Brianne Fitzgerald NP,


This is a tough one, as we have little scientific information on marijuana.  It is a schedule 1 drug and therefore limited rigorous scientific research has been conducted.  We do know from anecdotal information, social medical, personal experiences and hearsay that there are serious issues related to its use.   Marijuana is not harmless and yet it does not lead to fatal overdoses as alcohol does.  The potency of current strains may shock those who have not tried it for decades.  It can produce a serious dependency and regular use does interfere with job and school performance.  It is best to be avoided if you are an adolescent.  Casual use by adults poses minimal risk for healthy people.  Marijuana though is an intoxicant and cause euphoria. Damage caused from regular alcohol and nicotine use is higher because they are legally available.  Perhaps once the legalization of marijuana becomes more faintest, we will see similar trends.  Tobacco causes cancer and alcohol can lead to liver damage and cirrhosis.

Marijuana can cause wheezing and coughing, it can increase the heart rate.  Marijuana is not addictive in the same way that an opioid is.  It does however interact with the brain’s pleasure centers and can create a strong psychological dependence that may be equally hard to break. Withdrawal include irritability, insomnia and anxiety…the very reason many first started using it.  Many argue that marijuana is not a gateway drug.  For the record I have been seeing patients for over 30 years and alcohol/nicotine/marijuana were the first substances that they tried before embarking on a history of substance use problems.  The largest issue, in my opinion is that the adolescent brain is in active development to the early 20’s and there is scientific evidence that adolescents are more vulnerable to marijuana’s adverse effects.  Two studies I reviewed reported I.Q drops that were not restored by age 38.

There are 2 components in marijuana products cannabidiol (CBD) and tetrahydrocannabinol (THC).  CBD is sold in health food stores and online as a supplement, extract and more.  CBD is non-psychoactive.  It is well tolerated, and its side effects are minimal and may be related to other medications that one is taking.  THC is the psychoactive/euphoric compound and it is available by smoking, edibles, capsules and more.  THC side effects include, coordination issues, dry mouth/red yes (when smoked), slower reactions times and memory loss.  Neither compound is fatal, it is the TC+HC compounds that poses most risk for adolescents and it is from this point of view that my bias SHOWS.  The underdeveloped decision-making skills of an adolescent are most at risk  The bottom line is that marijuana may hold promise for the future, the risk is that the hype is bigger than the science out there today.  Marijuana cannot be pigeon holed.  The discussion on its benefits and harms requires a careful consideration of the limited science that we have this far and a humble and open attitude.  The irony of current discussions is that they are so emotionally and politically charged that polarization occurs.  It is complicated…but you already knew that.