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As Marijuana’s Popularity Grows, So Do Its Harms

By The New York Times

The Daily explores the rising popularity of marijuana and its potential harms. Recent surveys reveal a growing number of adults using cannabis, with young adults being particularly vulnerable to developing cannabis use disorder.

The podcast delves into the risks associated with chronic heavy use, including cannabinoid hyperemesis syndrome, a condition causing severe nausea and vomiting. It also examines the link between marijuana, especially high-potency products, and mental health issues like temporary psychotic episodes and the potential increased risk of developing chronic psychotic disorders like schizophrenia.

As marijuana use continues to grow, The Daily sheds light on the potential adverse effects, urging caution and awareness about the substance's impact on overall well-being.

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As Marijuana’s Popularity Grows, So Do Its Harms

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As Marijuana’s Popularity Grows, So Do Its Harms

1-Page Summary

Rising Marijuana Use and Cannabis Use Disorder

A government survey has found marijuana use increasing among adults, with more people now using it daily than alcohol. The survey also revealed that 30% of cannabis users aged 18 and over, or about 18 million Americans, meet criteria for having some level of cannabis use disorder.

High Prevalence Among Young Adults

The survey highlighted young adults aged 18-25 as particularly affected, with 81% of daily or near-daily users in this age group meeting the criteria for cannabis use disorder, according to medical experts.

Despite perceptions of marijuana as safe and natural, chronic heavy use can lead to dependence and withdrawal symptoms when use stops. High-potency products contribute to this risk.

Cannabinoid Hyperemesis Syndrome (CHS)

Chronic marijuana use can sometimes lead to Cannabinoid Hyperemesis Syndrome (CHS), a condition causing severe nausea, vomiting, and abdominal pain. CHS patients often find temporary relief through extremely hot showers or baths.

According to doctors' estimates, as many as 30% of regular marijuana users may experience symptoms of CHS, though the syndrome lacks a standardized diagnostic code, hindering awareness and understanding.

Mental Health Impacts

Marijuana use, especially of high-potency products, can trigger temporary psychotic episodes with paranoia, hallucinations, and detachment from reality. One example involved a veteran who experienced a severe psychotic episode after trying marijuana for the first time.

Long-term regular marijuana use, particularly starting in adolescence, has been linked to an increased risk of developing chronic psychotic disorders like schizophrenia. As with the link between smoking and lung cancer, while not causational, the association is supported by growing research. Physicians observe an uptick in psychotic disorders potentially related to cannabis use.

1-Page Summary

Additional Materials

Clarifications

  • Cannabis use disorder is a psychiatric condition where individuals continue using cannabis despite experiencing significant negative consequences or impairments in various aspects of their lives. It is recognized in diagnostic manuals like the DSM-5 and ICD-10. Symptoms can include difficulty stopping cannabis use, tolerance to its effects, and the presence of other mental health issues alongside cannabis dependence.
  • Cannabinoid Hyperemesis Syndrome (CHS) is a condition characterized by recurrent nausea, vomiting, and abdominal pain linked to prolonged and high-dose cannabis use. The syndrome typically requires regular cannabis use to manifest and can lead to complications like dehydration and kidney issues. The primary treatment for CHS involves ceasing cannabis consumption, with symptoms often improving after a period of abstinence. Hot showers or baths are commonly used by individuals with CHS for temporary relief, although the exact mechanism behind this is not fully understood.
  • Psychotic episodes triggered by marijuana use can involve symptoms like paranoia, hallucinations, and detachment from reality. These episodes are more common with high-potency marijuana products and can occur even in first-time users. Long-term, heavy marijuana use, especially starting in adolescence, is associated with an increased risk of developing chronic psychotic disorders like schizophrenia. While the exact relationship is complex and not fully understood, research suggests a potential link between marijuana use and the onset of psychotic symptoms.
  • Long-term regular marijuana use, especially when started in adolescence, has been associated with an increased risk of developing chronic psychotic disorders like schizophrenia. This association is not causational but is supported by a growing body of research. Physicians have observed a rise in psychotic disorders that may be linked to cannabis use. The exact mechanisms behind this association are still being studied.

