Since THC is the main psychoactive ingredient of marijuana, what risks would get carried over from direct pot usage, if one could use Marinol to get high?
This is a much more reasonable proposition. That said, the absence of evidence on your part does not constitute evidence of absence in the main. If one conducts a comprehensive literature review and possesses the requisite analytical savvy, it is quite possible to determine the “reasonableness” of a particular set of conclusions derived from a study. I would add that the researchers you implicitly cite are likely not a monolithic group of Puritans and messianic types with a conservative agenda. Researchers frequently conduct research on controversial matters. Sound methology coupled with good research administration help ensure accurate findings.
While I “tip my hat to your inelegant strawman” (to borrow your phrase) nobody is claiming, implicitly or explicitly, that any group of researchers is monolothic, puritanical or messianic (whatever that means).
I’m not going to try to speak for zabrain and Gyan9, but what I read them to claim, and what I certainly claim, is that it is difficult to get reasonable information about the health risks and benefits of marijuana, given the substantial interests–in the Federal Government and elsewhere–who are dead set against it, and quite intent–again in my view–in simply spreading propaganda.
One can hardly take issue with the abstract proposition that “Sound methodology coupled with good research administration help ensure accurate findings” but that is not the issue. The issue is that the standard scientific process in this case faces the significant obstacle of a federal government that has already decided what it wants to hear.
Define “reasonable information,” “elsewhere,” “substantial interests” and “propaganda.”
True, and the general public possesses neither the inclination nor the talent to do the above. They have to decide by proxy.
Their sources of information include:
[ul]
[li]Firsthand experience of causal or chronic use of marijuana. This creates the unfortunate tendency to designate their experience (of both kinds) as the norm.[/li][li]Ads in the print media and on the television/radio. These ads include those that say “I’m not only a hero, I’m a good mom” with regards to a mom who grounds her pot-smoking son. And ads that depict a girl getting pregnant superimposed with the fact that she smoked pot. So far, I haven’t seen any national ad campaign that highlights the Lancet editorial that moderate marijuana use is less harmful than alcohol or tobacco or similar viewpoints. In fact, although most of the wires in Europe picked that story up, none of the major American media outlets did.[/li][li]Anecdotal information obtained via gossip, mostly propagated by non-smokers or inexperienced smokers.[/li][li]The Internet. You have essentially 6 sources of information.[/li][ol]
[li]Government and government sponsored organizations. DEA, NIDA (pot page)…[/li][li]NGOs like freevibe.com (Pot)[/li][li]Pro legalization sites like marijuana.com [/li][li]Sites that purport to give balanced information like Erowid and Lycaeum[/li][li]Internet media presence of newspapers and networks like CNN, BBC, Fox…etc[/li][li]Scientific journals and the like.[/li][/ul]
Students in most schools are directed towards sources 1,2,5 above. They may stumble upon 3,4 but then will be in conflict. The vast majority of people don’t have access, inclination or ability to use 6. 1 and 2 have already decided that all drug use is abuse. Their information doesn’t categorize drug effects by dosage and the physical and mental constitution of the user, unlike ads for prescription drugs. Drug effects are implicitly presented as uniform and non-discriminatory with no context of dosage or relevant environmental factors included. 3 has an agenda on the other side, and their information is likely to be colored. 4 doesn’t openly advocate drug use. Their information appears to be balanced. Lay readers have to make a judgement. 5, in the US, generally tends to go along with 1. Most of them are big corporations catering to the mainstream population. It takes a courageous (and perhaps stupid) editorial team to approve any explicitly pro-drugs reporting, especially near the front pages.
[/ol]
So, for the vast majority of people, information that can be categorized as unbiased is almost impossible to come by.
Forget vasodilation or whatever. This is about parental vehicles pulling into the driveway while user is stoned.
Hey Qadgop the Mercotan,
I’m sorry, but this:
is a typical MD response. How can you make such a statement based on a single observational study? Based on this, I conclude that marijuana causes no ill effects on the human body. Is that a ridiculous statement? Yes it is. The real answer is this: we do not know whether the smoking of marijuana increases one’s risk of myocardial infarction.
-Apoptosis
Let’s not start up the MD vs. Ph.D. pissing contests, shall we? The last said contest resulted in a banning.
My statement was meant to indicate that said study shows a link. Do I believe that smoking (of anything) can precipitate an MI? Yes, I do. Is the data 100% conclusive? No, it’s not. But given the weight of data also available on the physiological effects of inhaling smoke from many other burning sources, I think it should be paid attention to.
If we wait until it is 100% proven that there is a link before advising our patients, we will be withholding such recommendations as: getting smokers out of the house where asthmatic children live, eliminating alcohol from the diets of individuals with active hepatitis C, and advising diabetics to shoot for ‘tight’ glucose control. In each of those cases, we have theoretical models as to why such recommendations would be valid, and we have data both for and against, with the preponderance of data being for it.
