Legal never has meant “safe” but the two words may at times overlap in our minds. When it comes to marijuana I’d suggest there is quite a bit of confusion right now about safety, recreational and medicinal use, and the effects of use on our population. In general, as laws change and access to marijuana increases we have a responsibility to be clear about what is known.
The adverse effects of marijuana in children and teens have been well-documented. Marijuana use can impair memory, decrease concentration, and change problem-solving capacity. It’s not good for the lungs nor long-term health; teens who use pot have a higher likelihood of drug addiction later on in life, the risks increase the earlier they start using. Research also finds that teens who use marijuana are less likely to finish high school, are more likely to use other (illicit) drugs, and have an increase in suicide attempts compared to those who don’t. The more they use, the more the effect. I can’t help but think about what a mom to a teen said to me recently in clinic, “marijuana is everywhere now.”
One in 5 high school students says they have used marijuana in the last month and up to 1 in every 16 students says they use it every single day. Who are we if we ignore these numbers?
As legal may mean “safe” to some a strong statement from pediatricians everywhere from The American Academy of Pediatrics (AAP) was released today to set the record straight. The two things to know:
- Research has found marijuana has adverse effects on teen health. It’s now known that the brain isn’t fully developed until the mid-20’s raising real concerns about what the drug does while the brain is still forming. The effects of marijuana change how teens think in school, how safe they are on the road, and potentially how they act for a lifetime (lifelong addiction risks increase with use, teens who use are less likely to finish high school, teens who use have higher suicide risk).
- Use Coupled With Criminalization Can Change Lives For Good: Legalization for medical and recreational use may imply marijuana is benign; for children and teens this is untrue. History shows that teens, especially those of racial minority groups, are incarcerated at higher rates secondary to possession or use of marijuana. A criminal record can have lifelong negative effects — the AAP is advocating to decrease marijuana crimes from felonies to misdemeanors, study effects of legalization in states like WA or Colorado, Alaska or in DC, and strictly limit access to and marketing of marijuana to youth. The big concern here as well is that policies that lead to more adult use will likely lead to more adolescent use. Decriminalization is especially important in states where recreational use is legal for those over 21 years of age.
Marijuana in Washington
Two years ago Washington made history by becoming one of the first states in the nation to legalize recreational marijuana. The first recreational stores opened in July of 2014 and slowly but surely, more and more have been popping up around the state (about 85 in all).
Washington Poison And Drug Information Center tracks ingestion and exposures. Calls are increasing likely because people aren’t afraid to seek help (and potentially because use is increasing). Their phone is always available for help if a teen or adult is concerned about marijuana health effects (1-800-222-1222) . Here’s a look at the numbers even though these are likely grossly underreported
- Before legalization total exposures to marijuana intoxication in 2011 (prior to legalization) was 146 while exposures in 2014 were reported at 246.
- Majority of exposures were from intentional use (108) meaning fewer cases were unintentional use by young children getting into pot in arm’s reach. Clearly smart, childproof packaging of pot-laden foods (like gummy bears) is essential! As a reminder approved infused products from the WA Liquor Control Board include:
- Soda
- Cookies
- Salted Caramels
- Gummy Bears
In early 2013, a month after our vote to legalize I published a guest post here that I think back on. For parents who feel they can’t control the choices or opinions of their teens consider what this addiction counselor affirmed:
One of the biggest mistakes parents to teens make is to believe that they no longer have influence on their kids
Safety Is Still A Concern
While the act of ingesting marijuana (if you’re over the age of 21) is technically legal in our state, it’s important to note there are several things you cannot do.
- Have possession of marijuana if you’re under the age of 21
- Use it in public (personal experience indicates this law is often ignored)
- Drive under the influence
My big concern with marijuana is the lifelong lasting effects of marijuana on the group of children growing up now. That being said, acute effects from marijuana use do happen. If you find yourself (or your child) in a situation with a potential marijuana overdose, don’t be afraid to call for help! Washington state has a Good Samaritan Law regarding drug overdoses that protects a person seeking medical assistance for someone experiencing a drug-related overdose from being prosecuted for possession of a controlled substance, even if under-age. Dr. Alexander Garrard, with the Washington Poison and Drug Information Center reiterates that it’s okay to call for help, saying “A call to the Poison Center is confidential and healthcare providers are available to answer your questions and provide medical advice should you or someone you know be experiencing a negative reaction from the use of marijuana or marijuana edibles.” Remind teens they’ll never be punished when calling for health concerns or support.
E Canfield says
Didn’t know you could actually overdose on marijuana. Weirdly, I do know people who’re allergic to pot. My mom and sister both break out in hives when the neighbors are having a joint
My dad (an asthmatic respiratory therapist and retired firefighter) says that any kind of smoke is bad for your lungs. The main difference, I guess, is that people who smoke marijuana generally don’t smoke as much as those who smoke tobacco.
Wendy Sue Swanson, MD, MBE says
You can overdose. Especially if you don’t know the dose. Most exposures/overdose calls to Poison Center are from “medical marijuana” and many can be from edibles.
The statement does address the concerns you mention about smoke. — American Academy says:
Any product that requires smoking to release the desired effects cannot be recommended by physicians, because smoke contains tar and other harmful chemicals. Alternative methods of administration of cannabis without combustion have been developed.
Emily Gibson, M.D. says
Curious if you or your colleagues are seeing a mild version of cannabinoid hyperemesis syndrome, with morning nausea and abdominal discomfort, something that I’m convinced is happening in our adolescent and young adult regular marijuana users. You inspired me to write about it today on my blog. Thanks for your clarity on this issue today.
Wendy Sue Swanson, MD, MBE says
This hyperemesis syndrome (or similar symptoms) sure is possible and I would love to learn more. Especially possible given the data presented in the technical report that accompanied the policy that details that over the past few decades marijuana:
Joe says
You keep mentioning a Marijuana overdose, but you haven’t told people what specific overdose symptoms to look out for. I too was under the impression that a Marijuana overdose is, in fact, nothing more than a Marijuana created panic attack. FWIW I’d focus all my time on eliminating alcohol use before I turned to potheads. It will be interesting to see how the fatality rates compare in WA & CO vis-a-vis directly attributable deaths.