Tag Archives: legalization of marijuana

Straight, No Chaser: Spice Drugs aka Herbal High aka K2 aka Synthetic Marijuana

January 28, 2018General Health and Wellness, Toxicology/Drugs844-SMA-TALK, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

So have you ever wondered why incense seems to relax you so? In our ongoing effort to keep you up to date with the latest drug teens may be using, today’s topic introduces “Spice” aka “herbal high.” Simply put, spice products are an effort to create a legal synthetic marijuana. You may be thinking: “Why wouldn’t they just find some marijuana?” Let’s pose and answer at some questions related to the topic.
How does this work? These drugs are synthetic cannabinoid receptor agonists, meaning these chemical compounds interact (fit into) the receptors where cannabis does, producing similar effects.

So it is the same as marijuana? No. The substances affect other parts of the body than cannabinoid receptors, which is how side effects and other symptoms are produced.
What types of symptoms are produced? Clinical symptoms are variable, but in a majority of cases, altered mental status and rapid heart beats occur, along with the typical high one gets from marijuana. Most patients normalize after 2-4 hours, assuming additional quantities aren’t inhaled. Additional symptoms described have included seizures, hallucinations, anxiety and very vivid dreams.
Is this as safe as marijuana? No. Many of these drugs are much more potent than the active substance in marijuana (delta-9-tetrahydrocannabinol – THC), therefore, the psychoactive dose may be much less. Given that marijuana and these substances aren’t some for effect per se, but habitually and recreationally, the potential for toxic inhalations is more significant. Furthermore, these substances are associated with addiction syndromes and withdrawal symptoms.
Do they show up on drug screens? No, not currently. Therein lies part of the attraction.

How do people obtain these substances? Therein lies more danger. If you’re in the know, you’re in the know. If you’re not, you could be playing with fire (no pun intended). These substances are easily obtainable legally, including on the Internet. The packaging usually refers to the content as herbal incense and “not for human consumption.” Many of these drugs are much more potent than delta-9-tetrahydrocannabinol (THC), therefore, the psychoactive dose may be < 1 mg.
But they’re legal? To be clear, selling and possession of these substances is illegal in the U.S. The Drug Enforcement Agency (DEA) and the US Department of Health and Human Services (DHHS) are currently determining if and how these entities will be permanently controlled in the United States.
The Straight, No Chaser recommendation is to find a way to get high on sunshine.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Marijuana Facts and Fiction, Part 2

January 27, 2018General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, Infant, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

The issues surrounding marijuana use are serious and need full examination, particularly with decriminalization legislature passing and being considered in various parts of the country. It is very important that you are fully aware of the current level of medical understanding regarding marijuana use. Feel free to ask additional questions, and check here for part one of Marijuana Facts and Fiction.

6. Marijuana leads to more serious illicit drug use.
The premise that marijuana is a “gateway drug” is a horrible one, regardless of your political bent. Here are some facts:

Currently, people use legal drugs–specifically alcohol and tobacco–more widely than marijuana, and use of these legal drugs leads to illicit drug use more often than marijuana use.
Pointing the term “gateway drugs” at marijuana misses the point of how much more dangerous these legal drugs are than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do. If their basis for complacency about marijuana use is insignificant ill effect, those individuals will suffer the consequences of their subsequent decision to use. From a public health standpoint, it’s not an either/or proposition.

