cannabisnews.com: Smoking Pot Kills... Not.





Smoking Pot Kills... Not.
Posted by CN Staff on September 25, 2003 at 12:19:52 PT
By Fred Gardner
Source: Anderson Valley Advertiser 
For the health-conscious pothead who can't afford or can't get motivated to use a vaporizer, the mother of all questions has to be: does smoking cannabis lower life expectancy? A recent editorial in the British Medical Journal generated ominous headlines, attributing some 30,000 deaths annually in the UK to cannabis smoking. But you can relax a little, dear reader: the authors simply extrapolated from the number of deaths caused by cigarette smoking (120,000) and assumed that pot smoking was 1/4 as common and equally dangerous.
In the Sept. 20 BMJ, Stephen Sidney, MD -the associate director of clinical research for Kaiser Permanente, who has conducted the most relevant studies- explains how to approach the question scientifically:"Firstly, we need to examine published data regarding use of cannabis and mortality. These data come from two large studies. The first study done in a cohort of 45,450 male Swedish conscripts, age 18-20 when interviewed about the use of cannabis, reported no increase in the 15-year mortality associated with the use of cannabis after social factors were taken into account."The second study was performed in a cohort of 65,171 men and women age 15-49, who were members of a large health maintenance organization in California, United States. [Sidney is referring to the Kaiser study on which he was principal investigator. His paper describing the results, 'Marijuana and Mortality,' was published in the American Journal of Public Health in 1997.] They completed a questionnaire assessing their use of cannabis, and reported no increase in mortality associated with use of cannabis over an average of 10 years of follow up, except for AIDS-related mortality in men. A detailed examination showed that the mortality link between cannabis and AIDS was not a causal one. Thus published data do not support the characterization of cannabis as a risk factor for mortality."Secondly, we need to consider the time course of exposure to cannabis and its potential relation to mortality. No acute lethal overdoses of cannabis are known, in contrast to several of its illegal (for example, cocaine) and legal (for example, alcohol, aspirin, acetaminophen) counterparts."Deaths due to chronic diseases resulting from substance misuse generally result from the use of that substance (for example, tobacco and alcohol) over a long time. Importantly, and in contrast to users of tobacco and alcohol, most cannabis users generally quit using cannabis relatively early in their adult lives. The proportion of older adults who use cannabis is only 18% that of younger adults, much lower than the comparable proportions for alcohol (89%) and tobacco cigarettes (60%)."Moreover since the use of cannabis in young adults declined steadily between 1979 and 1998, whereas use in older adults remained stable, the observed low prevalence in older adults is unlikely to increase in the foreseeable future. Therefore, even diseases that might be related to long term use of cannabis are unlikely to have a sizeable public health impact because most people who try cannabis do not become long term users. This observation is relevant to lung cancer, which, although strongly related to cigarette smoking, typically only occurs after at least 20 years of smoking."Also, a typical regular cannabis user smokes the equivalent of one marijuana cigarette or less per day, whereas consumption of 20 or more tobacco cigarettes is common. Exposure to smoke is therefore generally much lower in cannabis than in tobacco cigarette smokers, even taking into account the larger exposure per puff."A third issue to consider is the potential relation of the use of cannabis to diseases that contribute the most to total mortality. For example, in the United States and the United Kingdom the leading cause of death is diseases of the heart, predominantly coronary heart disease, which is strongly associated with smoking tobacco cigarettes and accounts for nearly one third of all deaths. Mittleman et al noted the quadrupling of risk found in one study when cannabis was smoked within one hour before a myocardial infarction [heart attack]. However, since only 0.2% of the patients with myocardial infarction reported this exposure, the number of myocardial infarctions attributable to the use of cannabis is extremely small."Cannabis does not contain nicotine, a component of tobacco that contributes importantly to the risk of coronary heart disease. Use of cannabis in a young adult population was not associated with the presence of calcium in coronary arteries -an indicator of coronary atherosclerosis- and a cohort study conducted in a large health maintenance organization showed no association between the use of cannabis and admission to hospital for myocardial infarction and all coronary heart disease. [Sidney was lead investigator on the two studies cited.]"Two caveats must be noted regarding available data. Firstly, the longer-term follow up of cohorts of cannabis users may still show an increased risk of cancers, chronic diseases, and mortality if enough members of the study cohort continue to smoke cannabis often enough and for long enough. The cohorts to date have not followed cannabis smokers into later adult life so that it might be too early to detect an increased risk of chronic diseases that are potentially associated with the use of cannabis. Secondly, the low rate of regular use of cannabis and the high rates of discontinuation during young adulthood in the United States may reflect the illegality and social disapproval of the use of cannabis. This means that we cannot assume that smoking cannabis would continue to have the same small impact on mortality (as it probably does with current patterns of use) if its use were to be decriminalized or legalized.""Although the use of cannabis is not harmless, the current knowledge base does not support the assertion that it has any notable adverse public health impact in relation to mortality. Common sense should dictate a variety of