Does Medical Weed Need Warning Labels for Moms?

You might not want to smoke around your kids either.

In 2015, the American College of Obstetricians and Gynecologists related a committee opinion discouraging the use of marijuana during preconception, pregnancy, and breastfeeding. While there's been no extensive, funded research on the topic, doctors still agree that smoking weed while pregnant is really risky. 

There’s been little hard information regarding women, their babies, and weed, and especially, little government funding for research that could provide real answers. Despite that lack of established facts, weed is still a federally illegal drug (one that could land you in prison if you’re a smoking mommy).

On Monday, Dr. Nora Volkow, director of the National Institute on Drug Abuse, published an opinion piece in the The Journal of the American Medical Association (JAMA) about women who smoke weed while pregnant. She looked at a few recent studies and concluded that women should not use cannabis while pregnant or nursing. She specifically analyzed data from annual U.S. government surveys on drug use and concluded that, while there's a huge research void, signs point to harm. 

Maybe it’s up to the medical cannabis industry to listen to doctors' causes for concern and include responsible cautions on weed packaging.

Despite a lack of federal funding to study marijuana's medical benefits, limited studies agree that weed can effectively treat nausea, especially the kind associated with chemotherapy. Volkow suspects that pregnant women are turning to weed, at much higher rates than ever before, to treat morning sickness. Those symptoms often peak during the first trimester of pregnancy. Treating them with cannabis may cause damage to the baby in those early stages of fetal development, according to National Institute on Drug Abuse findings.

From JAMA:

Although the evidence for the effects of marijuana on human prenatal development is limited at this point, research does suggest that there is cause for concern. A recent review and meta-analysis found that infants of women who used marijuana during pregnancy were more likely to be anemic, have lower birth weight, and require placement in neonatal intensive care than infants of mothers who did not use marijuana. Studies have also shown links between prenatal marijuana exposure and impaired higher-order executive functions such as impulse control, visual memory, and attention during the school years. Substances that interfere with this system could affect fetal brain growth and structural and functional neurodevelopment.

Volkow examined annual drug use surveys and found that in 2014, almost 4 percent of pregnant women said they'd recently used marijuana, up from 2.4 percent in 2002. That’s just the women who actually reported their drugs use while pregnant, and even among them accuracy cannot be presumed. JAMA published Volkow’s piece as an opinion only, because there’s so little definitive data about pregnancy and cannabis use, and self-reported studies are problematic. 

"In women who use drugs during pregnancy, there are often other confounding variables related to nutrition, prenatal care, and failure to disclose substance use because of concerns about adverse legal consequences,” Volkow says.

The most troubling takeaway from Volkow's report is that this lack of information leaves many mothers in the dark. Right now, many weed-legal states (29 to be exact) are not required to warn new or expecting mothers about the risks (maybe) associated with smoking weed while pregnant, or near a child. Unlike cigarettes and booze, where adverse consequences are well-established and plenty of warnings are plastered all over boxes and bottles, medical weed is packaged with no at-risk signage. 

"Although no states specifically list pregnancy-related conditions among the allowed recommendations for medical marijuana, neither do any states currently prohibit or include warnings about the possible harms of marijuana to the fetus when the drug is used during pregnancy,” Volkow says.

Maybe it’s up to the medical cannabis industry to listen to doctors' causes for concern and include responsible cautions on weed packaging.

Doctors in general agree that, for now, they don’t recommend weed for pregnant women or to smoke pot around children. They’d still like a lot more funded studies to get to some reliable research. 

But the medical cannabis industry's need for risk warnings may go beyond expectant mothers. Mothers of young children in general may be putting their kids at risk. According to research by Dr. Karen Wilson, the chief of general pediatrics at Mount Sinai New York and author of a new study in Pediatric Research, children absorb chemicals from secondhand marijuana smoke. Still, there’s no warning of this on the cute weed canister bought from your legal and local dispensary.

From NPR:

It's a small study, involving 43 young children in Colorado, another state where recreational marijuana use is legal. The children, ages 1 month to 2 years, were hospitalized for bronchiolitis. Their urine samples were sent to the Centers for Disease Control and Prevention, which used a new and highly sensitive test that can detect very low levels of marijuana metabolites. They found 16 percent of the overall samples tested positive. And for the children whose caregivers said they had been exposed to marijuana use, 75 percent had traces of marijuana in their urine.

The evidence that secondhand marijuana smoke or vapor causes health risks is limited, but proof that it is harmless is also unestablished. Wilson's hypothesis is that the smoke is not good for kids. She suspects that once proper research has been conducted, scientists will find that marijuana exposure has negative effects on children. According to one study, rats that inhaled random weed smoke had the same negative reaction as rats breathing in second-hand tobacco. 

"There is no reason to believe that it is any safer than tobacco smoke exposure," Dr. David Beuther, a pulmonologist and associate professor of medicine at National Jewish Health in Denver,  told NPR.

Doctors in general agree that, for now, they don’t recommend weed for pregnant women or to smoke pot around children. They’d still like a lot more funding to get to some reliable research. Until then, there’s no legal requirement for second-hand smoke or pregnancy-consumption warnings on packaging. A lot of women out there might not even know that some researchers believe they and their children are at risk.

"To a degree we suffer from lack of evidence, but without the federal okay, it's difficult to study it,” Beuther told NPR.

Perhaps we start with recognizing and labeling potential risk.