7. So marijuana doesn’t cause lung cancer?
Regarding medical considerations, heavy use can be harmful. Although marijuana use isn’t conclusively associated with lung cancer, heavy pot smokers are still at risk for some of the same health effects as cigarette smokers, like bronchitis. It would be unfair not to point out that these risks are associated with smoking marijuana, and these effects appear to be due to the smoke and not necessarily the cannabis itself.
8. You can overdose on marijuana.
Simply put, there isn’t a documented case of death directly attributable to marijuana overdose.
9. You can’t become dependent on marijuana.
I’ll resist the urge to make a joke about certain of your favorite celebrities. According to the National Institutes of Health, not only is it possible to become dependent on marijuana, but approximately nine percent of marijuana users became clinically dependent. To put this in perspective, 15% of cocaine users and approximately 25% of heroin users become addicted. By the way, there’s a 30% addiction rate for tobacco users.
10. Does marijuana cause withdrawal symptoms?
Yes, it does. Withdrawal symptoms include anxiety, nausea and insomnia. That said, these are minor compared with tobacco, alcohol, heroin and cocaine. The marijuana withdrawal syndrome is not considered life-threatening.
11. Marijuana has not currently been shown to contribute to traffic accidents and fatalities.
It is next to impossible to conduct a research study that would prove this point. What we do know is that studies have shown that smoking marijuana tends to affect spatial perceptions. If under the influence, drivers can lose concentration and experience slower reaction times, leading to swerving or following other cars too closely. Researchers have concluded that driving while high greatly increases the chances of having an accident, and smoking pot and drinking before driving is a particularly dangerous mix. Because of the varying effects of marijuana on individuals, it is hard to set a blood level that indicates intoxication in the same way as with alcohol.
12. Does marijuana causes criminal behavior?
The problem with that question is the word “cause.” It is true that the rate of pot use is higher among criminals, but that doesn’t mean that pot causes the criminal activity, and there is no compelling evidence to suggest that it does. It’s just as conceivable that criminals tend to engage in illicit drug use. Intuitively, the connection between marijuana and subsequent criminal activity isn’t obvious, given the relaxation that marijuana produces (which sharply distinguishes it from alcohol).
13. What’s the difference between smoking marijuana and consuming it in other ways?
When someone smokes marijuana, its active ingredient moves almost immediately into the bloodstream and to the brain. The effects typically last between one and three hours. When eaten, it can take between 30 and 60 minutes to have an effect, but that effect can last up to four hours.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Marijuana Facts and Fiction, Part 1

January 26, 2018General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

The truth of it all is that politicians are generally a terrible source of scientific and medical information. There are actually legitimate concerns about the use and legalization of marijuana. There is also real value to be obtained from the use and legalization of marijuana. This and the next post will provide you information without the bias you’ve become used to. You can check this Straight, No Chaser post for basic information on marijuana use and intoxication.
1. Does the research on marijuana prove that it’s safe?
Of course it’s not “safe.” The air we breathe and the water we drink aren’t “safe.” The better question is “How harmful is it and is that level of harm/risk acceptable?”
Research on marijuana has actually been limited and is largely under the control of the governmental entity charged with identifying risks and harm – instead of benefits. The relative unavailability of marijuana for research has been a source of complaints from the medical community for years, as it has largely limited medically reasonable use and limits.
The research that has been conducted suggests that marijuana is relatively safer than alcohol, tobacco and other illicit drugs. This is not the same as saying it is safe. Marijuana smoke contains carcinogens, just as tobacco smoke does. However, available research concludes that even heavy marijuana use doesn’t lead to lung cancer. Specifically, even the heaviest marijuana smokers don’t seem to consume enough to lead to a positive association with cancer. Any association that does exist with cancer seems to be due to the additives and the smoke itself, not the marijuana.
2. Smoking marijuana really doesn’t place you at risk for harm, does it?
The really big problem with marijuana is you’re doing other things while intoxicated. Car accidents occur in those who drive while high. The fact that it occurs at a lower rate than accidents from drunk drivers should NOT be reassuring. Being intoxicated from marijuana increases risks for many other injuries, which is why users really need to be kept in a safe environment.
Similarly, in the instances when individuals are using marijuana while drinking or using other drugs, the risks for injury and illness become compounded by this simultaneous use. Given that the injuries don’t care where they came from, data gets skewed because of the association with marijuana use.
3. Is it true that more teens smoke pot than cigarettes?
In 2011, for the first time, use of marijuana by teenagers exceeded cigarette use. Overall, one out of every 15 high school students reported they smoke most days.
4. Marijuana doesn’t affect kids any differently than adults, does it?
Teen exposure on a regular basis does appear to lead to a permanent decrease in IQ. The developing brain should not be exposed to it. Given that more teens are now using pot than smoking cigarettes, this is an immediate area of concern.
5. Does marijuana cause mental illness or long-term brain deficits?
This doesn’t appear to be the case, with the caveat that regular exposure to marijuana in the developing brain leads to a permanent decrease in IQ.
6. Marijuana leads to more serious illicit drug use.
The premise that marijuana is a “gateway drug” is a horrible one, regardless as to which side of the political spectrum you reside. Here are some facts:

