Can too much weed kill you?

 

The idea for this post came from a Facebook friend who indicated they were concerned about the US’s recent push to legalize marijuana, particularly in light of the chances of death from an overdose. Myself and another ED colleague had never heard of a death resulting from THC. So off to research I went.

Scouring the search engines I could find no credible evidence to say overdosing on marijuana has, in fact, been attributed to a death. Having too much marijuana can cause a number of unwanted conditions within the body which can make you VERY uncomfortable:

  • Temporary feelings of paranoia, fear and anxiety
  • Shortness of breath
  • Pupil dilation
  • Vomiting and/or nausea
  • Fast heart rate
  • Shaking that is hard to control, feeling cold
  • Disorientation or hallucinations
  • Hangover

But these symptoms are also common with other illicit and legal drugs, such as alcohol. Studies have shown that a person would have to receive a massive amount of THC, the active high-producing ingredient in marijuana, to die from it- this would equate to pounds being used at a time. Very unlikely.

So marijuana is harmless?

Not so fast! The question is whether you can die from a single overdose of marijuana. But just like other chemicals that humans used for pleasure marijuana can have serious effects which could indirectly lead to death. It is these items I think many are talking about when they discuss the dangers of marijuana consumption.

A report from Colorado USA where marijuana is legal has found that traffic fatalities with drivers showing marijuana in their system at the time of the accident rose by 154%! Hospital presentations were also mentioned as increasing due to marijuana consumption, however the evidence was not clear that marijuana definitely had an impact. School suspensions from marijuana use were also mentioned.

Marijuana also has shown long-term health affects in terms of memory and brain function. There can also be secondary effects from smoking the drug and there are associated birth defects when women who are pregnant use marijuana.

The bottom line…

The actual THC in marijuana can kill you if consumed in large enough quantities. However, obtaining and using those quantities will either land you in jail for a very long time or be practically impossible. There are no known attributed cases to anyone dying from consumption of marijuana.

However, there are dangers in misuse of marijuana. As with all other chemicals consumed by individuals to obtain a euphoric state marijuana can alter a person’s functioning and cause health concerns. Therefore, any use of this or any other substance must be done so with full knowledge of the effects. And there it goes without saying a careful review of current laws on consumption in your area.

Should it be legal?

The eternal debate in modern society. Like other legal substances marijuana has very negative side-effects both short and long term, however that has not stopped tobacco and alcohol from remaining legal. Some would argue that it is a ‘gateway’ drug and could lead to greater abuse. However we do not know the numbers of individuals who use marijuana and never progress to harder drugs, so how can we really know? Like alcohol marijuana can impair a person’s driving and other complex and fine motor skills. So policies and laws would need to be put in place outlining legal limits on consumption and operation.

There is growing credible evidence that marijuana is beneficial to relieving pain and other neurological symptoms. Therefore, I think it’s use as a medical alternative to stronger and harsher medications is welcomed. Especially if those with severe and chronic pain can be helped. These individuals are often struggling, and if allowing this avenue can bring relief then I am all for it.

As for the rest of us, I still don’t know. I will state for the record I have never used marijuana. I can see both sides of the debate, and I guess as I have gotten older my views have become more complex. While once very much against the idea now I am leaning toward society’s choice. There are some distinct advantages to legalizing marijuana.

  • Once legal safe limits on consumption can be placed.
  • Regulations on growing, processing, and distribution can be instated and ensure a safe product.
  • There will be a decreased demand from law enforcement agents in going after marijuana users and dealers.
  • Marijuana use can be taxed leading to revenue.
  • Legalization may also spark increased interest in investigating other medicinal properties.

So I guess I am on the legalizing side of the debate. I also can see the arguments with those who wish to uphold the laws against marijuana use. However, I do feel that they will be fighting a loosing battle in years to come.

References

Herb.com: Marijuana Deaths: How Many Are There?

Huff post: Here’s How Many People Fatally Overdosed On Marijuana Last Year

New Health Guide: Can You Overdose On Marijuana?

Family Council: Number of Deaths Caused by Marijuana Much More than 0

National Institute on Drug Abuse: What is marijuana?

 

 

 

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Telehealth to combat Australia’s growing demand for healthcare?

An article in IT Brief tackles the topic of how Australia is going to tackle the increased need for healthcare moving forward. According to a report in the Newcastle Herald Australian men are ranked in the top three countries worldwide in life expectancy, while women are in the top fourth. This is great news for Australians, and can cause sleepless nights for policy makers. The World Health Organization reports that currently Australia as of 2014 spends 9.4% of Gross Domestic Product on healthcare, that equates to approximately $4,357 per person. With the baby boomers expected to reach their senior age this figure is surely going to rise.

The IT Brief discussed several

items relating to IT and healthcare. One such discussion was over the My Health Record program by the federal government. I have previously discussed the My Health Record in another post. I believe it is a vital and important forward step in advancing the Australian healthcare system.

Another item discussed was the use of smartphone apps and other personal IT devices to aid in chronic disease management. This is a field that is sure to improve as our tech-savy population ages.

But the item discussed that interested me was that of individuals being able to visit with a doctor via an online medium. This was described in the article as a potential way for people to access medical care without needing to wait in a doctor’s office and would allow access in rural areas. In Australia we have a similar system in place in rural areas. However, looking to rely on this as a measure to markedly decrease the reliance on in-person healthcare is suspect.

