DEAR DR. SHIEH

"Dear Dr. Shieh" is the result of a partnership between the Pacific
Daily News and Dr. Thomas Shieh, an obstetrician and a longtime
proponent of health and education programs for Guam's youths. If you
have a question you would like answered, e-mail: life@guampdn.com

Dear Dr. Shieh,

I am pregnant and throwing up all the time. My girl friend told me to
smoke marijuana because it can get rid of my nausea. Is marijuana
safe during pregnancy? - Anita

Dear Anita,

No. Your girl friend may be correct in that marijuana can decrease
nausea and prevent you from throwing up, but I would not recommend it.

Marijuana contains hundreds of different chemicals. We don't
specifically know the effects in pregnancy because it is not a
well-studied area to recommend its use as a "safe" substance.

We do know that one of the chemicals in marijuana,
Delta-9-Tetrahydrocannabinol (THC), crosses the placenta to the baby,
and we can associate chronic users to low birth weight and premature
delivery just like cigarette smoking would do.

Additionally, there are some reports of developmental effects on
children from parents who smoked marijuana during their pregnancy;
however, it is really difficult to concretely pinpoint that the use
of marijuana was a direct cause.

The pharmaceutical extract of marijuana is legal in some States as
"medical marijuana," for certain illnesses, but its dosage is not
established for severe nausea and vomiting during pregnancy.

The controversy always comes up in medical discussions on the
benefits of marijuana in some patients, and perhaps in the future we
may be able to have more data to support the extract in a pill form
so that physicians can better prescribe the efficacious dose.

Finally, the Food and Drug Administration has always been against the
"smoked medical marijuana," and I am sure this will disappoint many
people who still seek marijuana in that particular form. We know
there are medical benefits from marijuana, but we'll just have to
wait for more evidenced-based studies and to see if all 50 states and
Guam will follow and allow for its use in specified medical conditions.