Currently, legal drugs, specifically alcohol and tobacco, are more widely used and more often lead to use of additional illicit drugs than marijuana. As an additional consideration, talking about “gateway drugs” misses the point when currently legal drugs are much more dangerous than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do, and if that’s based on having developed a sense of complacency due to marijuana use without significant ill effect, those individuals will suffer the consequences of that decision. From a public health standpoint, it’s not an either/or consideration.

Check back for questions on addiction, medical complications and other questions regarding marijuana use.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Weeding Through the Basics of Marijuana Use and Intoxication

January 25, 2018Toxicology/Drugs844-SMA-TALK, Behind the Curtain, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

As we survey the landscape, marijuana use is become legal in more parts of the United States. In this series, we will review the facts (and only the facts) on its clinical effects, the health risks and benefits, intoxication, public health considerations and myths, facts and fiction. Let’s get started.

Marijuana (cannabis) is the most commonly used illegal drug in the U.S. It is estimated that over 100 million Americans have used marijuana. Consumption usually occurs by smoking, which produces a rapid onset of symptoms, but some people eat it.

The “high” of marijuana (intoxication) is typically a euphoric, relaxed state. Other typical side effects include sleepiness and an increased appetite.
Less frequent, more serious and less desirable side effects include the following:

decreased memory
motor skills and perception
dryness of the mouth
dryness and redness of the eyes
panic
paranoia or acute psychosis

Much of the conversation about marijuana involves not just the drug itself but other drugs taken or other activities performed while using marijuana. Along those lines, additional side effects seen in marijuana users not directly attributable to the marijuana itself include abnormal heartbeats and rhythms, chest pain, headache, heart attacks with and without cardiac arrest, high blood pressure, hyperactivity, physical violence, seizures and strokes.
Treatment is largely supportive. It’s necessary to make sure that secondary injuries from irresponsible actions don’t occur. Therefore, it’s important to keep intoxicated individuals in a safe environment. In some instances when medical attention is needed, it is necessary to treat with medicines to combat anxiety and address injuries or side effects that have occurred.

Twenty states and the District of Columbia have enacted medical marijuana laws. Marijuana has been known for thousands of years to have certain medicinal effects, most notably as a treatment for pain and as an appetite stimulant, which has applicability in certain scenarios. Although physicians may not yet prescribe medical marijuana without violating federal law, they may legally recommend it.
Marijuana as treatment for pain has proven useful for patients suffering from the following conditions.

Glaucoma
Nausea
Neuropathic pain (nerve damage)
Movement disorders and spasticity

Marijuana is an appetite stimulant that has been proven useful for patients suffering from the following conditions:

If this part of the conversation seemed simple to you, it’s because marijuana is a rather simple drug on many levels. That said, I know what your questions are! Next up, we’ll address many myths and controversies involving marijuana.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Marijuana Facts and Fiction, Part 2

January 12, 2017General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, Infant, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

6. Marijuana leads to more serious illicit drug use.
The premise that marijuana is a “gateway drug” is a horrible one, regardless of your political bent. Here are some facts:

Currently, people use legal drugs–specifically alcohol and tobacco–more widely than marijuana, and use of these legal drugs leads to illicit drug use more often than marijuana use.
Pointing the term “gateway drugs” at marijuana misses the point of how much more dangerous these legal drugs are than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do. If their basis for complacency about marijuana use is insignificant ill effect, those individuals will suffer the consequences of their subsequent decision to use. From a public health standpoint, it’s not an either/or proposition.

