Wherein I Tumble Into the Weeds Yet Again…

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Well, I didn’t really think I’d be returning to this topic—certainly not so soon—but I’ve learned some things since the first post appeared that I feel are worth sharing.

As I noted previously, despite my ambivalence concerning legalization, I’ve been assuming that it will eventually happen. I still do. A number of you have pointed out the analogy to Prohibition, and we all know how that effort to oppose the public will turned out.

But a New York Times report on the collapse of an effort to legalize marijuana in New Jersey, which was a campaign promise made by the state’s governor, Phil Murphy, and had both his strong backing and statewide public support, points to some opposing arguments that legislators made. (I promise if you stay with me through this, you’ll see that I conclude my findings on a high note. Oops, there I go again with the bad puns.)

From the Times:

“Some lawmakers were unsure about how to tax marijuana sales. Others feared legalization would flood the state’s congested streets and highways with impaired drivers. Some would not be deterred from believing that marijuana was a dangerous menace to public health.”

The Times pointed out that New Jersey lawmakers, and those in the neighboring states of New York and Connecticut, have tried to avoid problems that have occurred in states that have already legalized cannabis. 

Colorado, for example, according to a state-sponsored study published in the March 26, 2019, issue of Annals of Internal Medicine, has seen three times as many cases of people presenting to the emergency room for visits attributable to pot since legalization in 2012. 

The greater number of visits was attributed to edibles—“tales of tourists needing emergency care after gobbling too many marijuana gummies”—leading to vomiting, racing hearts, and psychotic episodes. But the worst problems at a Denver hospital were caused by inhaled marijuana. The study was also prompted by three deaths in Colorado related to edible marijuana products. 

An Associated Press report in the Times observed:

“The analysis confirmed edibles are trouble. Statewide, they made up less than 1 percent of total cannabis sales, measured by THC content [the ingredient that creates the “high”]. Yet 11 percent of ER visits were triggered by edibles.”

There’s no information on safe dosing of these edibles, according to Andre Monte, MD, lead author of the Annals study. An accompanying editorial by Dr. Nora Volkow, the director of the National Institute on Drug Abuse, stressed the need for additional research about marijuana’s benefits and harms and called increased oversight of marijuana manufacturing and labeling an “urgent need.”

Some of the legislative concerns have been financial: in California and Massachusetts, tax revenues from marijuana sales have been disappointing.  My biggest worry, about how to protect teenagers from the drug, has also evoked serious discussions.

I’m going to digress slightly here because a dear friend who’s a long-time mental health professional observed after reading my first post that discussing marijuana is not sufficient without also talking about vaping, which she knows from experiences among acquaintances has led to psychotic breaks in some adolescents. 

If you know any young people who are tempted by or are engaged in this activity, this fact sheet for teens contains information about the dangers of vaping both e-cigarettes and marijuana. Many brands particularly target youth, prompting one report to ask:

“How can a tween, teen, or 20-something looking for inclusion, status, or the next cool thing resist? Given that vaping among high school students in grades 9-12 increased approximately 1286% between 2011 and 2018, it appears they are willing to give vaping a try.”

Some people have suggested to me that if pot were legal, teenagers might be less likely to find it attractive. A 1286% increase in 7 years? If that statistic is even half right, it offers little support for the “if it’s no longer illegal, it loses its allure” argument.

Another important issue in states that have legalized marijuana, notes the Times article,  involves “a burgeoning industry dominated by white corporate interests even as advocates in Hispanic and black communities say their neighborhoods have been most negatively affected by the drug.”

As I noted in my previous post, I am deeply concerned that the social aspect of marijuana legalization be addressed. While I touched on that issue, it clearly needs more exploration. (I mentioned that the records for marijuana arrests in areas where it’s legal continue to show racial disparities, and there’s agreement that better police training is needed.)  If legalization is to take place, it had better be done in a way that rights the wrongs that have been inflicted by the criminal justice system for years.

In this regard, the bill that was voted on in the New Jersey legislature last week was exceptionally strong. According to the ACLU:

“The bill before the Legislature is truly historic. It includes forward-thinking measures to reverse the injustices wrought by the failed drug war.”

  • expedited expungements for cannabis-related criminal records;
  • ability for people to vacate current sentences;
  • non-discrimination for cannabis use;
  • opportunities in the industry for people with criminal records;
  • social justice representatives on the cannabis regulatory board;
  • meaningful provisions for diversity in the industry.

