By Jon Cronin
With Massachusetts having legalized recreational marijuana and New Jersey’s governor seeking to do the same, New York Gov. Andrew Cuomo tasked the state Department of Health (DOH) earlier this year with studying the effects of marijuana.
At an April press conference, Cuomo said, “What I’m trying to do is get the legislative process to focus on the new facts. They’re still focused, in my opinion, many of them, on the old facts, which is marijuana is illegal everywhere, period, and we would be the exception,” Politico reported.
The DOH recommended at the end of June that the popular recreational drug be legalized. The agency cited cost savings in the penal system, state tax revenue, regulation and consumer harm reduction as benefits of legalization.
Although dealing with marijuana and its recreational smokers may be new to the state, it is not new to physicians.
Dr. Walter Chua, a pulmonologist at Forest Hills Hospital, noted that because it has long been illegal, there are no long-term studies on recreational use of the drug.
“The jury is still out on long-term effects of marijuana,” he said.
He added that because it is not regulated, no one knows who is manufacturing the drug and there is little information on the resulting impurities.
In 2002, New York City banned smoking in restaurants and bars, largely due to the determination of the adverse effects of secondhand tobacco smoke. The same ban could be applied to marijuana, but the impact would be unclear due to a lack of studies on the effects of secondhand smoke from the drug.
Chua pointed out that the danger of getting a secondhand high from the psychoactive drug would depend on proximity and air flow in the area.
There are also different strengths of marijuana, depending on breeding.
“Right now, there is only anecdotal evidence,” Chua said, adding that there have been no randomized trials. “No one really knows.”
And there have been few studies on how the drug affects cognition — ”especially while driving,” Chua added.
“Anything you inhale into your lungs that’s foreign could be potentially damaging to your lungs,” he said.
He added that the only point of comparison he has seen in recent years is vaping.
“It suddenly happened — now pulmonologists are talking,” he said, adding that vaping manufacturers have added flavors to their products. “Who knows what burning those flavors could do?”
Chua explained that the strength of the psychoactive substance depends on how the state will regulate the marijuana market.
Dr. Isabella Park, a pain-management specialist at Forest Hills Hospital, said that even with medical marijuana legalized in New York, it is difficult for her chronic-pain patients to obtain it. She noted that patients must first find a certified physician and be diagnosed with a need for pain management. Then, they would have to pay with cash.
She said that within the Northwell Health system, which includes Forest Hills Hospital, there are only three physicians who do not require cash payments.
“They charge a lot of money for visits,” she said.
Park said that even when a patient in need of pain management finds a certified doctor, that patient might have difficulty reaching the doctor’s office.
“It may be easier to have a friend get it off the street,” she said.
However, marijuana sold by a dealer would include THC, the drug’s psychoactive component. THC is filtered out of medical-grade marijuana.
“THC has a most dramatic side effect,” she said. “On the street, you don’t know what’s in it.”
She said that patients could use cannabinoid (CBD) oils as a substitute, although they might not be as effective.
“Those are a lot cheaper,” she said. “The accessibility is easier.”
Park also pointed out that medical-grade marijuana is much more reliable for relieving pain. It is available in oil, lozenge and vaping oil form, but not for smoking.
She said that in the future, Northwell Health will certify more doctors to prescribe medical marijuana.
“We have our own medical cannabis task force and share best practices,” she said, adding that she believes that legalization will result in the further study and research of the once-outlawed drug.