Why marijuana should still be taboo

Cannabis leaf on grunge background, shallow DOF.Something has changed in the past five years– pot isn’t really considered a street drug anymore by my patients.  Marijuana use isn’t anything they feel a need to deny or hide.   With increasing frequency, my adolescent patients openly discuss their marijuana use in front of their parents.  Some adamantly deny alcohol use yet don’t hesitate to discuss their regular marijuana use.

Just a few years ago, this wasn’t true.  As soon as I mentioned the need to get a drug screen, my patients would get a nervous look on their face, often confessing marijuana use before the test results came back and begging me not to tell their parents.

My patients now recognize marijuana as a drug– a medical drug, that is.  They tell their parents how it helps with depression and anxiety.  And I tell them I believe them.  Marijuana probably does help them feel better.  I also tell them we have other drugs to treat depression, anxiety, and pain, drugs that are better regulated and have risk profiles that are better understood, drugs with standard concentrations and doses.  Nicotine, too, is a stimulant that can improve ADHD symptoms, but we don’t recommend smoking as an ADHD treatment.  We have better drugs for that, too.

Now that recreational marijuana is legal in Colorado, marijuana is just losing its taboo identity.  Other states are following– the district attorney in Brooklyn, New York recently announced his plans to stop prosecuting people arrested on charges of possessing small amounts of marijuana.

I spent a summer in college doing cannabinoid research at the NIH, trying to understand the effects of marijuana in the brain.  I’m the first to admit that cannabinoids are a promising class of drugs.  But marijuana is just that — a drug — and its recreational use should still be taboo.  Here’s why:

1) Is it synthetic?  A patient came into my ER hallucinating with tales of a very bad trip.  He showed me his “marijuana,” a bunch of leaves rolled into a joint.  And then his drug screen came back negative.  His was synthetic marijuana, a bunch of herbs sprayed with some unknown chemical.  Synthetic marijuana often contains laboratory manufactured chemicals that have the same effect as THC, the psychoactive ingredient in marijuana.  But sometimes the product is actually laced with bath salts or other street drugs.  I never really know what my patient has taken, which makes it hard for me to treat them.

2) How much THC is in that candy?  My four-year-old saw a brownie at a beach bake-sale and started begging me to buy it for him.  The guy selling it looked me directly in the eyes and shook his head.  I knew what he meant.  Marijuana brownies, cookies, and jolly-rancher-like hard candies are common now.  The problem is that you just don’t know how much THC is in the treats.  Some contain much higher concentrations than one joint, and who can eat only one cookie?  The result is an overdose effect that can land people in the ER.  Dr. Dan Hehir is an ER physician at Telluride Medical Center is Colorado who recounts his stories of recreational marijuana overdoses, especially in marijuana baked goods and candies.

3) Infertility: Marijuana use reduces fertility in both men and women (but no, marijuana is not a form of birth-control).  Anandamide is an “endogenous cannabinoid,” a THC-like chemical that is naturally occurring in all of our bodies.  Anandamide also helps human conception, giving signals to sperm to “hyperactivate,” or swim faster so they can penetrate the egg.  (Anandamide is also in chocolate, perhaps one reason people often use the words “sex” and “chocolate” in the same sentence).  Using marijuana sends signals to sperm to hyperactivate too early, so they are all burned out before they ever reach the egg (pun intended).  Marijuana use is also known to reduce the volume of sperm production.  If women use marijuana, the THC is in their cervical fluids, also causing hyperactivation of sperm and reducing the likelihood of conception.

4) Impaired memory: What was that? That’s right, marijuana use impairs memory, a critical skill for academic success (marriage, too).  Most of the time memory loss is subtle, just enough to cause a drop in school grades, but occasionally memory loss can be profound.  A case report published last month describes a patient with marijuana-induced transient global amnesia.

5) Paranoia: Marijuana can cause paranoia, especially in patients who have underlying mental illness.  In a study published in July, 2014, intravenous THC was administered to 121 patients.  The authors write, “THC significantly increased paranoia, negative affect (anxiety, worry, depression, negative thoughts about the self), and a range of anomalous experiences, and reduced working memory capacity.”

