Melanie Cole (Host): While marijuana use is not allowed on MIT campus, the laws in Massachusetts have changed, and it's possible that some people might have some questions about this drug. Welcome to Conversations with MIT Health. I'm Melanie Cole. My guests today are Don Camelio. He's the Assistant Dean of Student Support and Well Being and the Director in the Office of Community Development and Substance Abuse at MIT; and Dr. Shawn Ferullo. He's the Director of Student Health at MIT Health. Welcome to the show, gentlemen. Don, I'd like to start with you. What are the laws in Massachusetts now? What has changed? 

Dr. Don Camelio (Guest): So, up until this past election cycle, marijuana was illegal, like it is across most of the country. Now, in Massachusetts, it is able to be purchased and used recreationally. So, there are lots of different components to that. Folks are now allowed to possess - if they're up to 21 years of age or older - can possess up to one ounce of marijuana outside of their residences without penalty. They can do that up to 10 ounces of marijuana inside their residences. They're allowed to grow up to 6 marijuana plants in their homes. They can give an ounce or less of marijuana as a gift to someone else who's 21 years of age or older as long as there's no payment involved. It really has changed the landscape of how we deal with marijuana. It's now really a recreational substance, much like alcohol, regulated in similar ways.

Melanie: So, Don, sticking with you for a minute now, what is the policy of MIT on campus?

Dr. Camelio: It's actually different than the state law. Within MIT's properties, the properties that we own or manage, it is still considered to be a prohibited substance. So, that means that even if you are 21 years of age, you can't have the substance on campus, in your dorm, in your workplace, and things like that. The reason why that is that we follow not just state laws and mandates, but also those handed down by the Federal government, and we are governed by something called the “Drug-Free Schools and Community Act”, and in that Act, the federal government still lists marijuana as a Schedule 1 substance, which means it's still illegal. And if we don't follow the mandate by the federal government, we risk losing a variety of forms of Federal financial aid for our students and for our institution.

Melanie: So, Dr. Ferullo, I'll move to you now. Tell us about how marijuana works and how it affects the brain, judgment, athletic performance, or overall health.

Dr. Shawn Ferullo (Guest): Marijuana is a component of the dried and shredded leaves of the cannabis plant. There are psychoactive properties and the main psychoactive component in marijuana is delta-9 tetrahydrocannabol, or what's more commonly known as THC. Then, there are other cannabinoids within the marijuana plant which also have psychotropic properties and what these do is that they impair different areas of the brain. Certainly, learning and memory, the ability to perform complicated work or complicated tasks can be affected. Also, it will affect and impair judgment and thinking as well as other areas of the brain including the cerebellum and basal ganglia which are involved in balance and posture and reaction time. So, really all of these functions are impaired and affected by marijuana use, both from cognitive--learning and memory--to also athletic performance and balance and judgment, reaction time as well.

Melanie: So, Dr. Ferullo, you're in sports medicine, yourself. So, tell us about you mentioned athletic performance and I think that this is an important thing for students to note as far as motivation to remain in athletics or to exercise or to remain healthy.

Dr. Ferullo: Absolutely. I think the balance issues, the impaired reaction time and posture all factor in to athletic performance. The other thing that we also worry about is how marijuana would be used. If someone is primarily smoking marijuana, we then worry about the inflammatory effects on the lungs, which might also then add to asthma-type symptoms, bronchitis, breathing issues. So, not just the neurologic impairment with their athletic performance, but also some of their cardiovascular and respiratory issues, might come up a bit as well.

Melanie: So, then, what about the institute's Good Samaritan policy, Don? What is that and how does that relate to marijuana?

Dr. Camelio: The Good Samaritan policy was something that was put into place to ensure that folks who might be experiencing alcohol or other drug-related overdoses were getting the help--mainly the emergency medical help--that they needed. So, the policy is set up in such a way that, if a person is experiencing these types of symptoms and outcomes, if someone reaches out - if a student reaches out - on behalf of their peer to get some help, and get them services that they need, neither the person who calls nor the person who needs the service will be experiencing any of the typical conduct repercussions that come with the violation of a policy. What it's meant to do is to reduce barriers to help-seeking behaviors and get people to get the help that they need immediately, for people who need it.

