Expert Opinion: What Does Legalizing Marijuana Mean to Healthcare?
Now that marijuana is being legalized in several states (Pennsylvania to follow, perhaps?), what health and safety issues will we face?
We’ve made huge strides in making tobacco-related health issues well known to the public and kids, regulating cigarette sales and promoting smoking cessation. I’m not equating tobacco to pot, but there are clearly still health issues that can arise. For example: an employee shows up to work high on marijuana, with visibly impaired judgment and makes a catastrophic error that leads to harm. Are we okay with this? Of course not—it’s no different than alcohol-related incidents. However, all this talk about legalizing marijuana has to be balanced with an ongoing discussion about its possible impact on concentration, judgment, memory and reaction time—all of which can be impaired with use.
Furthermore, we can’t just think of the recreational enjoyment: Employers need to factor this issue in to their human-resource policies, physicians will need to consider marijuana usage similar to alcohol when assessing their patients, and public-health officials will have to re-brand their tobacco campaigns to include pot.
Does legalization increase risks for motor vehicle accidents, school-related behavior issues, negative impact on job performance and other risky behavior that may be associated with use? What are our responsibilities in healthcare to ensure safe usage? Right now, screening for alcohol-related health issues is very much a part of a health maintenance assessment. Questioning specifically around pot and alcohol as the legal substances and cocaine, heroine and other illicit substances, on the other hand, is more than just moving a category of drug over to a different screen in the health assessment.
Physicians must consider its impact on function and underlying health issues and its overall impact on one’s health and wellbeing. Should patients be given narcotic medications if they disclose they are regular marijuana users and find the pain-reducing benefits helpful? Like most things in healthcare, a patient-centered approach will be important.
As a wider public-health issue, what approach will schools take in teaching marijuana usage, now that it is moving (slowly, surely) into the “legal” addictive substances category? If prosecution is not an issue, then a health-related approach to drug education will be even more critical. Will regulation of the substance help control access or will older, of-age people be buying younger ones pot from the corner vendor? Again, a public-health and social conundrum.
I pose a lot of questions because I have a lot of them, as both a healthcare provider and mother. All I can hope is that we move forward educating our employees, patients and kids as the terrain changes regarding marijuana use to avoid a public-health crisis in the future.
Bindu Kumar, M.D., is a Philadelphia-area physician with expertise in primary care and occupational medicine. She maintains her family medicine board certification in both the United States and Canada.