What is Specific Research Regarding Cannabis and Birth Defects and Breastfeeding?

A recent news article reported that cannabis was added to the California list of chemicals that CAN cause birth defects. Since I am well informed on the subject of cannabis therapeutics and their effects, I was surprised by the action.

As a physician involved in drug abuse treatment and prevention since 1967, I am curious as to the basis that your panel used to determine that cannabis smoke and  Δ-9-tetrahydrocannabinol (Δ-9-THC) were shown to cause reproductive toxicity. This determination fly’s in the face of the research done by Melony Dreher, RN, Ph.D., Dean of Rush School of Nursing and the extensive literature review done by Dr. Ciana Torres-Vargas, Ph.D. of Columbia - among a handful of other respected medical professionals and researchers.

The findings of Doctors Dreher and Torres-Vargas denote that there was no issue with birth defects caused by THC.

  • They did find an increase in NICU admissions. (This appears to be out of caution, not because of birth defects.)
  • Laws require observation of illicit drug exposed infants
  • Cannabis exposed infants did not have extended hospital stays
  • Apgar score: There was no significant associations between in utero exposure to cannabis and Apgar scores

As a physician who ran the drug treatment program at the Haight-Ashbury Clinic in the late 1960s and was the founder and Medical Director of the Isla Vista Medical Clinic (1970-75), where 85% of patients used cannabis, as a long time member of the APHA, and as a former Medical Director of the oldest County Organized Health System (COHS) Medicaid managed care program in the U.S., I am unaware of any epidemiological evidence to support this determination.

I’m assuming that regulators and their consultants missed the 1988 position of the DEA’s Chief Administrative Law Judge, Francis Young. In 1988 after a two year rescheduling hearing, in his Finding of Fact, Judge Young found cannabis to be “one of the safest therapeutic agents known to man.”

The history of medical cannabis is pretty compelling on the point of safety. Cannabis has been a medicine for over 4,000 years. There is little or no mention of birth defects over these millennia. In the 1920s American physicians wrote 3 million prescriptions per year that contained cannabis. In 1937 the AMA chief legal counsel, Dr William L. Woodland, testified AGAINST the Marihuana Tax Act of 1937, which started cannabis prohibition. In his testimony before the House Ways and Means Committee, Dr. Woodward said that “the AMA knows of no dangers from the medical use of cannabis.”

I hope that this decision was made based on science rather than cultural bias and stigma. Cannabis has been used by pregnant and breastfeeding women throughout history. We don’t know THC to cause detrimental birth or cognitive effects.

Marinol (synthetic THC) has been on the market since the mid 1980s. The warning for pregnant women is that it may cause fetal harm but there is no evidence of such harm. There is an illusion to claims made about cannabis but again, thin on data.

What constituents of the plant do regulators believe are implicated in causing birth defects? There are over 200 terpenes in cannabis. Terpenes are the most ubiquitous molecules found in nature. There are more than 20,000 different terpenes. They are found in spices, citrus fruit and flowers.

Unless regulators have solid science to support adding cannabis to this list they are making the list less useful.  No less an authority than Dr. Donald Tashkin has deemed cannabis an anti-cancer drug. Dr. Raphael Mechoulam has done research showing cannabis is neuroprotective.