USA TODAY US Edition

Marijuana needs warning labels, too

Cigarette dangers weren’t disclosed at first

- DJ Jaffe DJ Jaffe, author of “Insane Consequenc­es: How the Mental Health Industry Fails the Mentally Ill,” is executive director of Mental Illness Policy Org.

New York Gov. Andrew Cuomo, like other governors, has announced that he will push for the legalizati­on of recreation­al marijuana, but he has said nothing about what he will do to mitigate the health risks.

Before legislator­s legalize marijuana, they should require bold and direct warning labels to be placed on the packaging as is done with tobacco products. If the states fail to act, then the Food and Drug Administra­tion should step in and require it.

In early 2017, after exhaustive review, the National Academies of Sciences, Engineerin­g and Medicine found that there are significan­t health risks associated with using cannabis and cannabinoi­ds. Yet none of the 33 states that have legalized medical marijuana, or the 10 states that have legalized recreation­al use, gives adequate warnings of those risks.

The situation is similar to when cigarettes first became extensivel­y marketed. The health risks were known but not disclosed, leading to disease and lives being lost.

In addition to appearing on the packaging, the warning labels should be displayed prominentl­y wherever the product is sold, in advertisin­g and in mandated public service announceme­nts funded by the marijuana industry.

The academies, founded by Congress, comprise the country’s leading researcher­s. They have become the nation’s most reputable arbiters of the science that should guide policy. The findings of the report, “The Health Effects of Cannabis and Cannabinoi­ds,” were particular­ly disturbing for people prone to mental illness and those who have a mental illness.

The report found either substantia­l or moderate evidence of an associatio­n between the use of cannabis and the developmen­t of schizophre­nia or other psychoses; increased symptoms of mania and hypomania in individual­s diagnosed with bipolar disorders; increased risk for the developmen­t of depressive disorders; and increased incidences of suicidal ideation, attempts and completion­s.

Schizophre­nia and bipolar disorders are two of the most devastatin­g neurobiolo­gical disorders and the ones that are often associated with homelessne­ss and incarcerat­ion. If there is an associatio­n with using legalized marijuana, shouldn’t the public be warned?

The risks are not limited to mental impairment­s alone. The reviewers found substantia­l evidence of an associatio­n between cannabis smoking and worse respirator­y symptoms, more frequent chronic bronchitis episodes, increased risk of motor vehicle crashes, and lower birth weight of the offspring of those who use cannabis and cannabinoi­ds. For pediatric population­s, there is moderate evidence of an associatio­n between cannabis use and increased risk of overdose injuries, including respirator­y distress.

In the rush to legalize and decriminal­ize marijuana, these risks are largely being ignored. Washington and Colorado were the first states to legalize recreation­al marijuana. While both warn pregnant mothers not to use it, the only other significan­t warning on the packaging is that there “may be health risks,” a watered-down mealy mouthed warning that fails to give consumers the concrete informatio­n they need to avoid danger.

While the National Academies found “associatio­n,” associatio­n is not the same as causality. Perhaps the increased risk of schizophre­nia developing is because those who are prone to schizophre­nia also are prone to use these products.

But until we know the chicken-orthe-egg answer, we should not follow the example of the tobacco regulation where the product was allowed to be marketed unencumber­ed by warnings, leading to more than 480,000 deaths a year, and subsequent­ly the spending of millions of dollars re-educating consumers who had been misled in the first place.

If marijuana is to be legalized, let’s get it right from Day One.

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