Marijuana (cannabis) is generally viewed as a safe, innocent recreational drug and medical cure-all.  It is neither, according to a recent MedScape report, “Smoke and Mirrors: Is Marijuana Actually Medicinal?” (April 18, 2018).  The benefits are limited, the potential for harm is high.

 The National Institute on Drug Abuse has further warned that “70 percent of today’s illicit drug users started with marijuana, not prescription drugs.”

 Proponents argue that marijuana has palliative benefits that will reduce the need for stronger, highly addicting narcotic pain-killers.  A recent study (Am J Psychiatry. 2018; 175(1):47-53) concluded just the opposite: “Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.”  Caution is advised in promoting cannabis use for pain.

 Cannabis is commonly prescribed for post-traumatic stress disorder (PTSD), despite the fact that a 2017 review found “scant evidence at best” to support its use, with the “lack of high quality evidence alarming.”  Even more troubling, there is a robust and growing body of evidence that “cannabis can cause otherwise preventable psychotic illness and worsen its prognosis following onset” (MedScape April 18, 2018).  Furthermore, since the currently available higher-potency strains of marijuana heighten the risk for psychosis, mental health practitioners are advised to counsel their patients of the inherent dangers.

 A 2018 report from the National Academy of Sciences, Engineering and Medicine (NASEM) found there to be “no or insufficient evidence to support the use of cannabis and its various formulations in the treatment of neurodegenerative conditions such as Parkinson’s disease, amyotrophic lateral sclerosis, and Huntington disease.”

There is evidence that marijuana second-hand smoke may lead to respiratory disorders, and it “substantially impairs vascular endothelial function” (J Am Heart Assoc. 2016;5).  Among heavy users whose systems have become oversaturated, marijuana can lead to cannabinoid hyperemesis syndrome (CHS), with cyclic vomiting, and violent retching and abdominal pain (Kaiser Health News, Dec. 26, 2017).

Patrick Kennedy, a member of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, and Kevin Sabet, a former drug-policy adviser to three U.S. presidents, have further warned against the dangers posed by high-potency pot.  Public health data from states that have legalized cannabis products reveal “more fatalities from driving while stoned, more emergency room visits and poison-control calls, and more worker accidents and absenteeism.”

“Marijuana is not a harmless drug, nor is the pot industry made up of responsible corporate citizens. Researchers in Colorado called 400 marijuana dispensaries, pretending to be eight weeks pregnant and experiencing nausea. Seventy percent of the stores recommended THC products, ignoring the risks of marijuana use during pregnancy” (Kennedy, Sabet – Wall Street Journal, Jun 14, 2018).

“Marijuana is not a benign drug, especially for teens. Their brains are still developing, and marijuana can cause abnormal and unhealthy changes,” according to a study in the New American Academy of Pediatrics (Feb. 27, 2017).  Adolescents who are regular users can develop “serious mental health disorders such as addiction, depression and psychosis,” due to the highly potent products on the market today. The concentration of tetrahydrocannabinol (THC), the psychoactive substance in marijuana plants, has increased from “roughly 4 percent in 1995 to 12 percent in 2014, and current strains contain concentrations as much as 20 percent – increasing the risk of overdose and addiction.

 American College of Pediatricians (ACP), April 2017, also confirms that “Marijuana is addicting, has adverse effects upon the adolescent brain, is a risk for both cardio-respiratory disease and testicular cancer, and is associated with both psychiatric illness and negative social outcomes…. THC suppresses neurons in the information-processing system of the hippocampus, thus learned behaviors, dependent on the hippocampus, also deteriorate.”

 The ACP strongly opposes the legalization of marijuana “for recreational use and urges extreme caution in legalizing it for medicinal use.”  It further “urges parents to do all they can to oppose the legalization of marijuana, such as working with elected officials against the drug’s legalization and scrutinizing a candidate’s positions on this important child’s issue when making voting decisions. The College encourages legislators to consider the establishment and generous funding of more facilities to treat marijuana addiction. Children look to their parents for help and guidance in working out problems and in making decisions, including the decision to not use drugs. Therefore, parents should be role models, and not use marijuana or other illicit drugs. Finally, these reports strikingly emphasize the need for parents to recognize and discuss these serious health consequences of marijuana use with their children and adolescents. They also point to the requirement for medical experts and legislators to seriously discuss and review these observations prior to promoting any state or federal effort considering legalization.”

 The American Academy of Child and Adolescent Psychiatry (AACAP) recently published their May 2018 policy statement also opposing efforts to legalize marijuana.

Several currently available FDA-approved, pharmaceutical-grade THC/CBD products have been fully researched and scientifically formulated to provide safe and effective treatment options for specific medical conditions.

“Pot-shop” marijuana, on the other hand, with highly variable concentrations of psychoactive compounds, can have dangerous short-term and long-term consequences.  “Street-grade” marijuana is becoming particularly hazardous due to the growing risk of adulteration with other illicit drugs like heroin, meth, fentanyl, even embalming fluid – to “enhance the high.”

 For all Americans, marijuana has a dark side that should not be ignored.