10 ms·

As America's Marijuana Use Grows, So Do the Harms

42 points by gist 2y ago

musicale 2y ago
No one could have predicted this.
toomuchtodo 2y ago
Previous: https://news.ycombinator.com/item?id=41771085 https://news.ycombinator.com/item?id=41771085 - October 7th, 2024 (4 comments) https://news.ycombinator.com/item?id=41743399 https://news.ycombinator.com/item?id=41743399 - October 4th, 2024 (1 comment) (no material discussions previously)
gist 2y ago
Also see this and note who the OP is: https://gothamgal.com/2024/10/journalism-vs-media/ https://gothamgal.com/2024/10/journalism-vs-media/
- tyleo 2y ago
  I really appreciate you sharing both sides of this story. Haven’t really made up my mind on the matter myself but both perspectives are interesting.
  - Me001 2y ago
    I don’t understand, it’s not two sides just evidence vs lack of evidence.
- slibhb 2y ago
  This response guestures towards a few things, but it doesn't really dispute the claims being made. I was left confused with exactly what the author disagrees with in the Times article (other than the overall conclusion: "weed is bad").
- Terretta 2y ago
  Authored and editored sentence in the NY Times article: NY Times: ”Researchers don’t know why heat soothes the syndrome, known as C.H.S., nor why certain chronic marijuana users develop it and others don’t.“ Let's read that again: "why certain do ... and others don't". Now, a sentence containing numbers from Gotham Gal: Gotham Gal: “Cannabinoid hyperemesis syndrome is what a lot of the article focused on. Reporters surveyed 200 physicians who have different specialties and found almost 600 people who suffer from this syndrome. 600 people spread throughout 200 physicians? I mean seriously. Thirty-five million people use cannabis daily in the United States.” Certain do. Others don't. Later in the NY Times article we get this selection-bias + self-reporting bias gem: “A 2018 survey of emergency department patients at Bellevue Hospital in New York found that among 18- to 49-year-olds who disclosed consuming cannabis at least 20 times a month, one-third met criteria for the syndrome.” Pot or not, what are the odds of ER patients reporting symptoms meeting critera of "nausea, vomiting, and pain"? Followed immediately by extrapolating to everyone: “Based on those rates, the researchers estimate that today about six million near-daily marijuana users in the United States could have symptoms of C.H.S.” They could. Certain do. Others don't. And then one last amazing couplet about our 600 person sample: “600 people with C.H.S. who responded to the Times survey said ...” “Many of the respondents, who are in a Facebook support group, said...” Oh. These do. Others don't.
api 2y ago
I have known alcoholics and heavy marijuana users. Alcohol is hands down far worse for health long term if used heavily and regularly. It’s not even close. I personally consider alcohol a “hard drug” at least at higher doses. That being said there is this myth that weed is harmless. It’s not. It’s a drug. If it’s smoked it damages the lungs just like smoking anything else, and the compounds in it might have negative long term effects on cognition. Like anything else of the sort if it’s used at all it should be used in moderation.
- shrubby 2y ago
  Alcohol and tobacco are worst ones as in addition to harms they're also available practically everywhere and the harms are huge. Weed is harmful as well, but it might not be quite as obviously harmful as ethanol. I have considered and read a crapton, trying to learn addiction. And there isn't a safe substance and there's no way of knowing how close to problem use one is, as genetics, repetitions and traumas are personal. And addiction is transferable, learnt with one substance the nervous systems will quickly pick up a new one should the supply be cut off. And it's also a disease that progresses. Like a coil in a bolt, once it's broken you can't turn back. And there's no torque wrench for substance use. I loved my alcohol, weed and nails. But unfortunately there's no use that's safe.
- nelup20 2y ago
  > If it’s smoked it damages the lungs just like smoking anything else, and the compounds in it might have negative long term effects on cognition. Also higher risk of a heart attack and/or stroke: https://www.ahajournals.org/doi/10.1161/JAHA.123.030178 https://www.ahajournals.org/doi/10.1161/JAHA.123.030178
lenerdenator 2y ago
I imagine that the harms that come with medium-or-heavy marijuana consumption are still probably less than, say, being locked in a cell at a state prison for selling it, or using other drugs that are both illicit and tainted with opioids. I don't partake, but I'm in a recreational state, and I think it's accurate to say that the stuff you can purchase at a dispensary is one of the few guaranteed safe highs you can get in 2024.
- deergomoo 2y ago
  This has always been my argument for legalisation (apart from a general feeling of "I am not hurting anyone else, so why do you get a say in this"). If you think it's harmless you're kidding yourself, but for most people, the associated harms of criminalisation far outweigh the harms of the drug itself.
  - slibhb 2y ago
    I think this is probably wrong. The total society wide harms of legalization are higher than the total society wide harms of criminalization. The former harms are more diffuse but probably greater in sum. Of course, criminalization isn't a binary. Probably, we could have just moved a little slower here.
    - bsder 2y ago
      > The total society wide harms of legalization are higher than the total society wide harms of criminalization. We have quite a lot of evidence to the contrary. In the US, marijuana legalization is being fought because the criminalization provides so much revenue to the enforcement system. That's a REALLY, REALLY BAD perverse incentive and it does an enormous amount of very visible damage. It provides incentives to jail people rather than treat them. It corrupts the "justice" system with monetary incentives. It funnels money into black market operators. etc. Unfortunately, the only real way to control that perverse incentive is to legalize. Yes, there are other ways, but they require a significant amount of sustained political will that is much harder to muster than that required for simple legalization.
