Every day as chief of the emergency department of her hospital in San Diego, Roneet Lev sees the consequences of marijuana use in many of her patients.
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Lev talked Wednesday in Memorial Union at the University of Missouri in the inaugural Three Deans Lecture, referring to the School of Medicine, Sinclair School of Nursing and College of Health Sciences.
Lev, chief medical officer of the White House National Drug Control Policy from 2018-2020, gave a talk titled "It's just pot. What's the problem?"
There are many, it turns out, she said.
She said she's no marijuana prohibitionist.
"If you're going to be a user, you need to be informed," Lev said. "You need to know the risks."
The information isn't easily available, she said.
Talk of marijuana was discouraged in the Trump administration, she said.
"When I was at the White House, it was the M-word," Lev said. "It was too political."
One often hears that marijuana isn't addictive, but it's not true, Lev said.
"Marijuana is addicting like any other drug," Lev said
Speaking to reporters after the talk, she said the formal term is cannabis use disorder, but it's an addiction.
Patients in her emergency department are in denial when they insist they're not addicted and can quit anytime, she said.
Withdrawal resembles the experience one has when stopping smoking, she said during the talk.
"If there's addiction, there's also withdrawal," Lev said.
Lev probably is most well-known for inventing the term "scromiting," simultaneously screaming and vomiting, which she said is a symptom among chronic marijuana users called cannabis hyperemesis syndrome.
"These people are miserable," Lev said. "It's all from marijuana."
All the products on the market are high potency, Lev said.
A one-gram joint in 1990 produced at 50 mg dose of THC, while a one gram joint today contains 200 mg of THC.
Cannabis-induced psychosis affects many patients, she said.
"There is a risk factor for psychosis," she said.
She used the example of a user who committed suicide.
There was also a 4-year-old who ate her mom's marijuana gummy bear.
"With pediatric poisoning, they're getting into their parents stash," Lev said.
The child recovered after several days, she said.
She told parents to lock up their marijuana.
In a reverse situation, there was the grandson who gave his grandfather a marijuana brownie, causing the grandfather to fall asleep and not wake up for days. The grandfather was taken to the hospital, but the marijuana had to work its way out of his system.
Marijuana damages one's cardiovascular system, especially if it's smoked, she said.
That marijuana helps with all seizures is false, Lev said. There's a lack of research related to pain relief or as a substitute for prescriptions.
It inhibits brain development in adolescents, she said.
What is termed medical marijuana is just marijuana, she said.
"I think it's an insult to our profession to call it medical," Lev said.
Impaired driving is another overlooked issue, she said. One needs to wait 4.5 hours after smoking marijuana or 8 hours after an edible before getting behind the wheel.
She asked the audience its guess about the social norm related the percentage of 18- to 45-year-olds who don't use marijuana. Most shouted the correct answer: 75%
.
"We need to really promote that social norm," Lev said. "You want to empower those people."
Lev is host of a podcast: "High Truths on Drugs and Addiction."
Emergency room visits related to marijuana use aren't an everyday occurrence, but they have increased at MU Hospital since legalization of marijuana, said Christopher Samson, emergency department physician.
With adults, it's often first-time users who seek medical attention, he said.
Children do sometimes ingest their parents' marijuana. Those children become altered and less responsive, he said.
Psychosis caused by marijuana is rare, Samson said.
He agreed it's accurate to consider marijuana addictive.
"Any substance can be addicting," Samson said.
