SMOKING, DRINKING, AND THE NEW PLAYER: MARIJUANA!

marijuana

We medical practitioners have long been preaching about the dangers of both smoking (tobacco) and drinking in excess (alcohol). But nowhere has the old adage “familiarity breeds contempt” been more appropriate than in connection with these two vices. We seem to ignore the fact that tobacco smoke accounts for at least 450,000 deaths yearly in this country alone. And although the numbers are not as clear in regard to excessive alcohol consumption, we do know that alcohol accounts for numerous deaths yearly, both acutely or chronically. As we leisurely sip our martinis at cocktail parties, we pay little heed to this danger, finding it reassuring that—in contrast to many confirmed alcoholics—we are able to confine our intake to safe quantities at less frequent intervals.

And now we are being confronted by a new challenge: Marijuana! This substance is moving to center stage because of its legalization in such states as Colorado and because of political pressure on the federal government to avoid conflict with the states and stop incarcerating users and sellers of marijuana.

Unfortunately, until now, far too little research has been done on this substance—either for medical uses as well as for recreational purposes. But one thing is quite clear: Marijuana will never account for as many deaths as do both tobacco and alcohol.

For a clear-headed discussion of the subject of marijuana, I refer you to a recent article written by Sheila Kennedy, my cousin, who normally comments accurately on many important topics of public and political concern. http://www.sheilakennedy.net/2016/08/smoking-and-drinking/

In this article, she makes an eloquent case for legalization, or at least decriminalization, of marijuana. It’s well worth reading!

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MARIJUANA: A FEW FACTS ABOUT MEDICAL AND REACREATIONAL USE


     For better understanding about marijuana, I can provide a few facts below in answer to some common questions:

Does marijuana provide any health benefits?

Yes:  Your body already makes marijuana-like chemicals that affect pain, inflammation, and many other processes. Marijuana can sometimes help those natural chemicals work better. Moreover, it reduces intraocular pressure and because of this fact, it is recommended in treating glaucoma (excessive pressure in the eyes). The anti-spastic and anti-convulsive properties are indicated in some cases of epilepsy, multiple sclerosis and various muscular spasms. In individuals afflicted with cancer, cannabis (and especially the oil in cannabis) leads to the loss of states of dizziness, nausea and vomiting which are specific to chemotherapy. For patients suffering from AIDS and hepatitis, marijuana helps with regaining weight through increasing appetite and reducing states of nausea and vomiting.

Because of its properties and effects, but less certain, marijuana can be helpful on occasion in treating several other conditions like insomnia, anxiety, panic attacks, depression, neuralgias, rheumatism, gastrointestinal dysfunction, and ulcers.

      How can Marijuana be Given for Medical Purposes?

Marijuana may be:

  • Smoked
  • Vaporized (heated until active ingredients are released, but no smoke is formed)
  • Eaten (usually in the form of cookies or candy)
  • Taken as a liquid extract

     Are there Side Effects?

Side effects of marijuana that usually don’t last long can include:

  • Dizziness
  • Drowsiness
  • Short-term memory loss
  • Euphoria
  • Any of the above can impair operation of an automobile
  • More serious side effects include severe anxiety and psychosis

      What are the Risks and Limits?

What are the Risks and Limits?Medical marijuana is not monitored like FDA-approved medicines. Uncertainties include its potential to cause cancer, its purity, potency, or side effects.

Only a physician can prescribe medical marijuana. Doctors will not prescribe medical marijuana to anyone under 18. Others who should not use it include those who have heart disease, pregnant women, and anyone with a history of psychosis.

Does Legalization of Medical Marijuana Increase its Recreational Use?

Legalizing medicinal marijuana does not inevitably lead to a higher rate of consumption, according to a US study published in “The Lancet Psychiatry”.

For the study, researchers at Columbia University in New York analyzed data taken over 24 years and in 48 US states. In the 21 states where medicinal marijuana was legalized, the scientists focused on drug use of teenagers between 13 and 18 years old.

The rate of marijuana consumption did not rise as a result of medical legalization. Analyzing the data according to certain factors (education, origin, gender, etc.) did not influence the results. The authors concluded that there is no indication that people consume more recreational marijuana after medical legalization.

             Does Indiana Allow for Medical Use?

 No. But two Democrats — one in the Senate and one in the House — have introduced bills that would allow the use of medical marijuana in Indiana.

Senate Bill 284, by Sen. Karen Tallian, and House Bill 1487, by Rep. Sue Errington, would allow people with a doctor’s recommendation to use marijuana for medical purposes.

Tallian’s bill would create the Department of Marijuana Enforcement, or DOME, which would oversee a program for those who use marijuana for treatment. The Democrat from Portage has long fought for legalization of marijuana in Indiana, but her efforts have failed. She has introduced bills that would have decriminalized possession of small amounts of marijuana. Two bills Tallian wrote the past two years died without a hearing.

In an earlier interview with The Indianapolis Star, Tallian said she hoped a more narrowly defined bill focusing on people with certain medical conditions would gain more support in Indiana.