No other state has leaned into the social justice elements of marijuana legalization the way New Jersey is poised to.”

Let’s hope that any future legalization legislation is equally forward-looking and just.

So the concerns I expressed in that first post—about the need for sensible regulation, careful monitoring, greater awareness of potency, focus on teenagers, and emphasis on criminal justice reform—remain intact, even heightened somewhat by the Colorado study. I guess this is a societal experiment in which we’ll bumble along and, I hope, with good sense and good luck, get better at doing things right with time.

Here’s where I end this unplanned revisit on a high note:

A friend alerted me to an article in Scientific American with the optimistic title: “Marijuana May Boost, Rather Than Dull, the Elderly Brain.” (The original study appeared in Nature Medicine; here’s the abstract.)

Before anyone gets too excited, the senior citizens in question were of the genus Mus—specifically, mice. According to Scientific American, 

“…the drug might affect older users very differently than young ones—at least in mice. Instead of impairing learning and memory, as it does in young people, the drug appears to reverse age-related declines in the cognitive performance of elderly mice.”

Scientists not involved in the study who found it intriguing cautioned, of course, that additional research is needed before assuming the findings would be relevant to aging humans. But those who did the study noticed that in the treated elderly mice, the neurons in the hippocampus (the part of the brain essential for memory and learning) had developed more of what’s called synaptic spines, by which neurons communicate with each other. 

The Scientific American author pointed out that the researchers were even more struck by the dramatic difference in the hippocampus of the THC-treated mice as compared with the elderly, untreated mice. Andreas Zimmer from University of Bonn, Germany, the lead researcher, stated:

 ‘That is something we absolutely did not expect: the old animals [that received] THC looked most similar to the young untreated control mice.” 

The hypothesis is that the THC and possibly other components in cannabinoids act similarly to the brain’s naturally occurring endocannabinoids, which are directly associated with the brain’s neural activity and appear to decline with age. Thus, externally introduced cannabinoids could, theoretically, reverse that process. 

One clinical researcher who wasn’t associated with the study, Mark Ware at McGill University, observed:

“To anyone who studies the endocannabinoid system, the findings are not necessarily surprising, because the system has homeostatic properties everywhere we look.” In other words, it adjusts to changes in order to maintain internal stability.

That can explain the variations we see, points out the Scientific American author. 

“For example, a little marijuana may alleviate anxiety, but too much can bring on paranoid delusions. Likewise, cannabis can spark an appetite in cancer patients but in other people may produce nausea. Thus, the detrimental effects seen in young brains, in which cannabinoids are already plentiful, may turn out to be beneficial in older brains that have a dearth of them.”

Of course, this is just one study, but it’s quite fascinating, isn’t it? While I’m still worrying about teenage abuse of the substance, and irresponsible drivers, and lack of information about potency that’s sending people to the ER for glomming down too many gummies (I wonder how many gummies it took…), I find myself eagerly awaiting further research on the effects of cannabis on the aging brain.

I received several new clearly weed-related followers after my first post on this topic, and I wondered why they found me a kindred spirit when I was so filled with skepticism and concerns.  Then a friend reminded me of my reverie about cherry tomatoes after my one-and-only experience with pot decades ago.

Another friend had commented that he had been pro-legalization, but my first post made him rethink his position. But I told him about this study. After hearing about it, I now have images of happy elderly folk in all sorts of places, reveling in their carefully regulated dosages of brownies, gummy bears, and the like—followed by a chaser of cherry tomatoes unlike any they’ve ever experienced before.

And in my fantasy view of memory nirvana, all who so engage will be able to promptly retrieve the first and last names of everyone they’ve ever met; the actors, titles, and stories of all those wonderful movies; the plays, players, and scores of sports events they viewed with pleasure decades ago; and…well, you get the picture.

…And Mr. Google will simply have to find another line of work.

As always, I welcome your thoughts, opinions, and stories in the comment box below—as well as your feedback in the form of stars (from the one on the left for “awful” to the one on the right for “excellent”) and the “likes” from WordPress folks.  Thanks so much.

Annie

Getting Into the Weeds of the Marijuana Debate

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First, sorry about that title; I couldn’t help myself.

