Wednesday, November 17, 2010

Marijuana Smoke

When I smoked marijuana, I wouldn't have listened to what I'm about to say. Studies in motivation to change tell us that people who do drugs are often extremely closed minded. This is called the "Pre-contemplation" phase. If you try to bring anything up with them they will get angry and bullying. Best to just 'mention' the issue and escape. Only when people are in the 'Contemplation' phase are they open minded and ready to hear any information that might be in conflict with their own opinion.

Marijuania smoke causes the brain in MRI studies to appear brain damaged. This is likely a reversible effect. Cocaine in a different way causes the brain to appear brain damaged on MRI studies. The frontal lobes of a person doing cocaine will appear dysfunctional for 3 months after a person uses cocaine but then those frontal lobes begin to function again. With marijuana the damage is in the hippocampal area which is associated with memory. The amygdalla associated with emotional modulation is affected as are other areas association with judgement and decision making.

A colleague has asked me to research the latest information on the negative effects of marijuana and I've been meaning to do the detailed review that his question warrants. Because I work in this field, see the horrible waste and damage daily, and am commonly reading the literature on this I thought I'd just here review what I know to be true. I'll get the 'sources' or 'evidence based studies' or 'references' eventually for my friend. Because he was interested in giving this information to someone with a problem in the hope that it would help them and their friends change I thought I'd do this much now.

The politics of the issue is that scientists are being challenged to 'prove' the earth is round to a group of 'flat landers' because business interests and a variety of other players have a huge invested interest in this multi billion dollar marijuana industry. To get some comparison of the influence of drugs in a community I encourage people to watch the brilliant youtube presentation "cocaine cowboys". It's only about 20 minutes long and discusses the effects and influence of drugs on Florida, ultimately 'infesting' the banking, political and business machines of the community.

I have little doubt that marijuana has has a similar influence on British Columbia and maybe even California. Gambling might not be beneficial to a society but you're not going to get a balanced discussion of this subject in Los Vegas where the casinos make a killing daily financially from the promotion of something some would say requires regulation. In the world of addiction the 'one armed bandit' is the cocaine of addiction and online gambling is devastating countless families. But then the recent economic crisis has been dubbed 'white collar gambling'. There is a 'line' where something moves from fun to sickness. The obesity in America today reflects the 'loss of control' aspects of a binging culture.

That said:

1) No Marijuana Smoke is Healthy. None. Not even a toke. Anyone who says different is lying. More likely they smoke marijuana, their brain has changed as a result, and they are insane. Smoke is not healthy for the human body. God did not give us a chimney. No smoke is healthy. The same goes for tobacco smoke, pipe smoke, cigarette smoke, or roach smoke. Just so we are starting on the same page. Lots of what humans do are risk taking and unhealthy. Marijuana smoking is just one of the unhealthy things and unsafe things that humans engage in. But simply said anyone who says smoking marijuana is good for you is no more your friend than a person who says smoking cigarettes is good for you. Smoke is not good for you. Smoking marijuana causes lung damage as any inhallation of smoke does and the damage is greater over time.

