I recently finished my residency in emergency medicine and began to practice in Pueblo, Colorado. I grew up there, and I was excited to return home. However, when I returned home, the Pueblo I once knew had drastically changed. Where there were once hardware stores, animal feed shops, and homes along dotted farms, I now found marijuana shops—and lots of them. As of January 2016, there were 424 retail marijuana stores in Colorado compared with 202 McDonald’s restaurants.1
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ACEP Now: Vol 36 – No 05 – May 2017These stores are not selling the marijuana I had seen in high school. Multiple different types of patients are coming into the emergency department with a variety of unexpected problems such as marijuana-induced psychosis, dependence, burn injuries, increased abuse of other drugs, increased homelessness and its associated problems, and self-medication with marijuana to treat their medical problems instead of seeking appropriate medical care.
I watched one of my colleagues and several security guards restrain a psychotic teenage girl who was reportedly “dabbing” (heating highly concentrated, solidified THC, which is inhaled). A short time later, a young adult male came in, having reportedly tried to hang himself three times. He stated that he had been smoking marijuana “all day, every day.” He was “seeing ghosts” that told him to kill himself. Not long after, a man presented in tears, saying that he had lost his job, was on the verge of losing his family, and needed help stopping the use of marijuana and didn’t know where go for help. Another colleague saw two young adult patients from a hash oil explosion that left them with very severe burns. I have certainly seen more cases of infective endocarditis from injection drug use than I expected in this once-quaint town.
I had expected to see more patients with cannabinoid hyperemesis syndrome (and I have), but they were the least of my concern. Our local homeless shelter reported seeing 5,486 (unique) people between January and July 2016, while for the entire year of 2013 (before recreational marijuana) that number had been 2,444 people.2 Most disturbing, we weren’t seeing just homeless adults but entire families. It is a relatively common occurrence to have patients who just moved here for the marijuana show up to the emergency department with multiple medical problems, without any of their medications, often with poor or nonexistent housing, and with no plan for medical care other than to use marijuana. They have often left established medical care and support to move here for marijuana and show up to the emergency department, often with suitcase in hand.
Increasingly Potent & Dangerous Drug
This new commercialized marijuana is near 20 percent tetrahydrocannabinol (THC, the psychoactive component of cannabis), while the marijuana of the 1980s was less than 2 percent THC. This tenfold increase in potency doesn’t include other formulations such as oils, “shatter” (highly concentrated solidified THC), or “dabbing” (heated shatter that is inhaled to get an even more potent form) that have up to 80 or 90 percent THC.3
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9 Responses to “Opinion: Dangers of Marijuana Experienced Firsthand”
May 29, 2017
Charles R CaffreyInteresting take! Can you comment on how many patients you see harmed from marijuana intoxication vs. alcohol intoxication? Both being unregulated in your state. In my experience, the devastating effects from alcohol seem to far outpace that of marijuana, in terms of addiction, trauma, suicide risk, end-organ damage, etc. However, I don’t practice in an environment where marijuana is legal, so perhaps marijuana is much more of a scourge in your practice setting. It seems that the Colorado Dept of Health has some interesting statistics regarding marijuana use in your state, including that daily or near-daily use of marijuana among adults in Colorado is much lower than daily use of alcohol. Further, past-month marijuana use along Colorado teens is almost identical to the national average.
June 10, 2017
YeVondaOne of the blading concerns mentioned in the article is non- medical employees diagnosing & prescribing in pot shops. Thankfully that’s not yet an occurrence in our CO liquor stores.
June 14, 2017
Brad RobertsThanks for the comment! Alcohol certainly remains a problem as well. I don’t have any specific data to say which is more of a contributing factor. I would say compared to New Mexico, I am seeing significantly more paranoia/anxiety/psychotic type symptoms and these correlate with MJ more than alcohol. Depression, SI, seem more correlated with alcohol- just anecdotally.
October 6, 2018
Aleksey DorofeyevBrad Roberts. I noticed something all too familiar. The most dangerous parts are limited to smoking, as well as “They were taking this with opioids and benzodiazepines”.
Trust me. My friend committed suicide after mixing xanax and lean. Alone they are fine, together they will accelerate a complete rewiring of the brain. Please consider OPIODS and benzos to be a more dangerous combination than any other medication out there.
Please research the effects of OPIODS and BENZOS COMBINED. Not seperate. I will guarentee you any patients that mix those drugs will be permanently mentally crippled.
May 29, 2017
Erik St.Pierre MDGreat article. Fairly new concept in Maine, but I am expecting the same to happen here. Everyone is excited about the increased tax revenue, but I doubt that it will be redirected at healthcare and drug rehabilitation. You can add marijuana to the list that includes alcohol, lottery tickets, and casinos as a really “poor”” way to generate tax revenue.
June 11, 2017
Pamela McCollno only a poor way but no way as the state of Colorado has a deficit after the cost of marijuana impaired driving costs- that alone ate up any tax revenue – not even mentioning the social and medical costs – other studies show millions of onpaid bills hospitals face dealing with marijuana cases. Then there is the increase in drop outs at $350,00 to society per case and the list goes on and on – we can not afford as taxpayers for this small minority to use this drug for a temporary intoxicating high.
July 14, 2017
medicoUpon what data are you basing your assertion that we “ate up any tax revenue” on impaired driving costs?
June 11, 2017
Todd B. Taylor, MDI have a very simple way to look at this burgeoning issue.
Who exactly do we think is “safe” or reasonable to use cannabis? Certainly not airline pilots, bus drivers, law enforcement, doctors, nurses, & pharmacists? Right, they are all regulated & will likely lose their license, assuming they get caught.
But what about Uber\Lyft drivers? What about school teachers, daycare workers, truck drivers, heavy machine operators?
Or what about the 218M US drivers? Right, they are going to be responsible & not drive when acutely intoxicated. But unlike alcohol, there’s no objective way to determine that. So, do we put very driver in jail who tests positive for cannabis they used two weeks ago?
So, for the people YOU count on every day to provide services to you & your family, who do you feel ok with them using cannabis on a regular basis? Might want to think about that the next time you sit down to get your hair cut.
Problem is, when the general public thinks about voting YES for a pot referendum, they are just thinking about how THEY would use it (responsibly) & would never give it to teenagers. Apparently, they fail to understand how the world really works. Put a McDonalds on every corner & the world gets fat. Put a Pot Dispensary on every corner & the world (including kids) gets stoned. Well, at least kids can’t get sugary drinks in schools.
October 21, 2018
AnnaThank you for your wonderful article. I have Epilepsy and marijuana and CBD Oil make my seizures WORSE. I can’t even be near anyone smoking because the 2nd hand smoke will cause me to go into a seizure.
If it’s really a medicine then it needs to be tested by the FDA and approved. Even then, one mans medicine is another mans poison.
Thank you for bravely speaking out.