hemp as a federally-controlled substance.

Today, hemp’s delta-9 THC can be found in about 120 brands online. And, you do not have to be over 18 to buy these products legally.

Again, under federal law, there’s a compelling argument that drinks with delta-9 THC are legal so long as they contain .3 percent delta THC or less by weight. They argue that the weight restriction in the law applies to the product being sold. Others argue that that is not an accurate interpretation of the law. They say that the law speaks to the amount of delta-9 THC allowed in the hemp plant.

At some point, Congress probably will clarify federal law. Most likely, hemp-derived delta-9 THC products will only be allowed to be sold in the same dispensaries and with the same regulations and taxes as marijuana derived delta-9 THC.

Here’s more from Just Care:
October 31, 2022
Legalization of marijuana without safeguards creates large public health risks
Medical marijuana is now legal in 33 states and Washington D.C. Recreational marijuana is legal in 11 states and Washington D.C. And more than 37 million Americans use marijuana. Without safeguards, marijuana legalization creates large public health risks, writes Rosalie Liccardo Pacula for Stat News.

States benefit significantly from legalizing marijuana by way of increased tax revenue. And, legalizing marijuana creates more jobs. Americans who use marijuana, in turn, don’t have to fear criminal prosecution in their states.

But, there are also considerable risks for Americans. Marijuana can be harmful. Like vitamin supplements, most marijuana products are unregulated, so drug safety is a serious issue. The Food and Drug Administration does not ensure their safety, unless they are prescribed. In fact the federal government still considers possession and use of marijuana products a crime.

States are left to oversee the safety of marijuana products. And, for the most part, they have neither the skills nor the resources to do so, even if they have the will. Lack of oversight can present serious problems.

Already, four states have recalled marijuana products found to be unsafe. They contained dangerous pesticides. We don’t know how many other marijuana products are unsafe.

People using marijuana legally in their states are increasingly ending up in hospital emergency rooms. Their ER visits have doubled. They may experience uncontrolled vomiting or acute psychosis. And, some develop vaping-related lung injuries, such as burns from butane hash oil.

Americans need greater protections in states where marijuana use is legal. One way to protect Americans from overuse of marijuana products would be for states to establish non-competitive markets, permitting the sale of marijuana only from government or non-profit agencies, rather than for-profit businesses.

States could then better guarantee the safety of marijuana products. States could control their marketing and promotion, reducing their overuse. Today, businesses selling marijuana products are focused on driving revenue and not on public health or safety.

States could also set stiff financial penalties on producers, dispensaries and companies that provide inaccurate information to people about marijuana products.

Given the cost involved, it’s unlikely that states will step in to ensure accurate labeling of marijuana products or that they are tested for safety, though states should. (States don’t generally do testing for vitamin supplements, even though several have been found to be unsafe.) States might, however, prevent the sale of high potency waxes and oils.

States could also require that marijuana dispensaries have someone on staff who can advise people accurately about products. New York, Connecticut and Minnesota require this.

Here’s more from Just Care:
January 22, 2020
Older adults increasingly using marijuana products with some risk
Older adults are taking medical marijuana to ease pain and anxiety. But, as Dr. Marc Manseau has previously reported on Just Care, there is little to no scientific evidence that weed helps any mental illness, and it can be addictive. In fact, there are studies showing that cannabis can make depression, anxiety, and post-traumatic stress disorder worse. Now, Paula Span reports for the New York Times, that older adults are increasingly smoking and vaping marijuana as well as taking marijuana edibles and using other marijuana products, including salves, oils, tinctures, and patches, despite the lack of scientific evidence that they help.

Span interviews one older Californian from Laguna Woods who says that virtually every older person she knows is using some form of marijuana. They use it to calm their nerves, as a sleep aid and for pleasure. A local shop charters a bus to bring older residents to their outlet to buy marijuana at a “discount.”

In November, residents of Utah and Missouri voted to legalize medical marijuana. Now, medical marijuana is legal in 33 states and the District of Columbia. Recreational use of marijuana is legal in ten states. Marijuana is not legal under federal law.

Medicare does not cover medical marijuana even though some physicians believe that marijuana can be beneficial for easing pain without the side effects of opioids. And, there is some evidence that it also helps people reduce nausea and vomiting that may accompany chemotherapy. The National Academies of Sciences, Engineering and Medicine issued a report in 2017 citing a number of conditions for which marijuana may have clinical benefits.

That said, it is worrisome that people are treating themselves with little direction from their physicians. And, as we have previously reported, marijuana can have dangerous interactions with some prescription drugs.

Here’s more from Just Care:
December 11, 2018
Don’t overlook marijuana-prescription drug interactions
Middle-aged and older adults are increasingly using marijuana. As these groups tend to take more medications, marijuana-drug interactions are overlooked.
When I think of a typical marijuana user, I admit I tend to stereotype. I see a young person, at home or with friends, smoking a large joint and having a good time. I don’t picture a grandma toking. Yet new research indicates that older people, in fact, are using cannabis more and more.

A new study found that the number of middle-aged and older adults using marijuana is on the rise. The analysis, based on the National Survey on Drug Use and Health, found that about 9% of adults between 50 and 65 had used cannabis in the last year, and about 3% of those 65 and older had. In 2013, those figures were, respectively, 7% and 1.4%.

