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Obama: Pot no more dangerous than booze

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On Jan. 19, The New Yorker released an on-line piece revealing interviews of President Barack Obama conducted by David Remnick. The piece is titled "Going the Distance" and is dated Jan. 27. In one interview, the President is asked about the legalization of marijuana and he responds by citing his use of the drug when younger. He tells Remnick "I don’t think it is more dangerous than alcohol."

Obama states "It’s not something I encourage, and I’ve told my daughters I think it’s a bad idea, a waste of time, not very healthy." Can the two be compared? What are the dangers of marijuana use?

The FDA’s senior advisor for science innovation and policy, Vicki Seyfert-Margolis, Ph.D., stated in Aug. 2013 "All drugs have side effects." The effects of alcohol are widely known and have been studied by health professionals for centuries. Marijuana has received less attention, and, as the National Institutes of Health have said

As the marijuana plant contains hundreds of chemical compounds that may have different effects and that vary from plant to plant, its use as a medicine is difficult to evaluate.

Alcohol versus marijuana is not an apples to apple comparison. The Centers for Disease Control define the drug alcohol as a "central nervous system depressant." Alcohol can harm unborn children if consumed by the pregnant mother. An over dose of alcohol can be fatal. Long term alcohol use can cause liver damage, cancers, cardiac disease and other disorders. Alcohol use can interfere with the actions of many prescription medicines, reducing their effectiveness or causing other medical conditions.

Marijuana contains two chemicals that are considered the primary drugs that the plant delivers. One is delta-9-tetrahydrocannabinol or THC. The other is cannabidiol. A synthetic form of THC, dronabinol or Marinol, is available by prescription for the treatment of nausea and vomiting during chemotherapy, and for the treatment of anorexia in HIV patients.

THC is the ingredient in marijuana that produces the "high". The amount of THC varies, sometimes dramatically, from sample to sample. No state has set standards for the THC content of the medical or personal use marijuana being sold in that state.

Cannabidiol is similar to THC but does not produce a "high". It is being studied for a wide number of potential medical uses, including cancer treatment. As with THC, the amount in any sample varies.

Smoking marijuana exposes the user to similar ill effects as does cigarette smoking. In addition, there are no quality standards or limits on additives or pesticide residue on the product. There are studies that suggest that a percentage of users can become addicted, and other studies that suggest that the psychoactive properties of the plant can create or worsen mental illnesses in users. Marijuana intoxication rarely requires medical treatment. Serious symptoms are most often associated with other drugs that have been mixed with the marijuana, such as PCP.

The risk from drug interactions is high for marijuana or THC. The medically approved synthetic THC, dronabinol, carries warnings about interactions with the following medications:

amphetamines such as amphetamine (in Adderall), dextroamphetamine (Dexedrine, Dextrostat, in Adderall), and methamphetamine (Desoxyn); atropine (Atropen, in Hycodan, in Lomotil, in Tussigon); anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants, including amitriptyline (in Limbitrol), amoxapine, and desipramine (Norpramin); antihistamines; barbiturates including phenobarbital (Luminal) and secobarbital (Seconal, in Tuinal); buspirone (BuSpar); diazepam (Valium); digoxin (Lanoxicaps, Lanoxin); disulfiram (Antabuse); fluoxetine (Prozac, Sarafem); ipratropium (Atrovent); lithium (Eskalith, Lithobid); medications for anxiety, asthma, colds, irritable bowel disease, motion sickness, Parkinson's disease, seizures, ulcers, or urinary problems; muscle relaxants; naltrexone (Revia, Vivitrol); narcotic medications for pain; propranolol (Inderal); scopolamine (Transderm-Scop); sedatives; sleeping pills; tranquilizers; and theophylline (TheoDur, Theochron, Theolair).

There can be no side-by-side comparison of the safety of alcohol and marijuana. President Obama's opinion as a user of both is newsworthy but not evidence for the safety of either. The piecemeal legalization of marijuana in the United States without any medical or product safety standards does present more of a danger to the user at this time than does alcohol. The health effects of this process remain to be seen.

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