After regressing all other arrest rates, drunken arrests remains the only significant category affected by MMICs. So with the given data, there is no evidence that marijuana is a substitute for dangerous drugs, other drugs, felony drugs, nor narcotics. It is particularly surprising that we see no effect on narcotics, considering most medical marijuana patients specifically use cannabis as a substitute for narcotics. An explanation for this can be that some medical marijuana users do not use for medical reasons many of the MMIC holders in this particular data base may only use for recreational purposes. To observe any further substitution effects, I used Equation 5.7 to regress alcoholinduced crude rates, drug-induced crude rates, and all other crude rates on MMICs and unemployment still controlling for county and year fixed effects. Unlike the arrest rate data, no substitution effects were found. Referring to the regression output in Table 5.9 for alcohol-induced deaths, MMICs actually had a statistically significant positive effect on alcohol related deaths. The interpretation is that for every new medical marijuana user, the alcohol crude rate increases by 0.0068 deaths per 100,000. However, observing that zero is in the confidence interval and that the t-statistic is borderline significant, it is likely that there is no effect at all. While this is still a positive number, its suggested effect is so small, it becomes negligible. This can be determined by looking at the average crude rate for alcohol related deaths,grow slide racks which is 15.8. There would have to be an additional 147 MMICs per 100,000 to increase this crude rate by 1 death per 100,000. This is a highly unlikely scenario, and could therefore be dismissed. By applying this same model to drug-related deaths, we again get a statistically significant positive effect on the crude rate, shown in Table 5.10.
While this would typically suggest that marijuana is a complement drug to other drugs, the effect is again, miniscule. With the average drug-induced crude rate of 13.4 deaths per 100,000, the number of medical marijuana cardholders would have to increase by 142 to cause 1 drug-related death. Similar to the effect on alcohol-induced mortality rates, this is a very unlikely event, and can be disregarded. While the drug and alcohol related deaths were affected slightly by medical marijuana, all other crude rates did not. There was no statistically significant effect when applying Equation 5.7 to all other crude rates.Papers range from casual discussion, passionate and involved such as those by Annas1 and Okie2 , to serious logical argument exemplified beautifully in Cohen’s3 work. Annas1 and Okie2 focused on California’s 1996 medical marijuana law and the 2005 Supreme Court trial Gonzales v. Raich respectively. Cohen3 had a larger scope, reviewing marijuana’s history in the United States from the colonial era to present-day. While the former sources made mention of some valuable scientific evidence, they did so amidst a great deal of personal appeal and anecdotes about those affected. Quotes from doctors, talking about their personal recommendations for patients to use marijuana, and, admittedly, evocative statements from politicians or newspapers frame the discussions. For instance, Annas quotes a Boston Globe writer’s question asking that if legalizing medical marijuana would send the terrible message to children that “If you hurry up and get cancer, you, too, can get high?”1 . Cohen’s argument did not lack pathos, but he presented his opinion in a strong logical argument, clearly referencing medical findings. All three papers argued, presuming that sufficient medical evidence exists to prescribe marijuana. They, instead, focused on the issue marijuana’s legality, rather than on analyzing the validity of the cited data. Drug abuse and dependence are important considerations for both FDA and Congressional policymakers. While marijuana is relatively non-addictive, especially when compared to FDA-approved opium, cocaine, and methamphetamine, it remains the most abused drug in America.The authors of “Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence” analyzed use, abuse, and dependence statistics across the U.S. to measure variance caused by marijuana’s legal status.
They concluded that rates of addiction, abuse, and dependence did not vary with overall use, but did not develop the idea much further. To expand upon the study the authors could have spent more time discussing why use rates varied with legality. The authors also could have discussed the consequences of the observed use, abuse, and dependence rates and how they should concern or placate readers. While ample research has been done on the cannabinoids thought to give marijuana its medical value, not all results have been conclusive or widely accepted. “Endocannabinoids in nervous system health and disease: the big picture in a nutshell” provides a broad yet detailed overview of the endocannabinoid system, which is the biochemical pathway that delta-9-tetrahydrocannabinol and other cannabinoids act upon.Some of the sections within this article require more than a casual knowledge of biochemical pathways, or at least their terminology, to follow. Though it occasionally delves into deeper discussion of biochemical pathways, the paper is not too difficult to follow and certainly delivers a “big picture in a nutshell.Borgelt, Franson, Nussbaum, and Wang6 and the Harvard Mental Health Letter article “Medical marijuana and the mind”put an emphasis on the pharmacology of marijuana and discuss both the current drug delivery methods and the side effects. These two articles differ drastically in their tone, however. Borgelt, Franson, Nussbaum, and Wang discuss, in detail, the mechanisms by which marijuana elicits its effects. “Medical marijuana and the mind”lists the effects of marijuana and discusses the drugs that contain THC, but doesn’t delve into the pharmacokinetics. Unlike most papers, emphasis was placed upon findings that indicate marijuana may increase psychotic episodes in those with schizophrenia and bipolar disorder. The debate on these findings continues to this day without a clear consensus. The author refrains from discussing precise biochemical pathways in favor of discussing the consequences of each mode of delivery or side effect. By keeping avoiding technical terms when possible, the author achieves a casual tone capable of reaching out to a broad audience. Both “Medical marijuana and the mind” and “The pharmacological and clinical effects of medical cannabis” agree that smoking constitutes the largest barrier to marijuana’s acceptance within the medical community.Should a viable alternative be developed, marijuana could become legal once again. With the exception of Cohen3 , these two articles have the most balanced discussion of both the pros and cons of medical marijuana in its current state. Increasing amounts of research have been performed on the effects of marijuana smoke and ways to replicate its efficient drug delivery without its harmful side effects. Owen, Sutter, and Albertson look exclusively at the harm of marijuana smoke on the lungs as it compares to tobacco smoke. They found that, like tobacco smoke, marijuana smoke increases the risk of “pulmonary symptoms such as wheeze, cough, and sputum production.”However, it may not lead to chronic obstructive pulmonary disease.
