If It Sounds Too Good To Be True, It Probably Is

The proponents for the legalization of marijuana have a few constant drum beats that thrum their way into popular thinking and decision-making as undisputed facts. Yet it seems few people seek out scientific evidence supporting the core messaging for marijuana. Let’s take a closer look at one of the cornerstone declarations frequently touted as absolute truth: marijuana is safe.

This statement comes with various taglines, such as: no overdose deaths related to marijuana, safer than alcohol, safer than other drugs, not a gateway drug and not addictive.

Remember the saying, “If it sounds too good to be true, it probably is”? These marijuana misstatements are precisely why there are continued efforts to legalize marijuana and why people of the most conservative ilk are considering votes in favor of “tax and regulate”.

But those who live where marijuana is legal are learning more information about the “safety” of marijuana and quite frankly, they feel duped. People often ask, “How can I take my vote back?” Unfortunately for them, it is not going to be easy undoing their decision, but maybe others can learn from Colorado’s colossal mistake.

Here is just how SAFE marijuana is proving to be in Colorado:

Child poisonings have climbed significantly. According to Dr. Sam Wang of Children’s Hospital, these increases have only occurred in states with some form of legalized marijuana but not in states that have yet to change their laws[1]. In fact calls to poison control centers have increased 30% on this issue alone. Accidental poisoning from ingestion of marijuana edibles is not insignificant for children. In seven Colorado cases, the child required intensive care with extended hospitalization and at least two children have required intubation because they required assistance to continue breathing. Please consider what other action could cause a child this type of trauma and yet be hailed as “safe”?

If the immediate response is, “The law states it is for people over 21 years of age” then we need to consider two issues: a) why is the marijuana industry not taking proactive, public measures to issue warnings and disclaimers about the dangers associated with childhood exposures and b) why are adults being treated in such large numbers for poisonings as well?

According to the Drug Abuse Warning Network, marijuana is the greatest reason for Emergency Room visits over all other drugs combined[2]. Dr. Daniel Hehir of Telluride Medical Center states, “I have served in emergency departments for over 15 years. During those first 10 years I don’t recall treating a single case of an adverse reaction to marijuana. This changed as medicinal marijuana use became more prevalent. Now, after the legalization of recreational marijuana, I’m noticing a dramatic increase in emergency visits related to the drug.” The symptoms for adults range from collapsing, painful cyclic-vomiting, extreme anxiety, elevated heart rate, hyper-ventilating and high blood pressure to fear of dying. Dr. David Hughes of Durango’s Mercy Regional Medical Center says, “In such a health-conscious community where gluten, red dye no. 5, high-fructose corn syrup are anathemas, you would think that people would recognize that cannabis isn’t so wonderful and harmless.”

In one recent episode, a female student from Denver University ate a portion of a marijuana brownie and had a violent reaction that included biting herself and others around her to the point of injury. She was taken to the emergency room for treatment. Later she brought the remainder of the brownie to a drug testing facility in order to determine what her THC-infused brownie had been laced with, only to discover that the single substance causing her reaction was in fact, marijuana.

The definition of safe quite literally means “not exposed to danger or risk”. Yet it seems in the case of marijuana we are re-defining safe to mean, “not dead”. And that is certainly a claim that cannabis supporters firmly stand upon. And yet according to the World Health Organization’s statistics on alcohol-related deaths include alcohol-related diseases, accidents caused by impairment resulting in fatal injuries, road traffic crashes, violence and suicides[3]. Why then are marijuana-related deaths not calculated in the same method to include like statistics? After all, “regulate like alcohol” (as Colorado’s Amendment 64 was titled) should mean that we draw parallel comparisons in the exact same manner.

Studies show that marijuana use is associated with risk of myocardial infarction among those with pre-existing coronary artery disease. Smoking cannabis is recognized as a contributing factor among deaths in those who used prior to the fatal heart event due to the increased heart rate side-effect[4]. Consistent marijuana use is associated with lung disease and cancers of the head and neck[5]. Additionally, fatalities associated with marijuana use are well-known. In Colorado alone, marijuana-impaired traffic fatalities have increased 100% from 2007 – 2012[6].

Recent incidents in Colorado where marijuana was a major contributing factor to death would be: the death of exchange student Levy Pongi, who leapt to his death from a hotel room after suffering paranoia and erratic, hallucinatory behavior following ingestion of a marijuana edible product. Another case is pending trial where a married father of two shot his wife to death after eating marijuana candy that caused him to act out of paranoid delusions and extreme anxiety triggered by the high THC content in the edible product. Yet another tragic incident includes the death of 2 year old Levi Walton who tested positive for THC in a DHS investigation just hours before a fatal house fire took his life, as adults in another room smoked marijuana.

Were these incidents caused by any other impairing substance we would read headlines screaming that the substance was responsible for their deaths. In various social media commentary where these stories are noted by individuals, a barrage of denials are posted by the hundreds with responses such as, “everyone knows marijuana is safe, they had to be on something other than weed.”

