Pubdate: Tue, 11 Mar 2014 Source: Orlando Sentinel (FL) Copyright: 2014 Orlando Sentinel Contact: http://www.orlandosentinel.com/ Details: http://www.mapinc.org/media/325 Note: Rarely prints out-of-state LTEs. Author: Chris Woolston, Special to Tribune Newspapers Page: D4 AS LAWS CHANGE, HEALTH RISKS OF POT USE WEIGHED Now that people in Colorado (and, soon, Washington state) can buy marijuana about as easily as they can pick up a 12-pack of Bud Light, it's a good time to ask: How risky is it to turn to pot? President Barack Obama has already shared his opinion, telling The New Yorker magazine, "I don't think (marijuana) is more dangerous than alcohol." The president's opinion stands in stark contrast to official federal policy that still classifies marijuana as a Schedule 1 drug, in the same class as heroin and LSD. In this case, the president seems to be more correct than the government, says Richard Miller, professor of pharmacology at Northwestern University Feinberg School of Medicine in Chicago. "No question about it," Miller says. "It's absolutely clear that marijuana is much less dangerous than alcohol." According to Miller, marijuana is the safer choice whether you're using it for a single night or a lifetime. "When people drink alcohol, they often get out of control and get violent. They crash their cars and beat their wives. But when people smoke marijuana, they get very relaxed and mellow." Roughly 10 percent of people who try marijuana will eventually run into trouble, says Dr. Christian Hopfer, associate professor of psychiatry at the University of Colorado School of Medicine in Aurora. That's about the same odds that a drinker will abuse alcohol, he says, but there's a big difference: Alcoholism causes far more physical and emotional devastation. The signs of marijuana addiction are subtle, he says. Adults who smoke heavily - as in four or five times a day, every day - tend to have trouble learning, remembering and dealing with complicated tasks. "They're definitely impaired," Hopfer says. "They organize their lives around using." Fortunately, the habit is breakable. "A lot of people who use marijuana heavily in their 20s eventually quit on their own," he says. "It's probably easier than stopping (tobacco) smoking." The toll seems to be worse for young brains. According to Hopfer, adolescents who smoke a lot of marijuana can expect to lose about 8 points from their IQ. Young users also seem to be more likely to become psychotic in later years, although the risk is still small. "About one user in a thousand will end up with a psychotic illness that they wouldn't have had otherwise," he says. As reported in November in Current Psychiatric Reports, marijuana can threaten physical health too, although the dangers appear to be mostly small and unpredictable. After summing up studies over the last 15 years, researchers at the U.S. Department of Veterans Affairs found evidence linking marijuana to lung disease, heart disease and other ailments, but the actual risks were hard to pin down. For example, one study suggested that smoking a single joint increases the odds of a heart attack within the next hour, but other studies have failed to find any sign that marijuana users are more likely than nonusers to suffer a heart attack over the long term. The report also noted some growing but inconclusive evidence that long-term marijuana use could increase the risk of cancer in the lungs, bladder, head and neck. The authors noted, however, that marijuana doesn't seem to be in the same league as tobacco when it comes to the potential to cause cancer - another comparison that was practically guaranteed to cast marijuana in a positive light. A 2013 study published in the Journal of General Internal Medicine suggests that even heavy marijuana users aren't necessarily a sickly bunch. The study looked at nearly 600 primary-care patients who had tested positive for marijuana or another illicit drug. Chronic marijuana smokers were just as healthy as occasional smokers and weren't any more likely to have had a recent stint in the ER or a hospital bed. The president's pot analysis may have been accurate, but it wasn't necessarily helpful, says Dr. Timothy Naimi, an associate professor of medicine and community health sciences at Boston University School of Medicine. "Saying marijuana's safer than alcohol sets an incredibly low bar," Naimi says, adding that alcohol kills about 80,000 people a year. "Marijuana can still be a dangerous substance." While the risks of marijuana may be relatively small for each individual user, Naimi believes problems are likely to grow with access to the drug. "It's five times more potent than the pot I grew up with. We've lowered the price and increased the supply. I'm not for or against legalization, but those are red flags." Supporters of legalization often say marijuana should be as freely available as beer or whiskey. But Naimi says the nation's experience with alcohol isn't exactly a ringing endorsement of lax regulations and easy access to mindaltering substances. Instead, he says, the toll of alcohol should "give pause" to anyone hoping to bring marijuana to the masses. [sidebar] Does marijuana help with pain, MS and appetite loss? While recreational marijuana is legal in just two states (for now), 20 states plus the District of Columbia already allow marijuana for medicinal uses, and up to nine other states may soon follow suit. Many patients swear that cannabis helps ease their symptoms, but the drug has never gone through anything close to the testing required for prescription drugs. One reason: Marijuana is a Schedule 1 drug (a federal classification of the most dangerous drugs, including heroin and LSD), so researchers have to jump through a lot of hoops to even get it into their labs. So just how medicinal is medical marijuana? Here's a look at the current evidence. Pain: Marijuana is a proven pain reliever. Studies show it works against pain of many sorts, including neuropathic pain, rheumatoid arthritis, fibromyalgia and cancer-related pain. However, the relief can be underwhelming compared with prescription medications, and many users report side effects such as dry mouth, dizziness and sleepiness. Multiple sclerosis: Several studies over the years have shown that marijuana and its compounds can offer at least some relief for muscle spasticity in patients with multiple sclerosis. Sativex, a mouth spray that combines two compounds from marijuana, is already available for MS patients in Europe and Canada and undergoing studies in the U.S. Appetite: Marijuana's wellknown tendency to induce the "munchies" could potentially be helpful for patients who have lost their appetite because of cancer, chemotherapy or infection with HIV. Few studies have looked at smoking marijuana to improve appetite, but Marinol, a synthetic drug that mimics one of its compounds, has been approved by the Food and Drug Administration for treating weight loss in patients with HIV and relieving nausea and vomiting in cancer patients. - --- MAP posted-by: Matt