exabrial 2y ago
Inhaling combustion byproducts of cigarettes, devils lettuce... a car tire, etc is terrible for your lungs. Theres nothing about weed that makes it safe to smoke. I imagine it's probably worse the tobacco in some areas I imagine (not that "filters" help, but I'm sure they do something), but I'm just speculating. I would treat it with the same risks as 'regular' smoking. There are better ways.
- terminalbraid 2y ago
  Good news! Marijuana consumption isn't limited to smoking.
- david-gpu 2y ago
  Growing up it was not unusual for people to smoke one or two packs of cigarettes a day. That is 20 to 40 units daily. Do you have a sense of how much weed most people consume? It is a tiny fraction of that. I honestly don't know how I would feel after smoking a whole joint all by myself because I have experienced hallucinations after a lot less than that. Granted, I have low tolerance, but still. Modern weed packs a punch. Not to mention that vaping bypasses the need for burning the flowers in the first place.
  - consteval 2y ago
    I think this is the key to why smoking MJ isn't really that bad (and, conversely, why vaping nicotine vapes may be worse in some respects than Tobacco). The quantity matters. MJ smoke is a tiny amount if done daily, while Tobacco is orders of magnitude more. And vapes have no limits, so to speak. One disposable is maybe 12 packs worth of nicotine, but you can easily finish it in 4 days if you try.
- deleted 2y ago
  [deleted]
deergomoo 2y ago
Interesting that only two states cap THC quantity. I'm in the UK and my friend has a (quite rare, here) medical prescription; the part I find most appealing is his ability to purchase significantly lower % THC stuff (though high-THC is very much available, which I found surprising). I still like it recreationally from time to time, but the problem is anything I get black market is just incapacitating, because I have no tolerance anymore. I (and I suspect many users over a certain age) would like the equivalent of a few beers, but the only thing available is absinthe.
- ls612 2y ago
  You can buy edibles and then split them into whatever dosage does the trick for you. At least in most legal states you can.
  - zikduruqe 2y ago
    Or take a tiny hit off a vape pen. No need to rip clouds.
- wkat4242 2y ago
  I think it's because the market has used THC content as a marketing point and that has driven its content to grow massively. Leading to infrequent users getting overwhelmed. I think it's good to keep that under control a bit. From what I hear the normal marijuana that's not "enhanced" is much more enjoyable.
bsder 2y ago
Part of the problem is that, currently, marijuana seems to be the only socially acceptable "treatment" for your mental health. None of the people in this story were using marijuana for pleasure. They were using it heavily as a medical treatment. This is just like lots of people who used alcohol and nicotine for exactly these same reasons for many, many years until those drugs became regarded as socially unacceptable. A better solution is for us all to have genuine medical mental health treatment rather than a bunch of people all relying on ad hoc personal chemical experiments.
- drdaeman 2y ago
  It also must be widely accessible so there is minimal effort necessary to get help if you suspect you need it. When mental health is not accessible (reasons vary from country to country - in some it's merely a stigma, but in some it can have legal consequences[1], and in some it's simply financially prohibitive) there no surprise folks tend hit a joint, or swig from a bottle, rather than visit a doctor's office. [1] Like a difficulty to obtain or renew a driver license with a medical history of having a diagnosed mental disorder (even if it formally shouldn't be an issue). Which is why I'd even argue for ability to seek help anonymously (if desired so) as a potential requirement. Should help with any stigmas just as well.
- readthenotes1 2y ago
  You're saying that the kids are using marijuana on a daily basis and a scary amount are taking it as medical treatment? For what? Growing up? It is traumatic and definitely causes anxiety but the people I know that resorted to regular marijuana used to handle the anxiety never learned to handle anxiety...
  - SauciestGNU 2y ago
    Cannabis plus SSRIs have allowed me to manage depression/anxiety symptoms as well as ADHD tendencies. It's been genuinely life-changing for me. I suspect that's more along the lines people are talking about.
metalman 2y ago
down ,Cuba way, they are dealing with a weed derivative they call "chemico" which by all accounts will FUU (fuck you up) Here is the deal with humans and substinces we will keep refining anything and everything untill we get it concentrated into a white chrystaline powder,ie: 100% X.And then moan and groan till we can find something else with a bigger kick and bang for the buck and start refining that.
johnea 2y ago
Of course, people should use alcohol tobacco and firearms, like the little baby jesus intended! The deamonization of weed is a witch hunt, plain and simple. Paid for by the ATF industry. Through 50 years of routine marijuana use, I've seen a number of people shrivel up and die of various tobacco use cancers, I've seen people die from liver disease and car crashes due to alcohol (not to mention the routine bar fighting and gutter puking), but I've never know anyone who died from marijuana use, ever. As psychoactive substances go, it's about as harmless as they come. With probably only magic mushrooms being less harmful. This article speaks much more loudly to the NYT's support of the ATF industry, than to any harms due to marijuana. People who are allergic will die from eating peanuts, I think this is on the same scale of danger that marijuana brings. But, don't forget, that new chardaney is delightful!
ldehaan 2y ago
[dead]
meiraleal 2y ago
I've been smoking weed daily for the past 15 years and if much, my health is much, much better today than it was 15 years ago. Yeah, not a great study of 1 case, but tacit knowledge is the real deal.

