Wednesday, November 4, 2015

Marijuana: Real and Synthetic

Four states have approved marijuana for both medicinal and recreational use. More states seem poised to follow because of income potential. Colorado posted an extra $70 million in tax revenue for 2014 from combined medicinal and recreational marijuana sales. More states want to share the wealth; therefore, we want our patients and their families informed on the facts.

1. According to the American Chemical Society, the marijuana of today is not the marijuana of the 1970s. The marijuana produced today is much more potent, and the effects on the central nervous system will also be more pronounced.

2. No adolescents should be using marijuana for recreational use ever. Because of the war on drugs decades ago, all research on THC was stopped and we are now trying to catch up. We don’t know as much as we should, but we do know this: Marijuana changes the chemistry of the brain. The brain is composed of fatty tissue. Marijuana is a fat-loving (lipophilic) product. Does it make any sense to insert a lipophilic product into a growing brain? Ever?
3. The Archives of General Psychiatry.( 2011;68(6):555-561) state that marijuana is associated with an earlier onset of psychosis in patients prone to schizophrenia. Schizophrenia often manifests in the late teens or early twenties, and the later it manifests, the better the outcome as patients are old enough to learn coping mechanisms to help manage the condition. Early onset can have devastating results.

4. Your teen or young adult may tell you that marijuana is a natural product, so it is much better to use than alcohol. While it is true that alcohol is more of a neurotoxin than marijuana, "natural" does not always mean better. Arsenic is naturally occurring.

5. While there are patients for whom medical marijuana is indicated, we cannot be an advocate of recreational marijuana when more research needs to be done on both acute and chronic effects of marijuana use. For every study that shows benefit, there is another showing detriment. The jury is out, and in that case, caution is advised.

And now there is synthetic marijuana! Also known as K-2, Spice, or Moon Rocks, synthetic marijuana is being sold on line and in convenience stores nationwide as potpourri or incense. A random herb is sprayed with a chemically produced form of marijuana, and the results have been frightening at best with patients presenting in the emergency room with agitation, vomiting, hallucinations, seizure, stroke, psychosis, and death.

While marijuana binds to cannaboid receptors in the brain as a partial agonist (meaning not completely covering the receptor), synthetic marijuana binds as a full agonist meaning that it is much more efficient, so smaller doses produce more dramatic results.

Also, the body does not remove synthetic marijuana from the body easily, and the metabolites can bind to receptors in the brain. Because there is no regulatory agency monitoring production, quality control is non-existent and pesticides can be part of the package.

Talk with your teens about drugs, preferably before they are teens while they are still good listeners. They have friends telling them that smoking once or twice a week can’t hurt them. The truth is that each person responds differently and there is not enough information on safe amounts, especially in an adolescent. The stakes are too high to gamble when dealing with brain function.

Healthy, informed living with John Hollis Pharmacy from Cindy Franklin, staff pharmacist