Dr. John Douillard examines the cultural and psychological effects of long term marijuana use.
In Colorado, we have watched medical marijuana become legal, with dispensaries popping up all over the state, and a curious concentration here in Boulder.
Recently, recreational marijuana has been legalized in Washington and Colorado, and legislators are scurrying to figure out what this will look like.
No doubt the times are changing, and marijuana seems destined in the near future to be widely and legally attainable, much like a bottle of wine.
It would be impossible to dispute that fact that marijuana has a role to play in medicine (1). But, like most medicines, there are side effects. Ideally, medicines do their job to help us get one well and then, once better, we get off the medicine. Sadly, our culture has become accustomed to long-term use of medicines, and part of that culture is that we endure the side effects. With regard to marijuana, it’s important to note that prolonged and heavy use, particularly in teenagers, does have side effects and has been linked to numerous health concerns (2,3,4).
Join me as I discuss the documented benefits, the potential dangers, the serious risk for teenagers, and the Ayurvedic perspective with regards to marijuana use.
It is very clear that you can find research on both sides of the aisle citing numerous benefits and associated health risks of marijuana.
Let’s take a look at some of the medicinal properties that marijuana can potentially deliver.
- for pain as an antipsychotic (6)
- as an anti-anxiety agent (5)
- for mood and sleep in cases of chronic pain (8)
- as analgesia for chronic neuropathic pain (1)
- as an appetite stimulant in debilitating diseases (cancer and AIDS) (1)
- for Crohn’s Disease (10)
- in the treatment of multiple sclerosis (1,11), fibromyalgia (9), and glaucoma (12)
… to name a few.
Additionally, the two major cannabinoids found in marijuana—namely Tetrahydrocannabinol (THC) and Cannabidiol (CBD)—have both been found to offer unique benefits for pain management in chronic disease, benefits that may support and even balance each other’s side effects.
As research in this field accumulates, it’s clear that we may see the common understanding of marijuana benefits and side effects shift immensely. For now, there are still some well-documented side effects of long-term use that are worth looking at.
The Danger of Marijuana:
A 2012 study conducted by the National Institutes of Health and the National Institute of Drug Abuse concluded findings I believe we should all be aware of (2,3,4). I’ve pulled some quotes from the discussion of this and related studies, so you can see for yourself.
Persistent cannabis use was associated with neuropsychological decline broadly across domains of functioning, even after controlling for years of education. Informants also reported noticing more cognitive problems for persistent cannabis users. Impairment was concentrated among adolescent-onset cannabis users, with more persistent use associated with greater decline. Further, cessation of cannabis use did not fully restore neuropsychological functioning among adolescent-onset cannabis users. Findings are suggestive of a neurotoxic effect of cannabis on the adolescent brain and highlight the importance of prevention and policy efforts targeting adolescents (2).
The message inherent in these and in multiple supporting studies is clear. Regular marijuana use in adolescence is known to be part of a cluster of behaviors that can produce enduring detrimental effects and alter the trajectory of a young person’s life—thwarting his or her potential. Beyond potentially lowering IQ, teen marijuana use is linked to school dropout, other drug use, mental health problems, etc. Given the current number of regular marijuana users (about 1 in 15 high school seniors) and the possibility of this number increasing with marijuana legalization, we cannot afford to divert our focus from the central point: regular marijuana use stands to jeopardize a young person’s chances of success—in school and in life (3).
We repeatedly hear the myth that marijuana is a benign drug—that it is not addictive (which it is) or that it does not pose a threat to the user’s health or brain (which it does). A major new study published in Proceedings of the National Academy of Sciences (and funded partly by NIDA and other NIH institutes) provides objective evidence that, at least for adolescents, marijuana is harmful to the brain (4).
The new research is part of a large-scale study of health and development conducted in New Zealand. Researchers administered IQ tests to over 1,000 individuals at age 13 (born in 1972 and 1973) and assessed their patterns of cannabis use at several points as they aged. Participants were again tested for IQ at age 38, and their two scores were compared as a function of their marijuana use. The results were striking: Participants who used cannabis heavily in their teens and continued through adulthood showed a significant drop in IQ between the ages of 13 and 38–an average of 8 points for those who met criteria for cannabis dependence. (For context, a loss of 8 IQ points could drop a person of average intelligence into the lowest third of the intelligence range.) Those who started using marijuana regularly or heavily after age 18 showed minor declines. By comparison, those who never used marijuana showed no declines in IQ (3,4).
Unfortunately, the proportion of American teens who believe marijuana use is harmful has been declining for the past several years, which has corresponded to a steady rise in their use of the drug, as shown by NIDA’s annual Monitoring the Future survey of 8th, 10th, and 12th graders. Since it decreases IQ, regular marijuana use stands to jeopardize a young person’s chances of success in school (3).
The Ayurvedic Perspective:
The sattwic state is completely content, joyful, and giving, like a flower opening to the sun.
According to Ayurveda, marijuana, like all mind altering substances including alcohol, has a dulling effect on the mind.
Ayurveda categorizes the state of being into three qualities:
• Sattwa: Inner peace. Completely content, joyful, loving and giving—all heart.
• Rajas: Uses senses and emotions to be stimulated and therefore satisfied.
• Tamas: Withdraws or secludes oneself from the world as a means of protection.
