Sure, it’s big business, but is marijuana safe?

BY GEORGETTE GOUVEIA ggouveia@westfairinc.com

The legalization of marijuana, for both medical and recreational use, is on the rise across the nation, with 22 states and Washington, D.C. having legalized its recreational use for adults 21 years and older and 38 states having legalized medical marijuana. (The drug is still illegal under the federal government.)

In New York state, cannabis data company BDSA predicts $1.3 billion in total marijuana sales this year. Connecticut saw a record $22 million in adult-use and medical marijuana sales in March, only the third month in which adult-use marijuana was legal in the Nutmeg State. The more established medical market accounted for $12.6 million and the newer market $9.6 million.

Yet there is growing alarm in the medical community over the popularity of the drug’s recreational use.

The National Institutes of Health (NIH) recently reported on a study that found an increased risk of schizophrenia in young men with cannabis use disorder. Now the American Heart Association warns that using marijuana may increase your risk for deadly cardiovascular diseases, heart attacks and strokes, based on research in two of its scientif ic statements.

The 2020 scientif ic statement “Medical Marijuana, Recreational Cannabis, and Cardiovascular Health,” said that while marijuana, also known as cannabis, may be helpful for some other medical conditions, it does not appear to have any well-documented benef its for the prevention or treatment of cardiovascular diseases (CVD). Indeed, the chemicals in cannabis have been linked to an increased risk of heart attacks, heart failure and atrial f ibrillation in observational studies.

Marijuana users may also have an increased risk of clot-caused stroke, according to the heart association’s 2022 scientific statement, “Use of Marijuana: Effect on Brain Health.” Studies cited in the statement found people who used marijuana had more strokes – as many as 17% to 24% more – compared to those who did not use the drug.

“There is a lot of confusion about the benef its versus the dangers of marijuana use, and much of that depends on the ingredients in and the method of use of the product,” said Robert L. Page II, Pharm.D., M.S.P.H., FAHA, volunteer chair of the writing group for the statement on medical and recreational marijuana and CVD. “The most common chemicals in cannabis include

THC, or tetrahydrocannabinolic acid, the psychoactive component of the plant that induces a ‘high,’ and CBD, or cannabidiol, which can be purchased over the counter. These chemicals may be working at cross purposes, as some studies suggest CBD could reduce heart rate and blood pressure, while others found THC may raise heart rate and blood pressure. Many marijuana products are becoming increasingly potent with higher levels of THC, which is very concerning.”

Smoking and inhaling marijuana, regardless of THC content, has been associated with heart muscle dysfunction, chest pain, heart attacks, heart rhythm disturbances, sudden cardiac death and other serious cardiovascular conditions. In states where cannabis has been legalized, an increase in hospitalizations and emergency department visits for heart attacks has been observed, according to the heart association’s 2020 scientif ic statement on cannabis use and cardiovascular health.

“The way cannabis is consumed may make a difference in how it affects the heart and blood vessels,” said Page, a professor in the department of clinical pharmacy and the department of physical medicine/rehabilitation at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, Colorado. “Many people don’t realize that cannabis smoke contains components similar to tobacco smoke. Smoking and inhaling cannabis, regardless of THC content, has been shown to increase the concentrations of poisonous carbon monoxide and tar in the blood similar to the effects of inhaling the smoke from a tobacco cigarette. Also, limited information exists on the hazards of exposure to secondhand cannabis smoke. According to the U.S. Centers for Disease Control and Prevention, ‘THC can be passed to infants and children through secondhand smoke, and people exposed to secondhand marijuana smoke can experience psychoactive effects.’”

More recent research published supports the evidence reported in the earlier scientif ic statements:

A new study presented at the heart association’s Epidemiolog y and Lifestyle 2023 meeting found that vaping THC was linked with self-reported symptoms of depression and anxiety, even more so than vaping nicotine.

A recent study from Stanford University researchers found that people who reported using marijuana daily were 34% more likely to be diagnosed with coronary heart disease, compared to those who reported no history of cannabis use.

Proponents of the relatively recent legalization of adult-use marijuana note that the studies are limited and that the judicial and f inancial practicalities and benef its of the legalization must be weighed in the balance. They point to the criminalization of alcohol use in Prohibition (1920 -33), which did not stop people from making, selling, buying and consuming liquor ––classif ied by the International Agency for Research on Cancer as a Group 1 carcinogen, along with asbestos, radiation and tobacco. (Connecticut, along with Rhode Island, never ratif ied the 18th Amendment, which outlawed recreational alcohol in the U.S.)

Page acknowledged that the federal government’s very disinclination to legalize recreational pot actually impedes the scientif ic study of it:

“The federal government still classif ies marijuana as a Schedule 1 drug ‘with no currently accepted medical use and a high potential for abuse.’ That means researchers face tight restrictions on conducting rigorous controlled trials with marijuana products. So much of what we do know about cannabis use is based on data from short-term, observational and retrospective studies, which identify trends but do not prove cause and effect. Until we know more def initively the specif ic pros and cons of marijuana use, people need to be aware of the potential dangers.”

