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Sanjay Gupta: What the Next Surgeon General Doesn't Know About Pot

The next surgeon general needs to stop putting politics before science. Gupta may not be ready for that.

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I'm constantly amazed that after all these years -- and all the wars on drugs and all the public-service announcements -- nearly 15 million Americans still use marijuana at least once a month.

Frequent marijuana use can seriously affect your short-term memory. It can impair your cognitive ability (why do you think people call it dope?) and lead to long-lasting depression or anxiety. While many people smoke marijuana to relax, it can have the opposite effect on frequent users. And smoking anything, whether it's tobacco or marijuana, can seriously damage your lung tissue.

But I'm here to tell you, as a doctor, that despite all the talk about the medical benefits of marijuana, smoking the stuff is not going to do your health any good. And if you get high before climbing behind the wheel of a car, you will be putting yourself and those around you in danger.

First, I'm wondering what Gupta is amazed about -- that 15 million Americans trust their own experiences with cannabis over government anti-drug propaganda and hyperbole? The anti-drug PSAs he mentions have been proven to not reduce teen cannabis use and may actually increase it. The Annenberg Public Policy Center at the University of Pennsylvania was commissioned by the National Institute on Drug Abuse to study the effect of government anti-cannabis ad campaigns over four years and found, "Youth who were more exposed to Campaign messages are no more likely to hold favorable beliefs or intentions about marijuana than are youth less exposed to those messages, both during the Marijuana Initiative period and over the entire course of the Campaign."

Gupta claims that smoking cannabis will impair your cognitive ability, and again, I fear he's parroting politics rather than following the research. Just this November, the journal  Neuropsychopharmacology published data from Columbia University that reported " the finding that accuracy [on cognitive testing] was unaffected by smoked marijuana indicates that heavy, daily marijuana smokers will not fulfill the DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, 4th edition] criterion for marijuana intoxication that requires impairment of complex cognitive functioning,"  This is on the heels of a Harvard study published in the  Archives of General Psychiatry that determined that long-term marijuana smokers who abstain from the drug for one week or more perform identically on cognition tests as non-users, and a previous study on marijuana and cognition by researchers at Johns Hopkins that found "no significant differences in cognitive decline between heavy users, light users and non-users of cannabis" over a 15-year period in a cohort of 1,318 subjects.

Gupta also makes the mistake of comparing tobacco smoke to cannabis smoke. While it is true that long-term cannabis smoking can lead to wheezing, cough and bronchitis, investigators writing last year in the journal Thorax did not find a positive association between smoking cannabis and the development of emphysema (overinflation of the air sacs in the lungs). Of course, all the pulmonary harms of smoking cannabis can be alleviated through eating it or through cannabis vaporization.  Investigators at San Francisco General Hospital reported last year in the journal  Clinical Pharmacology & Therapeutics that the " vaporization of marijuana does not result in exposure to combustion gases." A previous clinical trial, published in 2006 in the  Journal of Pharmaceutical Sciences, reported that vaporization is a " safe and effective" cannabinoid delivery system that "avoid[s] the respiratory disadvantages of smoking."

In 1997, Dr. Donald Tashkin's research at the UCLA Medical Center found that, "Neither the continuing nor the intermittent marijuana smokers exhibited any significantly different rates of decline in [lung function]" as compared with those individuals who never smoked marijuana. " No differences were noted between even quite heavy marijuana smoking and nonsmoking of marijuana." These findings starkly contrasted those experienced by tobacco-only smokers who suffered a significant rate of decline in lung function.

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