University of New Mexico, Department of Emergency Medicine, Albuquerque, New Mexico Partner, Southern Colorado Emergency Medicine Associates, Pueblo, Colorado.
West J Emerg Med. 2019 Jul;20(4):557-572. doi: 10.5811/westjem.2019.4.39935. Epub 2019 Jun 3.
Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. Increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries in preparation of drug concentrates have been documented. Cannabis dispensary workers ("budtenders") without medical training are giving medical advice that may be harmful to patients. Cannabis research may offer novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. Progress has been slow due to absent standards for chemical composition of cannabis products and limitations on research imposed by federal classification of cannabis as illegal. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use.
大麻合法化导致了重大的健康后果，尤其是在科罗拉多州的急诊科和医院的患者中。最令人担忧的包括精神病、自杀和其他物质滥用。对大脑的有害影响包括复杂决策能力下降，即使戒除也可能无法逆转。致命机动车碰撞的增加、对心血管和肺部系统的不良影响、意外的儿科暴露、使使用者接触传染病原体、重金属和杀虫剂的大麻污染物、以及在准备药物浓缩物时的哈希油烧伤伤害都有记录。没有医学培训的大麻药房工人（“大麻专家”）正在提供可能对患者有害的医疗建议。大麻研究可能为癫痫发作、多发性硬化症引起的痉挛、化疗引起的恶心和呕吐、慢性疼痛、心血管结局的改善以及睡眠障碍提供新的治疗方法。由于缺乏大麻产品化学成分的标准以及联邦将大麻归类为非法对研究施加的限制，进展一直缓慢。考虑到这些因素和科罗拉多州的经验，其他州应该仔细评估是否以及如何将非医用大麻使用合法化或非刑事化。
