JAMA: Long-Term Exposure To Cannabis Smoke Is Not Associated With Adverse Effects On Pulmonary Function

Exposure to cannabis smoke, even over the long-term, is not associated with adverse effects on pulmonary function. That’s the conclusion of a major clinical trial published today in the prestigious Journal of the American Medical Association (JAMA).

Investigators at the University of California, San Francisco analyzed the association between marijuana exposure and pulmonary function over a 20 year period in a cohort of 5,115 men and women in four US cities.

Predictably, researchers “confirmed the expected reductions in FEV1 (forced expiratory volume in the first second of expiration) and FVC (forced vital capacity)” in tobacco smokers. By contrast, “Marijuana use was associated with higher FEV1 and FVC at the low levels of exposure typical for most marijuana users. With up to 7 joint-years of lifetime exposure (eg, 1 joint/d for 7 years or 1 joint/wk for 49 years), we found no evidence that increasing exposure to marijuana adversely affects pulmonary function.”

The study concludes, “Our findings suggest that occasional use of marijuana … may not be associated with adverse consequences on pulmonary function.”

To those familiar with the science of cannabis, JAMA’s findings should come as no great surprise. They are consistent with previous findings reporting no significant decrease in pulmonary function associated with moderate cannabis smoke exposure. For instance, according to a 2007 literature review conducted by researchers at the Yale University School of Medicine and published in the Archives of Internal Medicine (and summarized by NORML here), cannabis smoke exposure is not associated airflow obstruction (emphysema), as measured by airway hyperreactivity, forced expiratory volume, or other measures.

Further, in 2006, the results of the largest case-controlled study ever to investigate the respiratory effects of marijuana smoking reported that cannabis use was not associated with lung-related cancers, even among subjects who reported smoking more than 22,000 joints over their lifetime. (Read NORML’s summary of this study here.)

“We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use,” the study’s lead researcher, Dr. Donald Tashkin of the University of California at Los Angeles stated. “What we found instead was no association at all, and even a suggestion of some protective effect” among marijuana smokers who had lower incidences of cancer compared to non-users.

A previous 1997 retrospective cohort study consisting of 64,855 examinees in the Kaiser Permanente multiphasic health checkup in San Francisco and Oakland also reported, “[E]ver- and current use of marijuana were not associated with increased risk of cancer … of the following sites: colorectal, lung, melanoma, prostate, breast, cervix.”

Separate studies of cannabis smoke and pulmonary function have indicated that chronic exposure may be associated with an increased risk of certain respiratory complications, including cough, bronchitis, phlegm. However, the ingestion of cannabis via alternative methods such as edibles, liquid tinctures, or via vaporization — a process whereby the plant’s cannabinoids are heated to the point of vaporization but below the point of combustion –- virtually eliminates consumers’ exposure to such unwanted risk factors and has been determined to be a ‘safe and effective’ method of ingestion in clinical trial settings.

Oh The Irony (Part II): Obama The Home Brewer

Oh to be governed…by hypocrites.

Last week the nation watched President Obama bestow a rarely presented Medal of Honor to former Marine Sgt. Dakota Meyer. News reports indicate Mr. Meyer requested to have a beer the night before with his former commander-in-chief before the formal ceremonies.

The two men were in fact widely photographed enjoying a beer on the White House back porch.

Where did the beer the two men consume come from?

The same news reports reveal that our President has become the first ever home brew resident of the White House, brewing a “White House Honey Blonde Ale”.

Is it not painfully ironic to the point of disgust that the President of these United States of America–an occasional tobacco consumer and home brewer–along with the Speaker of the House John Boehner (a well-known tobacco and alcohol consumer), can responsibly engage in these adult-oriented activities, while at the same time providing ample public resources and rhetoric for continuing the nation’s farcical and long-suffering Cannabis Prohibition (74 years as of October 2nd!)?

Next time you hear one of these two elected policy makers spout off about being ‘anti-drug’ and not being in favor of cannabis law reforms…just remember that both men are just selective Prohibitionists…and hypocrites.

