Surgeon General’s Marijuana Warning Omits Crucial Context

Shefali Luthra, Kaiser Health News

Speaking a few current federal advisory on marijuana, Dr. Jerome Adams, the surgeon common, put a new spin on long-standing admonitions concerning the drug.

“Marijuana has a unique impact on the developing brain. It can prime your brain for addiction to other substances,” Adams stated at a Washington, D.C., substance abuse convention held late in August and sponsored by Oxford House, a restoration middle community.

This is a reiteration of the outdated “gateway” argument: the concept that marijuana is incessantly an entree to utilizing different, more durable medicine. And the surgeon common’s emphasis comes simply as many states are loosening restrictions round its medicinal and grownup leisure use.

But marijuana analysis is restricted, and this explicit speculation is pretty controversial. We determined to place Adams’ declare to the take a look at. Is his central thesis ⁠— marijuana has a “unique impact” on creating brains and might “prime your brain for addiction” ⁠— correct?

We contacted the surgeon common’s workplace, which directed us to statements from the National Institute on Drug Abuse. NIDA famous that marijuana could have a gateway impact, however that most individuals who use the drug don’t progress to different, more durable substances; and that alcohol and nicotine seem to have the same influence. But the surgeon common’s workplace was additionally unequivocal on a associated level: “From a public health perspective, no amount of drug use is safe for the developing brain.”

So how truthful is Adams’ assertion? When we interviewed specialists, the responses had been all around the map ⁠— reflecting simply how contested this challenge is and the way troublesome it’s to talk definitively about marijuana’s influence.

The Gateway Effect?

The concept that marijuana can “prime your brain for addiction” has some foundation: specifically, the outcomes of some research performed with rodents.

There are findings to counsel that early publicity to the drug could “sensitize animals to the effects of other drugs,” famous Joshua Isen, an assistant professor on the University of South Alabama, who researches adolescent marijuana use.

For occasion, Adams’ workplace famous that preclinical research point out publicity to THC ⁠— marijuana’s major psychoactive compound ⁠— throughout a interval roughly equal to adolescence in rats resulted in better self-administration of heroin when the animals attain maturity.

In addition, THC publicity yielded modifications of their brains’ reward system ⁠— in different phrases, sure, priming the mind for the rewarding results of opioids.

But, Isen stated, it’s scientifically problematic to attract a line from the consequences seen in rodents to what may occur to a human. Ethical concerns about human analysis make it kind of not possible to do a randomized managed trial ⁠— the gold customary of scientific analysis ⁠— that might measure how marijuana does or doesn’t have an effect on a creating mind.

“We should remain agnostic about the surgeon general’s claim,” Isen argued.

Other specialists recommended in any other case, saying that since animal analysis is one of the best we will get, it’s price taking severely ⁠— and it’s pretty conclusive.

Jonathan Caulkins, a professor and drug coverage researcher at Carnegie Mellon University in Pittsburgh, took a extra optimistic view of that analysis, arguing that the animal proof is “very clear” in relation to marijuana’s neurological influence. He known as it a good foundation for the surgeon common’s warning.

“What we know is strong enough to say that exposure during adolescence when the brain is developing is a risk,” stated Susan Weiss, a scientific adviser to the NIDA director.

But how significant a danger ⁠— and the way it compares with different medicine ⁠— is exceptionally powerful to say, given the constraints on analysis. Studies on people are restricted as a result of individuals who use marijuana at a younger age could also be uncovered to different danger components, corresponding to peer influencers utilizing more durable medicine, or sociodemographic components which may predispose them to abuse or habit.

As Dr. Sue Sisley, an Arizona-based psychiatrist who tracks the state of marijuana analysis, put it: “I don’t see very much good, rigorous data to confirm either way.”

What About Uniqueness?

In the narrowest sense, marijuana certainly has a “unique” impact on the mind. It elicits a response from what are known as “endocannabinoid receptors.” Other medicine don’t ⁠— they work together with completely different mind receptors. So, actually, marijuana impacts growth utilizing a special (or “unique”) neurological mechanism from those utilized by, say, nicotine or alcohol.

And, as finest as science can inform us, marijuana harms creating brains, each Weiss and Sisley stated. From a commonsense public well being perspective, younger folks particularly needs to be exceptionally cautious when utilizing the drug.

But ⁠— and that is vital context ⁠— marijuana isn’t the one substance that has this potential “priming” for subsequent habit. The surgeon common’s workplace acknowledged this discovering after we requested follow-up questions. That identical context, although, is lacking from Adams’ public assertion.

“It seems that early exposure to many substances can make it likely someone will be addicted to other substances,” Weiss stated. She acknowledged that rodent research do additionally counsel nicotine could have a priming impact, albeit by way of a special neurological route.

On a sensible stage, Isen stated, whereas one may spotlight the distinct scientific impact marijuana has, “there is no evidence that marijuana has a uniquely deleterious effect on the developing brain — certainly not more than other substances such as alcohol.”

Our Ruling

Speaking concerning the dangers related to marijuana, the surgeon common stated it “has a unique impact on the developing brain” and “can prime your brain for addiction to other substances.”

The implications are difficult, and it’s vital to notice the numerous limitations on marijuana analysis, in addition to the way it compares with different medicine. It could have its personal, distinctive mechanism of “priming” grownup habit.

Still, different substances have comparable results ⁠— even when they take a special mind path to get there. And since this concept about marijuana’s priming impact is central to Adams’ broader public well being marketing campaign, emphasizing that nicotine and alcohol additionally may perform on this method issues much more.

This assertion is partially correct, but it surely leaves out vital particulars and context. We price it Half True.

Kaiser Health News (KHN) is a nationwide well being coverage information service. It is an editorially impartial program of the Henry J. Kaiser Family Foundation which isn’t affiliated with Kaiser Permanente.

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