7. So marijuana doesn’t cause lung cancer?
Regarding medical considerations, heavy use can be harmful. Although marijuana use isn’t conclusively associated with lung cancer, heavy pot smokers are still at risk for some of the same health effects as cigarette smokers, like bronchitis. It would be unfair not to point out that these risks are associated with smoking marijuana, and these effects appear to be due to the smoke and not necessarily the cannabis itself.
8. You can overdose on marijuana.
Simply put, there isn’t a documented case of death directly attributable to marijuana overdose.
9. You can’t become dependent on marijuana.
I’ll resist the urge to make a joke about certain of your favorite celebrities. According to the National Institutes of Health, not only is it possible to become dependent on marijuana, but approximately nine percent of marijuana users became clinically dependent. To put this in perspective, 15% of cocaine users and approximately 25% of heroin users become addicted. By the way, there’s a 30% addiction rate for tobacco users.
10. Does marijuana cause withdrawal symptoms?
Yes, it does. Withdrawal symptoms include anxiety, nausea and insomnia. That said, these are minor compared with tobacco, alcohol, heroin and cocaine. The marijuana withdrawal syndrome is not considered life-threatening.
11. Marijuana has not currently been shown to contribute to traffic accidents and fatalities.
It is next to impossible to conduct a research study that would prove this point. What we do know is that studies have shown that smoking marijuana tends to affect spatial perceptions. If under the influence, drivers can lose concentration and experience slower reaction times, leading to swerving or following other cars too closely. Researchers have concluded that driving while high greatly increases the chances of having an accident, and smoking pot and drinking before driving is a particularly dangerous mix. Because of the varying effects of marijuana on individuals, it is hard to set a blood level that indicates intoxication in the same way as with alcohol.
12. Does marijuana causes criminal behavior?
The problem with that question is the word “cause.” It is true that the rate of pot use is higher among criminals, but that doesn’t mean that pot causes the criminal activity, and there is no compelling evidence to suggest that it does. It’s just as conceivable that criminals tend to engage in illicit drug use. Intuitively, the connection between marijuana and subsequent criminal activity isn’t obvious, given the relaxation that marijuana produces (which sharply distinguishes it from alcohol).
13. What’s the difference between smoking marijuana and consuming it in other ways?
When someone smokes marijuana, its active ingredient moves almost immediately into the bloodstream and to the brain. The effects typically last between one and three hours. When eaten, it can take between 30 and 60 minutes to have an effect, but that effect can last up to four hours.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Marijuana Facts and Fiction, Part 1

January 11, 2017General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Currently, legal drugs, specifically alcohol and tobacco, are more widely used and more often lead to use of additional illicit drugs than marijuana. As an additional consideration, talking about “gateway drugs” misses the point when currently legal drugs are much more dangerous than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do, and if that’s based on having developed a sense of complacency due to marijuana use without significant ill effect, those individuals will suffer the consequences of that decision. From a public health standpoint, it’s not an either/or consideration.

Check back for questions on addiction, medical complications and other questions regarding marijuana use.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Weeding Through the Basics of Marijuana Use and Intoxication

January 10, 2017General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

As we survey the landscape, marijuana use has become legal in more parts of the United States. In this series, we will review the facts (and only the facts) on its clinical effects, the health risks and benefits, intoxication, public health considerations and myths, facts and fiction. Let’s get started.

decreased memory
motor skills and perception
dryness of the mouth
dryness and redness of the eyes
panic
paranoia or acute psychosis

Glaucoma
Nausea
Neuropathic pain (nerve damage)
Movement disorders and spasticity

Marijuana is an appetite stimulant that has been proven useful for patients suffering from the following conditions:

If this part of the conversation seemed simple to you, it’s because marijuana is a rather simple drug on many levels. That said, I know what your questions are! Next up, we’ll address many myths and controversies involving marijuana. Feel free to ask any questions you have on this topic.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Marijuana Facts and Fiction, Part 2

January 14, 2016General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

6. Marijuana leads to more serious illicit drug use.
The premise that marijuana is a “gateway drug” is a horrible one, regardless of your political bent. Here are some facts:

Currently, people use legal drugs–specifically alcohol and tobacco–more widely than marijuana, and use of these legal drugs leads to illicit drug use more often than marijuana use.
Pointing the term “gateway drugs” at marijuana misses the point of how much more dangerous these legal drugs are than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do. If their basis for complacency about marijuana use is insignificant ill effect, those individuals will suffer the consequences of their subsequent decision to use. From a public health standpoint, it’s not an either/or proposition.

