Review: recreational marijuana use
November 10, 2015, 3:21 pm
Recreational cannabis use: Pleasures and pitfalls. Rella JG. Cleve Clin J Med 2015 Nov;82:765-72.
This somewhat superficial but relatively well done review article gets extra credit for being available via open access. The author covers the history, pharmacology, toxicology, and acute and chronic effects of cannabis use, as well as withdrawal and the cannabinoid hyperemesis syndrome.
My main problem with this paper involves the author’s casual use of references. For example, he states that previous literature had reported “a fivefold increased risk of myocardial infarction in the 60 minutes following cannabis use . . .” The reference for this is a 2001 paper by Mittleman et al. This statement does have some face validity, since acute marijuana use can cause tachycardia and hypertension, in addition to exposure to products of combustion. However, the study was based on a case-crossover design, a technique that uses patients as their own controls and is susceptible to many biases, including incomplete data, flawed recall that underestimates exposure during the control period. These are, in my opinion, crippling problems with this design, and should have been at least mentioned in the review.
Finally, the author states that during cannabis intoxication the user may experience that “time seems to pass quickly.” This is not always the case: