MDNews - Minnesota

" There is enough data showing adverse effects, as well as the theoretical rationale from our understanding of the role played by the endocannabinoid system in prenatal brain development, to justify great caution around this drug during pregnancy." ‰ NORA VOLKOW, MD, DIRECTOR OF THE NATIONAL INSTITUTE ON DRUG ABUSE expectant mothers. The study also found infants who were exposed to cannabis in the womb had decreased birth weight and were more likely to need intensive care compared with infants who were not exposed. Isolating the ež ect of marijuana is a challenge, however. "As the use of cannabis gains social and medical acceptance, understanding its ež ects on maternal and fetal outcomes remains essential," authors of the study write. "There remains a gap in the literature assessing the ež ects of cannabis excluding other illicit drug use. As many cannabis users are often tobacco or alcohol users, determining a cannabis-only ež ect was currently not possible." Although research is ongoing, the fetal and child health risk associated with prenatal marijuana use led the American College of Obstetricians and Gynecologists (ACOG) to recommend that physicians refrain from prescribing or suggesting marijuana for medical purposes during preconcep- tion, pregnancy and lactation. Women with medical needs addressed by marijuana should be counseled about other treatment options that present less risk for mother and baby. Furthermore, ACOG urges physicians to ask pregnant women and women contemplating pregnancy if they use illicit or recreational drugs and provide resources to help them avoid using these substances during pregnancy. Brown agrees with these recommendations, encouraging physicians to use their infl uence to protect the health of their patients. "Physicians can be key change agents in treating and preventing substance use during pregnancy," Brown says. "Although some people can use marijuana without harm, prenatal marijuana use should be viewed as a separate public health and medical concern, considering its potential risk to both maternal and child health." ■ Widespread Legalization CA LIFORNIA WA S THE fi rst state to allow medical marijuana use, enacting legislation in 1996. Today, 28 states, along with the District of Columbia, Guam and Puerto Rico, have legalized the drug for medical purposes. They are Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont and Washington. In addition, Alaska, California, Colorado, the District of Columbia, Maine, Massachusetts, Nevada, Oregon and Washington have laws permitting recreational use of the drug. At the federal level, marijuana remains a Schedule I substance under the Controlled Substances Act. Those substances are deemed to have no accepted medical use and high potential for dependency. 1 3 M D N E W S .C O M /// M D N E W S M I N N E S O TA ■ 2 017

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