Somehow along the way, we’ve made a distinction between “hard” drugs and, well, other drugs, as though only “hard” drugs cause problems. We’ve forgotten that those other, less “hard” drugs are also dangerous. We’ve also stopped thinking of alcohol as a drug at all, despite it being one of the most abused and dangerous drugs available. And now, with the increasing legalization of THC, there’s even more of an impression that “legal” means “safe,” but I’m here to tell you that it doesn’t, especially for babies.
The May/June 2023 issue of the Journal of Addiction Medicine published a study where nearly 2.4 million pregnancies were included for analysis, and of those, .38%, or about 9,000 birthing persons had cannabis use disorders (CUD) (Journals).
First, I’d say this number is suspiciously low, and better direct biomarker testing, especially umbilical cord testing, would provide much more accurate and necessary information. But we use what we have, and even with CUD likely being severely underreported, this study indicates that those birthing persons with CUD had higher proportions of all the following:
- gestational hypertension
- preeclampsia
- preterm delivery
- severe maternal morbidity
- adverse neonatal outcomes
- infant death
- neonatal intensive care unit admission
- respiratory distress syndrome
- hypoglycemia
- small for gestational age
Harmless? Not so much.
Since 1973 we’ve known how harmful alcohol use during pregnancy is to babies (NCBI), and we still don’t address that as we should. In fact, alcohol is STILL the most common psychoactive substance used during pregnancy. So we’ve known for FIFTY years that it’s dangerous to use during pregnancy, and for FIFTY years, we’ve continued its use!
From the Centers for Disease Control and Prevention (CDC), here’s a partial list of the lifelong effects that a person with a fetal alcohol spectrum disorder (FASD) may have:
- Poor coordination
- Hyperactive behavior
- Difficulty with attention
- Poor memory
- Learning disabilities
- Intellectual disability or low IQ
- Poor reasoning and judgment skills
- Vision or hearing problems
- Problems with the heart, kidneys, or bones
- Shorter-than-average height
- Abnormal facial features
There’s a lot of confusion about cannabis use – its dangers, its benefits, its uses, its harms – and my fervent hope is that we figure it out well before we have two negatively-affected generations, as we do with FASD. We already know cannabis use is not harmless, but the message that it’s MORE harmless than other drugs precludes people from hearing the message that THC really does cause harm.
Further, we’re currently inundated with inaccurate information, and those with CUD have fewer opportunities to get good information, if their doctors can even provide it: that is, those with CUD have fewer than five prenatal visits during the course of their pregnancies, just one more negative outcome for pregnant cannabis users.
Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) ought to be a cautionary tale for staying away from all mood-altering substances during pregnancy rather than a green light for cannabis use during that period, under the auspices that cannabis is less harmful than alcohol and therefore harmless. With alcohol, the message is that “there is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time for alcohol use during pregnancy. All types of alcohol are equally harmful, including all wines and beer” (CDC).
Sadly, the Substance Abuse and Mental Health Services Administration (SAMHSA) has only this message around cannabis use during pregnancy: “studies show that marijuana use during pregnancy may be harmful to a baby’s health and cause a variety of problems” (SAMHSA). We call those weasel words: “may be harmful” and “may cause […] problems.” We all take calculated risks, but when you consider that there’s another life at stake, shouldn’t the message about the risk be more clear? And, as one of the nation’s most brilliant voices about alcohol and other drug misuse Robert DuPont, MD, has said, “It’s not a teeter-totter!” He meant that when people start using THC they don’t necessarily stop using other substances. And he’s right; in fact, those with CUD during pregnancy are also using other substances eleven percent of the time (Journals).
Cannabis is damaging to a developing fetus. Alcohol is damaging to a developing fetus. Opioids, nicotine, and likely lots of other substances we don’t even know about yet are damaging to a developing fetus. While addiction is a disease, those with that disease often don’t understand the effects. Professionals can do more, through umbilical cord testing and referrals to service for both the parent and the affected newborn. Let’s not wait fifty years to do better.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876473/
https://www.cdc.gov/ncbddd/fasd/facts.html
Guided by Guida 
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