A recent study finds the majority of Colorado dispensaries think pregnant women can use marijuana for nausea.
As marijuana legalization expands and cannabis products become more common, consumers suddenly find they have access to alternative cannabis-derived treatments that claim to help a host of medical conditions.
Could one of those ailments include morning sickness of expectant mothers? People who work at marijuana dispensaries think so.
But medical experts caution it isnâ€™t a good idea, and using marijuana can harm a pregnancy.
This recommendation from dispensary employees goes directly against the guidance of the experts at ACOG.
ACOG notes children prenatally exposed to marijuana may be at increased risk for behavioral issues, decreased attention span, and other visual-motor conditions. Pregnant women who use marijuana may be at increased risk for stillbirth.
Dr. Katrina Mark, assistant professor in the department of obstetrics, gynecology, and reproductive sciences at the University of Maryland School of Medicine, said that as peopleâ€™s attitudes on marijuana change, the medical community needs to make sure they can address and answer patientsâ€™ questions about the drug.
â€œThe liberalization of laws related to marijuana use are rapidly changing. This is not necessarily a negative thing, but we as healthcare professionals need to make sure that we are keeping up with our evidence-based counseling of patients,â€ Mark said.
â€œLegalization does not equate to safety, particularly in pregnancy,â€ Mark added, pointing out the study is needed to bring attention to this topic.
â€œThe most obvious example of this is alcohol,â€ she said. â€œNo liquor store would recommend alcohol to treat pregnancy ailments, and neither should a marijuana dispensary. I actually think the fact that dispensaries are providing any recommendations for treatment of medical conditions is very much overstepping appropriate boundaries.â€
Risky advice for pregnant women
To get the data, the study researchers used a â€œmystery caller approachâ€ in calling 400 randomly selected dispensaries throughout Colorado. The licensed dispensaries were found on the Colorado Department of Revenue Enforcement Division website.
Researchers found that 69 percent of the dispensaries recommended treatment of morning sickness with cannabis products.
Of the 400 dispensaries contacted, 37 percent were licensed for medical sale, 28 percent for retail, and 35 percent for both.
Two study investigators called the selected dispensaries using a phone script that asked if the dispensary had any products recommended for morning sickness.
The investigators also gave prompts depending on whether the dispensary employee recommended cannabis or not. If no recommendation was initially given, the first prompt was to ask, â€œWhat if I have a medical [marijuana] card?â€
The investigator would also ask a series of follow-up questions, including â€œIs it safe to take during pregnancy?â€ and â€œIs it also safe for my baby?â€
If only risks for the baby were addressed, the investigator asked, â€œIs it also safe for me?â€
Before ending the call, the investigators who hadnâ€™t received a recommendation to talk to a healthcare provider asked, â€œShould I talk to my doctor about this?â€
A majority of the dispensary employees (65 percent) based their recommendation for use in pregnancy on personal opinion, while 36 percent said cannabis use is safe in pregnancy.
The researchers also found that 81.5 percent of dispensary employees recommended talking with a healthcare provider. But only 31.8 percent made the recommendation without any prompting.
The murky risks of using cannabis while pregnant
Mark says the potential risks surrounding marijuana use during pregnancy arenâ€™t as cut-and-dry as in the case of alcohol use.
â€œPart of the reason that many providers avoid the conversation about marijuana in pregnancy is that it is not as black and white as something like alcohol,â€ Mark said. â€œWe know beyond a doubt that alcohol causes fetal alcohol syndrome, and that is easy enough to explain.â€
Mark says the studies on marijuana use during pregnancy arenâ€™t conclusive because itâ€™s not ethical to knowingly give people marijuana while pregnant.
â€œThere are many, many studies on marijuana use in pregnancy, and the outcomes are more nuanced. Animal models show neurodevelopmental differences in offspring exposed to cannabis in uterus,â€ she said. â€œThere have been studies that show long-term behavioral differences in children who were exposed to marijuana in utero, which makes sense because we know cannabis [affects] receptors in the brain.â€
Dr. Diana Ramos, an OB-GYN and chair of The National Preconception Health and Health Care Initiative, said that research has shown that pregnant women who use marijuana have a 2.3 times greater risk of stillbirth.
â€œDo not use it,â€ Ramos said. â€œUnlike prescription medication, you really donâ€™t know the content, additives, grade of the cannabis being used. You are taking a chance not only with your health but your babyâ€™s as well.â€
The question remains: Is there any merit to some form of cannabis for morning sickness?
â€œThe truth is that no one knows for sure,â€ Mark said. â€œI have had many patients report that they use marijuana to help treat their nausea in pregnancy, but it has never been adequately studied.â€
â€œEven if we had evidence that it is helpful to treat nausea, however, it still should not be recommended as we know there are potential harms,â€ she said. â€œNausea and vomiting, while very disruptive to the woman, is typically self- limited and does not have long-term health consequences for the mother or baby.â€
Mark points out there are other, safer medications to help a pregnant woman through even the worst bouts of morning sickness.