measures to minimize adverse effects of cannabis. These include discouraging the use by teenagers, who seem to be most at risk of future problems from drug use, not using before or during the operation of automobiles or machinery, not using excessively, and cautioning people with known coronary heart disease." Some Comments Some of the harm-reduction measures recommended by Sidney are indeed "common sense;" but some are at odds with findings reported by Tom O'Connell and Tod Mikuriya, two doctors who have made a specialty of monitoring their patients' cannabis use. O'Connell's data indicate that cannabis use as a teenager predisposes against problematic use of hard drugs later in life. And according to Mikuriya, "Cannabis does not have an adverse effect on cardiac functioning. It decreases stress with its resultant cardiac problems."Sidney assumes that cannabis use would increase if Prohibition were ended. He's almost certainly right, but who would start using, and would they be smoking the crude plant? There are millions of older Californians who have not availed themselves of the right to use marijuana medicinally but might do so if access became easier. And they'd almost certainly prefer sublingual extracts or vaporization... Sidney's paper seems like a strong argument to get a vaporizer. It would be almost like quitting, lung-wise. Unfortunately, the only really cool one, the German-made Volcano, costs around $550.The rate at which teenagers use cannabis probably wouldn't change significantly if the Prohibition eased -they have access to it now. The only longterm way to reduce drug use by teenagers is to create a society in which they have skills, purpose, freedom, and dignity. We could start by calling off the dogs and getting rid of the bottles they're made to pee in.Potshots "Ferris Fain was the one who grew the clones for the local professional growers," according to a Georgetowner who knew him slightly in his final decade. "That's why he had to do time -he had thousands of plants." Our source was under the impression that Fain, when he'd met him, had been using marijuana to ease his aches and pains. What a shame that marijuana could become an "issue" between him and a loved one. How many parent-vs.-kid and kid-vs.-parent tensions have been exacerbated by Prohibition?The Med Board v. Mikuriya hearing resumes and is expected to conclude on Wednesday, Sept. 24. The dignified Berkeley psychiatrist has spent five hours on the stand defending his treatment of 16 patients. He has yet to be cross-examined. The lawyers will have three or four weeks to submit briefs to Administrative Law Judge Jonathan Lew, who will then have three or four weeks to make his "recommended decision" to the Medical Board, which will then have three or four weeks to publish it and as much time as they want to act on it. The Board can depart from the ALJ's recommended decision in either direction -punishment or leniency.Upton Sinclair on medical care: "I number many doctors among my friends, and the better they know me, the more freely they admit the unsatisfactory state of their work. Leo Buerger, a college mate who became a leading specialist in New York, summed the situation up when I mentioned the osteopaths, and remarked that they sometimes made cures. Said my eminent friend: 'they cure without diagnosing, and we diagnose without curing.'"Source: Anderson Valley Advertiser (CA)Author: Fred GardnerPublished: September 25, 2003Copyright: 2003 Anderson Valley AdvertiserContact: ava pacific.netWebsite: http://www.theava.com/Related Articles & Web Site:Tod H. Mikuriya, M.D.http://www.mikuriya.com/Dr Mikuriya Defends His Practice http://cannabisnews.com/news/thread17264.shtmlDoctor Litigates With State Medical Boardhttp://cannabisnews.com/news/thread17224.shtmlMikuriya To Med Board: No Dealhttp://cannabisnews.com/news/thread17183.shtml
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Comment #2 posted by mayan on September 25, 2003 at 18:24:40 PT
Could Be A While...
"The Med Board v. Mikuriya hearing resumes and is expected to conclude on Wednesday, Sept. 24. The dignified Berkeley psychiatrist has spent five hours on the stand defending his treatment of 16 patients. He has yet to be cross-examined. The lawyers will have three or four weeks to submit briefs to Administrative Law Judge Jonathan Lew, who will then have three or four weeks to make his "recommended decision" to the Medical Board, which will then have three or four weeks to publish it and as much time as they want to act on it. The Board can depart from the ALJ's recommended decision in either direction -punishment or leniency."Sounds like it could be a while before this all concludes. Does anyone have any more details regarding Dr. Mikuriya's hearing?Here is an article from the UK that some here may find alarming...Eye scanner introduced to test for drugs in the workplace:
http://news.independent.co.uk/uk/this_britain/story.jsp?story=446756The way out is the way in...White House Faces Crunch Time on 9/11 Files:
http://www.newsday.com/news/opinion/ny-vpcoc253467718sep25,0,5959106.column?coll=ny-viewpoints-headlines
 
9/11 Citizens' Watchdog Group Issues Report Challenging 9/11 Commission:
http://www.scoop.co.nz/mason/archive/scoop/stories/33/bd/200309230951.c6102309.html9/11 CitizensWatch:
http://www.911citizenswatch.org/October 25th - Mass March on the White House & Pentagon: 
http://www.internationalanswer.org/ 
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Comment #1 posted by Virgil on September 25, 2003 at 18:02:33 PT
Thanks Fred Gardner
Truth and good sense are refreshing. Tell it all brother, one article at a time. I wish you would get your own Walters puppet and program some of his biggest lies like "Marijuana is a dangerous drug" and the SOL of "Marijuana has no medical value" and carry on a debate on stage or online. Walters lies when he calls for a real debate and you do not need the real puppet when you can have a real wooden puppet move its mouth and lie at the same time.Anyway, Fred is the man. He could get rich stabbing prohition in public and those that call for on with failure.
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