Debunking the Latest Viral Pot Paranoid Theory

"Legalized pot sends more teens to the ER in Colorado, study finds." So claimed CBS News and numerous other mainstream media outlets this month in response to a May 4 American Academy of Pediatrics press release. But in actuality, no published study exists. And the data highlighted in the AAP presser provides little evidence to substantiate these alarmist headlines.

In fact, what headline writers across the country inaccurately referred to as a "study" was no more than preliminary data presented during the 2017 Pediatric Academic Societies Meeting in San Francisco. These data sets, which assessed year-over-year trends in the prevalence of marijuana use among patients ages 13 to 21 who were admitted to the emergency room of a Colorado children’s hospital, have yet to be peer-reviewed or accepted for publication in a scientific journal. Yet one would have to skip to the final sentence of mainstream media coverage like this in order to be aware of these facts.

Furthermore, despite the misleading headlines, the data never addressed the question of whether marijuana played a causal role in patients’ ER admissions. Rather, researchers simply reported an increase in the number of ER patients who acknowledged either having used pot in the past or who tested positive for it on a hospital authorized urine screen. But this result is likely because Colorado hospital staff is placing a greater emphasis on marijuana detection today than they did a decade ago. Furthermore, it is likely that patients are more willing to acknowledge their use of cannabis to hospital employees now, post-legalization, than they were when pot was illegal.

Nevertheless, researchers opined that their data provides new evidence to support the claim that the legalization and regulating of marijuana for adults is having a “significant public health impact on adolescent populations.”

But more well established research casts serious doubt on this claim. For example, state survey data compiled by the Colorado Department of Public Health and Environment dismisses the notion that teens’ use of marijuana has increased in the years following legalization. In fact, youth marijuana use rates in Colorado are lower today than they were in 2009 — several years prior to the establishment of adult use regulations. National survey data similarly refutes allegations that more young people are engaging in the problematic use of cannabis. According to a 2016 study published in the Journal of the American Academy of Child & Adolescent Psychiatry, the number of adolescents reporting marijuana-related problems declined by 24 percent from 2002 to 2013.

In addition, legal cannabis products sold by Colorado retailers are seldom making their way to the underage market. According to a 2016 study published in the Journal of Studies of Alcohol and Drugs, licensed retailers strictly adhere to statewide regulations forbidding sales to minors. It determined, "Compliance with laws restricting marijuana sales to individuals age 21 years or older with a valid ID was extremely high and possibly higher than compliance with restrictions on alcohol sales.” Authors concluded, "The retail market at present may not be a direct source of marijuana for underage individuals.” Studies from other jurisdictions also report no link between the proliferation of marijuana dispensaries and increased pot use by teens.

Moreover, studies have largely failed to identify a significant causal link between marijuana use and ER visits. Specifically, researchers at the University of Michigan analyzed patterns and correlates of drug-related ER visits in a nationally representative survey of 43,093 residents age 18 or older. They reported, "[M]arijuana was by far the most commonly used (illicit) drug, but individuals who used marijuana had a low prevalence of drug-related ED [emergency department] visits.” A Canadian study published this month in the journal Drug and Alcohol Dependence determined that marijuana use did not increase subjects’ likelihood of hospitalization in the hours immediately following its use. Other studies assessing drug use patterns in smaller cohorts have even reported that cannabis use is inversely associated with injury risk.

This is not to say that cannabis use is without potential risk, particularly in instances where it is consumed by younger or more naive subjects. Marijuana can elevate blood pressure and in some users trigger tachycardia (rapid heart beat). Higher potency cannabis may also cause paranoia and other feelings of dysphoria. In patients with certain pre-existing psychiatric disorders, there also lies the potential for pot to exacerbate a psychotic episode. Any of these side effects may result in an ER visit. However, these sort of severe adverse reactions to cannabis are atypical. Further, none of these conditions are life-threatening and the symptoms almost always subside after a few hours.

Nevertheless, retailers and regulators in legal cannabis states ought to take steps to try and mitigate consumers’ risk of experiencing such unpleasant reactions, many of which are the result of overconsumption. These steps include better product labeling, potential limits on THC potency per serving in edible products, and greater efforts to encourage consumers to moderate their cannabis intake — particularly if they are consuming pot-infused edibles or concentrates. Such efforts are not only in the best interest of public safety, but they will also result in greater consumer satisfaction and awareness.

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