The Canadian Medical Association was polled about the health benefits of marijuana and collectively the doctors were en mass against prescribing marijuana smoking principally because of the delivery system, smoke. Synthetic marijuana pills and new inhaler nebulizer systems are more acceptable to doctors in general. Part of the problem was 'dosage'. The greater the dosage of marijuana, as with other medicinal substances , the greater the potential harm. When the government of Canada, politically pressured Canadian doctors to prescribe marijuana and came out with guidelines saying who we should prescribe to, most doctors persisted in being resistant because the Canadian Medical Protective Association, our medical insurance lawyers, said that we could be liable for the potential negative consequences if there wasn't something done about the 'dose' issue. Doctors prescribe all manner of dangerous substances in allopathic medicine. These curative medicines have windows of benefit. Just like a surgeon doesn't cut through the human front to back back but stops his knife at 1 millimetre depth in a particular procedure so the specific dose of dangerous compound is used in this safe 'window' of benefit. Marijuana is a dangerous drug.
2) Marijuana ingested as a pill form, or eaten as in 'hash brown cookies' is clearly safer than marijuana smoked. However while eating or injesting marijuana gives people all the so called 'medicinal' benefits of the drug it's political proponents insist on growing plants and smoking the 'buds'. This is because this is the the best delivery for 'psychoactive' substance effects and this is all about getting 'high', 'wasted', 'blasted', 'blotto', 'shit faced' 'buzzed' or any of the other terms for the alteration of consciousness that comes with smoking marijuana. The quicker a substance hits the pleasure centers of the brain the more 'blast' is associated. Hence 'snorting' cocaine and ultimately 'smoking crack cocaine' gives a far greater high than eating cocaine. IV injection of heroin gets the drug right into the blood stream. It's why addicts will crush up a morphine pill and inject it rather than just 'eat' the pill. The manner in which a drug is taken can tell you a whole lot about what the purpose of it's use is. Marijuana smokers are not smoking for their health. They're smoking to get high and are justifying their addiction and pleasure by a variety of often downright insane marketting communications. In contrast a person who only drinks marijuana tea might well be after some health benefit associated with marijuana as a medicine. Such individuals are so rare as to be as anomalous as a person who never drinks alcohol but occasionally bakes a rum cake and eats it for the medicinal effects of alcohol.
3) Marijuana is addictive. The cocaine marketting group insisted cocaine was safe and not addictive. The tobacco industry said the same about tobacco. Marijuana is addictive and it makes you stupid. Stupid marijuana smokers can't see how addictive marijuana is and refuse to accept all the proof of it's addictiveness. Instead they will commonly say, "well, I haven't smoked a joint for a week and I can take it or leave it." The classic Irish alcoholic insisted he wasn't addicted to alcohol because he took a prescribed alcohol 'holiday' in February before returning to destroying brain, liver, heart and families and work starting again in March. Marijuana is addictive. I have a brilliant scientific paper so elegantly prepared and researched sitting in a file in my office. I used to show it to marijuana smokers but it literally had no influence. "So what if it's addictive, I like smoking marijuana" the marijuana slave would reply. Eventually I realized showing a picture of the earth from space wasn't going to change the mind of a religious or psychotic 'flatlander'.
Today marijuana is the second most common reason for people to enter inpatient treatment programs. It is extremely hard to stop and it is extremely hard to stay stopped for over a year. Recovery is not about hours or days but is indeed about years. Marijuana is psychoactive and can be shown to be present and acting in the system up to 3 months after the last use, standard labs will detect marijuana at 6 weeks after the last use. 3 months is the detoxification phase just like a week is considered the detox phase for alcohol.
4) Marijuana is a gateway drug. I work in a street methadone clinic and almost all of my severely addicted patients who have commonly had legal and health problems associated with drug abuse, ended on skid row, have become royally addicted to heroin and cocaine almost all had marijuana as their 'first' drug of abuse. Most had alcohol too.
5) Marijuana impairs performance across the board. Countless studies of jazz muscicians, car drivers, students, etc have showed that marijuana does not enhance performance. Still ask a drunken man if he's a better lover on alcohol and he will insist he is and if his partner is drunk she might well agree but sober people make better lovers and actually remember the night. The standard joke of the 60's is that if you remember it, you weren't there. The issue of performance is this. If Einstein smoked marijuana he'd still be a good physicist but he wouldn't be Einstein. When I asked hundreds of marijuana smokers if they'd want their neurosurgeon or space shuttle pilot to be on marijuana they all said no. Not one said yes. But if I'd asked them if they could play guitar on marijuania they'd say yes. Frank Zappa didn't want his band to be doing any drugs in rehearsals. I wish one hair dresser hadn't been on marijuana when they whacked the side of my hair and I went home lopsided. I later thought if marijuana smokers want doctors to be clean and sober couldn't we expect our garbage collectors and bus drivers to be doing a similar standard. Mostly couldn't we expect this of performers, politicians and especially judges. In the states the highest paid jobs and most safety sensitive require drug testing. There are some 40 plus million of these jobs and they are all associated with lowest accidents. Marijuana is highly associated with accidents in the workplace. It really is Cheech and Chong when people are at work and have smoked a bomber the night before.

There's more but hopefully this helps. From a public health perspective and from the insurance prospects associated with this, it's a well known maxim that the more available drugs are the more will be harmed by them. Given the politics and money involved in the promotion and distribution of marijuana we can anticipate even higher social costs than we are already seeing.

That said, yes if I had cancer and nausea I'd smoke a joint and I would and I have recommended marijuania for a very few selected patients where they would benefit from cannibis. I was doing this 25 years ago too. I disagree with the research on the benefits for marijuana for some conditions that it is said to help but there is a rare case in which marijuana is more beneficial than alternatives. It's risk though is very high and this needs to always be countered against perceived benefits.

- Posted using BlogPress from my iPad


Ledg Wins said...

A "gateway drug"? Good grief Bill, using your logic I could say that taking a crap leads to heroin addiction. After all, it's in the history of every one of those addicts.

haykind said...

Your argument depends upon ridicule and arrogance. It's also crude and meant to titillate with this lame marketting strategy. Smoking marijuania is a well established gateway drug. It's s slippery slope. Once I break the law to obatin an illicit drug that impairs my judgement then it's easier to break the law to obtain other drugs. Further, whereas once the marijuania supplier didn't traffic in other drugs this is no longer the case. Marijuania salesman most commonly sell other drugs and indeed offer them, "I've got some good y in if you want to try that" and promote it, "I've got a lot of y in and you can have some for free, it's on me (see I'm your buddy, your friendly neighbourhood drug pusher). Now as marijuania is big business, billions of dollars in sales, gangs are the principal suppliers and promoters so you become known to the underworld, associated and for the purpose of sales are targetted. It's just busin3ess. Increasingly I see chronic marijuania smokers developping a pain disorder and getting more opiates from the street before going to heroin. They'd not have been discussing their work related injury with a drug pusher if they weren't their buying drugsand the pusher just happened to have something 'stronger'. Now i can go on but since this is obvious and marijuania as a gateway drug is obvious to those who are experienced with marijuania, with drug abuse and have themselves been there, done that, and are working on helping others now out of the slavery, what's your take. I would guess you're either addicted and can't see the forest for the trees or you are promoting, possibly for profit. My association and biass is known. In the past we were concerned about 'freedom' to smoke and 'my body my own' and civil liberties issues, but today it's well recognised that marijuania impairs judgement (Amsterdam is closing cafes to foreigners, even) contributes to poverty (it's an expensive addiction right up there with nicotine), adds to the social health care burden, impairs performance, is associated with work accidents, and is a gateway drug. Was it a freudian slip that you associated it with 'crap' and it's commonly called 'shit'. Waste, toxin, ie, it's not healthy to smoke marijuania and it's not morally sound to promote marijuania smoking. Harm reduction strategies are an intermediary to abstinence. What is politically expedient is not necessarily healthy as evidenced by the governments continued orgy with the tobacco industry.