Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, June 20, 2017

Pregnancy and Marijuana Don't Gel

"Our worry is that because it is made legal [marijuana], people may think it is not a problem."
"While it will be legal [in Canada by July 2018], the SOGC's position is that we believe there are adverse effects on brain development from marijuana consumption until the brain development is finished, which is not until the early 20s. It is legal, but should be strongly discouraged."
"There are safe and more effective medications for nausea in pregnancy. My hope is that it is not used because of the adverse effects on brain development."
"This rise [of marijuana use in pregnancy] is purported to be a combination of the frequency of prescribed opioids for pain control in pregnant women, illicit use, and an increase in opioid-substitution programs for treatment of addiction -- opioids are now being used by a more diverse population that includes pregnant women."
Dr. George Carson, president, Society of Obstetricians and Gynecologists, Canada

"We really want to look at what women are doing now related to substance use -- what is happening during pregnancy, what do women believe, what are their behaviours and where do they get their information."
"We know that 15 percent of women drink alcohol during pregnancy, we don't have the same information around cannabis use -- we are scrambling to try to figure out how we can help target those populations."
Dr. Jocelynn Cook, chief scientific officer, SOGC
Marijuana Use During Pregnancy and Lactation
ABSTRACT: Cannabis sativa (marijuana) is the illicit drug most commonly used during pregnancy. The self-reported prevalence of marijuana use during pregnancy ranges from 2% to 5% in most studies. A growing number of states are legalizing marijuana for medicinal or recreational purposes, and its use by pregnant women could increase even further as a result. Because of concerns regarding impaired neurodevelopment, as well as maternal and fetal exposure to the adverse effects of smoking, women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Obstetrician–gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women or women contemplating pregnancy should be encouraged to discontinue use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data. There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.  Committee Opinion

The medical proscription against the use of alcohol during pregnancy is very well known throughout society. The fact that children are born with withdrawal symptoms in fetal alcohol syndrome is a blight on society. These are children whose full mental faculties have been impaired, whose development along the milestones of maturity will never catch up to their peers whose mothers did not indulge in alcohol and drugs during pregnancy.

Yet despite all that is known and that these behaviours during pregnancy bring into the world children whose full potential will never be realized, it seems that an almost casual use of marijuana among women during pregnancy is taking place. At a time when caution and care is required to ensure that the developing fetus has all the advantages that genetic inheritance can bestow upon a new life, a kind of low-grade epidemic of marijuana use meant to counter the early nausea stages of pregnancy appears to have become routine.

And it is this identified behaviour that has physicians concerned for the future of these children. Medical marijuana is already legal in Canada. In a year's time marijuana will be freely available for consumption when a new law is passed and regulation guidelines are in place, but even so there are concerns over the potential for the kind of abuse that law enforcement and society grapples with in the instance of driving while impaired by alcohol, soon to be joined by pot-impaired driving offences.

That marijuana is being promoted among some within society as an effective anti-nauseant during early pregnancy has become a growing problem in Canada. Concerning for a number of reasons, not least among them that a growing body of evidence isolates negative effects on brain development resulting from marijuana exposure; the executive functions of the brain affected, along with behaviours.

Dr. Jocelynn Cook of the Society of Obstetricians and Gynecologists of Canada points out that the second leading killer of women during pregnancy is substance use linked to the ubiquitous presence of fentanyl. The steadily emerging trend of opioids among women in pregnancy is concerning to the medical community. As it is, Canada is known to have some of the highest rates of cannabis use among developed nations by adolescents, and along with it, a rapid rise in opioid use.

Resulting in an increasing number of babies born addicted to opioids. Dr. Carson feels that convincing a pregnant woman addicted to opioids to seek medical treatment through a methadone program can still help to improve both her health and that of her baby. Cannabis remains the most used illicit substance during pregnancy, with estimates ranging from under two percent to over 15 percent in prevalence.

The report recently issued by the Society of Obstetricians and Gynecologists of Canada points out that its widespread use "may be due in part to its reputation as a harmless drug", while during pregnancy no drug is harmless.

Fast Facts

  • Using marijuana during pregnancy may increase your baby’s risk of developmental problems.
  • About one in 25 women in the U.S. reports using marijuana while pregnant.
  • The chemicals in any form of marijuana may be bad for your baby – this includes edible marijuana products (such as cookies, brownies, or candies).9
  • If you’re using marijuana and are pregnant or are planning to become pregnant, talk to your doctor.     Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People

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