{"id":19684,"date":"2025-07-15T20:07:04","date_gmt":"2025-07-15T19:07:04","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=19684"},"modified":"2025-10-21T20:51:28","modified_gmt":"2025-10-21T19:51:28","slug":"email-to-u-s-surgeon-general-adams-regarding-extremely-urgent-implications-of-cannabis-legalization-for-teratology-and-congenital-malformations-in-usa","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2025\/07\/email-to-u-s-surgeon-general-adams-regarding-extremely-urgent-implications-of-cannabis-legalization-for-teratology-and-congenital-malformations-in-usa\/","title":{"rendered":"Email to U.S. Surgeon General Adams Regarding EXTREMELY URGENT IMPLICATIONS OF CANNABIS LEGALIZATION FOR TERATOLOGY AND CONGENITAL MALFORMATIONS IN USA"},"content":{"rendered":"

Dear Surgeon General Adams,<\/span><\/p>\n

I am an Australian Professor of Addiction Medicine and researcher at the University of Western Australia and Edith Cowan University both in Perth, Western Australia.<\/span><\/p>\n

I have been becoming increasingly concerned at the implications of cannabis legalization across USA for patterns of congenital anomalies both in USA and across the world.<\/span><\/p>\n

The incidence of many congenital anomalies are rising in many places.\u00a0 This rise is even more marked if therapeutic early termination for anomaly<\/a> (ETOPFA) are taken into account.<\/span><\/p>\n

In 2007 the American Academy of Pediatrics issued a position statement<\/a> which noted that cannabis was a known teratogen for cardiovascular anomalies based on three studies.\u00a0 They cited ASD, VSD and Ebstein\u2019s<\/a> anomaly<\/a> in particular as major concerns. \u00a0This is also important as cardiovascular anomalies form the largest single group of congenital anomalies.\u00a0 As you would be well aware foetal anomalies is the single major cause of death in the first year of life.\u00a0 The aetiological pathway is further strengthened by the fact that the endocardial cushions have high density expression of CB1R\u2019s cannabinoid type 1 receptors from very early in embryonic life.\u00a0 This fits with the significant association of cannabis with defects of structures derived from the endocardial cushions and the associated conoventricular ridges including the cardiac valves and the interatrial and interventricular septa.<\/span><\/p>\n

Prof. Peter Fried in Ottawa has headed up a comprehensive, careful and detailed longitudinal study of brain damage in children exposed to cannabis in utero.\u00a0 They have been publishing positive findings from this study for forty years showing documented deficits of executive and higher brain function, the need to recruit more brain to perform tested tasks documented on fMRI<\/a>, in primary school, middle school<\/a>, high school<\/a> and even<\/a> into young adulthood<\/a>.\u00a0 It has now been convincingly demonstrated that endocannabinoids send the \u201coff\u201d signal halting synaptic neurotransmission at both stimulatory and inhibitory synapses<\/a> and hence shutting down the brain\u2019s normal oscillatory processes.\u00a0 Brain oscillations are known to form a key an pivotal function early in brain development guiding the migration and axonal projection of developing neuronal progenitor cells, and also guiding synapse formation.\u00a0 <\/span><\/p>\n

As you would be aware many neural progenitor cells fail to integrate into the neural network and die due to lack of circuit stimulated connectivity.\u00a0 This applies to both stimulatory and inhibitory synapses.\u00a0 Hence synaptic firing is therefore critical for synapse formation and integration and survival of the new nerve cells.\u00a0 Since cannabis and its constituent cannabinoids shut down this firing<\/a> and resultant neural oscillations<\/a> they<\/a> necessarily<\/a> impede brain development both in the cortex and in key subcortical major centres<\/a> including the thalamus and hypothalamus.\u00a0 \u00a0\u00a0Hence the demonstration by the Fried group that cannabis users have smaller cortical thickness and hippocampal volumes<\/a> \u2013 the hippocampus first encodes memory \u2013 fits well with the known developmental biological mechanisms.<\/span><\/p>\n

Given that cannabis in Colorado now is commonly at or above 30%, and was historically only 1-2% when most of its epidemiological studies were done; and given also that cannabis oils at up to 99% THC content are also increasingly widely available the conclusion becomes inescapable that the vast majority of children significantly exposed to these concentrations of cannabis in utero will be adversely and permanently affected.\u00a0 Importantly no population measure of this very important damage I easily accessible.<\/em><\/span><\/p>\n

