By
Brian Palmer
NEW YORK
The Journal of Neuroscience recently published a study linking
recreational marijuana use to subtle changes in brain structure.
The researchers, led by Jodi Gilman of
Massachusetts General Hospital, identified increased gray matter density
in the left nucleus accumbens and some bordering areas. The study was
fine, but the media coverage was abysmal. Reporters overstated the
findings, mischaracterized the study, and failed to mention previous
research done on pot smoking and health.
Goldfish may not have a three-second
memory, but some journalists seem to. When a new paper comes out, it's
often treated as the first ever and final word on the topic. There is a
significant body of literature on the neurological and wider health
effects of marijuana, and to ignore it when covering new studies seems
to me a form of journalistic malpractice.
A press release
from the Society for Neuroscience trumpeted the Gilman study's
importance because it looked at casual users rather than regular pot
smokers, who form the basis of most marijuana studies.
That claim is
dubious in the extreme. The subjects averaged 3.83 days of smoking and
11.2 total joints per week. Characterizing these people as casual pot
smokers was a great media hook, but it defied common sense. Occasional
users wondered if they'd done permanent damage, and parents were
concerned that their teen-agers might face profound neurological changes
from experimenting with pot. Any reporter who read the study, however,
should have known not to take that bait.
Even by the standards of past medical studies,
it's a stretch to call these subjects casual pot smokers. Just two
years ago, for example, Janna Cousijn and colleagues published a study
on a group that she called "heavy" marijuana users. In the average week,
they smoked 3 grams of cannabis — approximately 2 grams less than
Gilman's casual smokers. (A joint has about 0.5 grams of cannabis.) The
justification for calling Gilman's subjects casual smokers is that they
didn't meet the criteria for dependence, but when you count up the
joints, the study doesn't look so revolutionary.
Many stories also claimed that the
Gilman study showed direct causation between pot smoking and brain
abnormalities. That's wrong. The study looked at differences between pot
smokers and abstainers at a single moment.
Only a longitudinal study, examining brain changes over time, could
have suggested causation. As a letter writer to the Journal of
Neuroscience noted, it's possible that pre-existing brain differences
cause some people to seek out marijuana. Gilman's pot smokers also drank
more and smoked more cigarettes than the control group, which supports
this interpretation and also raises the possibility that other factors
led to brain structure differences.
The biggest problem with the coverage of
the marijuana study was that it failed to put the new research into
context. Valentina Lorenzetti of the University of Melbourne recently
published a widely cited review paper synthesizing dozens of studies on
marijuana and the brain. Taking the literature as a whole, there is
evidence suggesting that marijuana use causes structural changes in
three parts of the brain: the frontal lobes, temporal lobes and the
cerebellum.
The data also reinforces the idea that long-term, heavy
smokers experience greater changes than casual
users. The studies, however, have serious flaws. They are typically
small and have been unable to show that the structural changes cause
cognitive impairment. Gilman's study of 20 smokers is a good
contribution to the literature, but it doesn't resolve those problems.
If you are considering smoking pot — or quitting — here is what you need to know.
Smoking marijuana once is very unlikely to harm you. It takes at least
15 grams of cannabis to kill a person, and probably much more than that.
A healthy person would have to smoke dozens of joints in a single
session to risk death from overdose. People who do die from the acute
effects of marijuana die in accidents: A recent study suggested that
more than 10 percent of drivers killed in car accidents test positive
for cannabis.
The more likely risk from trying
marijuana is dependence. There is a debate over whether marijuana is
addictive, but you needn't bother with it — it's mainly about semantics.
The fact is, approximately 9 percent of people who start smoking pot
become dependent by ordinary medical standards.
That's low compared with
dependence rates for other drugs: More than 15 percent of people who
drink become alcoholics, and 32 percent of people who try cigarettes get
hooked. Still, you should think seriously about a 1-in-11 chance of
addiction, especially if you have a personal or family history of substance abuse.
Studies consistently show that frequent
marijuana smoking is associated with some forms of respiratory
dysfunction. Smokers report problems with coughing,
wheezing and phlegm. Lung cancer is a murkier issue. Cannabis smoke
contains higher concentrations of some carcinogens than cigarette smoke
does.
Some large studies show increased prevalence of respiratory tract
cancers in cannabis users, while others find no correlation.
The cognitive effects of chronic
marijuana use are uncertain. If you're an adult who smokes occasionally,
there appears to be little or no reason to believe your mental
performance will suffer. Several studies also show that those who
experience impairments may recover if they stop smoking. Heavy, long-term smokers may experience memory and attention loss.
As with alcohol and tobacco, it's fairly
clear that minors should not use marijuana. Many studies show that kids
who smoke pot do poorly in school, and some studies suggest that they
commit suicide at higher rates. Although the causal relationship isn't
clear, the risks are too great.
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