Medical Marijuana – It Is Time
A young woman named Megan resides in Michigan. After high school graduation, her future looked promising. She left for college to pursue a graphic arts degree. Then, during her senior year, tragedy struck. Following a routine appendectomy, she began to suffer fainting spells and unexplained episodes of intense pain. Eventually, she was diagnosed as suffering from POTS (postural orthostatic tachycardia syndrome). POTS is a chronic malady that affects the autonomic nervous system. There is no known cure.
Megan initially was treated with narcotics that left her so medicated and lethargic she was unable to work and function. She also feared addiction from their long-term use.
In the meantime, Michigan passed a law making permitting the prescription of cannabis (marijuana) for those suffering from identifiable illnesses. Megan researched the use of medical marijuana as an alternative treatment for her disease. Before approving a prescription for medical marijuana, the state required the filing of a detailed application for eligibility and submission of all her medical records documenting her disease. Ultimately, she was able to obtain a prescription.
Today, Megan is 27 years old and owns a non-profit art gallery in Grand Rapids, Michigan. To control the symptoms and side-effects of her disease, she uses a prescribed dose of marijuana delivered through a vaporizer. The vaporizer heats the marijuana rather than burning it, creating only a thin vapor mist. There is no smoke, and therefore no carcinogens released. It does not create a “high.” Instead, it soothes her nervous system, preventing her loss of consciousness and mitigating her pain. Most importantly, it allows her to continue to work and be a productive member of society. Her use of prescribed marijuana also removes the need for potent and expensive narcotics.
Megan is but one of the many thousands of patients who report the medical benefits of prescribed marijuana. Marijuana has been reported to alleviate symptoms and provide comfort for not less than 70 illnesses, including glaucoma, HIV, neurological disorders, post-traumatic stress disorder (PTSD), chronic pain, multiple sclerosis, radiation therapy and chemotherapy, arthritis, cancer, muscular dystrophy, and terminal illness.
Currently, 18 states, as well as Washington, D.C., allow legal protection for patients using cannabis for medical purposes, and further allow these patients to obtain marijuana for such usage.
In our state, recent polling indicates that 7 out of 10 Floridians support the option of doctors being able to prescribe marijuana to seriously ill patients. Additional poll results show that this support includes majorities of Democratic, Republican, and independent voters. Further, this support for doctor prescribed marijuana cuts across age, race, and income levels. Locally, a TCPalm.com internet poll shows that 86 percent of those responding favor medical use of marijuana.
Presently, bills have been introduced in both houses of the Florida Legislature seeking to make prescribed marijuana use legal for certain medical illnesses.
So, if a strong majority of Floridians think prescription marijuana is a good idea, then why has a law not yet been passed making that a reality? Unfortunately, the answer is multi-faceted. Any investigation of this issue must include an understanding of the federal government’s stance on of the use of marijuana.
Violation of Federal Law
Opponents of medical marijuana legislation point out that regardless of state action, marijuana possession and use still remains a Federal offense. However, 99% of criminal arrests for marijuana possession occur at state and local levels. Federal law does not prohibit states from removing criminal penalties for possession of marijuana, and nowhere does the U.S. Constitution or federal law prohibit a state from enacting penalties that differ from federal laws.
Many of the conservative minded who favor legalization of medical marijuana believe that it is a state’s rights issue, and that such decisions should be left up to individual states to decide, not dictated by Washington. Also, they point out that medical marijuana could be locally grown, taxed, regulated and monitored without federal involvement. If so, much of the foreign narco-trafficking from countries such as Mexico, and the crime associated with it, would likely decline.
It is interesting to note that while the Federal government’s official stance is that marijuana as medicine is myth, and Federal law makes marijuana possession a criminal offense, the federal government actually supplies certain individuals with medical marijuana and has been doing so since for over three decades. Growing out of a court settlement, in 1976 the federal government initiated a program whereby seriously ill patients could receive federally dispensed marijuana. At its peak, this program had 34 participants. In 1992 the program was closed to new participants, after an influx of participation requests from AIDS patients.
Marijuana for this Federal program is grown, harvested and stored at the University of Mississippi. Quantities are shipped to North Carolina, where the marijuana is rolled into cigarettes. Every month, the four patients still on the program (the other patients have since deceased) receive a tin with a white label. Inside is approximately 8-10 ounces of marijuana in 300 perfectly wrapped joints.