42 points by gist 2y ago

No one could have predicted this.

Previous: https://news.ycombinator.com/item?id=41771085 https://news.ycombinator.com/item?id=41771085 - October 7th, 2024 (4 comments) https://news.ycombinator.com/item?id=41743399 https://news.ycombinator.com/item?id=41743399 - October 4th, 2024 (1 comment) (no material discussions previously)

gist 2y ago

Also see this and note who the OP is: https://gothamgal.com/2024/10/journalism-vs-media/ https://gothamgal.com/2024/10/journalism-vs-media/

tyleo 2y ago
I really appreciate you sharing both sides of this story. Haven’t really made up my mind on the matter myself but both perspectives are interesting.
- Me001 2y ago
  I don’t understand, it’s not two sides just evidence vs lack of evidence.
slibhb 2y ago
This response guestures towards a few things, but it doesn't really dispute the claims being made. I was left confused with exactly what the author disagrees with in the Times article (other than the overall conclusion: "weed is bad").
Terretta 2y ago
Authored and editored sentence in the NY Times article: NY Times: ”Researchers don’t know why heat soothes the syndrome, known as C.H.S., nor why certain chronic marijuana users develop it and others don’t.“ Let's read that again: "why certain do ... and others don't". Now, a sentence containing numbers from Gotham Gal: Gotham Gal: “Cannabinoid hyperemesis syndrome is what a lot of the article focused on. Reporters surveyed 200 physicians who have different specialties and found almost 600 people who suffer from this syndrome. 600 people spread throughout 200 physicians? I mean seriously. Thirty-five million people use cannabis daily in the United States.” Certain do. Others don't. Later in the NY Times article we get this selection-bias + self-reporting bias gem: “A 2018 survey of emergency department patients at Bellevue Hospital in New York found that among 18- to 49-year-olds who disclosed consuming cannabis at least 20 times a month, one-third met criteria for the syndrome.” Pot or not, what are the odds of ER patients reporting symptoms meeting critera of "nausea, vomiting, and pain"? Followed immediately by extrapolating to everyone: “Based on those rates, the researchers estimate that today about six million near-daily marijuana users in the United States could have symptoms of C.H.S.” They could. Certain do. Others don't. And then one last amazing couplet about our 600 person sample: “600 people with C.H.S. who responded to the Times survey said ...” “Many of the respondents, who are in a Facebook support group, said...” Oh. These do. Others don't.

