M***D
发帖数: 249 | 1 Yesterday on 12/06/2012, recreational use of marijuana became legal in
Washington State. And in 01/2013, recreational use of marijuana will become
legal in Colorado. The Washington post reports that Marijuana legalization
in these two states complicates drug-free work policies. While as doctors, I
bet many of us have seen patients who smoke pot, good pot or bad pot, this
is the question.
Good pot: On 07/23/2012, a paper titled “Cognitive and clinical outcomes
with cannabis use patients with bipolar I disorder”, there was a general
pattern of superior cognitive functioning in the group with a history of
cannabis abuse. These patients performed better than their drug-free cohort
on all significant measures, such as processing speed, attention and working
memory.
Bad pot: It affects the intelligence, memory, respiratory functions and may
cause mental disorders such as schizophrenia, psychosis, depersonalization
and depression. On 07/30/2012, a 35-year study funded by NIH/ NIDA and
published on PNAS found that “Persistent cannabis users show
neuropsychological decline from childhood to midlife”. Abusing marijuana
before age 18 harms the user's intelligence, attention and memory. Quit
smoking marijuana did not reverse the loss. But people who started using
marijuana after age of 18 did not show similar declines.
So for adult bipolar disorder patients, smoking pot will be therapeutic;
while for people younger than 18, smoking pot will put themselves on the
fast track to bipolar disorder? What if the patients lie about their age or
use fake photo IDs in order to get pot?
It is getting complicated... | A*******s
发帖数: 9638 | | M***D
发帖数: 249 | 3 In short term, maybe legalization of marijuana will make a huge kick for
economics. However, considering how vulnerable the adolescent brains are,
will the money made from marijuana be enough to cover the medical and mental
health problems caused by it in long term?
I still remember one teenage boy who I saw at the ER. It took 10 people
including doctors, medical students, nurses and one EKG male tech to finally
held him down in order to prevent him from running out of ER into the
traffic. He smoked weed laced with PCP for the FIRST time.
【在 A*******s 的大作中提到】
: Money talks these days.
| a*****2
发帖数: 308 | 4 not in the presidential election, sir.
【在 A*******s 的大作中提到】
: Money talks these days.
| A*******s
发帖数: 9638 | 5 How about ETOH?
mental
finally
【在 M***D 的大作中提到】
: In short term, maybe legalization of marijuana will make a huge kick for
: economics. However, considering how vulnerable the adolescent brains are,
: will the money made from marijuana be enough to cover the medical and mental
: health problems caused by it in long term?
: I still remember one teenage boy who I saw at the ER. It took 10 people
: including doctors, medical students, nurses and one EKG male tech to finally
: held him down in order to prevent him from running out of ER into the
: traffic. He smoked weed laced with PCP for the FIRST time.
| M***D
发帖数: 249 | 6 A++, your point is well taken. I guess we all have our own share of PTSDs
from treating certain very ill patients. Like I cannot forget the marijuana
and PCP intoxicated teenager patient, I guess you have flashbacks of your
alcoholic patient who recently died from hyponatremia and central pontine
myelinolysis.
For the sake of prognosis, I think patients with alcohol abuse may have
better chances to get their lives straight again if they can stay sober and
receive successful liver transplants. However, according to above PNAS paper
, abusing marijuana before age 18 harms the user’s intelligence, attention
and memory, and more importantly quit smoking marijuana did not reverse the
loss. So if teenager patients lost their mind from smoking marijuana, we
cannot surgically fix their irreversible neurological deficits because we
are not able to do brain transplants yet :)
【在 A*******s 的大作中提到】
: How about ETOH?
:
: mental
: finally
| A*******s
发帖数: 9638 | 7 I just can't help thinking about ETOH when you mentioned the pot.
I oppose any sort of habit forming substances except caffeine with
reservation. I hate ETOH which causes too many social problems. Now comes
marijuana, more social problems I predict.
They can set up an age limit but what happens to ETOH will be the same to
marijuana.
marijuana
and
paper
attention
the
【在 M***D 的大作中提到】
: A++, your point is well taken. I guess we all have our own share of PTSDs
: from treating certain very ill patients. Like I cannot forget the marijuana
: and PCP intoxicated teenager patient, I guess you have flashbacks of your
: alcoholic patient who recently died from hyponatremia and central pontine
: myelinolysis.
: For the sake of prognosis, I think patients with alcohol abuse may have
: better chances to get their lives straight again if they can stay sober and
: receive successful liver transplants. However, according to above PNAS paper
: , abusing marijuana before age 18 harms the user’s intelligence, attention
: and memory, and more importantly quit smoking marijuana did not reverse the
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