While visual clues and interviews are important in assessing health concerns palpation, auscultation and the ability to have the patient in front of you make up much of both doctors’ and nurses’ assessments. Additionally, many presentations we see in hospital that have come from GPs requires further acute assessment not available in a doctor’s surgery: ultrasounds, CT scans, and urgent blood tests. These items would not be available to a patient sitting in their lounge room speaking with a doctor over the internet.

If there are chronic and stable conditions which only call for simple follow-up then online medical consultation would be fine. However, I wonder if that is not being done already? My concern is that moving forward the need for acute in-person healthcare will only increase. And with that increase will be the need for more acute beds in hospitals and more healthcare facilities to deal with demand.

Your thoughts?

References

IT Brief: Digital tech – the answer to Aussie healthcare’s biggest ailments?

Newcastle Herald: Australia about to lose top spot in this world health ranking

WHO: Australia

Comparison of nurses and doctors registered in Australia

doctors-nurse-group-nurses-set-hospital-47095908

Quick Facts

  • According to 2016 AHPRA data there were 342,221 nurses and 104,102 doctors practicing in Australia. This means more than three nurses for every doctor.
  • The gender of doctors was roughly equal as 58.2% were male, compared to the female-dominated nursing which encompassed 12% identifying as male.
  • Investigating age practitioners in both groups showed a majority were under 50- 65.6% of nurses and 72.9% of doctors. Both groups also showed the highest number of practitioners were in the 30-34 year age range.
  • The number of nurses state-by-state was not suprising with NSW showing the largest share (27.4%) followed by Victoria (26.3%) and Queensland (20.1%).
  • NSW showed a low density of people per kilometer but the highest number of nurses compared to other states and territories.  

The inspiration for my post this morning was a tweet by the Australian Health Practitioners Association (AHPRA) for International Nurses Day which stated that nationally there were 375,528 registered and enrolled nurses in Australia currently. This includes practicing and non-practicing nurses. An advantage of AHPRA becoming the central body for clinical registration is to allow for national statistics for registrants which can be compared. So I investigated some statistics regarding nurses in Australia and how those statistics compare to equivalent doctor numbers.
Both sets of figures were taken from comparable AHPRA reports; for nurses it is the Nursing and Midwifery Board of Australia registrant data, and for doctors it is the Medical Board of Australia registrant data. Both reports were for the 1st of October to 31st of December 2016 date range and all figures excluded practitioners who were not practicing their particular clinical area at the time of the report (therefore excluding non-practitioners). The results were surprising in some areas, while expected in others:
A total of 342, 221 nurses were practicing in Australia during the report, while only 104,102 doctors were licensed at the time. Therefore for every doctor there were over three nurses licensed. The gender gap for doctors was quite narrow with 58.2% being male, however nursing continues to be a female-dominant profession with only 12% being listed as male. This, however, shows improvement from the year I graduated in which less than 10% of nurses were male.
Age was also an interesting read. To allow for easier comparison I broke the data into two age ranges: under 25 to 49 and 50  to 80+. These ages seem to represent two classic working demographics, prime working years (U25-50), and those approaching retirement. A common statement heard amongst critics of the current nursing workforce is that the nursing cohort is ageing, however according to the reports investigated nurses over 50 only accounted for 34.4% of workers with the vast majority (65.6%) under the age of 50. Doctors showed even more youth with 72.9% being under the age of 50. Nurses over the age of 65 were double that of doctors (4.2% vs 1.9%). The largest decade-cohort was identical for both at 30-34 with nurses representing 13.5% and doctors representing 14% of this bracket.
A state-by-state comparison of nurses showed, to me, an expected result. The highest number of nurses was found in New South Wales (NSW) with 27.4%, Victoria seconding (26.3%) and Queensland in third-place with 19.7%. The other states and territories accounted for 26.6%. Doctors showed similar trends. This trend closely coincides with population statistics taken in September 2016 which showed NSW having 32.0% of the population of Australia, Victoria having 25.2% and Queensland again in third with 20.1%.
An insight into the difficulty of providing healthcare in Australia could be identified by looking at population density during the same September 2016 period. The Australian Capital Territory (ACT) ranks as the most dense state with 171.40 persons per kilometer meaning that the residents would be in close proximity to health facilities. Victoria is second with a density of 26.11 persons per kilometer showing more difficulty of providing healthcare services in a less urban environment. New South Wales shows that each kilometer only holds 9.52 persons, providing for vast rural area to cover.
So what does all of these numbers mean? Well there are over three nurses for every doctor in Australia. Both are showing younger cohorts with the largest number being in the 30-34 year old range. Within nursing this is a shift from the threat that the nursing population is becoming older and therefore going to retire soon. Medicine is showing to be an equal mix of male and female, however nursing is still female-dominated.

The numbers of nurses by state closely match that of population. However, when compared to density the ACT showed less nurses were required to take care of a highly dense state area showing a specifically urban landscape. While in my home state of New South Wales we had the highest number of licensed nursing staff and a very sparse 9.52 persons per kilometer, meaning a large rural component when compared to the ACT.

All in all the numbers renew my faith that nursing in Australia is not currently a profession of elderly women as it is sometimes portrayed, but a vibrant profession which attracts young (and male) talent. I am proud to be called a registered nurse, and I hope that all 375,528 licensed nurses can say the same.

What do you think of these figures?

 

References

Nursing and Midwifery Board registrant data

Medical Board of Australia registrant data