The marijuana condundrum

Well, election night wasn’t all bad news. More states legalized either recreational or medicinal marijuana! Woo-hoo! Take a look at the map now:

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However, no sooner than all this new legislation was passed did I read an article on Medscape about the dangers of marijuana use by a Dr. Melissa Walton-Shirley. The article is here if you’d like to read it, but I’ll be pulling out bits and pieces for the remainder of this post.

The crux of the article is this: there is some evidence that links marijuana to increased risk of certain cardiovascular diseases. The doctor who wrote the article cites a presentation that, “described an association between cannabis use and a twofold increase in the diagnosis of takotsubo cardiomyopathy.”

First of all, association isn’t causation. Walton-Shirley goes on to say,

“Seeing this uptick in apical ballooning in the young (and males to boot) is proof that manipulating the sympathetic and parasympathetic nervous systems is probably not a good thing for any age or gender unless those systems are producing pathology. Surely it’s predictable that inhaling substances never meant for human consumption doesn’t bode well for us, but it’s not the first time we’ve heard of pot’s potentially deleterious cardiovascular effects.”

There are a lot of things wrong here. First of all, a trend is not proof of anything. Second of all, and more importantly, the sample sizes of some of these studies are atrocious. Walton-Shirley even says in the article, “This article was lampooned due to its small sample size, but one must admit, where there is smoke, there can be fire (pun intended).” Hardy har, but you can’t just ignore the flaws and limitations of research to make a point or a pun.

I also find it very suspect that we’re never really given solid numbers about this “uptick.” Dr. Walton-Shirley gives some clues about it, saying that the rate of this cardiomyopathy is increased twofold by smoking pot. Well that’s all well and fine, but what does that mean in terms of naturally occurring cases? In other words, how many people are we talking about if we double the rate?

Well, we’ll have to do some detective work. Surfing the internet, I found an article from Circulation that states: “On the basis of recent analyses reported from several countries, this condition probably accounts for ≈1% to 2% of all cases of suspected acute myocardial infarction.” I think it’s also worth noting that the subtitle of the article is A New Form of Acute, Reversible Heart Failure. Turns out most people make a COMPLETE recovery. Anyway, the math.

 According to the American College of Cardiology, about 785,000 Americans have an MI every year. So we can say that in an average year, about 7,850-15,700 people suffer from TCM. But we also know what the prognosis for someone with TCM is: very good.  According to another Medscape article: “The prognosis in takotsubo cardiomyopathy (TCM) is typically excellent, with nearly 95% of patients experiencing complete recovery within 4-8 weeks.”

Well, let’s take those figures an apply them to our math above. We’re looking at a baseline mortality rate of 78.5-502.4 people per year. That’s it, folks. So let’s go with the worst case scenario, and say that smoking pot really does double the number of people who develop this. We’re talking about 1004 deaths per year due to marijuana. 

ARE YOU KIDDING ME?

Alcohol use kills 88,000 people per year.

Tobacco products kill 480,000 people per year.

Both perfectly legal. But heaven forbid we legalize pot, or 1000 people might get a rare form of cardiomyopathy. Do the people who make these arguments against pot not realize how insanely inconsistent their logic is? I mean, are we going to put people in jail because they use tobacco? Consumption of sugary drinks leads to diabetes, which affects 29 MILLION people in America. Should we jail anyone who drinks a big gulp?

And really, that’s what I think pisses me off the most about all this uproar over legalization. It’s not about health. Health is important, but legalizing pot isn’t a referendum on whether or not it’s bad for you, or whether or not you should use it. legalizing pot is about one thing:

NOT SENDING PEOPLE TO JAIL FOR USING IT.

That’s what decriminalization is about. It’s saying hey, maybe you shouldn’t go to jail for using a substance that’s less harmful than alcohol and tobacco, two perfectly legal products. 8.2 million people are arrested every year for pot-related offenses. Sure seems like we’re ruining more lives than we’re saving with anti-pot laws and policy. And we’re disproportionately ruining the lives of minorities, too, considering that white people use pot at the same rates of blacks and Latinos, yet are far less likely to be arrested for it. Not to mention the billions of dollars wasted every year enforcing these stupid laws:

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There’s no sensible reason to keep marijuana use illegal. There’s very poor evidence that it adversely affects health, at least compared to other perfectly legal substances. Anti-pot laws just waste everyone’s time and money. And people like Dr. Walton-Shirley are cherry picking data with very poor sample sizes to paint marijuana as some health menace, when there’s really no compelling body of evidence to support the stance.

Just make it legal everywhere and put those resources to better use.

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8 thoughts on “The marijuana condundrum

  1. One of my boxer dogs suffers from epilepsy and has been on phenos for a while.
    But the side effects from long term use are ugly.
    One of my son’s friends who is suffering from cancer uses Cannabis and he suggested we give his supplier a call as he was aware that he had prescribed it for certain animal ailments as well.
    We are now slowly weening the dog off the phenos and so far things are looking much much better.

      1. Weaning her off phenos is a gradual process. It’s early days yet, but the dog is not as dopey and more sure-footed. The phenos react on the central nervous system and long term effects also include potential irreversible liver damage.
        The Cannabis is illegal over here, of course, but apparently several vets ”consult” this chap. All strictly off the record, naturally.
        I will do a post once (if) we can see definitive (stable) results and the dog has no fits when completely off the prescribed drugs and solely using Cannabis.

  2. Preaching to the choir man. Preaching to the choir.

    I smoked a bit of weed in my day. Never could understand the demonization of it. I have said for decades “you will never see a pot crazed madman with an axe.”

    Sure as hell can’t say that about any other drug out there. Especially alcohol. When you look at the death, health issues, and misery associated with alcohol, there is the drug that needs a war waged on it.

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