It’s April 20th.

For the marijuana smoking counter culture, today is known as 420, pronounced four-twenty – National Weed Day. Many marijuana (MJ) users celebrate by convening  across the nation to light up a joint, smoke a bowl, or eat some pot brownies. Unlike Halloween, in which you probably wouldn’t find anyone in costume on the other 364 days, MJ use is ubiquitous and ever-present in the mainstream.  Whether you’re watching TV or listening to music on the radio, attending a sporting event or concert, you’re as likely to be exposed to something MJ-related (like Weeds, Bob Marley, or the downwind smell of pot) as you are to something Kate Gosselin-related at a supermarket checkout line.

MJ is the most prevalently used illicit substance in the world. It is often referred to as the “gateway” drug as once naive recreational drug users may later progress to experimenting with harder drugs such as dropping ecstasy, snorting a line of cocaine, or smoking crystal meth. MJ has more aliases than the National Hockey League has fans. In the medical profession, MJ is frequently referred to as Cannabis, the Greek name of the plant, and THC, its main active ingredient.

Many consider MJ use to be harmless, positive, and even beneficial. Recreationally, MJ is associated with facilitating philosophical thinking, enhancing creativity, and heightening subjective experiences. How many moviegoers do you think were high when they munched on popcorn as they trancedly watched Avatar in 3-D? Medically, MJ has been legalized in 14 US states for treatment of chronic conditions such as glaucoma, pain disorders, chemotherapy-induced nausea and vomiting, HIV unintentional weight loss, and some neurological disorders.

Legalized for medicinal use only in a minority of states, MJ is criminal and illegal on the federal level. As such, the federal governing agency of prescription meds, the FDA, strictly regulates MJ among the highest of controlled substances. MJ is classified as a substance with high abuse potential, no current accepted medical use, and a lack of accepted safety for use under medical supervision. You may get a marijuana card, but you’re absolutely not gonna get a prescription for MJ says Uncle Sam.

The medical marijuana debate remains controversial in the medical profession. Although MJ has been shown to improve the aforementioned medical conditions, it nevertheless has adverse effects on the lungs, heart, and immune and reproductive systems. Moreover, it has the potential to cause cancer.  

In psychiatry, the position on MJ use errs on the side of restriction. Aside from addiction, MJ has been associated with increasing the risk of common psychiatric disorders like anxiety, bipolar, and psychosis. Chronic heavy users of “the chronic” may also experience a generalized lack of interest, decreased motivation, and impaired cognitive functioning. You may want to stay off the grass if you’re gunning to be the school valedictorian. Many MJ users may go through their entire lives without any significant functional impairment, experiencing at worst a “bad trip” from time to time. But what if that bad trip was lasting and permanent like schizophrenia? Is that a journey worth embarking on?

The origin of 420  in reference to weed has as many postulations as that of Tupac’s death. Some think 420 refers to the number of chemicals found in MJ, the police code for MJ use, or Adolf Hitler’s birthday. The leading belief seems to credit a group of pot-smoking teenagers who met up daily to get high after school at 4:20pm back in the early 70s. Whatever the reason, as far as I’m concerned, 420 can mean the number of arguments you can make for or against the use of MJ.

Since I’m a psychiatrist, you can probably surmise where I stand on the issue of marijuana use.



Filed under Drugs

10 responses to “Marijuana

  1. John Tran

    Good article Dr. C. This is coming from a ex-weed smoker. I’ll still hit the weed from time to time but definately not as much as before. You have many good points in this article. I just wanna clear things up a little. I don’t believe its addictive. Cigarettes are addictive. I can quit weed anyday but I feel that I must have a cigarette everyday on a routine basis. As for the gateway drug, it just depends on who you are and the way you feel about other drugs. You are on the money when you say you get bad trips here and there just as long as there isn’t any permanent damage. I say if alchohol and cigarettes are legal, then weed should be too. How many people actually thought about doing harm to anyone while they were high? When I’m drunk, I occasionally have the urge to punch someone. I can’t recall hearing about any dui’s while being high and killing someone. I only see or hear of drinking and driving killing.

    • Thanks for your thoughtful comments JT. I’m glad you’re not addicted to weed, but it is an addictive substance. Nicotine is considered the most addictive substance, which is why you have trouble kicking that habit. Check out the rank order of other addictive substances:

      You are absolutely right about the “gateway” phenomenon being specific to the individual. You bring up a good point about alcohol use being more problematic than MJ as well. Many people would agree, and use it as an argument in favor of decriminalizing MJ.

  2. AJ

    Dr. C, smoking weed calms me and makes me less anxious…what do you think about that?

  3. Hi AJ,

    Many do report that using MJ decreases anxiety, which leads to continued “self-medication” and thus chronic use for relaxation and coping with stress. But anxiety is also caused by MJ use, often when taken in high doses or during withdrawal periods. Long term MJ is associated with increased anxiety disorders, and vice versa.

    Since there are other proven (and less harmful) methods to treat anxiety, it may be prudent to consider them instead of using MJ solely to reduce anxiety.

    I’ve included a link to a journal article that reviews the evidence of cannabis and anxiety.

  4. Vicky

    Dr. C,

    Interesting article. What does Hitler have to do with weed? Also, is there some psychiatric explanation as to why weed causes some people to feel paranoid?

    • Thanks Vicky. Great questions!

      Hitler’s connection with weed is that his birthday was on 420 – April 20, 1889. I doubt he actually smoked any MJ in his lifetime.

      Yes you are right about the causal relationship between weed and paranoia. THC affects dopamine activity in the brain, which in turn is implicated in paranoia and other forms of psychosis.

      I’m gonna reference Luzi et al’s research article “What is the Mechanism whereby Cannabis Use increases Risk of Psychosis?” They conducted a study injecting participants with IV THC. Their findings showed that acute MJ intoxication caused transient psychotic symptoms – “typical experiences …were acute paranoid misinterpretations of the immediate environment or of the intentions of the researchers. Commonly, participants inferred that something sinister was occurring, they struggled to balance two versions of reality and some felt persecuted. Several subjects were convinced that their mind was being read….”

      As to why some, but not all people become paranoid or psychotic is likely due to differences in genetics and dopamine activity.

  5. K

    I could not agree with you more. I feel that legalization of MJ increases the chances of the drug falling into the hands of children and others who don’t need it for medical reasons. It also sends a message to children that drug use is OK. Nicely written Dr. C.

  6. tracy

    A new post coming soon, please Dr. C? This is a fascinating blog and i apologize if i offended you with my remarks on BPD. i am sorry.

    • Hi Tracy,

      Please don’t apologize for your comment on BPD. This is a public blog and I do welcome all comments. I was not offended. I try my best to update with new posts regularly. Thanks for reading!

  7. I love 420 because it is a day of sharing and getting together with your friends and just enjoying their company. Pot is just something that facilitates friendship, peace, and love.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s