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Marijuana: What Your Doctor Is Reading

June 13, 2014  |  Falmouth Enterprise

Dr. Michael Bihari

The New England Journal of Medicine (NEJM), one of the most prestigious medical journals in the US, is widely read by local physicians. In the June 5, 2014 edition, the journal published the article, Adverse Health Effects of Marijuana Use, which reviews the science related to the harmful health effects of the recreational use of marijuana.

This article again raises concern about teen use of marijuana, noting that “use in this age group is associated with an increased likelihood of deleterious consequences.”

Based on a review of previously published studies about the effects of marijuana, the article outlines the adverse effects of the short-term, long-term and heavy use of pot.

Effects of Short-Term Marijuana Use

  • Impaired short-term memory, making it difficult to retain information.
  • Impaired motor coordination, interfering with driving skills and increasing the risk of injuries.
  • Altered judgement, increasing the risk of sexual behaviors that facilitate the transmission of sexually transmitted diseases.
  • In high doses, paranoia and psychosis

Effects of Long-Term or Heavy Marijuana Use

These effects are strongly associated with initial marijuana use early in adolescence:

  • Addiction (in about 9% of users overall, 17% of those who begin use in adolescence, and 25 to 50% of those who are daily users.)
  • Altered brain development.
  • Poor educational outcome, with increased likelihood of dropping out of school.
  • Cognitive impairment, with lower IQ among those who were frequent users during adolescence.
  • Diminished life satisfaction and achievement.

Medical Marijuana

The medicinal use of marijuana is now legal in Massachusetts and dispensaries and growing facilities are in the process of being established. To qualify for medical marijuana use “a patient must obtain a written certification from a physician for a debilitating medical condition. The law specifies: cancer, glaucoma, AIDS, hepatitis C, amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, multiple sclerosis and other conditions as determined in writing by a qualifying patient’s physician.” 

Also, the law allows qualifying patients to possess up to a 60-day supply of marijuana for their personal medical use. The regulations define a 60-day supply as up to 10 ounces. Typically, one ounce of weed can be used to make 60 joints, which adds up to 600 joints in a full prescription, or 10 joints a day. 

The amount of marijuana that is legal to dispense and the fact the a qualifying physician can write a prescription for pot “for other conditions” raises concerns that people without a legitimate medical condition (especially teens and young adults) may have easier access to the drug. It will be some time before medical marijuana dispensaries open on the Cape and it’s not clear in what form the marijuana will be dispensed. Aside from weed to smoke, other forms include oil that can be added to food or vaporized. Unfortunately, there have been recent reports that some local teens are using handheld vaporizers with hash oil that was obtained illegally.

Marijuana Use in Falmouth

The Falmouth Prevention Partnership has conducted surveys in local schools since 2009. The last survey, conducted in the spring semester of 2013 provides a detailed look at drug and alcohol use among Falmouth teens. Although underage drinking is the number one substance abuse issue, marijuana is the most commonly used illicit street drug. 

According to the 2013 survey, 28 percent of Falmouth High Schools students used marijuana in the past 30 days and 43 percent have tried pot in their lifetime. Not surprisingly 30-day use of marijuana increases by grade level; 17 percent of 9th graders used compared to 39 percent of 12th graders.

The good news is that the majority (about 70 percent) of Falmouth High School students do not use marijuana mostly due to parental guidance, involvement in prosocial activities, such as sports and volunteering, and programs sponsored by the Falmouth Prevention Partnership with strong support from the public school system and the Falmouth Police Department.

Marijuana Recreational Use Legalization

It is likely that the issue of legalizing marijuana for recreational use will be on the ballot in Massachusetts in 2016. The NEJM article ends with an interesting conclusion about legalization of pot: 

“The effects of a drug (legal or illegal) on individual health are determined not only by its pharmacologic properties but also by its availability and social acceptability. In this respect, legal drugs (alcohol and tobacco) offer a sobering perspective, accounting for the great burden of disease associated with drugs, not because they are more dangerous than illegal drugs but because their legal status allows for more widespread exposure. As policy shifts toward legalization of marijuana, it is reasonable and probably prudent to hypothesize that its use will increase and that, by extension, so will the number of persons for whom there will be negative consequences.”


The NEJM article is not available online unless you have a subscription to the journal. However, the journal is available in the Falmouth Public Library. 

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