Cannabis: Decriminalize, but don't legalize - learn from the US debacle, don't copy it!

Research from 50 years ago proving  that " weed ain't dangerous" is totally irrelevant to today's much more potent product. See why. Op-ed.

Rabbi Dr. Aryeh Hirsch   ,

Laboratory cannabis analysis
Laboratory cannabis analysis
iStock

The helicopter takes off, carrying CBS 60 Minutes reporter Sharyn Alfonsi and a State of California Drug Enforcement Agency officer. Flying over the hills north and east of Los Angeles, they look down over hill after hill covered with lush green plants. (Here I must paraphrase from memory, I don't have cable TV access in Beit El, and don't subscribe to US TV on the internet).

Officer: You've just seen mile after mile of illegal marijuana farms.

Sharyn: I don't understand. Wasn't the legalization of cannabis supposed to have put an end to the massive illegal growing, and business selling, marijuana?

Officer: That was the conventional wisdom. Except that the regulations on growers are so weighty and restrictive, the farmers are finding the crop not profitable and not worth their time. So the illegal growers have actually increased. Moreover, the sales tax windfall that was supposed to occur never materialized, because the legal growers are a minor sector of the market (60 minutes, Aug.2, 2020).

I tell this story because Israel's Knesset is about to make the irresponsible move of legalizing this drug, and as a physician I feel a responsibility to call them out for this travesty.


Israel doesn't need to be that tail wagged by such a dog. The Jewish people did not return to the Holy Land to be in a marijuana-induced mental fog.
As a Rabbi, I'm going to proceed from the lesser arguments to the weightier, a "lo zu af zu ". The helicopter story is important, because just 3 months ago, an Israeli online news station interviewed an Israeli-Russian businessman who made the same arguments that were proven to be false in California: it'll drive the gangsters who now produce weed, out of business - and it'll be a tax windfall for the government. As I will show, Israel would be better off selling natural gas and hi tech, than low tech pot.

Actually, it's not as low tech as it seems. It turns out that the cannabis sold now is not the 2% THC sold in the 60's,70's and 80's-the new pot is minimally 20% THC, and really serious businessmen are selling products with 60% THC in Colorado since legalization in 2014. Really serious affaciandos can easily process "oil" in their backyard, using simple propane gas , getting up to 90% THC. Of course, Colorado emergency rooms have been seeing the "hash burns" resulting from "occupational accidents", explosions. Moreover, it means that hippies who remember research from 50 years ago proving that " weed ain't dangerous" are totally irrelevant to a product 10-45 times more potent.

Research is the second reason presented by Prof. Itamar Grotto, former asst. head of the Ministry of Health, in favor of legalization: "The field of medical research into the long-term societal and health effects of cannabis would be greatly aided by legalization".

The man must be kidding: Little Israel is to be the lab rat for the rest of the world? It's not as if there is not plenty of data on the ills of weed. Moreover, his first reason for legalization is even more insane: since we've already been taking steps to reduce the harm, we can go full-steam ahead and legalize. The man must be one step ahead of the Knesset: to make such a statement, he he has got to be high on pot- I say that if you know it's harmful, don't legalize!

Make no mistake: there is plenty of experience to say that weed is harmful. I'll start with Dr. Brad Roberts, writing on the American College of Emergency Physicians website ACEPnow (May15,2017), describing the Colorado experience. I mention only a few of his ideas:

-Patients are being diagnosed and treated by personnel in the pot-shops who have no medical training. They are treating lung disease, abdominal disease, endocrine disease, even cancer- with potent 60% weed , with NO medical supervision.

-Many times these were being prescribed without regard that the patient was already taking potent sedatives like Percocet and Valium- with the attendant risk of overdose, respiratory cessation and death.

-Buyers were being told that there are no side-effects to pot, despite that pot clearly has cardiovascular, respiratory and neurologic adverse effects. Marijuana is a drug, and should be treated as one, prescribed only by physicians- rather than being treated like candy, to be dispensed without supervision by the local grocer.

Finally, Dr. Roberts notes that there are more marijuana shops in Colorado than MacDonald's by a factor of two to one (424 vs. 202)!

I don't know if you are ready for the Kafkaesque sight of more pot-shops than falafel stands, but I am not.

Next, though, I'd like to point out the known health damages caused by weed, starting with the cardiovascular: the acute use of pot causes blood vessels to constrict and the pulse to rise. The chronic, heavy use of pot causes accelerated atherosclerosis. Due to the first phenomenon, there has been well documented cases of heart attacks in healthy young people as young as 20 years old- even when they have clean coronary arteries!

You can read all this for yourself in Rezkalla and Kroner, Cardiovascular Effects of Marijuana, in Trends in Cardiovascular Medicine, volume 29, page 403 (Nov 14,2018). However, that article is not free, like Acepnow; it costs $31 for 5 pages. Alternatively, Google the same authors and same title, and in J Cardiovasc Pharm and Therapeutics (2016) there is a decent summary.

