With misplaced pride, the Seattle Post-Intelligencer editorial board today notes that our metro area ranks second out of the 15 largest nationwide in illicit drug use, including marijuana. Absent from the P-I's encomium to being stoned in Seattle is any mention of the increasingly-recognized harmful mental and medical health effects of marijuana. Sure, an occasional spliff or few tokes is usually pretty harmless. Besides, how else could one stomach The Flaming Lips? Habitual use is another matter, according to a range of journal articles.

Pulmonary specialist D.P. Tashkin of the David Geffen School of Medicine at UCLA reports:

...regular marijuana smoking produces a number of long-term pulmonary consequences, including chronic cough and sputum, histopathologic evidence of widespread airway inflammation and injury and immunohistochemical evidence of dysregulated growth of respiratory epithelial cells, that may be precursors to lung cancer. The THC in marijuana could contribute to some of these injurious changes through its ability to augment oxidative stress, cause mitochondrial dysfunction, and inhibit apoptosis....Habitual use of marijuana is also associated with abnormalities in the structure and function of alveolar macrophages, including impairment in microbial phagocytosis and killing that is associated with defective production of immunostimulatory cytokines and nitric oxide, thereby potentially predisposing to pulmonary infection. In view of the growing interest in medicinal marijuana, further epidemiologic studies are needed to clarify the true risks of regular marijuana smoking on respiratory health.

Pass the bong, dude. Because along with all that chronic cough, sputum, airway inflammation and lung cancer risk, well, hell.....it's cool to go crazy, too.

Scottish researchers reporting in The Journal Of Psychopharmacology confirmed worrisome links between regular, early use of pot and psychosis. Surveying 11 carefully-selected studies, they concluded:

Early use of cannabis did appear to increase the risk of psychosis. For psychotic symptoms, a dose-related effect of cannabis use was seen, with vulnerable groups including individuals who used cannabis during adolescence, those who had previously experienced psychotic symptoms, and those at high genetic risk of developing schizophrenia. In conclusion, the available evidence supports the hypothesis that cannabis is an independent risk factor, both for psychosis and the development of psychotic symptoms. Addressing cannabis use, particularly in vulnerable populations, is likely to have beneficial effects on psychiatric morbidity.

Considering the policy implications of the connection between regular cannabis use and development of psychoses, Australian researchers writing in the Canadian Journal of Psychiatry sound the alarm.

The observational evidence and biological plausibility of the hypothesis that cannabis is a contributory cause of psychosis is at least as strong as evidence for causal relations between heavy alcohol and amphetamine use and psychosis. On public health grounds, there is a good case for discouraging cannabis use among adolescents and young adults. It remains uncertain how best to discourage use and at whom campaigns to reduce cannabis use should be targeted. We should discourage young adults seeking treatment in mental health services from using cannabis and inform them of the probable mental health risks of cannabis use, especially of early and frequent use. We must exercise caution in liberalizing cannabis laws in ways that may increase young individuals' access to cannabis, decrease their age of first use, or increase their frequency of cannabis use. We should consider the feasibility of reducing the availability of high-potency cannabis products.

Once pot-induced psychosis occurs, it often recurs.

Danish researchers reporting their study in the British Journal of Psychiatry tracked for three years 535 patients treated for "cannabis-induced psychotic symptoms" and found 77.2% had "a new psychotic episode" and a subset of 44.5% specifically developed schizophrenia. They concluded "cannabis-induced psychotic disorders are of great clinical and prognostic importance."

And costly to taxpayers as well.

Reporting in Developmental Psychology on social outcomes of significant adolescent marijuana use among a sample of African-American males, Johns Hopkins researchers found:

Use of marijuana 20 times or more during adolescence was associated with being unemployed and unmarried in young adulthood and having children outside of marriage for both males and females. Dropping out of high school and more frequent adult marijuana use seem to be important parts of the pathway from adolescent marijuana use to negative life outcomes.

An organization called HomoHealth also warns of the effects of regular pot use.

As with cigarettes, smoking marijuana over time can cause heart disease, lung cancer, and emphysema. Supporters of medical marijuana recommend that you eat it rather than smoke it. The Betty Crocker brownie route is much safer for your lungs.

UC-SF researchers report in the American Journal of Cardiology that them munchies are more than a punchline. Looking at 15 years of longitudinal data in the Coronary Artery Risk Development In Young Adults study, they concluded:

In conclusion, although marijuana use was not independently associated with cardiovascular risk factors, it was associated with other unhealthy behaviors, such as high caloric diet, tobacco smoking, and other illicit drug use, which all have long-term detrimental effects on health.

Finally, guys, here's....ah.....a very special reason to park that waterpipe in the garbage.

Adult dialog about the real costs of marijuana to individuals, families and society is not allowed in Seattle, and other "progressive" cities, despite important and worrisome findings. If that intellectual flacidity is to change, media will have help spur the dialog.

Certainly, there is no shortage of reporting and advocacy on the sexier marijuana legalization debate. In a 2003 ballot initiative Seattle voters by a 58% majority directed local police to make arrests for possession of small adult personal stashes a low priority. The electorate thus put their stamp of approval not only on admittedly less harmful occasional personal pot use; but also on marijuana addiction and the substantial medical and mental health and social costs detailed above by researchers. No real cost-benefit analysis has occured here, although it is necessary.

The sobering policy implications are clear. If we legalize pot and perhaps also other drugs such as meth, heroin, and cocaine (which all have their own gnarly medical literature) we should not only mandate printed warnings on packages, we should take the FULL libertarian route. Meaning people assume the risks on their own. No taxpayer-funded medical or mental health treatment for symptoms determined by impartial clinical analysis to have substantially resulted from drug abuse. Drug-testing for social service aid recipients would be smart, too.

"The Man" doesn't make anybody take drugs. It is an individual choice, based on an often-flawed understanding of the costs and benefits.

And - despite the inevitably contrary caterwauling of institutionalized shills for victimology - addiction is not a disease.

It is a failure of the will.

TECHNORATI TAGS: SEATTLE, MARIJUANA, ADDICTION, HEALTH EFFECTS, PSYCHOSIS, LUNG CANCER

Posted by Matt Rosenberg at January 11, 2007 11:30 AM

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