Unlike our current president who acknowledges experience with the drug and a certain past president who smoked but famously did not inhale (really?), I have no personal experience with marijuana. But I do practice medicine in Colorado and given the state’s ongoing experiment with legal recreational marijuana, I am accumulating a significant amount of professional experience with the drug.
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Let’s be honest, though, marijuana is not a new drug. The earliest reference I could find is from the Chinese emperor Shen Nung in 2737 B.C. (helps with gout). More recently, thePew Research Center reported in 2015 that 49% of American adults have tried marijuana at some point and 12% of the population had used it in the last year. As a result, it is certainly possible that the only reason I have become aware of the influence of marijuana on urology is that it is much easier to talk about the drug in my office because it’s now legal.
On the other hand, the legalization of the drug certainly is leading to an increase in marijuana use in my state (we have gone from fourth place in regular marijuana use in 2011 before legalization to first in 2015, according to a survey by the U.S. Department of Health and Human Services. Thus, it’s possible I may be seeing connections to which I was previously oblivious.
Regardless, it has become obvious to me that marijuana is influencing how I practice medicine, and I thought it important to share some of my stories. The first time I found a connection between marijuana and urology was a year or two ago when a patient came back to my office a few hours after a vasectomy reporting that he had a seizure. I was a bit skeptical and after an exam, I sent him on his way home.
A few weeks later a second patient came back to my office with the same report. This case was different, as his wife who witnessed the event was a nurse on the floor at a local hospital. I trusted her, and she was confident it was a seizure. This case was also different because once I walked into the exam room, I was inundated with the very distinct, pungent smell of marijuana.
At this point, it’s worth noting that I offer my vasectomy patients a small cocktail of oral Valium and Percocet before the procedure. I don’t know if it does much for the actual procedure, but there is no doubt that it has a certain positive supratentorial effect.
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Since I am giving narcotics and benzodiazepines, I always tell the patient to avoid alcohol for a few hours after the procedure, and it turns out that both of the patients in question had done exactly what I asked them to do. Instead of having a beer to celebrate after their vasectomy, they smoked up. Since that event, I have started instructing everyone to also avoid marijuana for a day or so and have had no further problems.