President Obama - An education on Marijuana

Dear President Obama,

As a mother who regrets not attending Woodstock and lived in a day and age where pot was considered cool and chilled out more people than those living in Valley of the Dolls, I am proud to say that I never tried the stuff.  Why?  Though I was a nerd and had my nose in a chemistry book all of the time, the true effects of marijuana on the brain were not extensively researched.  The real reason is that my mother would have killed me and despite my being away from home,  she was sitting on my shoulder, I swear.

Despite pursuing a medical career and using short nose clamps to stop bleeders, I was surprised to see that they actually had another "off hospital grounds" use - to clip to the end of a  joint to assure that the user and sharer would not burn their fingers but, more importantly, get, as Maxwell House would say, enjoy the last drop.  I know this as I had to pass it around a friend's dinner party in the '70's and made sure in reached the end of the row at a Fleetwood Mac rock concert in the '90's.  Mom would have been proud - I passed it along and held my breath.

But now, having a background in radiology, medicine, and psychiatry, I have been exposed to all of the  growing literature that is exposing the dangers of marijuana.  Ever try to talk to a teen about the dangers in smoking marijuana?  Probably the most difficult task facing parents today.  Why?  They will quickly spout off that no one has died of an overdose of marijuana.  And, now, they have you, Mr. Obama, the leader of our country and a role model to many children, teens, and young adults, stating that you do not feel that it is any more harmful than alcohol.  Really?

Now, you are to be well informed on all topics and thank God that you have staff to keep you informed of the political issues affecting us all.  But guess what?  All you have to do is use your fatherly instincts to discuss drugs and alcohol.  Protecting our borders?  How about protecting our nation's youth.  I do not have a committee, a cabinet, an advisor.  I have the heart of a mother that fears another unnecessary death will result in the complacency by parents and adults towards alcohol and drugs.

A search of the literature shows other country's publishing the harms of marijuana.  Hopefully the United States will soon have legitimate candidates to study now that it is becoming legalized.  Let me list a few findings.  I will address the medical benefits of marijuana that are often used as the first line of defense when fighting for legalization of this drug.

MEDICAL BENEFITS OF MARIJUANA:

1)  Anti-emetic or anti-nausea effects:  Early on, THC, the active drug found in marijuana, had been shown to be effective for some patients who suffered nausea from cancer chemotherapy treatment.  However, the narrow window between the anti-nausea dose and that which caused unwanted psychic effects made THC difficult to use.  In some studies negative side effects occurred in 81% of patients.  In another study, 22% reported no effect of nausea symptoms.  The advent of serotonin 5-HT3 receptor antagonists (told you I was a nerd) demonstrated a more powerful anti-emetic effect.  For this reason, physicians virtually NEVER prescribe THC for use by chemotherapy patients as the new drugs are more powerful and have no psychic side effects. 

2) Multiple Sclerosis:  Although some studies have shown that cannabis can relieve muscle pain and spasticity in patients and also relieve tremors in animal studies, in can also further impair posture  and balance.  Please understand that THC receptors are found in those areas of the brain that control posture and balance and memory.  In addition, MS patients who use marijuana had a greater number of psychiatric diagnoses and a slower mean performance time on standard neurological tests.  And in some trials, an increase in aggressive behavior and paranoid tendencies were demonstrated in standard psychological tests.  Overall, without boring the reader any further with studies and trials, a minority of MS patients can receive some symptom relief through the use of marijuana extracts or THC, but a significant percentage of patients suffer unwanted adverse effects.

3) Glaucoma:  THC has been shown to reduce the intraocular pressure in humans who have glaucoma.  But the pressure was reduced only when the patient stayed under the effects of THC almost continually.  More effective medications such as prostaglandins have been developed to control the intro ocular pressure.  Now if one wants to be continuously high and suffer unwanted side effects, it is their choice.  but there are better and more effective treatment options.

4) Appetite control:  We are all aware of the "munchies" affecting marijuana use.  And laboratory studies do support the fact that THC does increase the appetite which may not be a good thing for most of us as poor food choices are made under the influence.  With the First Lady munching on an apple with NBA stars, the negative effects that marijuana has on our youth and teens is certainly something the couple should be on the same page with. However, those individuals suffering from debilitating diseases  such as AIDS-related wasting syndrome do benefit from the use of marijuana as THC has been able to maintain their weight.

5) Brain Effects:

Because I started my career with a residency in Radiology I will show this MRI coronal view of the brain.  The loss of brain matter is highlighted in the cannabis user with increased cerebral spinal fluid and loss of brain matter..  After all, pressure has to be maintained and when the brain loses neurons it is replaced with spinal fluid, thus the decreased gray matter and increased fluid showing as black.  The pink is our precious amygdala, responsible for important functions such as memory and emotions.  To me a picture speaks a thousand words.  Enough said.

6) Psychiatric illness:  A recent study found that marijuana use significantly increased the risk of developing mental health problems among those young people who possessed a genetic high risk for schizophrenia.  And if there is a family history of substance abuse, a young person is much more likely to develop an addiction to any substance.  There is also a strong correlation between development of depression and bipolar disorder.  Remember the picture above?  You can destroy your amygdala all by your lonesome without a family history.  You know the sad thing, so many mask symptoms of depression, bipolar, paranoia, voices, increased stressors, and the will to escape and chill out with marijuana.  And my attempts to teach these teens in school auditoriums have been met with laughter and disrespect.  Where will this culture that has developed with marijuana use begin to detach itself from the "utopia" they have associated with this drug?  One student had approached me after a lecture - one in which I threw out students in the class laughing and rolling their eyes at me.  She stated that she was 4 days clean and didn't miss the drug so much as she did the way of life it offered her.  This is not a chill out pill, folks, but strong ties develop and makes this particular drug with its "no one has died boasts" a major battle for parents such as myself.   Gee, thanks, Mr. Obama.

And now for the most important reason why parents should fight the battle!!

7) Gateway Hypothesis:  I saved the most difficult topic for last.  My son, Andy, who died at the age of 19 on 1/16/2004, would argue with me that it was not a gateway drug.  He also had no respect for me.  Although I had taught Drug and Alcohol Abuse and Dependence to med students rotating in Psychiatry at Case Western Reserve Med School, he saw me as a mother who never used and ignored the facts, claiming that it was "safe" and that maybe I needed a joint to "chill out".  But there is a tendency for marijuana users to go on to use other addictive drugs.  Whether it is a predisposition or just more easily available when traveling in a circle of drug using friends is not completely known.  However, studies have shown that 311 pairs of same sex twins with earlier marijuana use (before the age of 17 years) were 2-5 more likely to use illicit drugs.  Unfortunately, these young, beautiful individuals have no idea whether it will be their gateway drug.  It was my Andy's.

So Mr. Obama.  I wanted to inform you that I am angry with you.  You may send your Secret Service to my door, you may decided to audit me, some people will accuse me of taking issue with you because I am a "racist", or, the sad conclusion, I am a person who is uncool and should learn to keep her mouth shut and reach for my surgical clamp.

As a mother who has lost a son and knows that marijuana AND alcohol are dangerous, I will fight you tooth and nail on this topic until I am convinced that you have decided to reconsider your position, not as a previous marijuana smoker and using your own experience, but as a father who wants to protect his daughters and set a better example, not only to them but to the youth of our nation.

To the presidential assistant previewing this notice:  Please consider passing it along to your boss.

Sincerely,  Dr. Elaine Campbell