Really! Who wants to be governed by hypocrites who possess this ‘Good for Me, but not for Thee’ mentality?

Oh The Irony: Speaker Of The House John Boehner Continues To Support Marijuana Prohibition

Unlike Tennessee Congressman Steve Cohen (who favors America having a fair and constitutionally consistent cannabis policy…), the current Speaker of the House of Representatives, John Boehner, simply does not get how hypocritical he is by favoring another 74 years of the failed federal Cannabis Prohibition, while at the same time, being a frequent consumer (and longtime political ally) of far more dangerous and deadly drugs like alcohol and tobacco.

A NORML supporter from Ohio named Todd recently used NORML’s webpage to contact his elected representative in Congress, who just so happens to be the Speaker of the House John Boehner, to encourage him to become a co-sponsor of the Ron Paul/Barney Frank bill to allow states to legalize cannabis for responsible adult use.

What Todd did was exactly what tens of thousands of other like-minded NORML supporters have done since late June, when H.R. 2306 was introduced: they contacted their member of Congress and asked them to support the passage of H.R. 2306.

What cannabis reformers and consumers really need to do now is to send hundreds of thousands of letters and emails to their members of Congress, and to, like Todd, not take ‘no’ for an answer, especially from hypocrites like Speaker Boehner, who maybe one of the capital’s most notorious tobacco addicts and consumer of hard liquor.

Roll Call photo from a Sept. 2010 event capturing then Minority Leader John Boehner using society's most deadly and addictive drug: Tobacco

Last October at a fancy Washington restaurant in a section of town called ‘Barracks Row’, a week or so before his ascendency to the Speakership of the House, High Times’ associate publisher Rick Cusick and I watched Mr. Boehner (and five or six of his fellow Republican colleagues from the House, and one from the Senate) continuously leave their table–after rounds of shot glasses of hard liquor were consumed–to stand out in front of the establishment in a circle to smoke cigarettes. We witnessed this kind of excessive ‘drug’ consumption from Congressional leaders for over two hours.

Mr. Boehner, the son of a bar owner in Ohio, needs to get real and quick regarding losing his Reefer Madness about cannabis and to start treating cannabis consumers with the same respect and dignity that he wants afforded to him as a tobacco and alcohol consumer.

If not, then, based on his unscientific and non-sensible reply to his constituent in Ohio found below, the man should 1.) stop buying and consuming clearly deadly and dangerous drugs like hard booze and cigarettes and 2.) pass federal laws banning these unhealthy and unsafe products from people who’d be foolish enough to consume them.

NORML thanks ‘Todd’ from Ohio for being a stand up cannabis law reformer who is not keen to be governed by a hypocrite (who would have him consume drugs much, much less safe—and toxic—than cannabis. Just like him….).

Boehner writes below: “I am unalterably opposed to the legalization of marijuana or any other FDA Schedule I drug.  I remain concerned that legalization will result in increased abuse of all varieties of drugs, including alcohol.”

Maybe the Speaker of the House is speaking for himself here as both the science and my own personal experience is crystal clear here: When adults consume cannabis products they consume less—or no—alcohol products.

I, for one, have always publicly acknowledged that I consume far less alcohol (and don’t binge drink at all) if I have access to cannabis products.

Further, in the twenty years I’ve worked at NORML and convening dozens of major pro-reform conferences, fundraising parties and events I’ve watched bar managers, restaurant owners and hotel catering managers from coast-to-coast do major double and triple takes on our alcohol consumption bills, insisting that there must be some kind of billing error. When, in fact, if 500 cannabis consumers are attending a NORML soiree, we as a group consume 50%-75% less alcohol than similar size events.

At a large and famous San Francisco waterfront restaurant that hosted a NORML event a few years back, when I went into the manager’s office at the end of the night to settle the final bill and remit payment, he too was flabbergasted at the dearth of our large group’s alcohol consumption tab and wryly remarked to me: “No wonder ya’ll can’t get pot legalized, because, you’ll cut too deeply into the alcohol industry’s bottom line.”

