Caron appreciates the efforts made by Pennsylvania lawmakers with their thoughtful and highly regulated approach to the legalization of marijuana for medical use. We believe Pennsylvania’s restrictions should serve as a critical role model to other states. The drug was approved for use in a pill or in oil or liquid form and excludes smoking as a route of administration. Use is restricted to medical maladies including cancer, epilepsy, Parkinson’s disease, sickle cell anemia, AIDS, and glaucoma.
We have no objection to the appropriate and legal prescribing of medical marijuana for the conditions listed above. However, as an evidence-based treatment center, Caron’s position is that more research must be done to better understand the short- and long-term impact of the drug on individuals and the likelihood of abuse. We would prefer to see marijuana developed for medical purposes without the tetrahydrocannabinol (THC), which is the ingredient in marijuana that has psychoactive effects on the brain, and we do not approve of marijuana for recreational purposes in any capacity.
Society must take responsibility for the powerful message that any legalization sends – that marijuana heals and is safe. In fact, marijuana is not a benign substance. The current opiate epidemic in America is a cautionary tale. We must act before a crisis develops and reach out to those in the general population about the potential dangers of marijuana.
Just as with opiates – with freedom to prescribe comes great responsibility. It would be prudent to limit the ability to prescribe to doctors who treat patients with the legally approved medical conditions, such as oncologists, neurologists and infectious disease specialists etc. We also advocate for consideration of alternative treatments first and proper oversight of those with the ability to prescribe. We must have “checks and balances” in place to ensure safety and best practices.
These physicians and those intimately familiar with the impact of marijuana use and resultant use disorder must play a proactive leadership role. We propose that a percentage of all profits from marijuana sales in the United States be earmarked for education, prevention, research and treatment for marijuana substance use disorders.
Education and prevention efforts must be directed at communities, youth, parents and physicians. Parents whose children are in treatment at Caron often say they were not worried about their child’s marijuana use because they believed it was a “rite of passage.” Their concern arose only when they learned of other substance use. We must stop referring to marijuana as a “gateway drug” because it implies that it is less dangerous than other substances.
In reality, the average amount of THC in marijuana has risen from under 1 percent in the 1970s to nearly 13 percent today. We have seen an increase in psychotic symptoms, such as delusions, hallucinations and difficulty concentrating in patients who are heavy marijuana users. Some users also experience symptoms such as panic attacks and paranoia. The National Institute on Drug Abuse (NIDA) found that the drug can have a devastating impact on the developing brain of an adolescent and young adult.
As with any other substance used as medication, we should invest in clinical trials to understand the effects of marijuana on the brain. In a long-term study conducted in New Zealand and published in 2012, researchers found that persistent marijuana use was linked to a decline in IQ, even after they controlled for educational differences. Susan Weiss, PhD, director of the division of extramural research at NIDA, was recently interviewed about the report, and said the results were in the same realm as what you would see with lead exposure.
Unfortunately, it’s inevitable that with the increased perception that marijuana is safe – the need for treatment will only continue to expand. The federal government must approve measures, such as the Comprehensive Addiction and Recovery Act (CARA) of 2015, the most expansive bipartisan legislation to date which designates up to $80 million toward advancing treatment and recovery support services in state and local communities across the country.
As a leading not-for-profit provider of addiction treatment, Caron is in the trenches everyday supporting our patients with alternative approaches to anxiety, depression and pain, which are frequently the cause of underlying symptoms experienced by marijuana abusers. We will continue to be vocal about standards and outcomes around these issues. We hope that by elevating the dialogue, we can be a resource for effective prevention and treatment solutions that will make a difference for years to come.