To the Editor:

This personal opinion, which is not intended to reflect the view of my employer, is in response to recent concern about the safety of having a cannabis dispensary in town. As a family physician, it is my job to provide medical advice to my patients using the best clinical evidence available whenever possible. It has been more difficult to provide such advice for cannabis than either tobacco or alcohol. There are fewer clinical studies available to guide my advice on drug-drug interactions, disease-drug interactions, and the long-term impacts on physical and mental health from cannabis use. For nearly every other substance my adult patients are using recreationally or medicinally I have information on pharmokinetics, adverse effects, beneficial effects, which organs break down and secrete the drug and how that may impact the same process for other substances (prescription, over the counter, illicit or legal) being used by a patient.

Fortunately federal laws preventing quality clinical research on cannabis have been partially lifted in the last few years. This should be good news for those of us in clinical medicine struggling to stay informed enough to know when to advise against use or simply caution moderation in the use of cannabis products. My patients (who when asked about substance use answer me much more candidly now that the fear of criminal penalties have been lifted by legalization) have shown me that a sizeable portion of my practice has been and currently are using cannabis regardless of the concerns noted by medical organizations. The rising trend across the state of blocking cannabis dispensaries does nothing to stem the steady tide of cannabis use in our towns, but it does make it difficult for doctors to provide evidence-based guidance.

Not having a regulated market makes the question of the provenance and safety of the cannabis products people are using unknown, which could be problematic to people’s health and well-being. For example, someone might not know if the product they are using is real or is contaminated with toxins, nor might they know the chemical composition of that product, which greatly effects the complex plant chemistry and interaction with medications and preexisting conditions. Without secured, contaminant tested, component (CBD/G, THC, Terpenes) tested products, I am not able to give the most effective medical advice possible to my patients who have chosen to use cannabis.

The amount of cannabis in Princeton may not change significantly if a dispensary were to open, but the benefits to those who have made the choice to use cannabis of having a safe, regulated, accurately labeled product cannot be understated. Banning dispensaries does not roll back legalization or personal choice, it only hurts those adults who have legally made the choice to use cannabis and wish to do so in as safe a fashion as possible.

Kimberly Levitt MD, MPH
Witherspoon Street