While that may have been indicative of marijuana used in the 60’s, it is widely recognized that current cannabis products are not only much more potent, but Colorado’s new Wild West mentality of unrestricted THC allowance has caused an interesting array of products that have taken the norm from 2% up to a whopping 90% of THC. Keep in mind that European nations consider THC over 15% on par with hard drugs, such as heroin; nevertheless Colorado is celebrating products with potencies never before seen in marijuana use. Rather than researching the side-effects of these increasingly purified and powerful marijuana by-products while cautiously testing and learning what types of limitations and appropriate warnings should be included in the much-promised regulations, Colorado’s Department of Revenue is engaged in helping refine the process for creating butane hash oil extractions. The process, known as BHO, remains illegal everywhere else on the planet due to the dangerous nature which has caused a multitude of structure explosions, similar to incidents caused by meth labs. And yet, it is deemed … safe.

Though we are seeing increased frequency, the phenomenon of acute hallucinogenic responses to marijuana is nothing new. A report published in the New England Journal of Medicine in 1970 refers to distinct atypical reactions requiring psychiatric and psychopharmacologic intervention that included: depression, panic and toxic psychoses[7]. Interestingly enough the prediction was made that, “physicians will see more … as use of the drug increases and reaches new areas of society.”

The issue of mental illness, depression, psychotic episodes, schizophrenia, neuropsychological decline and suicide must be addressed where risks are associated with marijuana use. A systematic review based on 14 cohort studies reveals that marijuana users are at a 17% increased risk for depression onset, regardless of age. For heavy users (weekly) the risk is increased to 62%[8]. Several longitudinal studies report a 40% increased risk of psychotic symptoms or disorders in those who have used cannabis[9]. Suicide remains a prevalent problem in the U.S. The cost of life is incomparable with the cost of mental health treatment this country needs to address. Substance abuse is insidious for the mentally ill, as the promise of relief from a bottle, pill or bong creates a cyclic pattern of hopes dashed by greater problems and complications from addiction. Not only is drug legalization the least helpful response to this devastating problem, we need to ask ourselves if we are exacerbating the problem by perpetuating the notion that further drug use and addiction are safe alternatives.

It must be understood that the widely promoted belief that marijuana is not addictive has been thoroughly debunked and causes the need for substance abuse treatment second only to alcohol[10]. A 25 year longitudinal study of children in New Zealand found the frequency of cannabis use to be significantly associated with other illicit drug use and dependence[11]. Addiction comes with associated risks and other diseases that anyone would be hard-pressed to categorize as “safe” behavior and it is time to refrain from perpetuating the idea that marijuana use is not a contributing factor where 1 in 6 adolescents and 1 in 10 adult users develop dependency to the point of requiring treatment[12].

One of the most concerning items about marijuana-related illness, injury and death is that incidents pertaining to this substance are typically not tracked well. Due to the Schedule 1 nature of marijuana (listed as such because of potential for poisoning, addiction and lack of medical use) it has not historically been the subject of statistical data-gathering by hospitals or law enforcement and is not routinely included in criteria that would be managed in outcome reports. Therefore, the actual numbers of deaths specifically related to marijuana are not known. That does not mean the statement can be made “no deaths related to marijuana.” It simply means, we do not yet know, as the outcomes have not been calculated. New data gathering requirements will have no comparison numbers for decades. Futuristically, we will have data that causes our great-grandchildren to scratch their heads and wonder what we were thinking when we unleashed legal marijuana upon society and they will marvel at how we not only re-defined safe … but also: TRUTH.

[1] George Sam Wang, M.D. Pediatric Emergency Physician, Children’s Hospital Colorado, 2014

[2] SAMHSA National Estimates of Drug-related Emergency Department Visits, 2013

[3] http://www.who.int/mediacentre/factsheets

[4] Triggering myocardial infarction by marijuana. Mittleman, M, et al. 2001; 103:2805-2809

[5] Evidence on the carcinogenicity of marijuana smoke. Tomar, R, et al. California Environmental Protection Agency, 2009

[6] National Highway Transportation Safety Administration, Fatality analysis Reporting System, 2006-2011

[7] Adverse reactions to Marihuana – Classification and Suggested Treatment, Weil, A. New England Journal of Medicine, 2007

[8] The association between cannabis use and depression. Lev-Ran, S et al. Psychological Medicine, 2014

[9] Cannabis use and risk of psychotic or affective mental health outcomes: A systematic review. Moore, T, et al. Lancet. 2007

[10] SAMHSA, National Survey on Drug use and Health, Rockville, MD. 2010

[11] Cannabis use and other illicit drug use: testing the cannabis gateway hypothesis. Fergusson, D, et al. Addiction. 2006

[12] Structural magnetic resonance imaging of the adolescent brain.  Giedd, J, et al. Annals of NY Academy of Sciences. 2004