Please join Todd and tens of thousands of other citizens who do not support Cannabis Prohibition anymore by contacting your member of Congress and insist that they co-sponsor H.R. 2306.

The process to lobby your member of Congress is easy, free and necessary to finally—and once and for all—end Cannabis Prohibition in America.

Wed, Aug 24, 2011 at 1:19 PM, Congressman John Boehner wrote:

Dear Todd:

Thank you for contacting me regarding the legalization of marijuana.  I appreciate hearing from you.

On June 23, 2011, Representative Barney Frank (D-MA) introduced H.R. 2306, the Ending Federal Marijuana Prohibition Act of 2011.  H.R. 2306 would remove marijuana from Schedule I of the Controlled Substances Act to provide states with jurisdiction in the regulation of marijuana.  H.R. 2306 has been referred to the House Committees on the Judiciary and Energy and Commerce for consideration.

According to the Office of National Drug Control Policy (ONDCP), “research shows that marijuana use in its raw form is harmful and its average potency has tripled in the past 20 years.”  ONDCP goes on to say that “studies also show teens are using the drug at earlier ages and the earlier a person begins to use drugs, the more likely they are to progress to more serious abuse and addiction.”  In addition, the Department of Health and Human Services stated that “marijuana dependence in the U.S. population is higher than that for any other illicit drug and over 150,000 people who showed up voluntarily at treatment facilities in 2009 reported marijuana as their primary substance of abuse.”

As you know, the Food and Drug Administration (FDA) has classified marijuana, together with heroin, LSD, methamphetamines, hashish, and a number of other drugs as Schedule I drugs.  According to the FDA, these drugs carry a high potential for dangerous abuse.  To date, no clinical study of marijuana has progressed to the level required for approval by the FDA.  Even more, the Department of Justice has reiterated its intent to enforce the Controlled Substances Act in states who have legalized marijuana for medicinal purposes.

I am unalterably opposed to the legalization of marijuana or any other FDA Schedule I drug.  I remain concerned that legalization will result in increased abuse of all varieties of drugs, including alcohol.

Thank you again for contacting me with your thoughts.  Please don’t hesitate to inform me of your concerns in the future.  To sign up for email updates, I invite you to visit my website at http://johnboehner.house.gov.

Sincerely,

John A. Boehner

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Dear John Boehner,

Wow thats a mouthful did someone write that for you.  Your seriously trying to tell me that marijuana is as harmful as lsd, crack, methamphetamines, cocaine,legal sildenafil,merinol and other “chemicals” when marijuana is a plant which is nearly impossible to overdose. You sir are uninformed as are most of our “representatives”, who, are supposed to represent the interest of the people, but end up representing their own interests entirely. I would think that given our current economic crisis, it would be ideal to look objectively at every opportunity to decrease frivolous spending, and increase revenue. By legalizing and taxing marijuana on a federal level, the taxes alone are estimated at billions of dollars annually. Given the annual cost of the failed war on drugs and incarcerated nonviolent marijuana users, the annual savings plus revenue could reach in the hundreds of billions of dollarsNot to mention the tens of thousands of jobs legalizing marijuana would create. This is common sense knowledge and neither you nor the “F.D.A.” can tell me otherwise.

As for your statement ” I remain concerned that legalization will result in increased abuse of all varieties of drugs, including alcohol.” Please elaborate as I do not understand how the legalization and regulation of marijuana on a federal level, will result in increased abuse of other drugs and alcohol. Regulating marijuana will not only decrease it’s availability on the black market, but will also decrease its value, therefore being less available, and of less interest, to teens and other underage people.

On the subject of the Department of Health and Human Services statement that “marijuana dependence in the U.S. population is higher than that for any other illicit drug and over 150,000 people who showed up voluntarily at treatment facilities in 2009 reported marijuana as their primary substance of abuse.” What this statement does not tell you is that roughly 97% of these 150,000 people “voluntarily” showed up because they were given an ultimatum by the courts when found in possesion of marijuana, rather than face probation, or even worse, jail time.

