Is Marijuana Safe For Treating Morning Sickness During Pregnancy?


A headline in today’s Washington Post states that “Pregnant women are increasingly using marijuana for morning sickness, study finds. That’s not good.

It’s not? Keen-eyed observers of my social media feeds will note that I am a cisgender male, so maybe I’m not all up-to-date on the latest treatments for puking pregnant women. What does the Post say?

The findings present potentially serious medical concerns because of earlier studies indicating that infants who were exposed to marijuana were more likely to be anemic, have lower birth weight and be placed in neonatal intensive care than infants of mothers who did not use marijuana.

According to the study published Monday in the Journal of the American Medical Association, nearly 4 percent of pregnant women between the ages of 18 and 44 reported in 2014 they had used marijuana in the past month, compared with 2.4 percent in 2002.

“Some sources on the Internet are touting marijuana as a solution for the nausea that commonly accompanies pregnancy,” said Nora D. Volkow, director of the National Institute on Drug Abuse, writing in an editorial published online with the study. However, she said, “doctors must be aware of the risks involved and err on the side of caution by not recommending the drug for pregnant patients.”

This “morning sickness” that we refer to euphemistically is a medical condition known as “hyperemesis” it isn’t just an inconvenient breakfast interruption. As the website notes:

According to Britain’s Royal College of Obstetricians and Gynecologists, four out of five pregnant women experience morning sickness through pregnancy and, despite its name, this affliction can strike all day, every day.

Jonathan Schaffir, MD, an associate professor in the department of Obstetrics and Gynecology at The Ohio State University College of Medicine, explained that the issue of whether or not to treat morning sickness with medication is complicated. “Nausea and vomiting in pregnancy is extremely common and ranges from the occasional discomfort to a miserable experience with weight loss, dehydration and inability to tolerate any food at all,” he told Fit Pregnancy. ”While the low end of this spectrum may be amenable to non-prescription treatments like bland foods and ginger, the more severe symptoms will usually require some help in the form of medication.”

The most common prescription recommendation made by doctors for their nauseous maternal patients seems to be a combination of vitamin B6 (pyridoxine) and the sleep-aid Unisom (doxylamine). Say, what are the possible side effects from Unisom, anyway, WebMD?

Drowsiness, dizziness, headache, constipation, stomach upset, blurred vision, decreased coordination, or dry mouth/nose/throat may occur…. mental/mood changes (e.g., hallucinations, irritability, nervousness, confusion), ringing in the ears, trouble urinating, easy bruising/bleeding, fast/irregular heartbeat…. seizure…. rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

The vitamin B6 seems to be all right, though. Just don’t take too much of it:

Pyridoxine is POSSIBLY SAFE when taken by mouth in amounts greater than the recommended dietary allowance. In some people, pyridoxine might cause nausea, vomiting, stomach pain, loss of appetite, headache, tingling, sleepiness, and other side effects.

Pregnancy and breast-feeding: Pyridoxine is LIKELY SAFE for pregnant women when taken under the supervision of their healthcare provider. It is sometimes used in pregnancy to control morning sickness. High doses are UNSAFE. High doses can cause newborns to have seizures.

National Public Radio looked at this issue in October. Apparently, Dr. Volkow and NIDA are convinced by the science they see implicating cannabis as dangerous to use for morning sickness, preferring to rely on the science that shows treatments like B6 & Unisom to be safe for pregnant women. Despite…

When researchers combed through more than 13,000 studies that addressed morning sickness, they found that just 35 were robust enough to be relied upon.

One study found that vitamin B6 could help with nausea, but that it didn’t reduce vomiting any more than a placebo. Another study found that higher doses of vitamin B6 helped reduce symptoms of morning sickness better than lower doses.

Some over-the-counter and prescription allergy medications seem to help with morning sickness. Although they are considered safe, they do have side effects like drowsiness and headache, so they’re recommended as a second-tier offense.

A few studies directly compared the effectiveness of morning sickness treatments. Four compared ginger to Vitamin B6 and found that ginger was just as good, and in one case better, at reducing nausea.

If the morning sickness starts threatening the woman’s health, it’s known as hyperemesis gravidarium and may require hospitalization. When it gets to that point, doctors may prescribe more serious medications, such as these listed in the journal American Family Physician. I’ve included links within the text to the WebMD listings of those drugs’ possible side-effects, in case you’d like to compare them with cannabis’.

The phenothiazines prochlorperazine (Compazine) and chlorpromazine (Thorazine) have been shown to reduce nausea and vomiting of pregnancy compared with placebo.

…some physicians try other antiemetics, such as trimethobenzamide (Tigan) or ondansetron (Zofran).

Women with severe nausea and vomiting of pregnancy or hyperemesis gravidarum may benefit from droperidol (Inapsine) and diphenhydramine (Benadryl).

Metoclopramide (Reglan) acts by increasing pressure at the lower esophageal sphincter, as well as speeding transit through the stomach. This drug has been shown to be more effective than placebo in the treatment of hyperemesis gravidarum.

Corticosteroids - A randomized, double-blind, controlled study found no hospital readmissions for recurrent vomiting in women with hyperemesis gravidarum who were treated with orally administered methylprednisolone (Medrol), compared with five readmissions in those who received oral promethazine therapy.

I don’t know, I’m never going to be pregnant, but if I were and my choices to stop puking every day were all these pharmaceuticals that might work sometime later, or to take a couple puffs of a cannabis vaporizer and stop puking now, I think I’d defer to the latter.

Besides, if there were any severe risk of birth defects from the moderate use of cannabis by pregnant women, don’t you think we’d see a dramatic difference in the children of Rastafarians? Dr. Melanie Dreher published science on this very idea over two decades ago, finding no significant differences between the babies of ganja-smoking moms and their non-smoking counterparts.

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