7. So marijuana doesn’t cause lung cancer?
Regarding medical considerations, heavy use can be harmful. Although marijuana use isn’t conclusively associated with lung cancer, heavy pot smokers are still at risk for some of the same health effects as cigarette smokers, like bronchitis. It would be unfair not to point out that these risks are associated with smoking marijuana, and these effects appear to be due to the smoke and not necessarily the cannabis itself.
8. You can overdose on marijuana.
Simply put, there isn’t a documented case of death directly attributable to marijuana overdose.
9. You can’t become dependent on marijuana.
I’ll resist the urge to make a joke about certain of your favorite celebrities. According to the National Institutes of Health, not only is it possible to become dependent on marijuana, but approximately nine percent of marijuana users became clinically dependent. To put this in perspective, 15% of cocaine users and approximately 25% of heroin users become addicted. By the way, there’s a 30% addiction rate for tobacco users.
10. Does marijuana cause withdrawal symptoms?
Yes, it does. Withdrawal symptoms include anxiety, nausea and insomnia. That said, these are minor compared with tobacco, alcohol, heroin and cocaine. The marijuana withdrawal syndrome is not considered life-threatening.
11. Marijuana has not currently been shown to contribute to traffic accidents and fatalities.
It is next to impossible to conduct a research study that would prove this point. What we do know is that studies have shown that smoking marijuana tends to affect spatial perceptions. If under the influence, drivers can lose concentration and experience slower reaction times, leading to swerving or following other cars too closely. Researchers have concluded that driving while high greatly increases the chances of having an accident, and smoking pot and drinking before driving is a particularly dangerous mix. Because of the varying effects of marijuana on individuals, it is hard to set a blood level that indicates intoxication in the same way as with alcohol.
12. Does marijuana causes criminal behavior?
The problem with that question is the word “cause.” It is true that the rate of pot use is higher among criminals, but that doesn’t mean that pot causes the criminal activity, and there is no compelling evidence to suggest that it does. It’s just as conceivable that criminals tend to engage in illicit drug use. Intuitively, the connection between marijuana and subsequent criminal activity isn’t obvious, given the relaxation that marijuana produces (which sharply distinguishes it from alcohol).
13. What’s the difference between smoking marijuana and consuming it in other ways?
When someone smokes marijuana, its active ingredient moves almost immediately into the bloodstream and to the brain. The effects typically last between one and three hours. When eaten, it can take between 30 and 60 minutes to have an effect, but that effect can last up to four hours.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Marijuana Facts and Fiction, Part 1

January 13, 2016General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, illicit drugs, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Currently, legal drugs, specifically alcohol and tobacco, are more widely used and more often lead to use of additional illicit drugs than marijuana. As an additional consideration, talking about “gateway drugs” misses the point when currently legal drugs are much more dangerous than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do, and if that’s based on having developed a sense of complacency due to marijuana use without significant ill effect, those individuals will suffer the consequences of that decision. From a public health standpoint, it’s not an either/or consideration.

Check back for questions on addiction, medical complications and other questions regarding marijuana use. Feel free to ask your SMA expert consultant any questions you have on this topic.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Weeding Through the Basics of Marijuana Use and Intoxication

January 12, 2016Toxicology/Drugs844-SMA-TALK, Behind the Curtain, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

decreased memory
motor skills and perception
dryness of the mouth
dryness and redness of the eyes
panic
paranoia or acute psychosis

Glaucoma
Nausea
Neuropathic pain (nerve damage)
Movement disorders and spasticity

Marijuana is an appetite stimulant that has been proven useful for patients suffering from the following conditions:

Straight, No Chaser: Contrasting Healthcare Reform In the U.S. and Halfway Around the World

February 16, 2015General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, Affordable Care Act, healthcare reform, I844-SMA-TALK, Indonesia, legalization of marijuana, marijuana, Public Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Thoughts from a crowded Starbucks in Jakarta, Indonesia

Over my career, I’ve been fortunate to have studied and assisted healthcare systems all over the world. This past week, Sterling Medical Advice had the pleasure, privilege and outright honor of being invited to spend a week in Indonesia with the U.S. Department of Commerce on a healthcare mission in what will be a recurring role. By way of introduction (in case you weren’t aware), Indonesia is the fourth most populous country in the world (right after the U.S.) with a population of approximately 252 million people. It is approximately the same size as the United States, and it is a democracy and a member of the G-20 (with the 17^th largest world economy).

