A much more important issue than the one of marijuana access addressed in The Statement article is if marijuana is a useful medicinal substance (How Michigan marijuana patients get their medicine, 09/23/2009). Marijuana’s active ingredient, THC, is available orally and is approved by the FDA as an antiemetic, usually for nausea induced by cancer chemotherapy.

One needs to understand the THC content of marijuana. When smoked, small amounts of THC are no big deal. But with large amounts, the smoker is “spaced out.” Marijuana differs from alcohol and tobacco because of its unusual mind-altering effects. When a person is “high,” they do not care about the pain of migraine or their leukemia. Depending on the THC dose, the psychic effects include euphoria, emotional changes, altered associations, altered time and space sense, altered auditory and visual sensations, illusions, memory loss, disorientation and somnolence. If smokers do not obtain the altered sensations and illusions, they have probably used a poor grade of marijuana with little THC content.

The danger of smoking or ingesting marijuana is that some people will continually increase its use. Eventually, they become “potheads” with an amotivational syndrome. A recent study of University-related students indicated that even 36 hours after smoking marijuana, the users had reduced regional brain activity, as measured by fMRI methods. The gray matter neocortical areas of the brain affected involve error detection. The users mistakenly thought they were doing great on various tests, whereas the nonsmokers could detect their own errors. Clearly, it is much better for most people to use more rational forms of medically approved drugs than marijuana.

Edward Domino, M.D., Professor of Pharmacology

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