api 2y ago

I have known alcoholics and heavy marijuana users. Alcohol is hands down far worse for health long term if used heavily and regularly. It’s not even close. I personally consider alcohol a “hard drug” at least at higher doses. That being said there is this myth that weed is harmless. It’s not. It’s a drug. If it’s smoked it damages the lungs just like smoking anything else, and the compounds in it might have negative long term effects on cognition. Like anything else of the sort if it’s used at all it should be used in moderation.

shrubby 2y ago
Alcohol and tobacco are worst ones as in addition to harms they're also available practically everywhere and the harms are huge. Weed is harmful as well, but it might not be quite as obviously harmful as ethanol. I have considered and read a crapton, trying to learn addiction. And there isn't a safe substance and there's no way of knowing how close to problem use one is, as genetics, repetitions and traumas are personal. And addiction is transferable, learnt with one substance the nervous systems will quickly pick up a new one should the supply be cut off. And it's also a disease that progresses. Like a coil in a bolt, once it's broken you can't turn back. And there's no torque wrench for substance use. I loved my alcohol, weed and nails. But unfortunately there's no use that's safe.
nelup20 2y ago
> If it’s smoked it damages the lungs just like smoking anything else, and the compounds in it might have negative long term effects on cognition. Also higher risk of a heart attack and/or stroke: https://www.ahajournals.org/doi/10.1161/JAHA.123.030178 https://www.ahajournals.org/doi/10.1161/JAHA.123.030178

lenerdenator 2y ago

I imagine that the harms that come with medium-or-heavy marijuana consumption are still probably less than, say, being locked in a cell at a state prison for selling it, or using other drugs that are both illicit and tainted with opioids. I don't partake, but I'm in a recreational state, and I think it's accurate to say that the stuff you can purchase at a dispensary is one of the few guaranteed safe highs you can get in 2024.

deergomoo 2y ago
This has always been my argument for legalisation (apart from a general feeling of "I am not hurting anyone else, so why do you get a say in this"). If you think it's harmless you're kidding yourself, but for most people, the associated harms of criminalisation far outweigh the harms of the drug itself.
- slibhb 2y ago
  I think this is probably wrong. The total society wide harms of legalization are higher than the total society wide harms of criminalization. The former harms are more diffuse but probably greater in sum. Of course, criminalization isn't a binary. Probably, we could have just moved a little slower here.
  - bsder 2y ago
    > The total society wide harms of legalization are higher than the total society wide harms of criminalization. We have quite a lot of evidence to the contrary. In the US, marijuana legalization is being fought because the criminalization provides so much revenue to the enforcement system. That's a REALLY, REALLY BAD perverse incentive and it does an enormous amount of very visible damage. It provides incentives to jail people rather than treat them. It corrupts the "justice" system with monetary incentives. It funnels money into black market operators. etc. Unfortunately, the only real way to control that perverse incentive is to legalize. Yes, there are other ways, but they require a significant amount of sustained political will that is much harder to muster than that required for simple legalization.

exabrial 2y ago

Inhaling combustion byproducts of cigarettes, devils lettuce... a car tire, etc is terrible for your lungs. Theres nothing about weed that makes it safe to smoke. I imagine it's probably worse the tobacco in some areas I imagine (not that "filters" help, but I'm sure they do something), but I'm just speculating. I would treat it with the same risks as 'regular' smoking. There are better ways.