6) Thrush: Thrush, or an oral yeast infection, can result from chronic marijuana smoking.  There’s a reason why some people call thrush “trench-mouth.”  A white film grows over the inside of your mouth and tongue.

7) We don’t really understand most of the risks of marijuana: This is perhaps the biggest problem with Marijuana– it’s really hard to study it.  Would you take a drug that is poorly researched?  Research on marijuana is difficult because it is illegal in most states.  There are possible associations with some forms of cancer, but because most marijuana users are also tobacco users it is difficult to determine the effects of the marijuana alone.  There seems to be an association with lung disease, especially among people that smoke marijuana long term.  Its addictive nature is perhaps most controversial.  The bottom line is we don’t understand this drug like we do most pharmaceuticals.

Taboo or not, my patients take marijuana because they are desperate.  Desperate to dull the pains of stress, anxiety, depression, and the hardships of life.  Legalization of recreational marijuana is not the solution to these ills.

Do you have a stressed or depressed teen?  Here are 8 other ways teens are dulling the pain.

Kathleen Berchelmann, M.D. About Kathleen Berchelmann, M.D.

Kathleen M. Berchelmann, M.D., is a pediatrician at St. Louis Children's Hospital and Washington University School of Medicine, director of the St. Louis Children's Hospital Social Media Team, and co-founder of the ChildrensMD hospital physician blog. Her work has been featured in print and online publications including the St. Louis Post-Dispatch, the Chicago Tribune, and TIME magazine. She is a frequent contributor to Fox2 News STL Moms. Kathleen and her husband are raising five children.

Follow Dr. Kathleen Berchelmann on Facebook: ChildrensMomDocs Twitter: @MomDocKathleen and connect with her on .

Comments

  1. Julie Prestopnik says:

    Could you please post a reference for the following?
    “Research on marijuana is difficult because it is illegal in most states and is highly regulated by the FDA. There are some known associations with cancer, especially head and neck cancer, bladder cancer, and possibly testicular cancer. And there seems to be an association with lung disease, especially among people who smoke marijuana long term. ” Thanks!

  2. This is horrific fear mongering at absolute best. You should be ashamed to have published this! The arguments you give would make vitamin C something we should avoid. The truth is we have much worse things made legal (cigarettes and alcohol) while this, which actually has no real harmful effects and actual legitimate medical applications is mostly still illegal. People thinking as you do hold back society as a whole. You are the problem and you need to grow up.

  3. Judging by the titles of the related posts, I’m going to guess you smoke marijuana when you write this crap. The titles all seem paranoid to me. I’ll be sure to ground my child when I find out she vaporized marijuana, and quickly get her on some prescription pills. We all know those are safe. I’m sure you prescribe enough medications in a day to kill an elephant. Think you could do that with pot? Would it change your mind if marijuana growers started giving you kickbacks? Would any amount of positive studies persuade you to accept that marijuana is an effective and safe alternative to manufactured drugs? Do you even realize the street drugs that kill daily ARE the same drugs you think are safer? “… Vioxx caused between 88,000 and 139,000 heart attacks, probably 30%-40% of them fatal for an estimated 55,000 deaths.” The company was successfully sued for BILLIONS, they hid negative studies on their drug and it killed people. Do you even care about that? I bet you dont. I would bet you’ve prescribed drugs to kids who have gone on to become addicted to them. It’s highly likely one of them has ended up in prison or dead because of it. Think about that for a second and get down off your high horse. You’re no better than a drug dealer on the street. The only difference is you have a billion dollar industry with lobbyist standing behind you, but I say again YOU HAVE CREATED AT LEAST ONE DRUG ADDICTED PERSON IN THIS WORLD. Good luck in life. Stay away from my kids.

  4. Julie Prestopnik says:

    Could you please post a reference for the following?
    “Research on marijuana is difficult because it is illegal in most states and is highly regulated by the FDA. There are some known associations with cancer, especially head and neck cancer, bladder cancer, and possibly testicular cancer. And there seems to be an association with lung disease, especially among people who smoke marijuana long term. ” Thanks!

