Thoughts on the Marijuana Debate

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Today’s show on marijuana is a response to a drastically changing reality with respect to how our society is perceiving and consuming marijuana. While the discussion of medical marijuana has burned for years and was covered in prior programs, the passage of new laws in Colorado and Washington are the beginning of a new normal in the American outlook on marijuana.

My kids will know a completely different world than I knew with regards to marijuana, and my grandchildren may even live in a world where it’s available at the corner café. If the rapid trends of the last few years are any indication, it appears the levy is breaking and weed is here to stay. However, legalization of marijuana can obscure the health risks of the drug. Tobacco, for example, remains legal but is still very deadly and downright harmful when used as directed, and while alcohol is legal and can be safely enjoyed in moderation, it may also cause disease or be lethal.

Let me be very clear: A discussion of the health risks of marijuana is not a moral judgment on someone who smokes pot – rather it’s my moral obligation as a physician to inform my audience of the dangers. Also, whether legalization makes sense or not is a policy-centric discussion involving the expenditure of law enforcement resources and tax dollars, incarceration and control of organized crime. Legalization and safety are two vastly different things. Following prohibition, alcohol was made legal in 1933 to defuse some of these complex problems and we are likely better off – however its health risks did not disappear.

This is not the last we will hear of this debate. We need to give marijuana the attention it deserves in considering whether its use is safe and advisable for us and our children. As a physician, I believe marijuana has a therapeutic role for patients with conditions such as cancer and chronic pain. I have covered this topic on previous shows and my friend Montel Williams has so eloquently and candidly talked about his agony from his MS symptoms and his campaign to legalize medical marijuana.

Modern medicine has a system for managing powerful drugs. We currently use potentially dangerous drugs like morphine because we carefully control them and have judged them to have a strong medical benefit that outweighs their negative risks.

But my bottom line is that I cannot condone any type of impairment for recreational purposes, especially when the consequences are diminished mental capacity and possibly even dependence.

A substance is potentially harmful if it takes away your ability to think clearly and participate in life fully, and marijuana does both these things. To use the alcohol analogy – just because it may be legal to get drunk doesn’t mean it’s wise, and intoxication carries grave risk. During my medical education, I was taught that one of the markers for addiction and dependence was the severity of cravings and withdrawal symptoms – the classic overwhelming heroin cravings or the tremors and disorientation of alcoholic detoxification. The hallmark of addiction is the repeated use of a substance despite negative consequences. That is the pathology of the disease of addiction and many marijuana users fit this criteria. The negative consequences are not necessarily drastic withdrawal symptoms, but instead include depression, lack of motivation, paranoia, memory loss and cardiovascular problems from the smoke.

As the trend towards legalizing this drug continues, we need to be aware of its risks and teach our children its proper place, which is in the pharmacy, not in the kitchen cabinet and certainly not in the school locker.