One such recipient, Irv Rosenfield, a financial planner residing in Boca Raton, Florida, has been on the program since 1983. His medical condition, a rare illness called multiple congenital cartilaginous exostosis, causes tumor growth at the ends of his long bones, creating unbelievable pain. Mr. Rosenfield, who smokes 10-12 joints daily, states that medical marijuana replaced his use of prescription pain killers. An outspoken advocate in favor of medical marijuana, Mr. Rosenfield further has stated that without medical marijuana he would have been forced to seek governmental disability and would have become a “drain on society.”
Teen Marijuana Abuse
Another objection to legalization of marijuana for medical use is that it will lead further teen abuse of the drug. This proposition does not appear to be factually supported. According to statistics being gathered in states that currently allow medical marijuana, the opposite may be occurring: while the data is too early to allow for direct correlation, after laws decriminalizing marijuana for medical purposes have been enacted, overall teen marijuana usage has decreased, suggesting that medical marijuana may have positive, or at least a neutral effect on youthful experimentation.
Certainly, all drugs are subject to abuse. A recent newspaper article reported on a locally held drug symposium. The symposium discussed ways of combating drug use by young people. Several of the topics turned on helping parents prevent teens from abusing drugs. Of particular mention is the problem of young people using what they find available in their parent’s medical cabinets. Since 2006, law enforcement officials told symposium attendees, prescription drug abuse has been the major drug abuse problem. Narcotic drugs such as oxycodone, once reserved for patients suffering severe and crippling pain from severe illness and disease, is now widely marketed and being routinely prescribed for a host of lesser ailments. These easily available, highly addictive drugs are subject to wide-spread abuse, especially by young people.
Surely, marijuana also can be abused. That is why, proponents argue, medical marijuana should be available only under a doctor’s prescription. In this way, patients will be required to show legitimate, medically documented reasons before such a prescription may be obtained.
FDA Approval and Health Risks
A further argument against making marijuana available for medical reasons is that it lacks FDA (Food & Drug Administration) approval and does not come in a standardized formula. Those advancing this argument also point out that medical marijuana is unnecessary, as it already exists. Marinol, an FDA approved drug is available by prescription. It contains a standardized amount of synthetic THC, the drug derived from marijuana.
The FDA protects the public from being able to obtain unhealthy drugs. Opponents say that without FDA approval, then marijuana cannot be considered a legitimate drug. Legitimacy requires that a substance have well defined and measurable ingredients that will allow medical providers to use known dosing levels. When it comes to marijuana, there is no telling what a patient may be getting, regardless if that marijuana is purchased on the black market or from a state authorized dispensary. This is so, as there are different plant strains, and marijuana itself contains over 400 other substances in varying degrees, depending on genetic and environmental factors. There has been insufficient testing to determine if these other compounds in cannabis might pose health risks, especially in patients with compromised immune systems. Smoked marijuana also releases carcinogens, which can cause various diseases. Additionally, FDA approval only comes after extensive clinical testing and trials showing that a drug’s effectiveness outweighs any risks to patients, which has not occurred for marijuana.
In response, medical marijuana proponents cite medical studies that found medical marijuana use actually improved immune system functions in immune weakened patients. Poor city air, proponents argue, poses greater health risks than smoked marijuana. Any argument that smoked marijuana releases carcinogens and is thus harmful is also a red herring; tobacco, with no medically redeeming benefit, whose 599 ingredients include formaldehyde, ammonia, hydrogen cyanide, arsenic, and DDT, is readily available at any 7-11. Use of other FDA approved drugs can cause more severe side effects, including death, even at prescribed doses.
Proponents understand that FDA approval requires standardization and clinical trials, which have not yet taken place. The problem is that medical marijuana is caught in a Federal Catch-22 situation: FDA approval requires extensive clinical trials, but the Federal government, while allowing a few scattered small scale studies, has blocked large scale testing. One example is a request made to the Federal government from the University of Massachusetts, which sought to grow selected strains of marijuana for studies treating certain medical conditions. The testing would be designed to develop marijuana as a FDA approved drug. It never occurred, as the federal government refused to authorize the study.
Regarding standardization, proponents point to other plant based drugs that have passed FDA approval, including morphine and taxol. Proponents are confident that marijuana, when allowed to be properly researched and tested, will also.
