A Response to “Going to Pot” by Roxanne Khamsi

By Clint Werner, author of “Marijuana Gateway to Health”

In the June 2013 issue of Scientific American, “Science of Health” columnist Roxanne Khamsi wrote a surprisingly unscientific and biased piece on the health ramifications of legalizing marijuana that was sadly tainted with residue from last century’s reefer madness campaign. The title of the piece itself, “Going to Pot” is a loaded term that confers a negative association on the subject via cultural symbolism having nothing to do with the reality of what science is telling us about marijuana and how it affects the human organism and society. First, Ms. Khamsi is mistaken when she writes that doctors “may prescribe marijuana to treat or manage ailments.” In states with medical marijuana provisions, physicians write recommendations for their patients that allow access to dispensaries or cultivation cooperatives. Ms. Khamsi then asserts that “the safety of recreational use is poorly understood” and that “researchers worry that both short- and long-term use of the drug may harm the body and mind.” Researchers who are up-to-date on the science of marijuana have no such concerns regarding adult use. In terms of harming the body, recent research has revealed that regular use of marijuana actually seems to improve physical health. Population studies have shown that regular marijuana users have a reduced risk for developing lung cancer (Hashibe, Cancer Epidemiological, Biomarkers and Prevention, 2006), head and neck cancers (Liang, Cancer Prevention Research, 2009), bladder cancer (Thomas, American Urological Association meeting, 2013), lymphomas (Holly, American Journal of Epidemiology, 1999), as well as diabetes (Rajavashisth, BMJ Open, 2012). The diabetes protection data from the enormous NHANES report also revealed that subjects who smoked marijuana three times per week had a profound (> 50%) reduction in their blood levels of C reactive protein, a inflammation marker for heart disease, indicating that they experienced significant protection from developing cardiac disease. Research also revealed that regular, moderate marijuana smokers have improved lung function compared to non-marijuana smokers with no risk for developing COPD (Pletcher, JAMA, 2012). National Institute of Drug Abuse pulmonary researcher, Dr. Donald Tashkin has said that he now endorses legalization since there is no basis for concern about the substance’s negative effects on lung function. Given the nearly century-long reefer madness campaign waged with untold billions of government dollars, it is hard for people to grasp that a denigrated and criminalized substance could have such positive health effects, especially when smoked, but science trumps myth and superstition with evidence. In terms of mental health, a just-published paper reports that “marijuana use consistently buffered people from the negative consequences associated with loneliness and social exclusion” (Deckman, Social Psychological and Personality Science, 2013), which could be one of the reasons that researchers found a truly startling drop in suicides, especially among young adult men, following the enactment of state medical marijuana laws (Anderson, IDEAS, 2012). Other research has shown that marijuana’s anti-depressant effects could be the result of neurogenesis, the production of healthy and functional new brain cells, which is promoted by the cannabinoids in marijuana (Jiang, Journal of Clinical Investigation, 2005). Another recently-published study found that “mortality risk was lower in cannabis users than in non-cannabis users with psychotic disorders” (Koola, Journal of Psychiatric Research, 2013), indicating that marijuana is a beneficial treatment for mental problems rather than, as increasingly inferred, a causative agent. In attempting to explain the activity of marijuana’s cannabinoid molecules on the endocannabinoid receptors, Ms. Khamsi once again employs loaded language to imply a negative effect, writing that THC “triggers domino chains” which implies a collapse of order and function rather than an alteration in order and function, which is what is truly occurring. Ms. Khamsi then frets that using marijuana impairs “working memory.” Yes marijuana alters mental functioning; it shifts the mind into a blissful euphoria that redirects thought from the ordered and analytical to the relaxed and free-association style of thought that characterizes relaxation and insight. And unlike alcohol, which serves a similar function of quieting the work day mental noise, marijuana is not carcinogenic or lethal. Ms. Khamsi expresses the understandable concern that marijuana users will make our roadways more dangerous but this is not supported by data that shows us what actually happens when legal restrictions are eased. A comprehensive review of data from states with medical marijuana laws found that enactment of the laws led to a significant drop in traffic accident deaths by allowing for marijuana to substitute for alcohol, a far more impairing substance. Traffic accident fatalities dropped by 9 percent in medical marijuana states. (Anderson, pending publication in the Journal of Law and Economics, 2013). That is essentially the same level of protection afforded by the passage of mandatory sea belt laws and by increasing the age for alcohol consumption from 18 to 21 years. According to research conducted by the automobile insurance company 4autoinsurance.com, marijuana users are safe drivers because, unlike alcohol drinkers, they are aware of their level of impairment and either refuse to drive, delay driving or drive more carefully