  5. Jason Schnetzer says:

    I can not honestly believe you are spreading such lies and misconceptions regarding Cannabis.
    Can you please report the numbers of Actual Deaths related to Cannabis, or Could you cite the countless ill effects of Cannabis Related Overdose, Kathy you can not.
    For if you could this knowledge would be plastered all over the media.
    We would have headlines reading …
    “Millions of our children died last year from Cannabis.” We both know this is not nor will it ever be true.
    We know or those of us who actually read the scientific evidence regarding Cannabis are aware that we have studied Cannabis for Hundreds of years and it was at one time the most widely used Medication in the World.
    How dare you continue to even use the slang term Marijuana instead of the Scientific word Cannabis.
    Did they not teach you about Cannabis in Medical School?
    Me I am not a Doctor, Nor do I Play one on the internet, but I am fully aware of History and due to the internet I have access to thousands of Studies regarding Cannabis. I can only hope that you will in the interest of Science review some of the studies I will reference for you below.

    1988: DEA Judge Rules that Cannabis has Medical Value
    The DEA’s own conservative administrative law judge, Francis Young, after
    taking medical testimony for 15 days and reviewing hundreds of DEA/NIDA
    documents positioned against the evidence introduced by marijuana reform
    activists, concluded in September 1988 that “marijuana is one of the safest
    therapeutically active substances known to man.”

    Growing Acceptance
    By 1966, millions of young Americans had begun using marijuana. Concerned
    parents and government, wanting to know the dangers their children were
    risking, started funding dozens and later hundreds of marijuana health studies.
    Entrenched in the older generation’s minds were 30 years of Anslinger/Hearst
    scare stories of murder, atrocity, rape, and even zombie pacifism.
    Federally sponsored research results began to ease Americans’ fears of
    cannabis causing violence or zombie pacifism, and hundreds of new studies
    suggested that hidden inside the hemp plant’s chemistry lay a medicinal array
    of incredible therapeutic potential. The government funded more and more
    studies.
    Soon, legions of American researchers had positive indications using cannabis,
    anorexia, tumors and epilepsy, as well as for a general use antibiotic.
    Cumulative findings showed evidence of favorable results occurring in cases
    of Parkinson’s disease, anorexia, multiple sclerosis and muscular dystrophy;
    plus thousands of anecdotal stories all merited further clinical study.
    Prior to 1976, reports of positive effects and new therapeutic indications for
    cannabis were almost a weekly occurrence in medical journals and the national
    press.

    So I beg of you in the interest of Science and Education Please use Facts when addressing Cannabis.

    There have been several deaths due to Deadly drug overdose in the time it took me to gather this evidence and send it to you. This is and should be your concern.

    I anticipate your reply. I am available to address any concern as I myself am interested in Science, and Stopping the Drug Epidemic we are facing.

  6. Dave K, Phoenix, AZ says:

    Please review Donald Tashkin’s research at UCLA. He found no instances of cancer due in heavy marijuana smokers while studying those with head and neck cancers in LA county in a large, well conducted, epidemiological study. Also look at the pioneering work of Manuel Guzman in Spain. Cannabis does not cause cancer. Cannabis shrinks tumors by several identified mechanisms and due to its low toxicity (No one has ever died of an overdose) cannabis does not harm surrounding cells. The information presented here is outdated and based upon the many lies told by the DEA during its prohibition of cannabis. I would encourage any who read this article to do their own research into this important topic.

  7. tea toker says:

    you list 7 silly reasons kids should avoid marijuana:
    ——————————————————————-
    1) it might be deodorant they are smoking? (K2, Spice)
    that is not a reason to avoid marijuana, its a reason to legalize marijuana. the stuff you call “synthetic marijuana” is actually a deodorant that is NOT MEANT FOR HUMAN CONSUMPTION OR BURNING, and does not mention the words “synthetic” or “marijuana” anywhere on the packaging. legal recreational marijuana will put an end to people smoking those substances completely. the only way anyone would smoke that stuff is if a friend lied to them about what it was and told them it was marijuana. with legalized recreational pot, you can buy it directly from a legitimate store, without having to trust some kid at school to have safe drugs.

