This week Bobbi Conner talks with Dr. Kevin Gray about cannabis use and potential adverse effects. Dr. Gray is a practicing physician and Director of Addiction Sciences in the Department of Psychiatry and Behavioral Sciences at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Cannabis and cannabis products are increasingly available in the U.S., and recent reports of related side effects and health issues are surfacing in the news and also in clinical practice. Doctor Kevin Gray is here to provide some details. Doctor gray is a practicing physician, and he's director of Addiction Sciences in the Department of Psychiatry and Behavioral Sciences at MUSC. Doctor Gray, recreational and medical use of cannabis is illegal in South Carolina, but clinicians in our state are nonetheless dealing with health related issues or side effects from cannabis use in patients of various ages. What are you and your colleagues seeing along these lines?
Dr. Gray: Certainly cannabis is a complicated one. And, while policies are at the state to state level, attitudes and behaviors cross state lines. And so, while cannabis is not legal for use in South Carolina, in clinical practice we have seen an uptick in cannabis use. And I would say, like with many things, there's nothing that's all good or all bad. And with cannabis, we can be very excited about its therapeutic potential. There are some ingredients in cannabis that have been isolated and used therapeutically. At the same time, we can't ignore that as used, sometimes cannabis has adverse effects. And so, there's a variety of things that we see. The most common would be something we call cannabis use disorder. And that's where somebody has developed a pattern of use where it's impairing, but they have a difficult time cutting back or quitting despite that impairment.
Conner: And are there some groups of people in particular that you're especially concerned about related to cannabis use?
Dr. Gray: Absolutely. Our biggest concerns are one- with adolescent use while the brain is still developing in the mid 20s. We know that cannabis has more adverse effects in those who initiate use early. So, we're concerned about adolescent use.
Second is use during pregnancy. There's increasing evidence of adverse effects on the offspring if a mother uses during pregnancy. And then third is use during the course of a psychiatric illness, is that longitudinal studies show us time and again, is that adding cannabis to a psychiatric disorder tends to complicate the course of the disorder. People sometimes experience short term relief of some of their psychiatric symptoms with cannabis use. So, say, with insomnia or with depressed mood or with anxiety. We really tend to find over the longer course of time is that if somebody is using cannabis in the face of depression or anxiety or other psychiatric problems, it tends to complicate the course of the underlying problem. And so, things get more complicated when you add cannabis.
Conner: This is a dicey situation where people might be routinely using cannabis products, but they may not be mentioning this in their medical checkups, so they're not getting any guidance from their health care provider.
Dr. Gray: It is a bit of a Wild West situation, especially if people are seeking out cannabis for therapeutic purposes and they may understandably be sheepish about sharing this with their medical provider. But it's very important because sometimes there can be drug-drug interactions between cannabis and other prescribed medications. And at the same time, also there's very little guidance in terms of dosing and frequency with cannabis use. One concern we have is where there's a lot of high potency cannabis products available now, and particularly for naive users who may be a first time user, the dose may be so high that people have adverse reactions like a panic attack or even a brief psychotic episode. It's certainly important to discuss cannabis use with your health care provider, because that can help to inform your overall plan of care.
Conner: Doctor Gray, thanks for this information related to cannabis use.
Dr. Gray: Thank you so much Bobbi.
Conner: From the Radio Studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