More relevantly, Indonesia is in the midst of becoming the largest country in the world to implement a system of universal healthcare for its citizens. That’s right: by 2019, Indonesia will have enrolled their entire population in a universal healthcare system that is not owned or run by the government. This is a living rebuttal to those who insist that universal healthcare is necessarily socialist medicine.
There are some interesting observations to be made and contrasts between the system design and our own healthcare system. The U.S. currently spends over $8000 per person on healthcare per year; in Indonesia the average spend will be $60/person. This translates into Indonesia spending approximately $15 billion annually on health care after implementation of its new system, compared with over $2 trillion spent in the U.S., inclusive of Indonesia’s goal of doubling its current contributions toward its citizens’ health as part of its healthcare reform.

Dr. Sterling with Dr. Hasbullah Thabrany, professor of health policy at the University of Indonesia in Jakarta and architect of the world’s largest healthcare system

Access will be the foremost priority in the new system of Indonesia, whereas in the U.S., choice is the core component. Still, reform efforts of both systems are prioritizing access; unfortunately in the U.S., access still usually means utilization of the emergency room as a last resort as opposed to having everyone connected to a primary care physician.
Both systems suffer from dramatic physician shortages. In the U.S. this shortage has been addressed by the expansion of numbers and responsibilities for physician assistants and nurse practitioners. Indonesia has yet to permit non-physicians to obtaining status as independently licensed practitioners. In Indonesia, medical schools are opening in an attempt to address the shortage over the long-term; this is not a policy priority in the U.S.
These comments aren’t meant to suggest one country’s approach is better or worse. Such opinions are best addressed by review of objective data. Prior to the implementation of the Affordable Care Act in the U.S. and the current effort in Indonesia, both countries were performing less that either would have wanted. The World Health Organization’s (in)famous rankings of various countries’ systems (based largely on access and outcomes) placed the U.S. system #38 despite being the most expensive and Indonesia’s #92 while being #154 in costs. On the other hand, the U.S.’ ongoing spending of $2 trillion annually on healthcare does wonders for our economy.

As much as anything, the successful implementation of a universal healthcare system in a country the size of Indonesia should encourage those in the U.S. who have long advocated for such here, meaning if the political will ever existed, it could be accomplished. Unfortunately, the ingrained financial interests here continue to outweigh the desires of the public health community.
In the meantime, appreciate that the basics of a country’s ideal healthcare system should be the tools you utilize as your personal healthcare system. Embrace prevention through diet, exercise, screenings, immunizations and healthy life choices. Obtain information and advice to help guide your health decisions. Find a primary care physician. Get prompt treatment when you need it. The benefits of good health are worth the effort at every level.
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Marijuana Facts and Fiction, Part 2

January 27, 2015Toxicology/Drugs844-SMA-TALK, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

6. Marijuana leads to more serious illicit drug use.
The premise that marijuana is a “gateway drug” is a horrible one, regardless of your political bent. Here are some facts:

Currently, people use legal drugs–specifically alcohol and tobacco–more widely than marijuana, and use of these legal drugs leads to illicit drug use more often than marijuana use.
Pointing the term “gateway drugs” at marijuana misses the point of how much more dangerous these legal drugs are than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do. If their basis for complacency about marijuana use is insignificant ill effect, those individuals will suffer the consequences of their subsequent decision to use. From a public health standpoint, it’s not an either/or proposition.

