Looking at Marijuana Related Hospitalizations Versus Alcohol and Other Drugs

At the city council meeting on February 26, our mayor made some claims that marijuana costs and hospitalizations are larger than alcohol in states that have legalized it, either for medical or recreational use. Before presumptively calling bullshit, I asked for his sources to confirm what he was saying. In the interim, I told my doctor about the statements, and they were both amused and angry that sort of information is still being pushed. Finally talking to the mayor more than a week later, he was entirely vague where he got his information from, just that it was everywhere on the internet. Guess I’ll have to do my own research. Here it is:

There are currently 28 states plus the District of Columbia who have medical marijuana, and eight states plus DC with it legalized for recreational use, beginning with Colorado and Washington in 02014. There are few recent articles on the subject; most of what I found was from 02015 or before. Much of this has been focused on children and adolescents.

University of Colorado's Dr. George Sam Wang led a study that indicated ER visits and poison center calls regarding children increased dramatically in the state during the year following legalization. Most of it was due to children accidentally ingesting edibles, which can have higher doses of the active ingredient in marijuana, THC. [4] How does it compare to children who get into mom and dad’s liquor cabinet or medicine chest? No information on that. Is part of the reason for more calls more awareness that could be the problem when a child is having symptoms?

Additionally, in the 13 to 21-year-old group, more than half also had evidence of other drugs in their systems, including alcohol, amphetamines and cocaine. [4] Is marijuana really the issue? This has been found to be true of adult hospitalizations too. A Canadian study found in 02006 that alcohol puts seven times the amount of pressure on healthcare systems if a study released by British Columbia applies everywhere. Their calculations of the difference between healthcare costs for Canadian drinkers vs. weed smokers: $20.50 per year per toker vs $165.11 per drinker. [5] Have not found any more recent information.

One of the mayor’s points was pedestrian deaths. The first information I found was from Faux News. Imagine that. The report suggests that the proliferation of smartphones, legalized marijuana use and excessive drinking were contributors to the deaths, but does not claim a “definitive link.” [6, 7] In fact, there was no real data on a connection at all. Reading the original Governor’s Highway Safety Association report [8] finds only that the states with legal recreational marijuana had a combined 16.4% increase in pedestrian fatalities. Meanwhile, cell phone related emergency calls have risen on par with usage, 236%, though not distinguishing between total incidents and fatalities. Once again, are there more incidents reported simply because more people are asking those questions? Do states without legalized marijuana ask these questions at all? That in itself would skew any results. This report also fails to mention how many people with marijuana in their system also had alcohol or other drugs.

A unique approach called ‘Margin of Exposure’ (MOE) was studied and reported on in 02015. [9] The MOE is defined as the ratio between the point on the dose response curve, which characterizes toxicity in epidemiological or animal studies (also known as benchmark dose (BMD)), and the estimated human intake of the same compound. Using this ratio, the lower the MOE, the larger the risk for humans. The study found that alcohol, nicotine, cocaine and heroin are in the ‘high risk’ category, with MOE less than 10. All other compounds except THC, including amphetamine-type stimulants, ecstasy, and benzodiazepines, were in a ‘risk’ category with MOE up to ten times higher. THC was found to be ‘low risk’, with MOE greater than 10,000. In the report, risk is defined as “the probability of an adverse effect in an organism, system, or (sub)population caused under specified circumstances by exposure to an agent.” Clearly, the report shows that legal drugs such as alcohol and cigarettes are more than a thousand times more likely to be toxic.

Articles from government and corporate leaning entities such as the Center for Disease Control and Occupational Health and Safety are more alarming [2,3], but when we see every corner of our government controlled by corporate money, is it any surprise their ‘conclusions’ fall in line with the criminalization party? This is not to say that marijuana use doesn’t have its concerns, especially when it comes to children. When alcohol and cigarettes are even more readily accessible and dangerous, perhaps our fears are being placed on the wrong culprits though. Alcohol and cigarettes kill tens of thousands per year just in the United States, with no evidence of medicinal benefit. Marijuana not only doesn’t kill, but its addictive properties are still widely contested and if true much lower than that of nicotine, alcohol, and opioids. [1] Because the US government still lists marijuana as a Schedule 1 drug -- on the same level as heroin, methamphetamine, and cocaine -- the research has been strictly limited and not in any way conclusive. There is no way to make a definitive statement.

Sources

[1] http://bigthink.com/robby-berman/a-clear-eyed-comparison-of-alcohol-vs-marijuana

[2] https://www.cdc.gov/marijuana/health-effects.htm

[3] https://ohsonline.com/Articles/2014/09/01/Marijuana-Legalization.aspx?Page=3

[4] https://www.nbcnews.com/health/health-news/er-visits-kids-rise-significantly-after-pot-legalized-colorado-n754781

[5] http://www.heretohelp.bc.ca/visions/cannabis-vol5/cannabis-tobacco-and-alcohol-use-in-canada

[6] http://www.foxnews.com/us/2018/03/01/smartphones-impairment-blamed-for-rise-in-pedestrian-deaths.html

[7] http://www.bostonherald.com/topic/cannabis_control_commission

[8] https://www.ghsa.org/sites/default/files/2018-02/pedestrians18.pdf

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311234/