10 studies have linked cannabis exposure to incidence or severity of gastroschisis.\u00a0 This case is strengthened by the high density of CB1R\u2019s on the omphalovitelline artery, and the many studies now which implicate vasoactive drugs in the pathogenesis of this condition.\u00a0 Indeed although the activity of cannabinoids on arterial structure is not widely understood is has been documented in minute detail by no lesser a resource that Nature Reviews of Cardiology<\/a>.\u00a0 \u00a0And obviously cannabis arteriopathy underlies the elevated rate of both myocardial infarction and stroke seen in adults with cannabis exposure about which Dr Nora Volkow, Director of NIDA<\/a> has commented in New England Journal of Medicine<\/a>.<\/span><\/p>\n

A spectacular study from Hawaii in 2007<\/a> demonstrated that cannabis use was associated with Down\u2019s syndrome incidence at a rate 526% elevated above background.<\/span><\/p>\n

This is significant for several reasons.\u00a0 Firstly a substantial body of evidence shows that cannabis has been known to test positive in the micronucleus assay since the 1960\u2019s<\/a>.\u00a0 This is a major test for genotoxicity.\u00a0 The implications of this devastating genetic damage were worked out for the whole world to see by David Pellman\u2019s lab in New York<\/a> and links cannabis exposure directly with abnormalities of cellular division including the three major clinical trisomies \u2013 trisomies 21, 18 and 13 – and Turner\u2019s syndrome, XO.<\/span><\/p>\n

Furthermore this implies that since cannabis is linked with cardiovascular, neuropsychiatric and chromosomal defects, these being the three major groups of congenital disorders.<\/span><\/p>\n

If one goes to Colorado as a rather obvious test case indeed one finds a rise there of 70% in both total major congenital anomalies, and also cardiovascular anomalies, especially atrial septal defect and ventricular septal defects, which are the most common, exactly as predicted by the embryology.<\/span><\/p>\n

Indeed, the particular thoroughness of the way in which all kinds of social and health data is collected and made available in the USA, together with the very considerable spread in attitudes to drug legalization in different states, make USA the perfect teratological laboratory to study the mutagenic and genotoxic effects of cannabinoid exposure.\u00a0 My colleagues in addiction medicine and I at my university, aided by some of the top statisticians in this country have now commenced the enormous task of analyzing the US cannabis exposure data by state from the National Survey on Drug Use and Health<\/a>, together with cannabis concentration data quoted by Dr Nora Volkow the Director of NIDA in New England Journal of Medicine<\/a>, together with projections of the applicable therapeutic termination rates taken from the Western Australian Register of Developmental Anomalies<\/a> are analyzing this data at this time.<\/span><\/p>\n

Whilst our findings have not been finalized the following remarks can already be made:<\/span><\/p>\n

    \n
  1. In socially conservative states cannabis use is falling or flat whilst it is rising in more liberal states;<\/span><\/li>\n
  2. When one takes into account the dramatically increased cannabis concentration \u2013 to only 15% in 2015 in this series\u00a0 – the population exposure to cannabinoids has risen in all states regardless of social ethos;<\/span><\/li>\n
  3. The rate of almost all congenital anomalies in the USA has risen when reasonable estimates for ETOPFA rates are employed;<\/span><\/li>\n
  4. Cannabis exposure is significant for all 62 anomalies combined considered as a group; <\/strong><\/span><\/li>\n
  5. Not only are congenital anomalies uniformly rising against time, they are also rising against this metric of community cannabis exposure \u2013 defined as the product of the national mean cannabis concentration and the state based cannabis use rates; \u00a0<\/strong><\/span><\/li>\n
  6. If one considers the groups of:<\/span><\/li>\n<\/ol>\n
      \n
    1. \n
        \n
      1. Cannabis related disorders (as defined by the Hawaiian investigators);<\/em><\/span><\/li>\n
      2. Chromosomal defects;<\/em><\/span><\/li>\n
      3. Cardiovascular defects;<\/em><\/span><\/li>\n
      4. Derivatives of the endocardial cushions <\/em><\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

        The population exposure to cannabinoids remains highly significant including consideration of state and year<\/strong><\/span><\/p>\n

          \n
        1. Considering all 62 defects collected by the US National Birth Defects Prevention Network<\/a> :<\/span>\n
            \n
          1. In 43 cases (69.3%) the community cannabinoid exposure remains significant on linear regression testing before correction for multiple testing;<\/span><\/li>\n
          2. When one adjusts for multiple testing 38 defects (61.3%) remain significant \u2013 mostly as described by the Hawaiian researchers;<\/span><\/li>\n
          3. For example the national rate of the effect of cannabis exposure on Ebsteins anomaly is P<0.0001 for the effect of cannabis exposure alone and P<0.0001 for the interaction between cannabis exposure and time (multiple testing corrected results).\u00a0 The beta estimate for this effect is 18%, and the P value is much less than P < 10 -16<\/sup> .<\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