Proponents remain confident that marijuana, a substance that provides medicinal benefits without the devastating side effects or costs of so many FDA approved drugs, will eventually gain FDA approval. However, in order to move in that direction, the Federal government must allow large scale clinical testing without fear of criminal or civil reprisal.
Currently, a drug called Marinol, containing a synthetic version of THC, one of the cannabinoid compounds in marijuana, is available by prescription. Probably the most frequently cited criticism of Marinol is that it is ineffective for most of the ailments marijuana treats. Marinol is an orally administered pill, slowly digested. Inhaled THC, on the other hand, is rapidly absorbed into the bloodstream. Even those treatments Marinol has proven effective in treating, nausea in cancer patients and anorexia in AIDS sufferers, have been problematic, because its oral method of administration has led to numerous reports of patients having trouble keeping the medicine down.
Another shortcoming is that Marinol contains only THC, while there are many other cannabinoid compounds found in marijuana that researchers believe either may offer additional singular benefit, or work synergistically with other therapeutic compounds in inhaled marijuana to provide relief that Marinol simply cannot match.
Lastly, the production of synthetic THC used in Marinol is expensive, and that expense is passed on to the consumer. Thus, Marinol costs a great deal more than a comparable dose of medical marijuana. This high cost has dissuaded many medical providers from prescribing it for their patients.
As reported on March 12, 2013, by NBCNews.com, the National Cancer Institute (NCI), part of the Federal government’s National Institutes of Health (NIH), recently stated that marijuana reduces breast cancer risk, as it “inhibited the survival of both estrogen receptor positive and estrogen receptor negative breast cancer cell lines.” Further, the report states that not only does cannabis not cause lung cancer; it might have a protective effect against its formation. The report also suggests that marijuana may provide “risk reduction and treatment of colorectal cancer.” Finally, the NCI cited testing that shows marijuana effective in relieving insomnia, without the side effects found in prescription sleep aids such as zolipidem.
These findings, by an institution within a Federal agency, belie the Federal government’s claims that marijuana’s medicinal benefits are merely myth.
Finally: A Question
There are many more reasons than those discussed in this article to either support or oppose medical marijuana. I admit that I am biased in favor of legalization of marijuana for medical use; for you see, Megan, the young woman chronicled at the beginning of this article, is my niece. Obviously, having personally experienced a family member benefit from medical marijuana, I am in favor of legalization for medical purposes.
Before taking a position, consider this scenario: Your beloved grandmother is dying a slow, painful death from a tumor that has metastasized. She suffers from extreme nausea and is unable to keep down solid food. Although she is fed intravenously, she continues to lose weight and is wasting away before your eyes. Her joint pain is excruciating and unrelenting, even with the infusion of powerful narcotics, which keep her in a state of confusion.
If you were informed that marijuana could ease her pain, decrease her nausea, and allow her to consume solid foods, would you go looking for marijuana for her?
I am aware of the arguments against legalization of marijuana for medical purposes. However, too much evidence exists showing that medically prescribed cannabis can be beneficial for those who truly need it.
A doctor and patient should be able to have a frank, risk/benefit discussion about all medically available treatments, which should include marijuana. A doctor should be able to prescribe marijuana, and a patient should be able use it medicinally, without either party fearing criminal prosecution.
Partial List of Sources Consulted
Caputo, Marc, “Poll: 7 in 10 back Florida medical-marijuana plan, enough to possibly affect governor’s race,” Miami Herald, February 26, 2013
Abrams, Hilton, et. Al., “Short-Term Effects of Cannabinoids In Patients with HIV-1 Infection” Ann. of Internal Med, 2003; 135.258-266
Montopoli, Brian, “Does the Pot Pill Work?” CBS News, Nov. 9, 2009.
“Indian River County drug experts discuss drug abuse problems,” TCPalm.com; March 20, 2013.
“Medical Conditions for Marijuana Treatment” MarijuanaDoctors.com
Anderson, D. Mark, Hansen, Benjamin and Rees, Daniel I., “Medical Marijuana Laws and Teen Marijuana Use” (May 27, 2012).
Jaslow, Ryan, “Medical marijuana legalization won’t boost teen pot use, study finds,” CBS News, June 20, 2012.
Press Release, “Federal Government Reports Marijuana Effective in Combatting Certain Cancers Reports ADSI,” NBCNews.com, March 12, 2013.