The Doctor Is In

Q: My kids say now that marijuana is legal in California, they should be allowed to enjoy it at home. Now that it’s state legal, does that make it safe?

In the past several years, I have been asked by patients, young and old, for a letter recommending they use marijuana for medical reasons … everything from arthritis pain and headaches to nausea, insomnia and anxiety. Marijuana is being used by patients for all kinds of ailments, despite lack of scientific evidence that this treatment is either safe or effective.

With the passage of Proposition 64 last November, it will soon be just as easy to go to the store to buy a joint as it is to go buy a quart of milk today. No letter or prescription from a doctor is needed. You will be able to ask the “budtender” about which strain you might prefer, such as a sativa to feel energized or an indica to feel sedated.

But, before lighting up, I think it is important to become more educated on what the science says about the safety, pros and cons of this ubiquitous green herb.

First, the potency of pot today is markedly different from the 1960s when it first became popular. Back then, the THC content (the main psychoactive ingredient) was around three percent. Now, it is common to see 12 percent, or much higher with concentrated hash oils having as much as 50 percent THC. This may account for such negative consequences as psychosis and panic attacks.

It is important to limit marijuana consumption as you would with alcohol consumption and know your limits. Yes, marijuana can be addicting, especially if started early in adolescence.

Next, marijuana also comes in edibles, including cookies, brownies and candies. These have been known to cause accidental poisoning in kids and pets, and should be kept locked away.

The problem with these is that the consumer may not feel the effects right away because they take longer to get absorbed from the stomach. The user may then eat more and more until they find they are passed out on the floor. In addition, one dose may be just a few bites of a cookie, and the uninitiated may eat the whole cookie which may have several doses inside. Who can only eat a few bites of a cookie? Again, overdose is likely in this scenario.

More worrisome is the effect of chronic marijuana use on the young developing brain. Some good scientific studies have shown that young people who smoke pot daily starting in their teens have a lower IQ by six to eight points later in life compared to their peers who did not smoke pot.

Even though the recent passed legislation restricts the use of marijuana to those over 21, the fact is that more young people will have easier access to it and it is up to parents to educate their kids about these warnings.

Driving stoned could potentially be as dangerous as driving drunk, although the definitive studies have not been done. And more concerning is the potential that pot can have more dangerous effects when combined with other medications.

A landmark study on pros and cons of marijuana just released clearly shows that marijuana may have some benefits on chronic pain and can ease nausea. There have even been some reports about certain strains helping epileptic patients reduce the frequency of seizures.

On the other hand, regular users are more likely to develop schizophrenia, especially if they have a family history of psychiatric disease. All that said, more clinical research needs to be done to get answers to the scientific questions we have about the potential risks and benefit of this drug.

In the meantime, light up with caution and use common sense.

Palisadian Damon Raskin, MD, is a board-certified internist who offers preventative medicine, concierge services and addiction medicine to patients in and around the Palisades. Contact: 310-459-4333. To submit your medical questions, email john@palipost.com.