7. So marijuana doesn’t cause lung cancer?
Regarding medical considerations, heavy use can be harmful. Although marijuana use isn’t conclusively associated with lung cancer, heavy pot smokers are still at risk for some of the same health effects as cigarette smokers, like bronchitis. It would be unfair not to point out that these risks are associated with smoking marijuana, and these effects appear to be due to the smoke and not necessarily the cannabis itself.
8. You can overdose on marijuana.
Simply put, there isn’t a documented case of death directly attributable to marijuana overdose.
9. You can’t become dependent on marijuana.
I’ll resist the urge to make a joke about certain of your favorite celebrities. According to the National Institutes of Health, not only is it possible to become dependent on marijuana, but approximately nine percent of marijuana users became clinically dependent. To put this in perspective, 15% of cocaine users and approximately 25% of heroin users become addicted. By the way, there’s a 30% addiction rate for tobacco users.
10. Does marijuana cause withdrawal symptoms?
Yes, it does. Withdrawal symptoms include anxiety, nausea and insomnia. That said, these are minor compared with tobacco, alcohol, heroin and cocaine. The marijuana withdrawal syndrome is not considered life-threatening.
11. Marijuana has not currently been shown to contribute to traffic accidents and fatalities.
It is next to impossible to conduct a research study that would prove this point. What we do know is that studies have shown that smoking marijuana tends to affect spatial perceptions. If under the influence, drivers can lose concentration and experience slower reaction times, leading to swerving or following other cars too closely. Researchers have concluded that driving while high greatly increases the chances of having an accident, and smoking pot and drinking before driving is a particularly dangerous mix. Because of the varying effects of marijuana on individuals, it is hard to set a blood level that indicates intoxication in the same way as with alcohol.
12. Does marijuana causes criminal behavior?
The problem with that question is the word “cause.” It is true that the rate of pot use is higher among criminals, but that doesn’t mean that pot causes the criminal activity, and there is no compelling evidence to suggest that it does. It’s just as conceivable that criminals tend to engage in illicit drug use. Intuitively, the connection between marijuana and subsequent criminal activity isn’t obvious, given the relaxation that marijuana produces (which sharply distinguishes it from alcohol).
13. What’s the difference between smoking marijuana and consuming it in other ways?
When someone smokes marijuana, its active ingredient moves almost immediately into the bloodstream and to the brain. The effects typically last between one and three hours. When eaten, it can take between 30 and 60 minutes to have an effect, but that effect can last up to four hours.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Marijuana Facts and Fiction, Part 1

January 26, 2015General Health and Wellness, Toxicology/Drugs844-SMA-TALK, illicit drugs, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Currently, legal drugs, specifically alcohol and tobacco, are more widely used and more often lead to use of additional illicit drugs than marijuana. As an additional consideration, talking about “gateway drugs” misses the point when currently legal drugs are much more dangerous than marijuana.
The majority of marijuana users never use other illicit drugs, according to the U.S. Department of Health and Human Services. A report by the Institute of Medicine found “no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” It is likely more accurate to say that the same factors that drive marijuana use lead to the use of other illicit drugs.
On the other hand, it’s irrelevant that the majority of marijuana users never use other illicit drugs. A statistically significant number do, and if that’s based on having developed a sense of complacency due to marijuana use without significant ill effect, those individuals will suffer the consequences of that decision. From a public health standpoint, it’s not an either/or consideration.

Check back for questions on addiction, medical complications and other questions regarding marijuana use. Feel free to ask your SMA expert consultant any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Weeding Through the Basics of Marijuana Use and Intoxication

January 23, 2015Toxicology/Drugs844-SMA-TALK, legalization of marijuana, marijuana, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Let’s start by getting the obvious out of the way. For those of you who keep asking me: Yes, I’m finally discussing the use and effects of marijuana. In this series, we will review the facts (and only the facts) on its clinical effects, the health risks and benefits, intoxication, public health considerations and myths, facts and fiction. Let’s get started.

decreased memory
motor skills and perception
dryness of the mouth
dryness and redness of the eyes
panic
paranoia or acute psychosis

Glaucoma
Nausea
Neuropathic pain (nerve damage)
Movement disorders and spasticity

Marijuana is an appetite stimulant that has been proven useful for patients suffering from the following conditions:

If this part of the conversation seemed simple to you, it’s because marijuana is a rather simple drug on many levels. That said, I know what your questions are! Next up, we’ll address many myths and controversies involving marijuana. Feel free to ask any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.