September 24, 2013 in Features, Health

Marijuana users face plenty of unknowns

Marijuana, marijuana-infused products will soon be available over retail counters
By The Spokesman-Review
 
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Sean Green, owner of Pacific Northwest Medical, a marijuana dispensary in north Spokane, shows a spike of marijuana buds being dried for sale.
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The dried marijuana buds packed in jars, the marijuana-infused vitamin water, the Chewy Choo chocolate cannabis candies, the Canna Bull drinkable energy shots – they’re all sold at the Pacific Northwest Medical marijuana cooperative to people with prescriptions for marijuana to treat what ails them.

Soon – likely by next June – marijuana grown at the North Side business will be available for sale to those without prescriptions, too, under the voter-approved initiative legalizing the production and sale of recreational pot.

The state Liquor Control Board’s most recent version of recreational-marijuana regulations, issued this month, included health warnings about the drug’s potential effects that must appear on the products’ labels or in accompanying material. While some are straightforward – don’t drive under the influence of pot, and don’t use it if you’re under 21, pregnant or breast-feeding – others related to potential medical problems are more vague: This product has intoxicating effects and may be habit forming. There may be health risks associated with consumption of this product.

It’s possible, the state suggests, that marijuana and marijuana-infused products could be what ails the recreational users who buy them. Or maybe not. While there’s plenty of anecdotal evidence about what marijuana does or doesn’t do to users’ bodies, there’s a shortage of scientific consensus about its long-term health effects on users.

Whatever the effects, more people will be experiencing them, predicted Neal Hayden, an addiction counselor who founded Gateway Behavioral Health in Spokane 10 years ago. Marijuana comes in a close second among substances used by his clients, after alcohol.

“Sure, there’s going to be a substantial increase in the use of marijuana, because there’s no longer going to be an illicit stigma to it,” Hayden said. “You can sit on your porch and smoke a bowl and nobody can bug you about it.”

‘One of two opinions’

Sean Green, who operates the cooperative and another outlet in Shoreline, called the state’s health-related warnings “CYAs,” organizational parlance for statements meant to “cover your ass.”

“It may be habit forming. There may be health risks. They don’t know that,” he said. “But there’s been enough propaganda … they have to require the public to be informed of potential concerns, even if the concerns aren’t valid.”

It’s difficult to know what concerns are valid, said Randy Simmons, the Liquor Control Board employee charged with overseeing implementation the state’s new legal pot system.

While Initiative 502, passed by voters in November, requires the state agency to include “medically and scientifically accurate information about the health and safety risks posed by marijuana use,” that’s easier mandated than done. That’s partly due to what Green called propaganda – information about marijuana’s health risks usually comes with a slant, whether it’s from anti-drug forces such as the federal government or marijuana advocates who dismiss any concerns.

“You’re going to get one of two opinions, and finding some middle ground is really, really hard,” Simmons said.

To write the warnings, he said, the liquor board’s researchers studied the limited available research about marijuana’s health effects – the federal Drug Enforcement Administration’s classification of pot among the most dangerous drugs makes it difficult for scientists to study it – and borrowed from warning labels applied to tobacco and alcohol.

“There have been no long-term studies on the health impact of cannabis use,” Simmons said. “Unlike alcohol, where we could tell you what’s the physical impact to the liver and kidneys and all those things for X amount of use per day for how many years – those studies have not been done with cannabis. We basically went with, ‘You’re putting something foreign into your body, and it could impact you.’ ”

In dangerous company

Because of its illegal status, funding for marijuana research has been “miniscule,” said Dr. Joel McCullough, health officer for the Spokane Regional Health District. Studies here and there have probed pot’s chemical analysis along with some symptoms of users who have problems with it and its medical benefits for people with certain diseases.

But it hasn’t been enough to build much of a consensus about pot, McCullough said.

“One question would be, ‘What would be the chronic health effects, from chronic use?’ ” he said. “There’s been an emphasis on some of the acute effects, like depression, anxiety and schizophrenia coming out in some people, but … what diseases develop after years of long-term use?”

Marijuana is classified as a Schedule I drug under the Controlled Substances Act, along with other drugs considered the most dangerous of all, including heroin and LSD. (Schedule II drugs, deemed to have less abuse potential, include cocaine and meth.)

That’s why even a well-designed, peer-reviewed study of marijuana’s potential positive health effects would have trouble getting funding from a federal agency, said Roger Roffman, a professor emeritus of social work at the University of Washington.

“It would be rife with political risk for the agency in its next congressional appropriation hearing,” said Roffman, who co-sponsored I-502 after decades of marijuana policy activism beginning in the 1970s.

Roffman spent 25 years researching marijuana and treating adults with marijuana dependency. In 1977, he headed Washington state’s chapter of NORML, a national marijuana-law reform organization.

There’s a lot of “hyperbole and misinformation about marijuana in the general public,” in all directions, he said.

Teens, for example, commonly believe that smoking pot is no big deal, when, for them, it is, Roffman said. He pointed to research done in New Zealand that found a significant decline in IQ points among regular users in their 30s who started in their teens. Roffman said marijuana also carries significant risks for those at risk of schizophrenia, in whom it could lead to psychotic episodes, or people with cardiac disease, in whom it could lead to heart attacks.

On the other hand, Roffman said, heavy penalties for marijuana use grew out of exaggerated “reefer madness” lore from the 1930s, when stories in the press and presented to state legislatures claimed marijuana caused criminality and insanity. Those stories tied marijuana use to African-Americans in particular, Roffman said: “The image of the depraved insane criminal was often one of black men.”

Now, as Washington draws close to the day when anyone 21 or older can walk into a licensed retailer and buy a supply, Roffman is wondering if the federal government will at least permit research in the state. He wants to study whether marijuana-dependent people can be taught to use it moderately, moving from out-of-control to in-control use. Many users don’t seek help, he said, when their only alternative is abstinence.

Don’t worry, be happy

At the Pacific Northwest Medical cooperative last week, paying members filtered in and out of the sweet-smelling retail space in front and employees tended to young and mature plants in clean, brightly lit rooms behind closed doors. The marijuana plants – strains included Dutch Treat, Strawberry Sour Diesel, Maui Wowie and Purple Hair – got water and fertilizer, and the shipping manager pulled yellowed leaves from nearly mature plants.

Green, who opened his store on East Houston Avenue less than two months after voters passed I-502, plans to keep his license to sell pot to medical users while growing pot for other retailers to sell to recreational users.

Regardless of whether a customer is trying to ease symptoms of a disease or just enjoy the effects of marijuana, he noted, the plants are the same. He said he’s seen it change the lives of terminally ill patients and those addicted to other drugs prescribed pot to cope with quitting.

For those who smoke it recreationally, he said: “Let’s not knock the medicinal value of feeling good, of being happy.”


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