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NLM Director’s Comments Transcript
Rethinking Industrialized Marijuana: 07/28/2014

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

The production and marketing of legal marijuana may be following a pattern similar to tobacco’s diffusion in the first half of the 20th century, suggests a recent, insightful commentary in the New England Journal of Medicine.    

The commentary’s authors explain 19 U.S. states recently decriminalized or eliminated jail time for possession of small amounts of marijuana. They note 21 states and the District of Columbia legalized marijuana’s medical use. Moreover, Colorado and Washington recently approved the retail sale of marijuana, which the authors note sets the stage for a legal, mass produced, and well-marketed marijuana industry — similar to the tobacco industry’s opportunities a century ago.

The authors, who are from the University of Kansas Medical Center and Harvard Medical School, find in the late 19th century few Americans used tobacco products and only one percent of tobacco was consumed as manufactured cigarettes. Interestingly, the authors find most tobacco products were hand rolled at the turn of the 20th century similar to current marijuana use. However, the authors explain by the 1950s nearly half the U.S. population used tobacco and 80 percent of tobacco use was industrialized cigarettes.

The authors note the transformation of hand rolled tobacco into widely marketed, retail available, industrialized cigarettes was the result of innovations in product development, marketing, as well as successful state and national lobbing. The authors explain a similar scenario now could enable the mass-production, marketing, distribution, and sale of marijuana.

Among parallel developments, for example, the authors note marijuana producers have doubled the concentration of THC, which is marijuana’s principal psychoactive ingredient. The authors continue manufacturers now can deliver marijuana through new vaporized delivery systems that (and we quote) ‘ may reduce lung irritation from smoking (marijuana) but may also allow users to consume more THC … by enabling them to inhale more often and more deeply’ (end of quote).

As a result, similar to 20th century patterns where improved cigarette manufacturing enabled consumers to inhale more nicotine, the authors explain industrially produced marijuana boosts the ingredient that is most associated with user euphoria, marijuana’s addictive potential, and its possible mental health side effects.

Also similar to tobacco in the early 20th century, the authors explain the percentage of Americans age 12 or older who use marijuana is relatively small (around seven percent). To provide some historical perspective, the authors write (and we quote) “once machines began mass-producing cigarettes, marketing campaigns targeted women, children, and vulnerable groups by associating smoking with images of freedom, sex appeal, cartoon characters, and – in the early days – health benefits’ (end of quote).

Overall, the authors envision a tobacco-derived template to industrially produce and market marijuana that significantly increases consumer use and deemphasizes its possible, accompanying public health and clinical risks. The authors write (and we quote): ‘The tobacco industry has provided a detailed road map for marijuana; deny addition potential, downplay known adverse health effects, create as large a market as possible as quickly as possible, and protect that market through lobbying, campaign contributions, and other advocacy efforts’ (end of quote).

The authors conclude (and we quote) ‘history and current evidence suggest that simply legalizing marijuana, and giving free rein to the resulting industry, is not the answer’ (end of quote). Instead, they urge oversight of the marijuana industry’s growth, regulatory vigilance, as well as new health policies derived from research about the clinical risks and benefits of marijuana use.

Meanwhile, a website (from the National Institute on Drug Abuse) devoted to the topic whether marijuana is or is not medicine is available in the ‘related issues’ section of MedlinePlus.gov’s marijuana health topic page. Some tips for parents about teen and adult marijuana use (also from the National Institute on Drug Abuse) are found in the ‘overviews’ section of MedlinePlus.gov’s marijuana health topic page.

Some updated information about marijuana policy initiatives provided by the U.S. Office of National Drug Control Policy can be found in the ‘law and policy’ section of MedlinePlus.gov’s marijuana health topic page.

MedlinePlus.gov’s marijuana health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to relevant clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about marijuana and health as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s marijuana health topic page type ‘marijuana’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘marijuana (National Library of Medicine).’ MedlinePlus.gov also has health topic pages on drug abuse and substance abuse problems. 

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.