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Marijuana needs warning labels like tobacco for associated mental, physical health risks

In his inaugural address last Tuesday, New York’s Governor Cuomo, like other governors, announced he will push for the legalization of marijuana, but said nothing about what he will do to mitigate the health risks.

A warning label on packaged cannabis
Lars Hagberg/AFP/Getty Images

Before legislators legalize marijuana, they should require bold and direct warning labels to be placed on the packaging as is done with tobacco products. If the states fail to act, then the Food and Drug Administration should step in and require it.

In early 2017, after exhaustive review, the National Academy of Science found there are significant health risks associated with using cannabis and cannabinoid. Yet none of the 39 states that have legalized medical marijuana or the 10 states that have legalized recreational use give adequate warnings of those risks.

The situation is similar to when cigarettes first became extensively marketed. The health risks were known but not disclosed, leading to disease and lives being lost. In addition to appearing on the packaging, the warning labels should also be displayed prominently wherever the product is sold, in advertising and in mandated public service announcements funded by the marijuana industry.

The National Academy of Sciences was founded by Congress and is comprised of the country’s leading researchers. It has become the nation’s most reputable arbiter of the science that should guide policy. At the beginning of 2017, after conducting a comprehensive review, it issued its report, “The Health Effects of Cannabis and Cannabinoids.”

The findings were particularly disturbing for people prone to mental illness and those who have a mental illness. It found either substantial or moderate evidence of an association between cannabis use and the development of schizophrenia or other psychoses; increased symptoms of mania and hypomania in individuals diagnosed with bipolar disorders; increased risk for the development of depressive disorders and increased incidence of suicidal ideation, attempts and completions.

Schizophrenia and bipolar disorders are two of the most devastating neurobiological disorders and the ones that are often associated with homelessness and incarceration. If there is an association with using legalized marijuana, shouldn’t the public be warned?

Labels provide consumers info to avoid danger
The risks are not limited to mental impairments alone. The reviewers found substantial evidence of an association between cannabis smoking and worse respiratory symptoms; more frequent chronic bronchitis episodes; increased risk of motor vehicle crashes, and lower birth weight of the offspring of those who use cannabis and cannabinoids.

For pediatric populations there is moderate evidence of an association between cannabis use and increased risk of overdose injuries including respiratory distress.

In the rush to legalize and decriminalize marijuana these risks are largely being ignored. Washington and Colorado were the first states to legalize recreational marijuana. While both warn pregnant mothers not to use it, the only other significant warning on the packaging is that there “may be health risks” a watered-down mealy-mouthed warning that fails to give consumers the concrete information they need to avoid danger.

While the Academy found "association," association is not the same as causality. Perhaps the increased risk of schizophrenia developing is because those who are prone to schizophrenia also are prone to use these products. But until we know the chicken or egg answer, we should not follow the example of the tobacco regulation where the product was allowed to be marketed unencumbered by warnings leading to 480,000 deaths a year, and subsequently the spending of millions of dollars re-educating consumers who had been misled in the first place.
If marijuana is to be legalized, let’s get it right from day one.

[source: / published: January 9. 2019]


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