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UC San Diego Doctor Warns Of Medical Marijuana Risks

Associated Press
Customers buy products at a medical marijuana dispensary, April 20, 2016.

UC San Diego Doctor Warns Of Medical Marijuana Risks
UC San Diego Doctor Warns Of Medical Marijuana Risks GUEST: Dr. Kai MacDonald, assistant clinical professor, UC San Diego

This weekend Sunday go will host the cannabis conference. The conference will showcase new products and treatments in the medical marijuana industry. Legal marijuana is being this is -- big business in California even before voters weigh in this November are recreational use. Medical Cannabis is a $2 million industry in our state. A researcher put up a red flag about the increasing use of cannabis to treat everything from cancer related pain to eczema. Doctor Kai MacDonald is a psychiatry professor and he recently co-authored a paper titled why not pot? A review of the brain-based risks of cannabis. Welcome to the program. Split thank you for having me. It is common wisdom that cannabis is less addictive with fewer side effects than most medical prescriptions. My question is is that common wisdom wrong? McClearly cannabis can be addict to at risk individuals. As can some drugs to manage chronic pain like opiates. Though more new ones answer is that if you measure addiction of chemicals and put nicotine in here when and cannabis on the line, cannabis has the lowest overall risk of leading to addiction. It is balanced by the fact that so many people use cannabis that you actually see a significant amount of cannabis addicted patients if you run a treatment program like mine. There is a tremendous range of medical conditions that opponents they can be true with cannabis. What are some of the elements that we know medical Marijuana is effective in treating. I am a physician, which means that the quality of evidence which really gets my attention's pretty high and I like to think that most physicians can uphold to that standard. So indications for which they are considerable and motivating amount of data are for certain chronic pain conditions and for specificity. That as a condition of painful muscle contractions. Bows hasn't been studied that well. You have identified brain-based Ricks Amir -- marijuana what are those five risks? I wanted to inform clinician as this great tsunami was coming in a way that had a mnemonic. Of the risks I made -- I included the [ Indiscernible ]. Marijuana can cause an addiction syndrome in the second one is the driving risk that when we are on the road stoned driving is not safe. Underachievement there is a huge body of data showing that chronic cannabis use leads to underachievement if it started young and continued. Mental illness in a number of different mental illnesses psychotic disorders PTSD and bipolar cannabis use is associated with negative outcomes. The last one is bad to worse and there is reasonable evidence. This is the weakest but Wiesel evidence that cannabis use especially when started young can increase a person's risk of developing other more life-threatening or dangerous addictions like opiates or alcohol. You talked about being a doctor and you need hard evidence before you are going to be prescribing marijuana because it is still listed by the government by a scheduled 1 drug. That is a great point. I think most serious researchers would love to see an environment where we can really study not just cannabis but the components of cannabis in a more effective way because everyone admits on both sides that we need more good treatments for really disabling conditions like chronic pain and things. We need to have a scientific environment where things can be studied right now cannabis is higher risk than other drugs that cause four deaths. So most people agree that it was probably miss scheduled. That gets it away as a researcher. There are many compounds in the marijuana plant. The cannabis industry itself is busy experimenting with different strings that produce different effects on different diseases. Medical research on cannabis him of therefore, is really lagging behind isn't it what I think that is well said. The analogy I make is the word cannabis as a little bit like the word K-9. It is not a unique model fuel or unique thing. In other words, if I was going to say a dog move next door, is at safe? I think you would be interested to know if it was a toothless golden retriever or a formerly abused people. Both are canines but they have different risks. Cannabis is kind of like that that depending on what actually is in the thing and what are the component parts is a very different animal compared to something like aspirin, which is a single chemical compound that we can study with precision. How would you advise a patient would been prescribed medical Marijuana. What -- what should they be aware of what I would assess first if they were in a risk group it is someone under 18 or go risk group is someone who has a family history of personal history of addiction. Risk group is someone who has a history of a serious and disabling mental illness. For people in those risk groups I make a blanket advisement against it or go I think that the risk-benefit ratio is pretty lopsided. Otherwise, I would ask what the indication is and then have a discussion about what we know and what we don't know. Other treatments including nonmedical treatments and then assuming that they are a capable person just leave them with the information. I think might blanket recommendation against it is really reserved for high risk folks and then other folks just think they need to know what the risks are that they are getting into and how little we do know. I've been speaking with Doctor Kai MacDonald. He is a psychiatry professor and thank you very much.

Former NFL players who want the league to allow use of marijuana to treat injuries will join doctors and companies selling new treatments in San Diego this weekend at the Southern California Cannabis Conference and Expo.


The conference will feature speakers advocating for wider use of medical marijuana to treat diseases from multiple sclerosis to menstrual cramps. But UC San Diego School of Medicine’s Dr. Kai MacDonald, who is not planning to attend the conference, stresses that very little is known about marijuana’s long-term side effects.

MacDonald, an assistant clinical professor of psychiatry at UCSD, recently wrote a paper for the journal Innovations in Clinical Neuroscience titled “Why Not Pot? A Review of the Brain-Based Risks of Cannabis.” MacDonald writes that marijuana is addictive, though far less so than nicotine or heroin, and use of marijuana by those with schizophrenia may lead to an increase in symptoms.

MacDonald is quick to note that he is not opposed to medical marijuana, but that due to federal restrictions on marijuana research and the increasing number of strains used to target specific diseases, there is not enough research into the drug’s long-term effects. Much of the current research into marijuana studied regular or heavy users, not those prescribed marijuana by a doctor, so some of the findings are not directly applicable, MacDonald said.

“In a person with any kind of terminal condition, it’s hard to wax poetic about long-term risks,” MacDonald said. “Look at the hospice population, with nausea and pain. That’s a really good place to ease suffering.”

MacDonald joins KPBS Midday Edition on Wednesday with more on the medical research into marijuana.