Melanie: And, Don, as long as it is legal now, you mentioned regulated, is there a way to know if students purchase it? If it's clean and not laced with other substances? How does that work?

Dr. Camelio: I think things are going to change. There traditionally hasn't been a method by which you'd be able to know those things. I think with the new marketplace being open and it being able to be purchased legally, I think there are going to be different types of services that come into play that will help us know that. So, right now, there is none. But I think, from what I read, there are a number of different companies that are looking into being able to provide tests that help people to understand the amount of tetrahydrocannabinol in the substances as well as whether or not they're pure or whether they've been adulterated in any way.

Melanie: And, as a substance abuse professional, Don, tell us about how somebody would know if they've had too much. Is there too much? Can you abuse marijuana and is there an emergent situation that might come up?

Dr. Camelio: What we see is a couple of different things. Traditionally, we haven't seen a whole lot in the way of physiological dependence developing among people who are even frequent marijuana users. However, we have seen a lot of psychological dependence. So, when people start to see diminishments in other areas of functioning, such as their academics, their finances, their social relationships, and things like that, those are really good indications that they should reach out, maybe talk to somebody about reducing some of their use and really get those things under control. In terms of risk for negative outcomes, as with alcohol, there's a pretty clear lines about when someone is intoxicated to the point that they need some services. With marijuana, it really comes down to if the level of impairment the person is experiencing is causing them to make poor decisions and their judgment is so impaired that they're engaging in behaviors that could cause issues, such as operating a motor vehicle, or things along those lines. Unlike with alcohol, we don't have a blood alcohol concentration calculator for marijuana yet, so we can't tell people, "If you're at this number you should experience these things and these things are worrisome." With marijuana we don't have the technology yet. But, again, I think the market is going to come around and help us develop tools to better articulate when those situations arise.

Melanie: Dr. Ferullo, how would somebody know, as Don mentioned, about driving and other activities, as one glass of wine doesn't meant that someone is too drunk to drive, what about edibles and such, or smoking a joint. How would somebody know that they are impaired? And, tell us a little about edibles and are they different?

Dr. Ferullo: That's a great question. I think that's not only a question that many of us in the medical field have but also a lot of law enforcement as well. Historically, with marijuana being illegal, there's not really a lot of research done worth mentioning on blood levels and what levels are okay and which aren't. Edibles are essentially ingestion of the marijuana. They can be either oil or powders that can be mixed in with other food products and eaten and ingested. Typically, they have the same psychotropic effect as being smoked. There may be a little longer time to onset of action through the digestion but, essentially, it is still marijuana use and all the same effects would still be experienced. In terms of knowing how much is too much to drive, I think the safe thing at this point is the same thing with alcohol. If a person has used any, they should refrain from operating a motor vehicle to be on the safe side. We clearly know there is an impairment of judgment and reaction time with use of marijuana, so playing more on the safe side would be strongly recommended.

Melanie: So, Don, I'm going to give you the wrap up here. Would you want people to know and what would you want students to know about the new laws in Massachusetts, as the Director of the Office of Community Development and Substance Abuse at MIT, please let the students listening know what you want them to know about the use of marijuana on campus and off.

Dr. Camelio: I would think the big takeaways are that despite the law changes that have occurred in the state, MIT still handles the substance as a prohibited substance. However, what we want folks to know is that if they are engaging in use, if they are experiencing negative consequences related to their use, we want them to come in and talk to folks within the community development and substance abuse to get services. We don't want people to experience those negative outcomes. We want them to be well, and if they ever have an instance where the use of marijuana is leading to a reaction where people are concerned about the person's health and well-being we really want them to seek out help. Call 657-253-1212, let a medical professional come out and do an evaluation and ensure that the person is okay, because we have this Good Samaritan policy that protects people from experiencing some of the conduct consequences and we really want people to take care of one another.

Melanie: Thank you so much for being with us today, gentlemen. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.