    2) candy with High THC can cause uncomfortable experiences?
    that is only a reason to avoid marijuana candy, it has nothing to do with smoking or vaporizing pot. either way, it has never been fatal or detrimental to their health. the worst that could happen is they feel uncomfortable or take a nap. going to the ER is completely unnecessary no matter how much marijuana they consumed. it is non toxic, and no amount of marijuana will kill you or permanently damage you in any way. all you do for those kids is give them a very expensive bed to lie in, and maybe milk more of their parents money on useless organ monitoring and drug testing, just in case it wasn’t really marijuana.

    3) temporary drop in sperm count?
    are you seriously warning kids that it might be harder to get pregnant while smoking pot? what is wrong with you? why would you want teenage pregnancies? oh wait, you work in an ER and pregnancies make money for you. how convenient…

    4) temporary Impaired memory hurting grades?
    ok, that one is legit. it may have a small impact on your ability to recall names once in a while when you are stoned, which makes taking memory based tests in school slightly more difficult, especially when they try to force you to remember useless things like the state capitols or names of presidents.

    5) paranoia?
    some people get paranoia the first couple of times they smoke pot. regular smokers never get paranoia from pot, they only get paranoia from police who threaten to shoot their dog or choke them to death over a bag of flowers. that’s a practice that you seem to support, and if so, i hope the police shoot your loved ones or pets during a drug raid and see how you like it. even if you are one of the unlucky few who get paranoid from pot, that is a minor side affect compared to the opiates and anxiety pills you push on children.

    6) yeast infections? white stuff in your mouth? trench mouth?
    it sounds like you’re trying to dramatize plaque… i have never heard of this condition, and i have never seen anyone get yeast infections in their mouth from smoking pot, and i have known over 100 people who smoke pot regularly. also, even if that did happen to a few people, brushing their teeth or gargling would get rid of it, so that’s not a big deal, if it exists at all.

    7) you are too ignorant about marijuana to recommend it?
    the studies exist, and your willful ignorance is due to your profit motives. if you really wanted to help kids get pain relief without becoming addicts, you would recommend marijuana, but since you can’t write a prescription for it, you would be losing precious drug deals, so you would rather hurt kid’s health than hurt your bottom line. you should be ashamed of your ignorance and ashamed of your lies.

    in that link you make a very crazy statement:
    “we have much better drugs to treat depression, anxiety, and pain – drugs with fewer side effects (than marijuana)”

    name them.
    name a pain drug that has fewer side effects than marijuana, and you better not mention an opiate! if you are telling kids that opiates are safer than pot, than you are a disgusting ignorant dangerous person!

    name any anti-anxiety drug or anti-depressant that has fewer negative side effects than marijuana. im waiting…

    if you can’t name 1 drug for each of those ailments that is safer than marijuana, than you are a liar, and possibly a child abusing drug dealer who is trying to get kids hooked on the hard stuff so they have to go through you, instead of using a natural, safer alternative.

    you seem to be more worried about selling pills than the health and safety of those kids, to the point that you would lie to their faces to get them hooked on far more dangerous pain meds.

  8. Dear Dave, Tea, Jason, Julie and Mike,

    Thank you for your perspective– I have edited my article to include the reference that Julie requested, as well as to clarify my point about recreational vs. medical marijuana. I am arguing that recreational marijuana is nothing to be proud of– something that should still be taboo. I have not argued against medical marijuana. I have not made an argument for or against legalization of recreational marijuana. I am arguing that recreational marijuana should be taboo– something you don’t want to brag about to the people who love you.

    Tea: there are many effective medical drugs available for the “stress, anxiety, and depression” that I reference. The most common class are the SSRIs.

    Dave: Thank you for your respectful comment. I had not previously encountered the research you reference. I have edited my article to reflect the challenges of studying the relationship between smoked marijuana and cancer.

    Jason: I also am hopeful that it will become easier to conduct research regarding cannabinoids, and that we will be able to use this class of drugs for treatment of a host of conditions. But even if we do get to a point where we have excellent therapeutic cannabinoids, I still could not be proud of recreational marijuana use. I don’t recommend recreational use of any prescription medication.

    Do you really want it to be considered normal to smoke recreational marijuana? Would this make you proud of your children?

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