Somewhat confusingly, the paper also discusses marijuana’s effect on the immune system and cancer cells, which doesn’t seem to be directly related to the title of the paper. Though they explain how marijuana smoke can harm the lungs quite thoroughly, there are often departures into less closely related subjects such as the immune system. As a result, it sometimes feels as though the paper is about the endocannabinoid system as a whole, rather than how marijuana smoke affects the lungs. Hazekamp, Ruhaak, Zuurman, Van gerven, and Verpoorte decided to analyze the dosage delivery of the “Volcano” vaporizer. Vaporizers attempt to circumvent the harm of smoke during marijuana inhalation by boiling the THC and cannabinoids into a vapor without actual combustion,fl0od tables for greenhouse which produces most of the harmful particles in smoke. The study discovered that the vaporizer delivered similar amounts of THC as traditional smoking, but with less variance. They state that they used one of the multiple heat settings on the device because, by their calculations, it was the most efficient. Not all users may be able to tolerate that temperature setting, so it would be worthwhile to see if the delivery method remains passably effective at other settings. The examiners pointed out that they only studied THC delivery and, while this is the most studied and well understood cannabinoid present in marijuana, it may not be wholly responsible for marijuana’s therapeutic effect. Consequently, research comparing the delivery of the other compounds is necessary. Uritsky, McPherson, and Pradel10 ran an online survey of hospice workers to determine attitudes towards medical marijuana in the industry. While they found that a majority of responders support medical marijuana, they highlighted several potential flaws with their own research. They only surveyed workers for one company, which may attract employees with particular viewpoints based on its policies. Because the survey was run through a website, responders could have submitted answers multiple times by using different computers. Additionally, a high proportion of workers are either volunteers or unlicensed, so their support might be simple personal opinion rather than the result of research and knowledge about the issue. The questions in the survey seemed appropriate for what the researches sought to discover. Perhaps the imprecision of survey-taking, in general, caused more problems than anything the researchers did.Marijuana, a mix of dried flowers of the cannabis plant, is used by between 7.5% and 9.4% of the United States population. With increasing legalization for recreational and medical use, concern about its possible health effects is rising. Heart health is a special concern, since case reports from the early 2010s suggest that marijuana may trigger heart attacks in healthy adults without significant coronary atherosclerosis. Some retrospective studies in France and the USA explore the possible association between marijuana use and cardiovascular incidents around the same time and found recent marijuana use raised myocardial infarction incident risk nearly five-fold for a one-hour period after use ,, but most patients in this study were predisposed to cardiovascular disease . In contrast, larger observational studies in the USA, Sweden and Belgium published between the late 90’s and the late 2010’s found no association between marijuana use and incident CVD . We know marijuana can have both pro-atherogenic effects, from activating the Cannabinoid receptor type 1 , and anti-atherogenic effects, by activating CB2. Previous analyses of the Coronary Artery Disease Risk of the Young study, a longitudinal study with over 5,000 participants and up to 30-year follow-up in the USA, found that cumulative marijuana use was not associated with markers of sub-clinical atherosclerosis like coronary and abdominal calcium score, but that tobacco cigarette smoking was associated with increased risk of these outcomes. Since CARDIA follows a relatively young cohort into early middle-age, participants may be too young to exhibit signs of CVD. Marijuana could also be associated with increased risk of future CVD non-atherosclerotic in origin. A potential increase in future risk of CVD could be captured by studying the association between marijuana use and electrocardiograms , as observational studies following over 1,000 participants in the USA over more than 10 years suggest. So far, only a few, small experimental studies , mainly from the late 1970s, examined the cellular mechanism that might connect marijuana use and abnormalities in ECGs. Some identified associations between marijuana use and these ECG abnormalities: P-wave axis abnormality; atrial flutter; atrial fibrillation; transitory 2nd grade atrioventricular block; premature ventricular contraction; elevated ST-segments; T-wave axis abnormality; and, decreased or increased R-R interval , and signs of Brugada pattern. Because of the limited size of participants, findings of these studies are inconsistent, differed according to sex and race, and, in most cases, could not be reproduced between studies. We set out to explore potential associations between current and cumulative marijuana use and ECG abnormalities in a large black and white cohort, followed over two decades. We used data from the CARDIA study. CARDIA is a cohort of 5,115 black and white women and men, aged between 18 and 30 years at baseline, from four study sites in the USA followed over 30 years. The study strove for equal distribution of race, sex, education, and age at each site.