Marijuana consumption for recreational and medical purposes has increased significantly. As evidenced by the outcomes of a 2013 National Survey on Drug Use, approximately 17 million people in the United States have consumed marijuana (D’Souza, Wilkinson, Schalkwyk, & Davidson, 2016). Marijuana in Pennsylvania, including other 23 states, is legalized for medical purposes. Individuals supporting the legalization of the drug contend that it is a form of treatment for people diagnosed with chronic illnesses. For opponents of legalization, marijuana consumption results in poor social outcomes, long-term health impacts, and psychosis (D’Souza et al., 2016). Therefore, it is important to comprehend the effect of marijuana legalization for recreational and medical use.
Epidemiological Factors in Pennsylvania and Nationally
Marijuana is an
extensively consumed illegal drug in the United States. In a month, approximately 7.5% of the US
population aged above 12 years consume marijuana (Centers for Disease Control and Prevention, 2016).
The increase in the use of marijuana is attributable to state-level policies authorizing its
consumption for either recreational or medical use. Pennsylvania has recorded an increase in the
number of individuals arrested for possessing marijuana. Approximately 178,000 arrests between 2010
and 2014 were related to marijuana offenses, and 80% of the cases linked to marijuana possession
(Warner, Roussos-Ross, & Behnke, 2014). Despite being widely abused, the substance is associated
with mind-altering and psychoactive side effects.
Maternal, Perinatal and Fetal Risks
The use of marijuana during pregnancy
exposes the fetus and pregnant women to various risks. Warner et al. (2014) confirm that infants who
are exposed to prenatal marijuana are at increased risk of anemia and low birth weight, and may
require intensive neonatal care. Exposure to prenatal marijuana also affects fetal growth. In
pregnant women, abusing the substance leads to complications such as preterm labor, pre-eclampsia,
and miscarriage. The risks jeopardize the health of the fetus and mother.
Subjective and Objective Presentation of the Patient
Objective Presentation
- Urine drug testing indicates the presence of TCH (delta 9-tetrahydrocannabinol) and CBD (cannabidiol) chemicals in the patients’ bloodstream
- Time and perceptual distortions
- Impairment of short term memory, concentration, and attention including reaction time and information processing
- Paranoia, panic, and anxiety
- Xerostomia
- Undermined psychomotor coordination
- High blood pressure and increased heart rate
Subjective Presentation
- Patient notes that her appetite has increased in the previous two months
- She has not gone to work in the last two weeks
- Not interested in previously enjoyable recreational and social functions
- The patient denies cannabis-related symptoms despite evidence from reliable sources including urine drug testing, employer, and family reports.
Differential Diagnosis
Based on the subjective and objective presentation of
the patient, she is suffering from marijuana use disorder. The drug test indicates the presence of
major components of marijuana such as TCH and CBD chemicals in her body system. Besides, she is not
interested in recreational and social activities, and is unable to report to work regularly.
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Prenatal Care and Monitoring/Evaluation for Each Trimester
| Trimester | Prenatal Care | Evaluation |
| First Trimester | Educate patient on the significance of avoiding marijuana consumption to treat morning sickness. | The patient understands the impact of marijuana use on her unborn child and her health. |
| Second Trimester |
Examining the growth of the baby’s brain and other features |
The patient is aware of the adverse outcomes of marijuana use during pregnancy |
| Third Trimester | Apply motivational enhancement therapy and cognitive behavioral therapy to promote change of behavior. | Assess the patient’s coping skills to avoid dependence on smoking marijuana for different reasons. |
References
Centers for Disease Control and Prevention. (2016, September 2). National estimates of marijuana use and related indicators: National survey on drug use and health, United States, 2002-2004. Retrieved from https://www.cdc.gov/mmwr/volumes/65/ss/pdfs/ss6511.pdf
D’Souza, D., Wilkinson, S., Schalkwyk, G., & Davidson, L. (2016). The Formation of Marijuana Risk Perception in a Population of Substance Abusing Patients. Psychiatric Quarterly, 87(1), 177- 197.
Warner, T. D., Roussos-Ross, D., & Behnke, M. (2014). It’s not your mother’s marijuana: Effects on maternal-fetal health and the developing child. Clinical Perinatol, 41(4), 877-894. DOI: 10.1016/j.clp.2014.08.009