Now that people in Colorado
(and, soon, Washington state) can buy marijuana about as easily as they
can pick up a 12-pack of Bud Light, it's a good time to ask: How risky
is it to turn to pot?
President
Obama
has already shared his opinion, telling the New Yorker magazine, "I
don't think [marijuana] is more dangerous than alcohol." The president's
opinion stands in stark contrast with official federal policy that
still classifies marijuana as a Schedule 1 drug, putting it in the same
class as heroin and LSD.
In this case, the president seems to be more correct than the government, says Richard Miller, professor of pharmacology at
Northwestern University
Feinberg School of Medicine in Chicago. "No question about it," Miller
says. "It's absolutely clear that marijuana is much less dangerous than
alcohol."
According to Miller,
marijuana is the safer choice whether you're using it for a single night
or a lifetime. "When people drink alcohol, they often get out of
control and get violent. They crash their cars and beat their wives. But
when people smoke marijuana, they get very relaxed and mellow."
Roughly 10% of people who try marijuana will eventually run into
trouble, says Dr. Christian Hopfer, associate professor of psychiatry at
the University of Colorado School of Medicine in Aurora. That's about
the same odds that a drinker will abuse alcohol, he says, but there's a
big difference: Alcoholism causes far more physical and emotional
devastation.
The signs of marijuana addiction are subtle, he says. Adults who
smoke heavily — as in four or five time a day, every day — tend to have
trouble learning, remembering and dealing with complicated tasks.
"They're definitely impaired," Hopfer says. "They organize their lives
around using."
Fortunately, the habit is breakable. "A lot of people who use
marijuana heavily in their 20s eventually quit on their own," he says.
"It's probably easier than stopping [tobacco] smoking."
The toll seems to be worse for young brains. According to Hopfer,
adolescents who smoke a lot of marijuana can expect to lose about 8
points from their IQ. Young users also seem to be more likely to become
psychotic in later years, although the risk is still small. "About one
user in a thousand will end up with a psychotic illness that they
wouldn't have had otherwise," he says.
As reported in November in Current Psychiatric Reports, marijuana can
threaten physical health too, although the dangers appear to be mostly
small and unpredictable. After summing up studies over the last 15
years, researchers at the
U.S. Department of Veterans Affairs found evidence linking marijuana to
lung disease,
heart disease and other ailments, but the actual risks were hard to pin
down. For example, one study suggested that smoking a single joint
increases the odds of a heart attack within the next hour, but other
studies have failed to find any sign that marijuana users are more
likely than non-users to suffer a heart attack over the long term.
The report also noted some growing but inconclusive evidence that
long-term marijuana use could increase the risk of cancer in the lungs,
bladder, head and neck. The authors noted, however, that marijuana
doesn't seem to be in the same league as tobacco when it comes to the
potential to cause cancer — another comparison that was practically
guaranteed to cast marijuana in a positive light.
A 2013 study published in the Journal of General
Internal Medicine
suggests that even heavy marijuana users aren't necessarily a sickly
bunch. The study looked at nearly 600 primary-care patients who had
tested positive for marijuana or another illicit drug. Chronic marijuana
smokers were just as healthy as occasional smokers and weren't any more
likely to have had a recent stint in the ER or a hospital bed.
The president's pot analysis may have been accurate, but it wasn't
necessarily helpful, says Dr. Timothy Naimi, an associate professor of
medicine and community health sciences at Boston University School of
Medicine.
"Saying marijuana's safer than alcohol sets an incredibly low bar,"
Naimi says, adding that alcohol kills about 80,000 people a year.
"Marijuana can still be a dangerous substance."
While the risks of marijuana may be relatively small for each
individual user, Naimi believes problems are likely to grow with access
to the drug. "It's five times more potent than the pot I grew up with.
We've lowered the price and increased the supply. I'm not for or against
legalization, but those are red flags."
Supporters of legalization often say marijuana should be as freely
available as beer or whiskey. But Naimi says the nation's experience
with alcohol isn't exactly a ringing endorsement of lax regulations and
easy access to mind-altering substances. Instead, he says, the toll of
alcohol should "give pause" to anyone hoping to bring marijuana to the
masses.
health@latimes.com
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