Marijuana from a Healthcare Provider Perspective

November/December 2018

With some states legalizing “medical marijuana” and some states even legalizing “recreational marijuana,” health practitioners are having to increase their knowledge of the complications arising from marijuana use by their patients. “Medical marijuana” in these states includes the smoking or ingestion of parts of the marijuana plant that have not undergone the normal federal Food and Drug Administration medication approval process.

Healthcare professionals in these states are seeing an increase in marijuana users and the professional literature now warns healthcare practitioners of the adverse effects of medical marijuana. Those adverse effects include physical, psychological, cognitive and psychosocial dimensions.

Adverse psychological effects may include psychosis, memory loss, paranoia, hallucinations, depression and suicidal behaviors. Adolescents and young adults appear to be more prone to memory and psychological effects due to their brain development. A recent study among adolescents found a strong correlation between marijuana use and psychosis.

Reported cognitive (mental) effects of marijuana include a slower ability to process, poor social functioning, confusion, low academic achievement, memory loss, impaired executive functioning, poor impulse control and poor job performance.

Patients who seek care while intoxicated from marijuana may not be able to give proper consent for their medical treatment. This creates a legal and ethical dilemma for health care practitioners.

Practitioners must also consider adverse physical effects which may include less serious changes such as dry mouth, dilated pupils, fatigue, and loss of balance. Medical marijuana users may also experience changes in breathing (wheezing, coughing, shortness of breath) and more serious conditions such as respiratory depression. Reported cardiac effects include changes in heart rhythm, blood pressure, and central nervous system suppression.

With recent legalization in some states, many studies are now being done on the benefits and harms of “medical marijuana.” Health practitioners recognize the need for these studies to establish the adverse effects and the benefits of medical marijuana, and determining which medications it interacts or interferes with. Research is also needed to develop effective and consistent dosing and eliminate the impurities and the active components that cause impairment.

Call the toll-free Legislative Message Line, at 1-800-372-7181, and leave this two-part message for “all the legislators from my county.” (State Senators and Representatives) “Please act to have the FDA research and propose safe guidelines before any legalization.”

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