In an ideal world we would all live in sattwa. We would feel safe enough to let the delicate petals of our flower open and experience our true nature to be loving, kind, gentle, giving and even powerful—all the time.
This very sattvic or childlike mindset is quickly changed when the child realizes that people can be mean, the world can be unsafe and protection and self preservation is required. At this point in life, the mind is recruited by the heart to find a means of safety through the rajasic stimulation of the senses—looking for happiness outside of ourselves by indulging in sensory experience.
Rajas Turns to Tamas
As a result of years of unsuccessful and exhausting over-stimulation and emotional ups and downs, the mind feels exhausted and withdraws, seeking emotional safety. This is the transition into tamas. Here the mind can become depressed, and begin to seek safety in drugs and alcohol. What were recreational vices in a rajasic state of mind become serious addictions as the mind finds safety by checking out, socially withdrawing and disengaging.
The problem with tamasic behavior is that it is difficult to pull out of this protective emotional cocoon. While it feels safe here, there is still a longing for sattwa and a discontentment with rajasic behavior. The difficulty here is that one has to go through the mind and rajas before one can experience sattwa. In a tamasic state, the thought of exposing oneself to the stimulation and emotional uncertainty of rajas is overwhelming. Drugs and alcohol are often abused in this state to numb the feeling of loneliness, depression and fear.
Marijuana: Sattwa, Rajas, or Tamas?
Marijuana is a tamasic drug that can negatively affect memory (7). According to the NIH, it is addictive and mind-dulling, and can do permanent cognitive harm if used in excess. This is especially true if marijuana use begins in adolescence (3).
I have a story that comes to mind when I think of cannabis in this context of sattwa, rajas and tamas. When I lived in India, I visited quite a few ashrams, and two of them were ashrams where cannabis was regularly and openly used. Having no prior judgment about cannabis, I couldn’t help but notice that, for the most part, these ashrams were unkempt in comparison to the non-cannabis-smoking ashrams. The lawns were not taken care of, and the grounds were not swept.
This is not to say that using cannabis necessarily leads to this kind of negligence, but this is a perfect example of what can happen when the tamasic state goes unchecked.
I don’t doubt that one-time use of marijuana can still the mind from excessive thinking and give an active mind a taste of inner silence and peace. But, as with many things, more is not better. The tamasic effects of marijuana can dull the mind, leaving the aspirant dependent on marijuana use with only an illusion of real spiritual progress.
Pain Has Its Gifts:
Marijuana is a well proven medicine for eliminating chronic pain. It is said in Ayurveda that the pain is directly across from the bliss, and the reason for the pain is to get our attention so that we can go through the pain and experience a deeper, more real aspect of the self and let a more loving and powerful version of ourselves out.
According to this perspective, experiencing the pain is essential for emotional and spiritual growth. Once you take away the pain you have taken away the road map to mental and emotional maturity. Additionally, according to Alcoholics Anonymous, emotional maturation stops at the age ones starts drinking or doing drugs.
Our culture is quick to remove pain with medicines.
Long term use of marijuana can slowly slip the user into a tamasic state of mind in which it is difficult to engage mentally or emotionally with the world, and the longer it is used, the more difficult it is to re-enter.
Our culture is quick to remove pain with medicines. If you have a tooth ache, you get pain killers. If your girlfriend dumps you and you’re depressed, you get an anti-depressant. If you had a hard day, you reach for a glass of wine. If you are tired, you grab a cup of coffee. In our culture, any pain or discomfort is unacceptable and considered very treatable.
If folks realized that it is when we go through the pain that the doors to success and happiness open, we might not be so quick to suppress it. Of course, this is a very personal choice that each one of us has to make on our own.
Know the Facts and Use Your Discretion:
Long-term regular marijuana use, as we saw in the science above, is a concern for many reasons. The most trouble seems to lie in adolescents regularly using marijuana recreationally.
With teenagers now viewing marijuana as a medicine and therefore harmless, more and more adolescents are starting to use it thinking it is a safer alternative to alcohol. The research below shows that when regular marijuana use is started in adolescence, permanent and severe cognitive damage can occur (2, 3, 4).
As I mentioned earlier, as the landscape around marijuana changes and more strains are created with a medicinal purpose in mind, the cautions around marijuana use will most likely evolve also.
To adolescents using marijuana recreationally, I would caution: you only get one brain and you really can’t do much without it. If you choose to smoke pot, make sure you know the facts.
1. www.cannabis-med.org/index Review on clinical studies with cannabis and cannabinoids 2005-2009
5. J Psychopharmacol. 2010 Sep 9. Epub 2010 Sep 9. PMID: 20829306
6. Br J Psychiatry. 2008 Apr;192(4):306-7. PMID: 18378995
7. Br J Psychiatry. 2010 Oct;197(4):285-90. PMID: 20884951
8. Pain Res Manag. 2002 Summer;7(2):95-9. PMID: 12185373
9. PLoS One. 2011;6(4):e18440. Epub 2011 Apr 21. PMID: 21533029
10. Isr Med Assoc J. 2011 Aug ;13(8):455-8. PMID: 21910367
11. J Ethnopharmacol. 2010 Nov 19. Epub 2010 Nov 19. PMID: 21094240.
12. J Glaucoma. 2006 Oct;15(5):349-53. PMID: 16988594
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