Counterarguments

  • The increase in marijuana use among adults could be influenced by the growing legalization and normalization of cannabis in many states, which may not necessarily reflect an increase in problematic use.
  • The criteria for cannabis use disorder are based on the DSM-5, which some argue may pathologize normal use or fail to distinguish between different levels of severity.
  • The statistic that 81% of young adults who use marijuana daily or near-daily meet the criteria for cannabis use disorder could be skewed by self-reporting biases or may not account for varying social and cultural contexts.
  • Dependence and withdrawal symptoms from marijuana are generally considered to be less severe than those from substances like alcohol or opioids.
  • The risk of dependence and withdrawal symptoms from high-potency marijuana products may be overstated, as the relationship between potency and addiction is not fully understood.
  • The prevalence of Cannabinoid Hyperemesis Syndrome (CHS) is based on estimates and may not be as widespread as suggested; more research is needed to understand its incidence and causes.
  • The link between marijuana use and temporary psychotic episodes is complex and may involve a combination of genetic predisposition, environmental factors, and the specific context of use.
  • The association between long-term marijuana use and chronic psychotic disorders like schizophrenia is still a subject of debate, with some studies suggesting a correlation and others finding no significant connection.
  • The uptick in psychotic disorders observed by physicians could be influenced by increased awareness and reporting rather than a true increase in incidence related to cannabis use.

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As Marijuana’s Popularity Grows, So Do Its Harms

The increasing prevalence and problematic use of marijuana, including addiction and cannabis use disorder

Recent investigations have unveiled the serious health harms that heavy marijuana users are experiencing and shown that marijuana use is on the rise, particularly among young adults, with concerning rates of use disorders and addiction.

Marijuana use has been steadily rising among adults

The government survey has brought to light that not only is marijuana use increasing among adults aged 18 and over, but there has also been a significant rise in the number of people using it daily or near-daily. In a striking development, more people now report using marijuana daily or near-daily than those reporting the same levels of alcohol use—a first in 2022. As recreational marijuana becomes legal across an ever-growing number of U.S. states, a commercialized industry has emerged, offering a plethora of products with varying levels of THC, many of which bear little resemblance to the marijuana products of the past.

A government survey found that 30% of cannabis users aged 18 and over, or about 18 million Americans, reported having some level of cannabis use disorder, with 3 million considered addicted.

The market has seen a swift transition from primarily medical to recreational use, raising concerns about the safety and perceived naturalness of marijuana, irrespective of its legality. More people report that their marijuana use is negatively impacting their lives in what is known as cannabis use disorder. Individuals who meet two of the eleven designated criteria are considered to have a mild case of this disorder, while those meeting six or more are seen to have a severe disorder, also known as addiction.

Cannabis use disorder is especially prevalent among young adults, with 81% of daily or near-daily users aged 18-25 meeting the criteria for the disorder.

The survey has specifically highlighted that out of approximately 4.5 million young adults between the ages of 18 to 25 who use marijuana daily or near daily, a staggering 81% meet the ...

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The increasing prevalence and problematic use of marijuana, including addiction and cannabis use disorder

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Counterarguments

  • The increase in reported marijuana use could be partly due to a reduction in stigma and an increase in reporting honesty as legalization spreads, rather than a true increase in use rates.
  • Daily or near-daily use of a substance does not inherently indicate a disorder or addiction; it may reflect medical use or other non-problematic patterns of consumption.
  • The criteria for cannabis use disorder are based on a set of symptoms that may not fully capture the complexity of an individual's relationship with marijuana, and the threshold for what constitutes a "disorder" can be subjective.
  • The comparison of marijuana use to alcohol use does not account for the differences in harm profiles between the two substances; alcohol is well-documented to have a higher potential for harm.
  • The prevalence of cannabis use disorder, particularly among young adults, may be influenced by other factors such as socioeconomic status, mental health, and access to education about safe use.
  • Dependence and withdrawal symptoms are not unique to marijuana and can occur with many substances, including caffeine and prescription medications.
  • Tolerance ...