            Please note that none of these metrics quantitate what I regard as the most serious area of all \u2013 the neurobehavioural toxicology so carefully documented and chronicled with every imaginable psychological and imaging test at every developmental stage into young adult by the methodical Ottawa investigators referenced above.<\/strong><\/span><\/p>\n

            I am aware of course of the signal service performed in this area by your predecessor Dr Murthy in relation to his report on \u201cFacing Addiction in America<\/a>.\u201d<\/span><\/p>\n

            Naturally I am very concerned indeed that the USA, having avoided the horrors of thalidomide directly due to the due diligence of your FDA staff<\/a> at the time, is sailing directly into an even worse teratological morass related to the legalization of cannabis in your country, which apparently even your President appears to be powerless to avert.\u00a0 It is of the greatest concern to me that the carefully orchestrated US cannabis legalization campaign seems to be operating is such a manner as to at once bypass and simultaneously intimidate the FDA quality control and checks and safety balances processes.<\/strong><\/span><\/p>\n

            The medical conclusion appears inescapable to me that cannabis use should be avoided by males and females in the reproductive age group especially if involved in pregnancy or even considering pregnancy \u2013 because of the long half lives involved and its sluggish release from the body\u2019s fat stores.\u00a0 It is well known that these same young adults is the group most keen to use cannabis products!\u00a0 Indeed it is well documented that cannabis both increases sexual libido and reduces inhibitions; albeit after time and habituation it reduces both sexual desire and performance.\u00a0 This sets up an inescapable and unavoidable reproductive and genotoxic paradox – which also greatly escalates the present discussion beyond the arena of personal civil liberties to the future of our coming generations<\/u><\/em>.<\/span><\/p>\n

            Naturally I am particularly keen to discuss these issues with yourself at your earliest available opportunity.\u00a0<\/span><\/p>\n

            The teratological aspects of this epidemic seem to have been completely and systematically overlooked in the current discussions.<\/span><\/p>\n

            Please help me assist your wonderful, beautiful, noble and courageous nation at this critical juncture in your history.<\/span><\/p>\n

            And I am sure it will be self-evident to you that anything that happens in USA has enormous ramifications around the world, as you are obviously that world\u2019s leading democratic nation.<\/span><\/p>\n

            Hence USA is not only legislating for America \u2013 but for all citizens of the planet \u2013 present and future.\u00a0 Because of the epigenetic implications \u2013 not discussed above but very well substantiated nonetheless – for the next four generations \u2013 this is the next 100 years.<\/span><\/p>\n

            In such a circumstance \u2013 truth can be your only meaningful defence<\/u><\/strong>.\u00a0 And it must be your final bastion \u2013 and the last great hope of civilization.<\/span><\/p>\n

            I am very keen to set up a time which would be suitable to yourself to discuss these issues on the phone.<\/span><\/p>\n

            Oddly it seems to me that few professionals understand these issues thoroughly.<\/span><\/p>\n

            And even more strangely \u2013 it seems to me strange that USA, having alone amongst the family of nations done so extremely well with thalidomide, at the present time gives every appearance of acting before she has thought carefully, methodically and deeply about the ramifications of her present actions in this field.<\/span><\/p>\n

            With very best wishes,<\/span><\/p>\n

            Yours sincerely,<\/span><\/p>\n

            Dr. Stuart Reece,<\/span><\/p>\n

            Australia.<\/span><\/p>\n

            Email sent in copy to Drug Watch International June 2018\u00a0drug-watch-international@googlegroups.com<\/strong><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

            Dear Surgeon General Adams, I am an Australian Professor of Addiction Medicine and researcher at the University of Western Australia and Edith Cowan University both in Perth, Western Australia. I have been becoming increasingly concerned at the implications of cannabis legalization across USA for patterns of congenital anomalies both in USA and across the world. […]<\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30,41,121,90,64,12,104,19],"tags":[],"class_list":["post-19684","post","type-post","status-publish","format-standard","hentry","category-cannabis-marijuana","category-drug-use-effects-on-foetus","category-genes","category-global-drug-legalisation-efforts","category-health","category-legal-sector","category-political-sector","category-usa"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/19684","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=19684"}],"version-history":[{"count":1,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/19684\/revisions"}],"predecessor-version":[{"id":20093,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/19684\/revisions\/20093"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=19684"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=19684"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=19684"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}