How about the statement made by Francis Young, the D.E.A.s’ own judge, ”Marijuana in it’s natural form, is one of the safest therapeutically active substances known to man.”  If marijuana is considered a schedule I narcotic with no medicinal benefits, why do we have Marinol, the  synthetic form of T.H.C. (tetrahydrocannabinol), the main psycoactive substance found in marijuana?.  And why is the “chemical” Marinol a schedule III drug, meaning it is considered to be non-narcotic and to have a low risk of physical or mental dependence, when it is another form of T.H.C.?. There has never been a documented human fatality from overdosing on tetrahydrocannabinol or cannabis in its natural form. However, the synthetic T.H.C. pill Marinol was cited by the FDA as being responsible for 4 of the 11,687 deaths from 17 different FDA approved drugs between January 1, 1997 to June 30, 2005.

I would appreciate a personal response from you, rather than one of your pre-writen responses. Thank you for your time.

Sincerely,

Todd

Drug Czar’s Office To NORML: ‘We Can’t Legalize Marijuana Because Some People Abuse Prescription Drugs!’ Wait, Huh?

“First they ignore you, then they laugh at you, then they fight you, then you win.”
– Mahatma Gandhi

What can I say? I’m flattered. David Mineta, deputy director for demand reduction in the Office of National Drug Control Policy, has taken time to publicly respond to little ol’ me. I wonder if they pronounce ‘Armentano’ phonetically at the Drug Czar’s office?

The back story: Last week NORML Board member Paul Kuhn and I published a guest commentary in Nashville’s largest daily newspaper, The Tennessean, opining in favor of H.R. 2306, the ‘Ending Federal Marijuana Prohibition Act of 2011. Here’s an excerpt:

Marijuana legalization bill offers safer alternative
via The Tennessean

We know tobacco is the leading cause of death in America, contributing to 400,000 deaths each year. So it’s hardly any wonder the FDA will require the placement of prominent warning labels. Alcohol is the third-leading cause of death in America. The World Health Organization reported earlier this year that “alcohol causes nearly 4 percent of deaths worldwide, more than AIDS, tuberculosis or violence.”

… What about marijuana? With every other drug from Advil and alcohol to Zantac, a correct dose is effective, but too high a dose kills the patient. No dose of marijuana is capable of causing a fatal overdose.

… And unlike alcohol and tobacco, adverse effects of even heavy cannabis use are minimal. There is no epidemiological evidence in any country, after scores of studies and centuries of use by tens of millions of people, that marijuana smokers have a shorter life expectancy than non-smokers.

… They don’t become violent at sports events or beat their spouses and children. They don’t get heart disease, cancer, brain damage or any other deadly illness at a higher rate than those who abstain. In fact, a pair of studies conducted by Kaiser Permanente found that marijuana use, even long-term, was not associated with elevated levels of mortality or incidences of cancer, including types of cancers associated with tobacco smoking.

… America is on a path to allow adults to choose a safer alternative to tobacco and alcohol. And create more tax revenue and more jobs in Tennessee. And more freedom.

Apparently quite a few people read our editorial, including some folks at the Drug Czar’s office. And it must have gotten under their skin because today the White House responded with this.

Movement for legalized marijuana ignores dangers
via The Tennessean

Proponents of marijuana legalization often argue it will do everything from fixing our economy to ending violent crime (“Marijuana legalization bill offers safer alternative,” Tennessee Voices, Aug. 15). Yet, the science is clear: Marijuana use is not a benign drug and it is harmful to public health and safety.

… Would marijuana legalization make Tennessee healthier or safer? One needs to look no further than Tennessee’s current painful experience with prescription drug abuse. In Tennessee, prescription drugs are legal, regulated, and taxed — and yet rates of the abuse of pain relievers in the state exceed the national average by more than 10 percent.

Nationally, someone dies from an unintentional drug overdose — driven in large part by prescription drug abuse — on average every 19 minutes. What would America look like if we had just as many people using marijuana as we currently have smoking cigarettes, abusing alcohol, and abusing prescription drugs?