Errington, of Muncie, is advocating for medical marijuana use after hearing from constituents who are suffering from chronic pain and seizures, according to a news release. HB 1487 defines a “qualifying patient” as someone who has a written recommendation from a physician to use cannabis. Under Errington’s bill, people with medical conditions such as cancer, glaucoma, AIDS, hepatitis C, Crohn’s disease, Alzheimer’s disease and others could use cannabis for treatment.

But experts have said that the chances of a Republican-controlled legislature legalizing medical marijuana are pretty slim, and that Indiana likely would be one of the last states to act.

Could Indiana’s backwardness in this issue relate—directly or indirectly—to the ongoing clash between religious and public freedom?

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Marijuana: What Can Science Teach Us?

      With all the current hype, it’s time to take a reasoned look at the subject of Marijuana, now enjoying much publicity because of its recent acceptance in Colorado and Washington for recreational use. The marijuana (cannabis) plant contains over 60 cannabinoid substances, and the primary component of this group that accounts for its psychic effects is delta-9-tetrahydrocannabinol (THC). When the plant is smoked, about 20% of the THC is absorbed into the blood through the lungs. Herbal cannabis can also be eaten, but less THC reaches the circulation because it is partially inactivated by the liver. Whether smoked or eaten, the recipient usually experiences a “high”, i.e., a relaxed euphoric sense as anxiety recedes, but alertness also decreases. Exceptionally, users can experience increased fear or panic. Those high on marijuana usually experience an increased sense of sociability with an altered perception of time, with imagined time faster than real time. Spatial perceptions may change, and colors may seem brighter and music more resonant. Although high doses may cause hallucinations, dangerous or fatal outcomes have been virtually nonexistent. Mild or distressing withdrawal symptoms may occur after chronic use, they are also not generally serious or life threatening, and whether this agent is truly addictive remains controversial. These effects might be contrasted with alcohol, which, if given abruptly in large quantities, can be fatal, and if continuously imbibed for several weeks, can result, upon sudden withdrawal, in serious physical manifestations, and even death.

    Because of long-standing legal prohibitions against marijuana, reliable scientific data have been scarce. Two recent reviews, however, examine results from approximately one hundred randomized placebo-controlled trials involving over 6,100 patients with a variety of medical conditions. The results show that marijuana is useful in treating anorexia, nausea and vomiting, glaucoma, irritable bowed disease, muscle spasticity, multiple sclerosis, symptoms of amyotropic lateral sclerosis (Lou Gehrig’s Disease), and Tourette’s syndrome. It is also useful in providing modest relief of pain. In this latter regard, it seems to reduce chronic pain by about 30 percent, a benefit achieved with fewer serious side effects than encountered with commonly used opiates (codeine, morphine, etc). Thus there is ample evidence to support the legalization of marijuana for medicinal purposes. Notwithstanding this information, medicinal use is now authorized in only 20 states and remains proscribed at the federal level. One exception, however, is provided by Nabilone (CesametR), which represents an oral form of cannabis that is currently available and approved for use specifically against nausea and vomiting.

    But what about marijuana for recreational use? As noted, the psychic effects are basically euphoric, providing its chief rationale for use. But risks include the impairment of cognition and muscular responses, a decrease of one’s reaction time, attention, concentration, short-term memory, and assessment of risks. These impairments of psychomotor performance can last longer than the feeling of being high for as long as twenty four hours. This clearly impairs ability to drive vehicles, for several studies show that, in comparison to those who are drug and alcohol free, drivers who use marijuana are two to seven times more likely to be responsible for accidents.

    The effects of marijuana on overall behavior are controversial. Although chronic users have a repeated pattern of poor performance such as inability to fulfill responsibilities in the workplace and persistent social problems at home, this may result primarily from emotional disorders that cause one to use marijuana rather than this latter agent per se.      

     Scientific study has thus far not supported the common belief that initial use of marijuana will “lead” to subsequent use of hard drugs such as heroin, but further scrutiny of this subject is warranted. Many also believe that legalization of marijuana will lead to increased crime rates. This latter assertion has been refuted by a nationwide study recently published in a scientific journal. Researchers at the University of Texas at Dallas looked at the FBI’s Uniform Crime Report data across the country between 1990 and 2006, a span during which 11 states legalized medical marijuana. Although during this time period crime was broadly falling throughout the United States, those states that legalized the drug before and after the law’s passage demonstrated no relative increase across an entire spectrum of crimes: homicide, rape, robbery, assault, burglary, larceny, and auto theft. The robbery and burglary findings are particularly interesting, as those are the crimes we’d most likely expect to see outside of medical dispensaries.

   Interestingly, despite its common use through smoking, marijuana’s effects on the lungs appear far less than those of tobacco. According to a new study, habitual use of marijuana alone doesn’t appear to lead to significant abnormalities in lung function or chronic lung disease.

    So what can we conclude at this time? Legalizing marijuana for medicinal purposes is clearly justified. Allowing its use for recreational purposes remains clouded, but its effects appear similar—but less dangerous—than those of alcohol.

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