2017 may be the year that marijuana (cannabis) has its full coming out party. As TIME magazine reported on November 9, 2016, “When California voters approved Proposition 64 on Tuesday, the basic idea was simple: a majority of people in America’s most populous state believe that adults should be able to consume marijuana if they feel like it, like a glass of wine at 5 o’clock.”
TIME got additional information from Amanda Reiman, the Drug Policy Alliance’s manager of marijuana law and policy. The Drug Policy Alliance (DPA) is the nation’s leading organization promoting drug policies that are grounded in science, compassion, health and human rights.
I began working in the field of drug abuse prevention and health in 1968 after I graduated from U.C. Berkeley and started a therapeutic community program to help people recover from problems associated with drug and alcohol abuse. It soon became apparent that helping people with their problems was made more difficult by laws that criminalized use, rather than making use a health issue. This unnecessarily increased people’s level of anxiety and depression, and kept people from getting the help they needed.
In 1973 I wrote the first of many professional articles to expand our understanding of drugs and how they impact people’s thoughts, feelings, and behavior, both positively and negatively. In the article, I wrote,
“The drug problem in this country continues to get worse, and the programs that we have developed to combat the problem are actually adding fuel to the fire. The laws that have been developed over the past 60 years have done nothing to discourage the use of drugs. Their effect has caused the criminalization of millions of otherwise law abiding citizens.”
I went on to say,
“Legal restrictions on mind active drugs have produced a new industry that has proven extremely profitable to legal drug manufacturers and salesmen as well as the illegal drug entrepreneurs. The huge profits to be made in the drug business have caused corruption in large segments of society.”
Well, as Bob Dylan reminds us, the times, they are a changin’. As of January 2017, 28 states and the District of Columbia have legalized cannabis for the treatment of medical conditions. Eight of these states and the District of Columbia have also legalized cannabis for recreational use. In addition to the growing availability of legalized cannabis, there has also been a rapid expansion in the types of available cannabis products, including edibles, oils, and a variety of inhaled substances.
A recent report published by the National Academies of Science, Engineering, and Medicine, offers the most up-to-date and scientifically sound analysis of the changing world of cannabis. The report titled, “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research” offers a number of summary points, including the following:
- Based on a recent nationwide survey, 22.2 million Americans (12 years of age and older) reported using cannabis in the past 30 days.
- Between 2002 and 2015 the percentage of past month cannabis users in this age range have increased steadily from 6.2 to 8.3 percent.
The research findings note different levels of confidence in the findings for the health benefits or harms associated with the use of cannabis for various common problems as follows:
- There is conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.
- There is conclusive or substantial evidence that cannabis is effective for reducing chemotherapy induced vomiting and nausea.
- There is moderate evidence that cannabis is effective for improving short-term sleep outcomes in individuals with sleep disturbance associated with obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis.
- There is limited evidence that cannabis is effective for increasing appetite and decreasing weight loss associated with HIV/AIDS, improving anxiety symptoms in individuals with social anxiety disorders, and improving symptoms of posttraumatic stress disorder.
- There is no or insufficient evidence to support or refute the conclusion that cannabis is an effective treatment for cancers.
- There is substantial evidence of worsening respiratory symptoms and more frequent bronchitis episodes with long-term cannabis smoking.
- There is substantial evidence of a statistical association between cannabis use and increased risk of motor vehicle crashes.
- There is moderate evidence of a statistical association between cannabis use and increased risk of overdose injuries, including respiratory distress, among pediatric populations (i.e. children ingesting their parent’s cannabis).
Perhaps the most important finding for my work with men and women over forty, and for millions of others dealing with chronic pain, is the findings that cannabis can be helpful. More people in the U.S. suffer from chronic pain (116 million Americans), than from diabetes (25.8 million), coronary heart disease (16.3 million), stroke (7.0 million), and cancer (11.7 million) combined.
Doctors often prescribe opioids to deal with pain, which can be effective, but there are drawbacks. Opiates are addictive and they have the potential for overdose. In a recent article, “How medical marijuana could help curb the opioid crisis,” it was reported that researchers interviewed a number of patients who have benefited from medical marijuana. One of them, Derek Pedro, is a 44-year-old man who says, “I am no longer on any opiates, and I attribute it all to medical cannabis.”
Pedro had used opioid painkillers for most of his life. He suffers from a condition called Ehlers-Danlos Syndrome, which left him with chronic pain starting at the age of six. As a child, Pedro took Demerol pills with him to school. Over time, doctors prescribed more and more opioids to help him cope with his pain — including Percocet, Oxycodone, and fentanyl. “The cycle was horrible,” he recalls. “From the minute you wake up to the minute you go to bed, it’s all about the pills and how many you have. I never want to go back to that life again.”
Derek Pedro’s story comes as no surprise to Amanda Reiman, at the Drug Policy Institute. “I think that there are a great number of people out there with stories like Derek’s,” she says. “Unfortunately, because of the stigma around substance use and substance dependence, many people are afraid to reach out for help.”
Reiman says that thousands of men and women are using marijuana as a replacement for other substances — including alcohol and both illicit and prescription drugs. “They prefer cannabis to their other medications,” she says, “mostly because cannabis not only has a better effect for their illness — but because there are less side effects and less risk of dependence.”
So, what are the things we can take away from the latest findings about the benefits and drawbacks of cannabis use?
- There are significant benefits, particularly in dealing with pain, and people need to become aware of them.
- There are also some risks. People should not use cannabis while driving. They should be aware of possible respiratory problems with chronic use. They should take special care to keep cannabis out of the hands of young children.
- We need to change our attitudes to embrace what we are now learning.
- More research will be done as legalization spreads and new information will likely contribute to expanded knowledge that will help us all.
I look forward to your comments and experiences. Please share below.
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