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MEDICAL MARIJUANA 7
A Causal Analysis of the Effects of Medical Marijuana
Student E. Name
August 1, 2018
National University
ILR260: Information Literacy
Instructed by James Lhotak
Abstract
This paper examined the relationship between marijuana use and individual health and found an association with adverse health effects. This paper has three important contributions. First, studies have found that marijuana use has a causal role in adverse health effects. Second, marijuana use has a causal role in early onset of bipolar depression, Third, studies are ineffective in determining whether marijuana is associated with healthcare consumption. This paper is important because marijuana is the third most commonly used drug after alcohol and tobacco.
A Causal Analysis of the Effects of Medical Marijuana
This paper examined the relationship between marijuana use and individual health and found a causal role of adverse health effects. The problem this paper to addresses are the effects of medical marijuana on individual health and health consumption. The hypothesis of this paper was that research has not been effective in addressing the implications of marijuana use on individual health and health consumption. The research questions that guided this paper included what are the effects of marijuana use, and how effect has the research been? The most important findings of this paper are that marijuana use is associated with adverse health effects and causes psychosocial problems, and that research is ineffective in addressing its impact on health service utilization. The solution to the problem, which will be discussed in the conclusion section in detail, included federal legalization of marijuana that would lead to better research, increased studies about the long-term effects on middle-aged people, and public health campaigns to decrease use by adolescence. Understanding the effects of marijuana use is important because such use affect healthcare decisions.
History of the Problem
The discovery of cannabinoid receptors in the brain in the 1990s, raised interest in marijuana’s therapeutic values and has been used by patients who experienced anorexia caused by chemotherapy, nausea, vomiting, pain, and muscle spasms (Cavalet, 2016). Consequently, medical marijuana use has increased and debate has increased about associated risks and benefits (Cavalet). Given that many states throughout the U.S. are legalizing (Cavalet), marijuana has become the third most commonly used drug after alcohol and tobacco dependence (Fuster et al., 2014, p. 133). For the majority of marijuana users, the most effective way at achieving psychoactive effects of euphoria and sociability is by smoking or in a water pipe (Hall, 2015). Additionally, over the past 30 years, the potency of marijuana that is produced by delta-9-tetrahydrocannabinol (THC) has increased in the U.S. from <2% in 1980 to 8.5% in 2006 (Hall, p. 19). Although roughly 9% of people who experiment with marijuana become addicted (Volkow, Baler, Compton & Weiss, 2014, p. 2219), however, users do not perceive smoking the substance to be associated with major health problems (Fuster et al., p. 133). However, the consequences of marijuana use are associated with adverse health problems such as respiratory diseases, lung and brain cancers, heart disease, motor vehicle crashes, and higher risks of psychotic symptoms (Fuster et al.). Cohort studies suggested that marijuana use begins prior to the onset of bipolar disorder (BP) and that it has a causal role in the development of the disease (Tyler, Jones, Black, Carter & Barrowclough, 2015). Although marijuana is often used in conjunction with alcohol and other drugs, the results of its impact on healthcare utilization is mixed (Fuster et al.). While there are questions about the long-term use, careful investigation about the risks and benefits of medical marijuana needs to be conducted (Cavalet). It is important to understand how marijuana use impacts health and the use of healthcare services because these outcomes affect healthcare decisions (Fuster et al.).
Literature Review
Although marijuana is classified as an illicit drug, it is the third most frequently used substance by patients who were screened for use (Fuster et al., p.133). The attribution of adverse health effects to marijuana use is problematic because most of the data comes from treatment-seeking patients who are addicted to alcohol, tobacco and other drugs as well (Fuster et al.).
