Note from AAHPO Member Meroujan Maljian, MD, a forensic psychiatrist working in the New Jersey prison system: “I see a lot of substance use disorders among the prison inmate population. I mostly agree with the following article [from Johns Hopkins University] that Cannabis products are substances of abuse which can often be harmful. They are potentially addictive and can lead to medical complications, drug interactions, and mental health problems. I also agree that more research and data are needed to understand how legalization of recreational Marijuana affects patterns of drug use and associated drug-related crime in the community. The article seems to suggest that depending on what that data and research shows that recreational Marijuana is something that people can decide whether or not to have as a society, but I disagree with that notion. As a physician who has seen the harmful effects of casual Cannabis use and how it is often a gateway drug leading to the use of more harmful drugs like Heroin and Cocaine, I personally can only support the use of medical Marijuana with medical supervision as a society for treating specific illnesses like terminal cancer where it was shown to help symptoms like pain and appetite.”
On July 1, Maryland joined 23 other states (including New Jersey, New York and Connecticut) permitting anyone 21 and older to buy and use cannabis for both recreational and medicinal purposes. But as more states make cannabis legal, what are policymakers and government agencies doing to ensure its safety? What does the latest research on cannabis indicate that can help the public make informed decisions?
For answers, The Hub recently sat down with Ryan Vandrey, an experimental psychologist in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine, who works with an interdisciplinary team in the Cannabis Science Laboratory.
Q. As someone who spends day in and day out studying cannabis, what does the legalization mean to you?
A. People get harmed by drugs all the time, even prescription drugs, and cannabis is no exception. But if there wasn’t good reason to believe that some value would come from legalization, it wouldn’t have happened. On the benefits side, there’s been a clear demonstration that the long-lasting war on drugs has been largely ineffective and has marginalized subgroups of individuals. There’s also clear evidence that making cannabis illegal hasn’t stopped people from accessing it. This isn’t my area of expertise, but from a criminal justice perspective, it makes sense to try to establish quality control for this commodity and to pull manufacturing and revenue out of the hands of drug dealers and into the hands of responsible businesses.
But there’s always risk and some level of concern when you grant open access to the public of a substance that can produce intoxication and impairment. My biggest worry is with public education and the information about the risks and potential harms of using cannabis that might get lost in the excitement of legalization.
Q. What important research findings do you think are getting left out of the public conversation about cannabis?
A. [As a society,] we need an open dialogue and increased education about the risks and how to minimize the likelihood of harm for individual users. There just isn’t enough discussion currently. For example, research tells us that there are subgroups of people with certain health conditions who should not use products with high tetrahydrocannabinol (THC), the psychoactive component that produces the “high” in cannabis. These include individuals with a personal or family history of psychosis, who can end up in an acute psychotic state that lasts hours or days. Likewise, individuals with heart conditions or even asymptomatic cardiovascular disease can end up having a heart attack or heart failure, despite exhibiting no previous signs of trouble.