When I was in grad school, a sheltered 21-year-old living on her own in the Big City for the first time, I had a friend I’ll call Bo. An English major like me, Bo was a wildly creative character who scavenged through garbage cans and transformed odd stuff he’d found into some very interesting works of art.

He was also eager to share some of the things he regarded as life’s gifts with his friends. And so one day he offered me—a non-smoker, rule-abider, and rather fastidious sort—a dirty-looking piece of hemp. Despite myself, perhaps swept up by his enthusiasm, I took a few puffs. I coughed several times and waited for the mind-altering experience to sweep across me. Nothing.

Then Bo said, “Close your eyes and open your mouth.” Again despite myself, I did so. I bit down on what I realized were a couple of cherry tomatoes. But these weren’t just cherry tomatoes. They were the purveyors of what felt like thousands of tiny, glorious seeds that danced through my mouth, spurting forth and swirling among the juicy streams, evoking delight on a sensory journey I can still vividly recall.

That was my one and only experience with pot. I didn’t like smoking or the smoke, and I returned to my law-abiding self. Had I even had enough of the drug to create that euphoria, or was it a pot-cebo effect attributable to the circumstances and my friend’s delight? I’m not sure, but I think it was due to that puff, the magic drag-in. (It appears even the remembrance is making me giddy; could bad puns be a side effect of cannabis use?)

In fact, my admittedly blog-sized study of this very complex topic has led me to believe that the legalization of marijuana is no laughing matter. For one thing, the substance today is not, as some have said, “your father’s marijuana.” It’s also not my friend Bo’s. It’s far more potent, and the potency is one factor that can get people into a heap of trouble. 

“Today’s marijuana plants are grown differently than in the past and can contain two to three times more tetrahydrocannabinol (THC), the ingredient that makes people high,” states the American Academy of Child and Adolescent Psychiatry (AACAP). “The ingredient of the marijuana plant thought to have most medical benefits, cannabidiol (CBD), has not increased and remains at about 1%.”

Marijuana, I’ve learned, is a complicated substance, containing over 100 distinct chemicals. In addition to THC and CBD, it’s comprised of other elements that also have specific effects on the central nervous system. According to an article in the Annual Review of Medicine, 

“The concentration of these compounds can vary substantially, making it difficult to characterize the specific positive or negative health effects of marijuana, especially in uncontrolled and epidemiological studies.”

As this movement toward legalization seems to be gaining ground, I’m extremely conflicted about its implications. Though I lean toward the civil libertarian approach to life, I have worries about whether we as a society have sufficient data at this point to know the safest and wisest ways to proceed. 

I’ve concluded that it’s irrelevant for me to decide whether or not I support legalization because I assume it’s inevitable: 10 states and the District of Columbia have already passed laws legalizing recreational marijuana, and 33 states have legalized medical marijuana. Thus, I’m focused here simply on raising some of the issues that give me pause.

There’s no doubt the financial incentive is strong. When John Boehner, former Republican speaker of the House, spends his time leading events to woo cannabis investors, you can bet there’s gold in them thar weeds.Unknown-12

 

According to a leading analyst, the current US market opportunity is between $40 and $50 billion, and may increase by 2030 to $80 billion if there’s national availability.

Whether that’s enough to snatch the market away from the drug cartels is problematic.

Opponents of legalization argue that there’s no way these people will pack up their bags; they’ll simply focus on building up their clientele for even more dangerous drugs. There’s also concern about synthetic marijuana, which can be considerably worse than the natural variety.

The emphasis on medical use of marijuana, which I had thought was an easy issue before I began my research, is considerably less so. The authors of the study cited above point out that in many cases these substances have been legalized by voters in state elections or by state legislators, bypassing the scrutiny of the traditional FDA testing/approval process. 

These researchers said (in 2015) that “the evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia [wasting syndrome], nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis,” with other potential uses showing promise but lacking robust data.

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Web MD added to those conditions Alzheimer’s, Crohn’s disease, eating disorders, epilepsy, glaucoma, mental health conditions (eg, schizophrenia and PTSD), muscle spasms, and pain.