Studies found that of the patients who were admitted to detoxification, 19 % reported emergency healthcare use and 24 % reported hospitalization in the preceding 6 months (Fuster et al., p. 136). The results were therefore mixed on to the health of marijuana users, the use of healthcare services, and the healthcare outcomes (Fuster et al.). A three-month study found that the frequency of marijuana use had no significant association with any increases in emergency healthcare services or hospitalizations (Fuster et al.). The lack of this association was supported by the fact that marijuana had little chemical influence above that of other drugs (Fuster et al.). Fuster et al. found that daily users and less than daily marijuana users were healthier than those who reported no use, however the difference was insignificant (p. 135). This study was found to have limitations because of the inaccuracy of self-reporting, illicit drugs were used by all the participants, and past marijuana use were not taken into consideration (Fuster et. al.). Fuster et al. acknowledged that their study conflicts with other studies that show adverse effects of marijuana, and did not imply that the use of marijuana was without risk (p. 138).
Health Effects
Recreational marijuana use has become as common as tobacco use in teens and young adults predominantly in low and middle-income countries (Hall) and is concerning because use this age group is related to an increased likelihood of harmful consequences (Volkow et al). A 20-year study revealed that the public health campaign aimed at preventing smoking among adolescence caused an increase in marijuana use by young people who had never smoked tobacco before (Hall). In fact, studies found that early and consistent marijuana use predicted an increase risk of addiction that escalated the use of other illicit drugs (Volkow et al.).
Acute effects. Given that there are virtually no cannabinoid receptors in the brain stem, marijuana does affect the autonomic nervous system (Cavalet), and research found that marijuana use did not result in any fatal overdoses (Hall). However, a study found that marijuana users who drove while intoxicated were 2-3 time more likely to be involved in vehicle collisions in comparison to 6-15 times of alcohol related collisions (Hall, p. 21). In addition, the risk of fatalities increased significantly when marijuana was used in conjunction with alcohol (Hall).
Physical health outcomes. Regular marijuana use has been associated with cancers of the lungs, upper aerodigestive tract, bladder and testicular cancer (Hall, 2015). In addition, research showed that smoking marijuana increases the risk of developing chronic bronchitis and cardiovascular diseases in middle-aged adults (Hall). Nevertheless, the results were unclear because most marijuana smokers had smoked or still smoke tobacco (Hall).
Psychosocial effects. Epidemiological studies found that regular marijuana use doubled the risk of psychotic symptoms such as hallucinations, particularly in cases where there were personal or family history of psychotic disorders (Hall, 2015). An analysis of three Australian and New Zealand longitudinal studies revealed that marijuana use at an early age contributed to an estimated 17% of users failing to complete high school or post-secondary training (Hall, p. 24).
Self-Medication and Bipolar Disorders
Marijuana is most often used by persons suffering from bipolar disorder (BD) (Tyler et al.) It was estimated that marijuana use ranged between 8% to22% with a lifetime use of 30% to 64% (Tyler et al., p. 2). Tyler et al. hypothesized that: 1). marijuana use to self-medicate would increase as BD symptom change 2). marijuana would be associated with psychological changes and BD symptoms (p. 3). In an experience sampling method (ESM) study, twenty-four participants were prompted at random times to answer a series of questions regarding their thoughts, BD symptomatology, and marijuana use over a six-day period (Tyler et al.). Study participants were required to have used marijuana at least twice a week, however, individuals who had experienced current psychotic symptoms were excluded (Tyler et al.). The study found that marijuana use increased mania and depression (Tyler et al.). The results, which were consistent with results from previous studies, that found that marijuana use resulted in a younger age of BD onset (Tyler et al.). In fact, marijuana use produced a range of psychological effects that were primarily found to be attributed to the chemical compounds THC and cannabidiol (CBD) (Tyler et al.). On the other hand, the EMS study found that marijuana had not been used as self-medication to combat the negative effects of BD symptoms (Tyler et al.). Although the study found that EMS could be a valuable therapeutic tool in managing marijuana use for BD sufferers, there was insufficient evidence because research was still in its infancy (Tyler et al.).