Actionables

  • You can track your marijuana usage with a simple journal to become more aware of your consumption patterns. Start by noting down each time you use marijuana, including the amount and the reason for use. This self-monitoring can highlight patterns and triggers, helping you to understand your habits better and make informed decisions about your use.
  • Develop a personal scale to gauge your dependency risk by assessing your usage frequency against your ability to abstain. For instance, try setting periods of non-use and see how you feel during these times. If you notice difficulty in abstaining or withdrawal symptoms, this could indicate a higher dependency risk, prompting you to consider reducing your usage or seeking professional advice.
  • Create a THC content log for any cannabis products y ...

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As Marijuana’s Popularity Grows, So Do Its Harms

Severe physical health effects of chronic marijuana use, such as Cannabinoid Hyperemesis Syndrome (CHS)

Chronic marijuana use can sometimes lead to severe physical health effects, including a condition known as Cannabinoid Hyperemesis Syndrome (CHS), characterized by severe nausea, vomiting, and abdominal pain.

Some chronic marijuana users develop a condition called Cannabinoid Hyperemesis Syndrome (CHS), which causes severe nausea, vomiting, and abdominal pain.

Jennifer Macaluso started using marijuana medically on her doctor's suggestion to manage migraines and initially found it effective. However, after about six months, she began waking up nauseous every morning and experienced stomach aches. Instead of providing relief, her increased marijuana use exacerbated the situation, leading to cycles of severe vomiting and stomach pain.

CHS patients often find temporary relief by taking extremely hot showers or baths, sometimes to the point of burning themselves, and the syndrome can lead to serious complications like dehydration, seizures, and even cardiac arrest.

As Macaluso’s condition worsened, she encountered very dark days and felt she might die as she was bedridden. The pain was so intense at times that sufferers of CHS, like Macaluso, could be found screaming in agony.

CHS appears to be on the rise alongside the legalization and commercialization of increasingly potent marijuana products, but it is still not well-understood by the medical community.

Despite repeated medical consultations, including visits to four different gastroenterologists and undergoing numerous tes ...

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Severe physical health effects of chronic marijuana use, such as Cannabinoid Hyperemesis Syndrome (CHS)

Additional Materials

Clarifications

  • Cannabinoid Hyperemesis Syndrome (CHS) is a condition linked to prolonged, high-dose cannabis use, characterized by recurrent nausea, vomiting, and abdominal pain. Weekly cannabis use is typically necessary for CHS to manifest, and the primary treatment involves complete abstinence from cannabis. The exact cause of CHS is not fully understood, and diagnosis is based on symptoms and a history of cannabis use. Hot showers or baths are often used as a temporary relief measure for CHS symptoms.
  • Cannabinoid Hyperemesis Syndrome (CHS) is a condition linked to chronic marijuana use, characterized by severe nausea, vomiting, and abdominal pain. The relationship between CHS and marijuana use is complex and not fully understood, but it is believed that long-term, heavy cannabis consumption can trigger this syndrome in susceptible individuals. CHS is a relatively rare condition, but its prevalence seems to be increasing with the rising potency of marijuana products and the growing number of regular users. Understanding this association is crucial for both medical professionals and individuals using marijuana to recognize and address potential health risks.
  • In Cannabinoid Hyperemesis Syndrome (CHS), some patients find temporary relief from symptoms like nausea and vomiting by taking extremely hot showers or baths. The hot water is believed to help alleviate the discomfort associated with CHS, although the exact mechanism is not fully understood. This practice can sometimes be taken to extremes, where individuals may use water that is so hot it can lead to burns. It's important for individuals experiencing CHS to seek medical advice and not rely solely on hot water therapy for symptom management.
  • A standardized diagnostic code for a medical condition like Cannabinoid Hyperemesis Syndrome (CHS) is a specific code used by healthcare professionals to identify and classify the condition in medical records and billing systems. Without a stand ...