It's the chronic effects that are fascinating, in a gruesome way that only a doctor can appreciate. By causing accelerated atherosclerosis, which is hardening of the arteries, weed prematurely ages a person's arteries. Thus, strokes have occurred in kids as young as age 15. More perverse, a 25 year old, chronically using pot regularly, would have the blood vessels of a 35 year old. This is extremely important because doctors usually don't think that a 25 year old presenting to an emergency room with chest pain, is having a heart attack(MI); thus, the young man could be erroneously discharged, to die at home. Dr. Amal Matu, one of the leading ER heart specialists in the US, sees this as such a prevalent problem as more states legalize, that algorithms for diagnosing MI will have to be changed to include the pot factor.

There are enough heart attacks and strokes in Israel, that the Knesset doesn't need to add to the number with legalizing weed- and yet there's more neurologic disease than "just" strokes. There is no question that weed causes cognitive and motor impairment: poor judgement and incoordination- in short, a state akin to alcohol intoxication. Here I quote another Colorado physician ,Dr. Matt Zuckerman, speaking at the American Association of Emergency Medicine's 25th annual meeting, in 2019:

"77% of DUI arrests in Colorado have pot plus other drugs; 44% of arrests for driving under the influence, only pot". That means that some pot user was driving erratically enough to be stopped by a cop- and nearly half the time, the potential killer was high on weed.


Every Israeli knows that the Atar family of eight was snuffed out by a moron high on pot in an MVA on Municipal Election Day, October, 2018. MK's Nissenkorn, Shefa and Haskel are criminally negligent in proposing that this nightmarish scenario be played out again and again in the future.
"Insurance Institute for Highway Safety (IIHS) data for Colorado show that a pot user is 1.9 times more likely to involved in an auto accident(MVA), and 2.1 times more likely to be involved in a fatal MVA". There is a report that drivers, with their judgement impaired by weed, are less likely to put on a seat-belt, inviting more severe injury (Annals Emerg Med, volume 52, page s159- Oct. 2008).

This is the worst indictment of all against legalization: Israel has bad enough drivers, and enough fatal MVA's, without adding weed. Every Israeli knows that the Atar family of eight was snuffed out by a moron high on pot in an MVA on Municipal Election Day, October, 2018. MK's Nissenkorn, Shefa and Haskel are criminally negligent in proposing that this nightmarish scenario be played out again and again in the future. There is enough wine, beer, vodka, whiskey, etc. causing enough violence in this country (I've seen it in 11 years of running with MDA ambulances, and ER experience going back to 1996) that we don't need legal pot as well.

There are some other issues: young children who can't yet read, who get into their parents' stash of cannabis edibles that look like candy, and thus are poisoned (Google "cannabis edible candy look alikes", and you'll see gummy bears, jelly rings and knockoffs of many of your favorite candy bars in familiar wrappings. There is one picture from NEJM, volume 272, page 990-March 12,2015- sitting in the middle is a "Keef Kat" bar whose wrapper is a dead-ringer for Israeli Keef Kef, or US Kit Kat).

Finally, occupational medicine has a problem with the incoordination of workers high on pot who are more prone to disabling work injuries.

In short, let the Knesset decriminalize pot. In no way, however, should the stuff be legalized. The US, until the Trump years, was a failing country, with unemployed from coast to coast. I know. I took care of the backyard amphetamine makers and users in ER's in Illinois; the 12 year old with cirrhosis from alcohol abuse in Kentucky, whose unemployed ex-coal-miner dad had a still; to the opioid addicts throughout Kentucky, West Virginia and even the ex-steel centers in Pennsylvania; to drunken, cirrhotic 25 year old Apache Indians in Arizona. There was simply nothing else to spend their time on, now that the factories were in China and Japan.

Israel doesn't need to be that tail wagged by such a dog. The Jewish people did not return to the Holy Land to be in a marijuana-induced mental fog. Even if Trump turns the US around, they've got a marijuana problem that we do not need.

Remember those TV ads in the 80's and 90's for the Green Party, running for Knesset. We thought it was a joke.

It was .

A dangerous one. It appears that party actually got into the Knesset –but we can't let them legalize weed.

(PS- Speaking of President Trump: can you imagine the courage of the man. Tens of millions are howling for his scalp, demanding he concede, scoffing and insulting. Yet, he is holding his ground. This is Churchillian, the stuff of epics.)

Rabbi Dr. Aryeh Hirsch is a physician residing in Beit El who works at Hadassah Hospital. He recently completed Rabbinical ordination of the Chief Rabbinate of Israel through an adult study
program at Yeshivat Merkaz Harav



top