Laws allowing for marijuana use – either recreationally or for medical purposes – are on the rise and can explain the increase. There is some medical evidence that marijuana can be used for a variety of medical conditions, such as pain, nausea from chemotherapy, multiple sclerosis, epilepsy and seizures, and this may also help to explain the increase in the older population.

Why Worry?

So what’s the big deal, you might ask? Since older people tend to take multiple medications, there is a risk of marijuana potentially interacting with those drugs and undermining their effectiveness. Yet because marijuana research is limited in the US, thanks to strict restrictions from the government, it’s hard to know exactly what those impacts are.

If older individuals – or any people, for that matter – are using marijuana for medical purposes, hopefully their doctors are aware of the medications being taken. However, if you are using marijuana and your doctors don’t know, you should tell them as soon as possible. They may be aware of potential marijuana-drug interactions.

Despite the lack of research on marijuana-drug interactions, there are certain classes of drugs that don’t mix well with cannabis. Because marijuana is very calming on the body, taking drugs that have sedating effects is a big no-no. For example, taking benzodiazepines such as Valium (diazepam) and Xanax (alprazolam), which are used for anxiety and insomnia, or muscle relaxants can lead to central nervous system depression. The same goes with using cannabis and alcohol.

Cannabidiol (CBD), one of the chemicals found in marijuana, is a big culprit for problems. Why? It can inhibit an enzyme in the liver that is used to break down medicines. When this happens, the medication ends up staying in the body longer, which can enhance the effects of drugs. CBD can even slow the breakdown of statin medications, used to lower cholesterol. That can increase the chances of side effects associated with statins, such as muscle pain.

There is also evidence that marijuana can impact the effectiveness of antidepressants. This is because marijuana may speed up metabolism of the antidepressant in the body. As a result, a person may need higher doses in order to get the same effect from the antidepressant.

More research is needed not only on the benefits and risks of marijuana as a medical treatment, but on cannabis-drug interactions. The trend in older people using marijuana makes the research all the more urgent. It’s time for the federal government to loosen restriction of cannabis research.

This article was originally published in medshadow.org

Here’s more from Just Care:
September 17, 2018
Clearing the air on marijuana use
United States Attorney General Jeff Sessions just announced that he would reverse the Obama-era decision to not prosecute federal marijuana-related crimes in states where the drug has been legalized. And so again, marijuana is in the headlines. But amidst all the buzz, what do we actually know about the health effects of marijuana? This controversial topic could use an injection of calm, rational, fact-based discussion. As a psychiatrist specializing in the treatment of serious mental illness and co-occurring substance use disorders, I can provide a little clarity.

First, although nowhere near as damaging to public health as other drugs including tobacco, alcohol, and opioids, we can’t let cannabis completely off the hook. Many people can use pot safely in moderation, but there are several highly vulnerable groups who should avoid it. Despite numerous claims and even some state medical marijuana laws, there is little-to-no scientific evidence that weed helps any mental illness, and it can be addictive. In fact, there are studies showing that cannabis can make depression, anxiety, and post-traumatic stress disorder worse. So, people with psychiatric problems should probably steer clear of that joint. When the brain is forming in the womb, even the slightest external disruption can cause major problems for the child later on, so pregnant women should not use cannabis. Adolescence is another period of rapid and critical brain development, so it’s little surprise that cannabis use – especially frequent or heavy use – can disrupt academic achievement and lower IQ. Parents and teachers need to help young people make healthy choices about marijuana.

Second, speaking of adolescents, cannabis use raises the risk of developing a psychotic disorder, like schizophrenia, and lowers the age at which psychosis begins. This risk is higher with heavier use as well as use that begins at a younger age. There are also risk factors that make people much more likely to become psychotic after smoking weed, including a family history of schizophrenia, experiencing abuse or trauma in childhood, and growing up in an urban environment. Since psychotic disorders like schizophrenia cause massive disability worldwide, this is an important public health concern.

For older adults without a history of psychiatric problems, moderate marijuana use may be relatively safe for their mental health. However, cannabis smoke has many toxins including carbon monoxide and particulate matter that could cause and exacerbate medical problems. For instance, marijuana has recently been linked to increased risks of stroke and heart failure. Vaporizing or eating pot may be safer options, though we aren’t completely sure.

But aren’t there benefits to cannabis use? Maybe. There is some evidence that marijuana can provide relief for certain, specific medical conditions, such as severe pain from neurological problems, anorexia from HIV/AIDS, or maybe even seizures. And certain compounds in the marijuana plant – like cannabidiol – may help with some psychiatric symptoms.

So what to do? Avoid marijuana entirely? Support Jeff Sessions in his quest to start locking people up again for marijuana possession? On an individual level, the decision whether to use cannabis for medical or recreational purposes is highly personal, but people should at least be informed by scientific evidence rather than media hype, anecdotes, and strong opinions. On a societal level, my opinion is that the War on Drugs has been a complete failure for all drugs, but especially marijuana, causing many more problems than it has purported to solve. Rather than prosecute marijuana users, we should take a public health approach to help people who have a pot problem and work to prevent cannabis use in vulnerable populations like adolescents. And we should pursue rigorous scientific research to find effective ways to prevent harm from marijuana, and search for new medical treatments that could be hiding in this multi-faceted and fascinating plant.

Here’s more from Just Care:
January 8, 2018