The classic ‘bait-and-switch’ goes on and on, but you get the idea. But I’m not sure the Drug Czar’s office does. After all, if their logic above had even a hint of consistency then they would be arguing for the criminal prohibition of cigarettes, alcohol, and prescription drugs. And lots of other things.

Yet when it comes to Americans’ use of substances like tobacco, booze, and prescription drugs — substances that pose far greater dangers to health than does cannabis — the White House recognizes that prohibition is not the answer: regulation and education are. So why does the Drug Czar’s office fail to apply this same common-sense principle to pot? Perhaps it has something to do with the federal requirement requiring the office to lie about legalization.

Finally, as to the specific question: ‘What would America look like if we had just as many people using marijuana as are presently using tobacco, alcohol, and prescription medications?’ Well, what does America look like today? After all, the federal government imposed criminal prohibition over 70 years ago; yet today that very same federal government admits that over one out of ten Americans admit to having using cannabis in the past year. Among those age 18 to 25, almost half admit to consuming cannabis recently!

The question isn’t ‘What if Americans consumed marijuana?’ The reality is that tens of millions of Americans have and do consume marijuana. Most do so privately and responsibly. Legalizing cannabis simply acknowledges this reality and seeks to regulate the behavior appropriately. In a free society, why would even consider doing differently?

L.A. Times: Some Facts For The Drug Czar — Marijuana’s Social Costs Are Far Less Than Those Of Legal Intoxicants

Last week I posted a brief response to the Los Angeles Times commentary authored by Drug Czar Gil Kerlikowske (along with five previous drug czars) condemning California’s Prop. 19.

Today the Los Angeles Times has posted my full rebuttal, which I’ve excerpted below.

Some marijuana tax revenue is better than none
via The Los Angeles Times

… Kerlikowske’s opposition to Proposition 19 … is a fairly common one. Kerlikowske et al argue that, if legalized, marijuana’s perceived social costs would outweigh the economic benefits reaped by regulation. They base this allegation largely on the premise that present taxes on alcohol and cigarettes fail to adequately pay for the societal costs associated with those drugs’ use and abuse. True enough, but here’s why this sound bite is irrelevant to the present marijuana debate.

Marijuana is safer than alcohol.

Alcohol is toxic to healthy cells and organs, a side effect that results directly in about 35,000 deaths a year. … By contrast, the active compounds in marijuana … are remarkably non-toxic. Unlike alcohol, marijuana is incapable of causing a fatal overdose, and its use is inversely associated with aggression and injury. In fact, the recently released Rand Corp. report found that in 2008, there were fewer than 200 “admissions to hospitals in which marijuana abuse or dependence was listed as the primary reason for the hospitalization.” By comparison, there are more than 70,000 hospitalizations in California annually related to the use of alcohol.

Marijuana is far safer than tobacco.

According to a 2009 report by the Canadian Centre on Substance Abuse, health-related costs per user are eight times higher for drinkers than they are for those who use cannabis, and are more than 40 times higher for tobacco smokers. It states: “In terms of (health-related) costs per user: tobacco-related health costs are over $800 per user, alcohol-related health costs are much lower at $165 per user, and cannabis-related health costs are the lowest at $20 per user.”

Some tax revenue is better than no tax revenue.

According to a 2007 George Mason University study, U.S. citizens each year spend about $113 billion on marijuana. Under prohibition, all of this spending is directed toward an underground economy and goes untaxed. That means state and local governments are presently collecting zero dollars to offset societal and health costs related to recreational marijuana use. Therefore, the imposition of any retail tax or excise fee would be an improvement over the current situation.

In short, the drug czars’ assessment that present taxes on alcohol and tobacco — two deadly products — do not raise sufficient funding to offset their related social costs is not an argument in favor of maintaining the status quo, particularly when one recognizes that the social and health costs related to cannabis use are far less than those associated with the use of other intoxicants.

You can read my full commentary here. (You can also comment on it here.)