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December 11, 1972


JAMA. 1972;222(11):1424. doi:10.1001/jama.1972.03210110057020

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To the Editor.—  Drs. Kolansky and Moore very rightly point to the need for additional information and increased study of the long-term effects of marihuana. However, they also suggest that our education of the public on the dangers of this drug should undergo reassessment. The latter conclusion would not seem warranted from the data they have presented.Over a period of three years, 13 patients were seen who presented symptoms that are attributable to intensive, long-term marihuana use. Estimates of current marihuana usage are very variable, but it is at least very widespread. How do we know that only a very small number of people will sustain these serious toxic reactions? Perhaps these are not "toxic effects" but allergic or idiosyncratic effects. Perhaps these reactions are not due to marihuana at all but to a contaminant.The implication that these 13 patients may have sustained "permanent structural changes in the