That’s a pretty impressive list that could mean relief for many people, but the issues apparently aren’t so clear. James Beck, PhD, the Chief Scientific Officer of the Parkinson’s Foundation, said in a brief video called “Neuro Talks” that use of marijuana might help relieve anxiety, appetite loss, and pain in Parkinson’s patients, but the increased potency might mean it would exacerbate slowness of thinking, cognition, balance, and hallucinations. (For the video, click on the James Beck hyperlink above.)

Beck pointed out that the Parkinson’s Foundation was committed to research to help identify the different formulations, potencies, and components of cannabinoids and how they might affect patients at various stages of illness.

One of my major concerns involves the use of marijuana in young people, whose brains are apparently more greatly affected than those of adults. AACAP points out that many teenagers believe that marijuana is safer than alcohol or other drugs, possibly thinking it’s natural, non-addictive, or won’t affect their thought processes or grades.

But AACAP warns parents about the various difficulties arising from short-term use (such as problems with memory and concentration, increased aggression, car accidents, increased risk of psychosis); regular use (leading to Cannabis Use Disorder, involving cravings, unintentional heavier use, and interference with other activities); and long-term use (creating breathing problems, lower intelligence, and mental health problems, including risk of suicide). That’s a partial list.

The authors of the previously cited study say:

“Early and greater quantity of marijuana use results in greater cognitive deficits. This is particularly true for adolescents who begin smoking marijuana in their early teens.”

They refer to a finding that those who began between 14 and 22 years old and stopped by age 22 had significantly greater cognitive deficits at age 27 than those who’d never used marijuana.

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How can we protect our young people from the potential harm? Surely parents and schools who warn against drug and alcohol abuse must be similarly open about marijuana, since young people may find its new legality confusing.

One positive aspect of legalization is that it may help address the clear racial disparities in this issue. In a 2012 NPR Intelligence Squared debate on the legalization of drugs,  Paul Butler, a former prosecutor and current law professor at Georgetown whose expertise is in criminal law, especially involving race, advocated for legalization. 

Butler noted that, growing up in all-black neighborhoods, he’d had no contact with marijuana. His introduction came as an undergraduate at Yale College and at Harvard Law School (!).

In the war on drugs, he observed, about 90% of those arrested have been black, though people of color make up only 12% of drug users. Legalization, he said, “will stop the counterproductive practice of treating kids like seasoned criminals.”

But that’s not happening yet. According to Vox, the racial disparity in arrests continues, even in states that have legalized marijuana.

The Colorado Department of Public Safety reported in 2016, four years after Colorado legalized the drug, that the drop in arrests hadn’t occurred across the board equally.

“The decrease in the number of marijuana arrests by race is the greatest for White arrestees (-51%) compared to Hispanics (-33%) and African-Americans (-25%).”

To counteract these disparities, activists say that “legalization must include a change in how drug laws are enforced by police officers,” reports Vox. This issue will be addressed as part of the widening scrutiny of racial justice and policing.

[For more on that topic, see my earlier post, “How Do We Talk About Race in America? (Part 2) Meet Doug Glanville.”]

And an important driving factor in this effort, Vox observes, will be the activism of black women.

I would like to think that the arguments of proponents of legalization will actually hprevail: that there will be stricter regulation leading to safer marijuana; that legal resources will be freed up to be deployed where they’re really needed, and people can be spared unnecessary police records and damaging prison time; and that we may even see a drop in adolescents’ use of marijuana, as well as harder drugs. That would be wonderful. 

But we simply don’t know. We’re at the beginning of a complicated path as we increase access to marijuana. We live in an age of anxiety, and it’s not surprising that people are eager for substances that help them relax.

And, in my one, extremely brief encounter, I certainly got a hint of the pleasure that cannabis can provide.

I don’t worry about adults’ feeling comfortable with the occasional weed, freed from concern that they may soon find themselves involved in the criminal justice system.

I just hope that we as a society are up to the vigilance, research, and regulations needed to help us ease our way into this new era, ensuring that marijuana users have access to carefully regulated products so that excessive potency, bad processing, or dangerous synthetics doesn’t take them by surprise and/or damage them.

I hope that all users are as responsible and aware on the road as they would be after having alcohol—surrendering their keys to a designated driver before the high becomes “too high.”

And I hope, especially, that everyone protects and educates the children.

This is a controversial topic, and I’m sure many of you have strong opinions. Please let me know your thoughts, stories, insights, and other resources in the comments box below. Many thanks.

Annie