Page recommended people who do choose to use marijuana for medicinal or recreational purposes should:

• Only use legal cannabis products, because there are no controls on the quality or the contents of cannabis products sold on the street.

• Note that the dosage of cannabis in the oral and topical forms can be quantif ied, so this may possibly reduce some of the potential harms with inadvertent high dosages.

• Be open with your doctor about any marijuana use as it relates to your overall health. Even though it may be a sensitive topic, it will help you understand how marijuana might interfere with prescribed medications or trigger cardiovascular conditions or events, such as heart attacks and strokes.

“Attitudes towards recreational and medicinal use of marijuana are changing rapidly, and more states are continuing to move to have it legalized,” Page said. “However, there is still too much unknown, and I would urge anyone currently or considering using cannabis to proceed with extreme caution.”

Learn more about the importance of heart health at heart.org.

Changing jobs? Don't forget about your 401(k)

If you have a 401(k) plan, one of the most important decisions you face when changing jobs is what to do with it. The wrong move could cost you thousands or more in taxes, penalties and lower returns.

Let’s say you work f ive years at your current job. For most of those years, you’ve had the company take a set percentage of your pretax salary and put it into your employer’s plan. Now that you’re leaving, what should you do?

You need to resist the temptation to cash out. The worst thing you can do when leaving a job is to withdraw the money and put it in your bank account.

If you decide to have your distribution paid to you, the plan administrator will withhold 20% of your total for federal income taxes. So, if you had $100,000 in your account, you’re already down to $80,000.

Furthermore, if you’re younger than 59 ½ , you’ll generally face a 10% penalty for early withdrawal come tax time. Now you’re down another 10% from the top line to $70,000.

There is an exception to the 10% early withdrawal tax penalty for 401(k) plans if you separate from service during or after the year you reach age 55 (age 50 for public safety employees of a state, or political subdivision of a state, in a governmental def ined benef it plan). IRAs, SEPs, SIMPLE IRAs, and SARSEPs do not qualify for the exception.

In addition, because distributions are taxed as ordinary income, at the end of the year, you’ll have to pay the difference between your tax bracket and the 20% already taken out. For example, if you’re in the 32% tax bracket, you’ll still owe 12% or $12,000, which lowers the amount of your cash distribution to $58,000. If your tax bracket is less than 20%, you may qualify for a refund, depending on your overall tax liability for the year compared to what was withheld or paid in estimated taxes for the year.

But that’s not all. You also have to pay any applicable state and local taxes. Between taxes and penalties, you could end up with little over half of what you saved, short-changing your retirement savings signi f icantly. Finally, you will miss out on any future tax-deferred growth those assets would have produced had they remained in the retirement plan. What are the Alternatives?

If your new job offers a retirement plan, the easiest course of action is to roll your account into the new plan. A “rollover” is relatively painless to do. Contact the 401(k) plan administrator at your previous job, who should have all the necessary forms.

The best way to roll funds over from an old 401(k) plan to a new one is to use a direct transfer. With the direct transfer, you never receive a check, you avoid all the taxes and penalties mentioned above, and your savings will continue to grow tax-deferred.

Many employers require that you work a minimum length of time before you can participate in their 401(k) plan. If that is the case with your new employer, one solution is to keep your money in your former employer’s 401(k) plan until you are eligible for the new one. Then you can roll it over into the new plan. Most plans let former employees leave assets in their old plan for several months or longer.

If you’re not happy with the fund choices your new employer offers, you might opt for a rollover IRA instead of your company’s plan. You can then choose from hundreds of funds and have more control over your money. But again, to avoid the withholding hassle, use direct rollovers.

60 -Day Rollover Period

If you have your former employer make the distribution check out to you, the Internal Revenue Service considers this a cash distribution. The check you get will have 20% taken out automatically from your vested amount for federal income tax.

to your new employer’s plan or into a rollover IRA. Then you won’t owe the additional taxes or the 10% early withdrawal penalty and, depending on your overall tax liability for the year, you might receive a refund of some or all of the 20% withheld.

But keep in mind that in your rollover you will have to make up for the withheld 20% with funds from another source. Otherwise, the withheld amount will be treated as a distribution and subject to any applicable taxes and penalties.

If your vested account balance in your 401(k) is more than $5,000, you can usually leave it with your former employer’s retirement plan. Your balance will keep growing tax-deferred.

However, if you can’t leave the money in your former employer’s 401(k) and your new job doesn’t have a 401(k), your best bet is a direct rollover into an IRA. The same applies if you’ve decided to go into business for yourself. You can still continue to enjoy tax-deferred growth. This column is for information only and is not intended as advice. Consult a quali f ied retirement professional if you have questions.

Norman G. Grill is managing partner of Grill & Partners LLC, certi f ied public accountants and consultants to closely held companies and high-net-worth individuals, with of f ices in Fair f ield and Darien.

Don’t panic because you have 60 days to roll over the lump sum (including the 20%) Illustration by Westfrisco / Pixabay.