How `A Little’ Dope Can Hurt

Published on August 9,  2004- The Press Democrat PAGE: B9

Marijuana … what harm can a little dope do? The short answer is: Plenty.
First, is marijuana addictive? You bet it is. About one in eight people exposed to marijuana will become dependent on it. This makes it a little more addictive than alcohol. How do I define addiction? There’s a fancy medical definition or a more simple one: If you use marijuana every day you are probably addicted to it, especially if you have been doing this for a few months or more.So, let’s say you smoke marijuana every day. Isn’t that your business? Maybe yes, but most likely, no. When you are addicted to a substance your relationships in life are with that substance — not with other people.

In addiction medicine we have found that it is often best to ask the family members of the dependent individual how they feel. Frequently, there is a deep resentment and embitterment about the lack of support or the lack of emotional contact and empathy. A patient of mine was once asked by his wife to stop smoking marijuana for a few weeks, because her father was dying and she needed his support.

He managed to stop for a while, only to return to the addiction after his father-in-law died. It is remarkable how strong the dependency on marijuana can be.

Let’s say you don’t care about anyone else or that all your friends smoke or your significant other is tired of you and just as happy to have you stoned all the time.

What’s wrong with that?

There was an article in the Journal of the American Medical Association a few years ago, that looked at patients who used marijuana at least daily. The authors found that even 19 hours after stopping marijuana, these chronic users were not able to think as well (or memorize, or calculate, or analyze or perform other mental functions). In other words, if you smoke marijuana daily, you are always affected or “stoned” to a certain degree. You will not be able to realize your full intellectual capacity. This is especially important to high school and college students whose futures are determined by how well they do during that critically important eight-year window of academic opportunity.

Marijuana can also affect people in mid-career. A former patient of mine who was a Honda mechanic told me that he would read the shop manuals that came out every year seven or eight times. Despite the repetitive reviews, he was still not able to master the material. After stopping marijuana — which he had been using since high school — he found he only needed to read the manuals once.

One further caveat: some people seem to function very well on marijuana. They hold responsible positions and continue to perform relatively well. These folks are probably very bright and are able to accommodate the decrease in mental capacity. They may not, however, be the people you want performing brain surgery or negotiating an important contract.

Let’s say you really don’t care about any of the things that I’ve mentioned above. All you want is to smoke a little dope. A recent article, also in the Journal of the American Medical Association, showed that people who were using cocaine and methamphetamine (nasty stuff — there is a lot of evidence suggesting that these stimulants cause permanent brain injury) frequently followed a pattern of smoking cigarettes at a young age, then drinking alcohol, smoking marijuana and finally, progressing to harder drugs. The authors concluded that marijuana was not only a “gateway drug,” but seemed to actually precipitate the progression to the stimulants (cocaine and methamphetamine) and even to heroin, in certain individuals. So, you still don’t care. Well, I’ve saved the worst for last. The following is a partial list of the complications associated with the chronic use of marijuana: toxic psychosis (in susceptible individuals), increased heart rate and pain, decreased lung function, impaired fetal growth and development, decreased immune function (important for fighting infections and cancers), weight gain, bronchitis, and more.

Finally, a brief word about “medical marijuana.” The medical marijuana initiative passed by California voters, basically provides for the legalization of marijuana. This is because the initiative states that in addition to several serious illnesses, marijuana may be prescribed for “any other illness for which marijuana provides relief.” There was also no restriction on the age of the patient. Many physicians have no problem with the administration of marijuana to a patient with a terminal illness — but did the people of California really intend (as one United States Supreme Court justice put it) that marijuana be used for “anyone with a stomach ache” or for any reason at all?

I, for one, am not willing to sacrifice the one in eight individuals who are now at increased risk for developing an addiction to this drug due to its significantly increased availability.

I know that this article will raise deeply felt issues with some people. It is not my intention to offend anyone. I have attempted to provide factual information that can be reviewed, and hopefully, help you formulate an opinion about the use of marijuana. If you think that you have an addiction to marijuana, or you have further questions about it, the folks at Marijuana Anonymous can be an excellent source of information and assistance. You could also consult with a specialist in chemical dependency or one of the many local chemical dependency programs.

Dr. Kevin Costello is the chief of the medical division of Chemical Dependency Services for Kaiser in Santa Rosa.


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