than normal by reducing speed and not changing lanes. Regular marijuana users showed far less evidence of impairment than did novice and occasional users. Impairment testing is the only way to effectively police for marijuana-impaired drivers without ruining the lives of people who pose no threat on the roadways. The cannabinoid CBD steers THC away from the CB1 receptor, thus dulling or nullifying the mind-altering effects, but CBD does not reduce THC levels in the blood. Therefore, a driver using a high CBD strain of marijuana could test over the THC limit while experiencing no psychoactive effects whatsoever. Consequently, effective and fair impairment assessment techniques will need to be developed. Ms. Khamsi then returns to the health effects of marijuana, but ignores the previously cited benefits of reduced risks for developing numerous cancers, diabetes and other inflammation- and oxidation-based degenerative illnesses, such as Alzheimer’s disease and arthritis. She then refers to the recent study of data from New Zealand that indicates that teenagers who use marijuana heavily have up to an 8 percent drop in IQ points. Those results were called into question upon review but still indicate a disturbing effect of heavy marijuana use on the developing adolescent brain. Neurologist Dr. Gary Wenk, who has written “a puff is enough” to protect the adult brain from age-related dementia, says that the effect of marijuana on a developing brain, especially in those under 15 years of age, is impairing. Regular use of marijuana by teens may also interfere with social and professional skill development by monopolizing the time and consciousness of teens that enjoy it. Ms. Khamsi correctly notes that black market marijuana is sometimes contaminated with “sand or glass beads” which are far more harmful to the user than cannabis itself. Black market marijuana is also frequently contaminated with insecticides not intended for use on plants that are consumed. Some of these products are neurotoxic and, ironically, may induce neurodegenerative illnesses by interfering with the functions of the endocannabinoid system. (Casida, Annual Review of Entomolgy, 2013) Smuggled marijuana is also stale and often riddled with mold. Given these threats to heavy teenage users, the question needs to be asked: How do we best reduce access to marijuana, especially the most harmful forms of marijuana, by teenagers? One study suggests that multidimensional family therapy (MDFT) is the most effective approach for treating teenagers with what is termed “cannabis use disorder” (Rigter, Drug and Alcohol Dependence, 2012). MDFT essentially reestablishes parental authority and time management in teens’ lives. If parents remain involved in all aspects of their teenage children’s lives, MDFT would not be necessary to correct a deficit in parenting. The best way to prevent teenage substance abuse is for parents to rigorously monitor and guide their children’s activities. By doing this, parents might not prevent experimentation but they can create an environment where regular access to and use of marijuana is impossible. Shrinking and killing off the black market via legalization and regulation can assist parents in this task, by making marijuana more difficult for teens to obtain. Dealers do not card and taking marijuana away from the illicit drug black market will also protect teens from the multiple drug offerings of those dealers. If teens do obtain marijuana on the sly, at least, having been diverted from legal and tested supplies, it will be less likely to be contaminated with more harmful substances. Commercial medical marijuana venders such as Harborside Health Center, which Khamsi mentioned, contract with growers and test their marijuana for safety and potency. Legalization transforms marijuana cultivators from shady criminals into proud artisans. And despite the possible risk of heavy marijuana use to teenagers’ cognition, a study of adolescent binge drinkers found that those who used marijuana suffered significantly less alcohol-related brain damage than the booze-only drinkers (Jacobus, Neurotoxicology and Teratology, 2009). Consider the irony: Marijuana protects the brains of booze binge drinkers. Ms. Khamsi also mentions increases in emergency room visits and those seeking treatment for marijuana use. The emergency room statistic most frequently cited by opponents of legalization involve the detection of marijuana use via urinalysis, a method that only indicates if marijuana has been used within the last two to four weeks, therefore the data does not indicate that marijuana use caused the emergency room visit. It merely indicates that more people seem to be using marijuana overall (DAWN Drug Abuse Warning Network, HHS, 2008). In fact, two studies have found direct associations between marijuana use and a decrease in emergency room visits (Vinson, Missouri Medicine, 2006 and Gmel, BMC Public Health 9, 2009). The BMC study found that “relative risks decreased with increasing levels of use,” in other words, when more marijuana was used, fewer injuries occurred. This might seem odd until one recalls that a cannabinoid-blocking drug (rimonabant) was rejected for approval by the FDA due to its side-effects, which included an increase in accidents and injuries. Given that smoking marijuana reduces our risks for developing various cancers, diabetes, heart disease, COPD, Alzheimer’s disease, and other inflammation-based illnesses along with depression, suicidal tendencies and alcohol-caused traffic accidents, shouldn’t it’s use by adults be encouraged and safe, legal outlets be established? Science has spoken.