terminalbraid 2y ago
Good news! Marijuana consumption isn't limited to smoking.
david-gpu 2y ago
Growing up it was not unusual for people to smoke one or two packs of cigarettes a day. That is 20 to 40 units daily. Do you have a sense of how much weed most people consume? It is a tiny fraction of that. I honestly don't know how I would feel after smoking a whole joint all by myself because I have experienced hallucinations after a lot less than that. Granted, I have low tolerance, but still. Modern weed packs a punch. Not to mention that vaping bypasses the need for burning the flowers in the first place.
- consteval 2y ago
  I think this is the key to why smoking MJ isn't really that bad (and, conversely, why vaping nicotine vapes may be worse in some respects than Tobacco). The quantity matters. MJ smoke is a tiny amount if done daily, while Tobacco is orders of magnitude more. And vapes have no limits, so to speak. One disposable is maybe 12 packs worth of nicotine, but you can easily finish it in 4 days if you try.
deleted 2y ago
[deleted]

deergomoo 2y ago

Interesting that only two states cap THC quantity. I'm in the UK and my friend has a (quite rare, here) medical prescription; the part I find most appealing is his ability to purchase significantly lower % THC stuff (though high-THC is very much available, which I found surprising). I still like it recreationally from time to time, but the problem is anything I get black market is just incapacitating, because I have no tolerance anymore. I (and I suspect many users over a certain age) would like the equivalent of a few beers, but the only thing available is absinthe.

ls612 2y ago
You can buy edibles and then split them into whatever dosage does the trick for you. At least in most legal states you can.
- zikduruqe 2y ago
  Or take a tiny hit off a vape pen. No need to rip clouds.
wkat4242 2y ago
I think it's because the market has used THC content as a marketing point and that has driven its content to grow massively. Leading to infrequent users getting overwhelmed. I think it's good to keep that under control a bit. From what I hear the normal marijuana that's not "enhanced" is much more enjoyable.

bsder 2y ago

Part of the problem is that, currently, marijuana seems to be the only socially acceptable "treatment" for your mental health. None of the people in this story were using marijuana for pleasure. They were using it heavily as a medical treatment. This is just like lots of people who used alcohol and nicotine for exactly these same reasons for many, many years until those drugs became regarded as socially unacceptable. A better solution is for us all to have genuine medical mental health treatment rather than a bunch of people all relying on ad hoc personal chemical experiments.

drdaeman 2y ago
It also must be widely accessible so there is minimal effort necessary to get help if you suspect you need it. When mental health is not accessible (reasons vary from country to country - in some it's merely a stigma, but in some it can have legal consequences[1], and in some it's simply financially prohibitive) there no surprise folks tend hit a joint, or swig from a bottle, rather than visit a doctor's office. [1] Like a difficulty to obtain or renew a driver license with a medical history of having a diagnosed mental disorder (even if it formally shouldn't be an issue). Which is why I'd even argue for ability to seek help anonymously (if desired so) as a potential requirement. Should help with any stigmas just as well.
readthenotes1 2y ago
You're saying that the kids are using marijuana on a daily basis and a scary amount are taking it as medical treatment? For what? Growing up? It is traumatic and definitely causes anxiety but the people I know that resorted to regular marijuana used to handle the anxiety never learned to handle anxiety...
- SauciestGNU 2y ago
  Cannabis plus SSRIs have allowed me to manage depression/anxiety symptoms as well as ADHD tendencies. It's been genuinely life-changing for me. I suspect that's more along the lines people are talking about.

metalman 2y ago

down ,Cuba way, they are dealing with a weed derivative they call "chemico" which by all accounts will FUU (fuck you up) Here is the deal with humans and substinces we will keep refining anything and everything untill we get it concentrated into a white chrystaline powder,ie: 100% X.And then moan and groan till we can find something else with a bigger kick and bang for the buck and start refining that.

johnea 2y ago

Of course, people should use alcohol tobacco and firearms, like the little baby jesus intended! The deamonization of weed is a witch hunt, plain and simple. Paid for by the ATF industry. Through 50 years of routine marijuana use, I've seen a number of people shrivel up and die of various tobacco use cancers, I've seen people die from liver disease and car crashes due to alcohol (not to mention the routine bar fighting and gutter puking), but I've never know anyone who died from marijuana use, ever. As psychoactive substances go, it's about as harmless as they come. With probably only magic mushrooms being less harmful. This article speaks much more loudly to the NYT's support of the ATF industry, than to any harms due to marijuana. People who are allergic will die from eating peanuts, I think this is on the same scale of danger that marijuana brings. But, don't forget, that new chardaney is delightful!

ldehaan 2y ago

[dead]

meiraleal 2y ago

I've been smoking weed daily for the past 15 years and if much, my health is much, much better today than it was 15 years ago. Yeah, not a great study of 1 case, but tacit knowledge is the real deal.