Agency to study effects of pot during pregnancy
CHICAGO – Pregnancy started out rough for Leslie Siu. Morning sickness and migraines had her reeling and barely able to function at a demanding New York marketing job, so, like rising numbers of U.S. mothers-to-be, she turned to marijuana.
“l was finally able to get out from under my work desk,” said Siu, who later started her own pot company and says her daughter, now 4, is thriving.
There’s no proof that cannabis can relieve morning sickness, and mainstream medicine advises against use in pregnancy because of studies suggesting it might cause premature birth, low birth weight and infant brain deficits. But the National Institute on Drug Abuse is pressing for more solid evidence. Many of those studies were in animals or complicated by marijuana users’ other habits and lifestyles.
“I don’t want us to cry wolf,” said Dr. Nora Volkow, the agency’s director. “We have to do these studies in a way that can identify risks.”
With nearly $200,000 from her agency, University of Washington scientists in Seattle are seeking clearer answers in a new study investigating potential effects on infants’ brains. The agency is supporting three similar studies in other states.
In Seattle, they’re enrolling pregnant women during their first trimester who are already using marijuana for morning sickness. Researchers don’t provide the pot, and the use of other drugs, tobacco and alcohol isn’t allowed. Infants will undergo brain scans at 6 months and will be compared with babies whose mothers didn’t use marijuana while pregnant.
For government and university authorities, it’s worthy research that takes advantage of a booming trend. Recent data show the number of pregnant U.S. pot users has doubled since 2002, with 7% reporting recent use and higher rates in some states.
“There are so many reasons not to study drugs – particularly fear of causing birth defects. But the results would be no studies of the drugs’ efficacy during pregnancy, or the risks to the fetus,” said Dr. John Lantos, director of pediatric bioethics at Children’s Mercy hospital in Kansas City, Missouri.
Scientist Natalia Kleinhans is leading the University of Washington’s study, aiming to recruit 35 pregnant marijuana users and 35 pregnant women who didn’t use pot.
The pot users are asked to buy from licensed dealers and photograph it so researchers can calculate the THC and CBD, another compound that doesn’t cause a high. Participants are paid $300 but can quit using anytime and remain in the study.
Medical and recreational marijuana are legal in Washington state, and Kleinhans says women who use it for morning sickness are different from pregnant pot users in years past, who often used other drugs, smoked or drank.
Study opponents contend that researchers are recruiting marijuana addicts, that payment encourages participants to keep using, that women aren’t being adequately informed of risks, and that babies will be harmed by being tested. Researchers say MRI brain scans are safe and that infants will be tested while sleeping so they won’t need potentially risky sedatives.
While more than 30 states have legalized marijuana for medical and/or recreational use, opponents also note that the federal government still considers pot an illegal drug.
Dr. Pat Marmion, an OB-GYN in southern Washington, says he helped coordinate efforts to file complaints with the university and the U.S. Department of Health and Human Services, which oversees the National Institutes of Health. An HHS spokesperson declined to comment.
“We should be encouraging women who are pregnant to not use marijuana instead of incentivizing them to continue,” Marmion said.
Under U.S. law, research that involves humans must be approved by review boards to make sure participants’ rights and safety are protected.
Karen Moe, director of the university’s human subjects division, said authorities there investigated the critics’ concerns and concluded that most were unfounded. But she said they agreed to provide a handout on possible risks from marijuana use in pregnancy, not just links to similar information online, and also reworded recruitment materials to clarify that participants could quit using marijuana and still receive full payment.
Dr. Mishka Terplan, a member of the American College of Obstetricians and Gynecologists’ addiction expert group, said that for years, the thalidomide scare “shut down all research of medications in pregnancy.” Not enough is known even about medications commonly prescribed for morning sickness, he said.
The National Institute on Drug Abuse is providing almost $1.5 million for three similar studies of marijuana use in pregnancy – at Washington University in St. Louis, at the University of Denver and at Kaiser Permanente in Northern California.
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