Counterarguments

  • The prevalence of CHS may not be as high as estimated since the condition is not well-understood and could be misdiagnosed or underdiagnosed.
  • The association between CHS and the potency of marijuana products is not conclusively established; other factors such as individual susceptibility or consumption patterns may also play a significant role.
  • While CHS is serious, it is important to recognize that not all chronic marijuana users will develop the syndrome, and it may be related to other underlying health issues.
  • The lack of a standardized diagnostic code for CHS could be due to the novelty of the syndrome and the evolving understanding of cannabis-related health issues.
  • The narrative may unintentionally contribute to stigmatizing marijuana use, which for many individuals is a beneficial and effective treatment for various medical conditions.
  • The risks of hot showers and baths leading to burns and other complications might be overstated or not representative of all ...

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As Marijuana’s Popularity Grows, So Do Its Harms

The mental health impacts of marijuana, including temporary psychosis and chronic psychotic disorders

The relationship between marijuana use and mental health is layered and complex, encompassing temporary psychotic episodes and an increased risk of chronic psychotic disorders. Researchers and healthcare professionals are examining the link between marijuana, especially high-potency strains, and these debilitating health outcomes.

Marijuana use, especially of high-potency products, can trigger temporary psychotic episodes characterized by paranoia, hallucinations, and detachment from reality.

One dramatic example of the potential impact of marijuana use on mental health is the story of a veteran who, after trying marijuana for the first time, experienced a psychotic episode so severe that he shot and injured his girlfriend and killed one of their dogs. This tragic event highlights the unpredictable and sometimes dangerous nature of marijuana-induced psychosis. These temporary psychotic episodes are characterized by symptoms that include paranoia, hallucinations, and a detachment from reality, which can significantly disrupt a person’s life and can pose a danger to themselves and others.

Long-term, regular marijuana use, particularly starting in adolescence, has been linked to an increased risk of developing chronic psychotic disorders like schizophrenia.

The brain continues to develop well into a person's mid-20s, and this is also the period when chronic psychotic disorders, such as schizophrenia, frequently manifest. There is mounting evidence that suggests marijuana use plays a contributing role in the development of these disorders. The risk is reportedly higher with the use of higher potency cannabis products, more frequent usage, and earlier initiation of use.

Researchers are starting to compare the relationship betwee ...

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The mental health impacts of marijuana, including temporary psychosis and chronic psychotic disorders

Additional Materials

Clarifications

  • High-potency marijuana, especially with high levels of THC, can trigger temporary psychotic episodes characterized by paranoia, hallucinations, and detachment from reality. Long-term, regular use of high-potency cannabis, particularly starting in adolescence, has been linked to an increased risk of developing chronic psychotic disorders like schizophrenia. The risk is reportedly higher with the use of higher potency cannabis products, more frequent usage, and earlier initiation of use. Researchers are comparing the relationship between high-potency marijuana use and chronic psychotic disorders to illustrate the potential impact on mental health.
  • The comparison between marijuana use and chronic psychotic disorders to cigarette smoking and lung cancer is made to highlight a similar association between the two pairs. Just as not all smokers develop lung cancer and not all lung cancer patients are smokers, not everyone who uses marijuana will develop a psychotic disorder, and not all individuals with psychotic disorders have used marijuana. This comparison emphasizes the complex and nuanced relationship between marijuana use and chronic psychotic disorders, similar to ...

Counterarguments

  • The evidence linking marijuana use to mental health issues is correlational, and it is difficult to establish causation due to various confounding factors such as genetic predisposition, environmental stresses, and the use of other substances.
  • Some studies suggest that the risk of developing psychosis from marijuana use is relatively low and that there is a need for more research to understand the risk factors for those who may be more susceptible.
  • The association between marijuana use and chronic psychotic disorders may be overemphasized, and there is a need to consider the potential benefits of marijuana, such as its use in managing chronic pain, anxiety, and as an alternative to more harmful substances.
  • The narrative around marijuana use and mental health can contribute to stigma, which may prevent individuals who use marijuana and experience mental health issues from seeking help.
  • The potency of marijuana products is not the only factor to consider; the mode of consumption, individual tolerance, and the presence of other cannabinoids lik ...

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