Do you actually think that when I tell my patients “I believe that the smoking of marijuana increases the risk of acute myocardial infarction” that I am making a ridiculous statement? If so, I hope you’re not in patient care.
Hey Qadgop the Mercotan:
I have not stated whether I am an MD or a Ph.D. I was simply stating my belief that many physicians are woefully ignorant as to the molecular causes of disease, and are willing to accept any data that gets thrust into their faces.
This answer to this question (the OP’s):
is “true.”
The answer to this question: “Does the smoking of marijuana increase the risk of myocardial infarction”, is not:
The answer is: “We don’t know.”
-Apoptosis
Yes there’s crap data, crap studies, and lots of physicians who wouldn’t know how to tell whether the data represents diamonds or dog dirt.
And I concede that I should have typed my quote as “yes, according to the data in this study marijuana smoking does increase the risk of acute infarction”. Knowing what I do about coronary pathophysiology, the results don’t surprise me at all. So the study either supports my well thought out conclusions, or props up my inherent biases.
But what will you advise a patient, then? As I stated much earlier in the thread, I am concerned about the 55 year old sedentary hypertensive with elevated lipids. He’s a prime candidate for a 70+% coronary lesion which has been thus far asymptomatic. Now he contemplates taking his first bong hit in 6 years, and asks me if it’s safe. With the above data combined with my own knowledge (biases), I’d tell him “no, I don’t believe it’s safe”.
Will you tell him “We don’t know”?
Ok, my first impression is to say that’s a load of bull.
Nicotine is a vaso-constrictor, that is it causes blood vessels to contract. This raises blood pressure and reduces blood flow to the extremities. That’s why a lot of cigarette smokers have cold hands and feet.
THC on the other hand is a vaso-dilator. It relaxes the blood vessels and lowers blood pressure. That’s one of the reasons that smoking pot helps chemo patients keep food down. Increased blood flow to the stomach helps with digestion and increases appetite. It also lowers intra-ocular pressure. The pressure inside the eyeball, that’s why it’s such an effective treatement for glaucoma.
That said, taking anything into your lungs is a risk, in certain cities that includes the outdoor air. I doubt the validity of any study done in the US frankly. And I don’t think smoking a joint is going to precipitate a heart attack any faster than half a hundred other unhealthy things people do.
Hey Qadgop the Mercotan:
OK- I appreciate a good loaded question as much as the next guy, so I’ll answer it. “There is insufficient evidence in the literature to suggest that taking a bong hit will increase your chance of a heart attack. However, I doubt it would be good for you. I’d also recommend you avoid hyperventilating (or something else for which insufficient myocardially-related data exists).”
Strawman.
I can appreciate your stance. However, I like to keep an open mind about these things. The literature is replete with data that were acquired when the investigators were expecting opposite results.
-Apoptosis
Point taken, Apop. Gods know we’ve had egg on our face before, a la the issue of estrogen and cardiac disease. Still, I expect that the data will one day show that there is a small but significant risk increase for select patients on this issue. Frankly, unless the data demonstrates convincingly its not only safe but beneficial, I’ll advise my patients to steer clear. I just won’t speak ex cathedra, but rather ex gluteus.
And wheel, as I stated earlier in this thread,
And limited studies have shown both hypertensive and hypotensive responses to marijuana smoking. But given your statement above
I see no purpose in batting the issue around further.
Hey QtM:
Agreed. Re-reading my posts in this thread, I applaud you in your restraint in dealing with me. I swear I am not this confrontational in real life!
-Apoptosis
I knew those restraints I brought home from work would come in handy. 
As reported recently,
“Marijuana use associated with increased risk of stroke, heart failure”
Interesting…
I’d also like to note that QtM was all over this 14 years ago. Nice job.
I had a strain one time ( I am a very moderate user 1/4oz per year) that would give me severe arrhythmia, my heart would beat twice and then roll over in my chest. This would last for almost exactly 72 hours after I stopped using it. I am only talking 2 or 3 hits. Just to verify it was actually the pot I tried it 5 or 6 times over a period of months and each time the same result. So there was no doubt.
Well, Qadgop speculates upthread, 14 years ago, that the cause might be toxins in the smoke and not the pot directly. Have you tried edibles, in this glorious year 2017 where MJ can be bought at fine retailers near you*?
*not available in less progressive states
I don’t care for edibles. lately I haven’t experienced too many side effects. I have nervous twitch in my face that seems aggravated by pot it tends to act up not so much when smoking but up to two weeks after smoking before it subsides. Tiny cluster headaches about the size of a silver dollar are my most common side effect. These usually subside within 2 days of smoking that particular strain that gave me the headache.