Discussion
Health Care Consumption
Fuster et al. (2014) provided adequate evidence to support the claim that the frequency of marijuana use had no significant association with an increase in emergency healthcare services or hospitalizations. However, the evidence was insufficient to prove their hypothesis. Although Fuster et al. stressed the importance of understanding how marijuana use impacts health and healthcare decisions, they avoided the associations with drugs and alcohol abuse. While Fuster et al. acknowledged that marijuana use is associated with adverse health effects, such effects were not discussed. For example, Fuster et al. could have included data about the association between other illicit drugs and marijuana use and the combined effect on healthcare consumption. Since research is primarily based on self-reporting tools, the accuracy is inconclusive. While Fuster et al. claimed not to have any conflict of interest, the research appears biased because the research results were not irrefutable. Consequently, additional research is required to determine the long-term of marijuana use on healthcare consumption.
Health Effects
Hall’s (2015) examination of 20 years of research was able to provide adequate evidence of the adverse health effects of marijuana use. The research appears to be unbiased because Hall provided a clear analysis of the adverse health and psychosocial effects. While Hall found that marijuana use increases cardiovascular effects of middle-aged adults, his analysis was primarily focused on the adverse effects of teens and adolescence. Therefore, additional research is required to determine the long-term effects of marijuana use on middle-aged adults. Although most of the studies were conducted in Australia and New Zealand, it is important to note that such studies are not easily replicated because marijuana is still classified as an illegal substance by the U.S federal government. However, based on the breath, time frame, and extent of the literary analysis, the research could be a valuable tool for medical professionals in determining the diagnosis of marijuana related health effect.
Self-Medication and Bipolar Disorders
Tyler et al. (2015) provided adequate evidence to support the claim that marijuana use increases the onset of bipolar depression. While Tyler et al. sought to prove their hypotheses, the research was biased because an old research method was utilized that resulted in the same outcomes as previous studies. While the authors acknowledged that the different chemical components produced a range of psychological effects, they failed to provide evidence about the effects associated with THC as opposed to CBD. For example, marijuana that has more THC may produce mania and depression, whereas CBD may cause euphoria. While the EMS research is a valuable tool in monitoring marijuana use, the problem that the substance is associated with symptoms of mania and depression cannot be ignored.
Conclusion
A considerable amount of evidence revealed that marijuana use posed risks to individual health and caused psychosocial problems. Although many states have legalized marijuana, federal legalization would create research opportunities that would study the long-term effects of marijuana use. Federal legalization would also increase cohort studies with pharmaceutical companies. Since many middle-aged adults use marijuana for medical purposes, researchers should study the long-term effects of marijuana use in these adults. Understanding the long-term effects could assist doctors in diagnosis and treatment plans. Furthermore, states should launch public health campaigns about the adverse health effects of marijuana use. This could increase awareness about the growing marijuana use by teens and young adults and could decrease use and potentially decrease the psychosocial effects on this age group. Ultimately, understanding the negative effects of marijuana use would lead to a healthier society.
Source: Hall, W. (2015). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction, 110(1), 19-35. doi:10.1111/add.12703
References
Cavalet, J. (2016, October). The highs and lows of medical marijuana. Clinician Reviews, 26(10), p. 40-53
Fuster, D., Cheng, D. M., Allensworth-Davies, D., Palfai, T. P., Samet, J., & Saitz, R., (2014). No detectable association between frequency of marijuana use and health or healthcare utilization among primary care patients who screen positive for drug use. Journal of General Internal Medicine, 29(1), 133-139. doi: 10.1007/s11606-013-2605-z
Hall, W. (2015). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use?. Addiction, 110(1), 19-35. doi:10.1111/add.12703
Tyler, E., Jones, S., Black, N., Carter, L., & Barrowclough, C. (2015). The relationship between bipolar disorder and cannabis use in daily life: an experience sampling study. Plos ONE, 10(3), 1-15. doi: 10.1371/journal.pone.0118916
Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014). Adverse health effects of marijuana use. The New England Journal of Medicine, 370(23), 2219-2227.
