Medical marijuana is the use of marijuana for medicinal purposes, largely to relieve conditions such as glaucoma[note 1], nausea associated with chemotherapy, and appetite loss in AIDS patients. It is well established to relieve chronic pain without the intense physical dependency that comes with opiates or other CNS depressants. Marijuana has also been shown to assist in management of many gastrointestinal disorders, including Crohn's disease, irritable bowel disorder, and more.
The issue is a hotly contested one (in the United States) because many states have specifically legalized this use of marijuana, while the federal government continues to insist on classifying marijuana as a dangerous "narcotic" with no medical value, and criminally prosecuting those who grow, sell, and use the plant.
The main argument in favor of medical marijuana is a moral one: that the government should not be dictating what an informed person can and cannot put into their own body, and should not be treating those who choose to use one substance or another as criminals. However, see health freedom; depending on who is making the argument, this argument is sometimes the edge of a slippery slope.
While marijuana has any alternative medicine's fair share of anecdotal evidence for symptomatic relief (just ask any pothead about the munchies, regarding use as an appetite stimulant), its effectiveness has also been proven in numerous controlled studies. This even includes the aforementioned munchies.
Doctors in US states with medical marijuana write fewer prescription for opioid painkillers. In a later separate study, it was found that states with medical marijuana had a 25% lower rate of opioid overdose mortality, and that states with recently implemented medical marijuana laws had decrecreased opioid mortality over time.
If medical marijuana is taken by smoking it, this presents the usual problems from a scientific perspective, that is the harm done to the lungs — pot smoke actually contains more "tar" (i.e. aromatic carcinogens like pyrenes) than cigarettes, though usually less smoke is inhaled. Marijuana has not been shown to cause lung cancer, but bronchitis among other irritations are quite possible. This particular problem can be reduced or avoided by using a vaporizer or putting the marijuana in food. Also, researchers are working on isolating specific active compounds in order to make them deliverable via pill.
Medical marijuana is sometimes also associated with alternative medicine and the use of herbs for medicinal purposes. In this case, there is the lack of a controlled, carefully measured dose of the plant's active compounds,[note 2] which can widely vary from individual herb to herb. However, while it is possible to overdose on marijuana, there are no known cases of overdose by smoking/vaporizing/ingestion leading to permanent health effects or death, and as explained above, the problem of overdosing (as in using more than therapeutically beneficial) could possibly be alleviated by extracting or artificially producing the psychoactive compounds and submitting them for approval by the FDA.
The issue has implications for those of us who believe much (not necessarily all) of alternative medicine is quackery and woo. Believing that, for example, laetrile is ineffective bullshit does not necessarily mean believing that it should be illegal or that people should be prosecuted for using or selling it in the United States as they currently are. The same goes even more so for medical marijuana, which unlike Laetrile does have some scientific studies showing it is effective for treating some specific conditions.
Legalization and enforcement
One of the big bones of contention, and thus one of the largest arguments for legalization, is that penalties (jail time and/or fines) for possession and/or trafficking of marijuana in the United States are equivalent to that of any other Schedule I drug, such as heroin,
cocaine,[note 3] methamphetamines or PCP which are fairly high, especially for trafficking, repeat offenders and probation violators — in some cases, higher than rape, murder, larceny, grand theft or numerous types of white-collar crimes such as fraud, bribery, extortion, insider trading or embezzlement. The fact that so many people are willing to risk these penalties in order to seek pain relief is an indication that current laws may not be in the best interest of the citizens.
Proponents will also point out that, unlike other drugs, including nicotine and alcohol, prescription painkillers and drugs with lengthy side-effect disclaimers, as well as certain legal over-the-counter medications such as ephedrine, marijuana is extremely unlikely to cause death — and yet, all those other deadly drugs are perfectly legal and their traffickers don't face nearly the same penalties (at least, not prison time — selling alcohol to an intoxicated individual who then goes out and crashes a car causing injury or death can be severely penalized in "dram shop law" states).
As such, many states and municipalities have significantly reduced penalties and, in some cases, decriminalized possession altogether, in order to reduce the expenses of having to prosecute the relatively minor crimes and reserve jail and prison space for more heinous criminals. Some states have legalized the sale of medical marijuana, and other states like Colorado and recently California have completely legalized it, though it is very tightly regulated and there are still some problems with the legalities at the federal level. Setting up a dispensary in Colorado is a particularly lengthy and expensive affair, but the returns appear to be worth the effort — in 2010 (before complete legalization), Colorado was able to balance its budget and end the fiscal year with a surplus due to the revenues associated with dispensaries.
Federal 2012 crackdown in Colorado
In January 2012, the Attorney General of the United States informed 30 Colorado medical marijuana dispensaries that they must close their doors within 30 days or face — well, the "or" clause is rather ambiguous. The letter to these 30 dispensaries stated that the Feds have the right to close any and all dispensaries, regardless of the State law, but they are beginning with these 30 on the facts that these 30 are within 1000 feet of a school and that children are "smoking more pot", so clearly they are buying at the local dispensary. The studies that they are basing their "evidence" on suggests that most of the kids getting pot are getting it from adults who have a legal right to it and not the dispensaries themselves. But why let facts get in the way of a good
hippie-beating power trip?
R v Mernagh in Canada
In Ontario, Canada, Matt Mernagh has been fighting a court battle (see R v Mernagh for a detailed analysis) against Canada's medical marijuana program, the Medical Marijuana Access Regulations (MMAR). In April 2011, Justice Taliano ruled that the MMAR was unconstitutional because Health Canada deliberately made it look good on paper but be almost impossible to use in practice. As a result of Canada effectively not having a medical marijuana program at all, the judge also struck down the personal possession and cultivation sections of Canada's marijuana laws, since MMAR was effectively an attempt to appear to be providing Canadians with legal access to medicine they were legally entitled to but was de facto an extension of prohibition. The government appealed to the Ontario Court of Appeals, and the appeal's oral hearing was finally held over two days in May 2012. The decision, released on February 1, 2013, overturned the acquittal and ordered a new trial.
In California at least, the "medical marijuana"-only law has become more of a contrivance than a reality. If you can't find a pot doctor to give you a prescription, then there must be something wrong with you. Due to the panacea-level claims about medical marijuana, just tell the doctor that you've got headaches (41%) or spasms (also 41%). The doctor can't prove you don't and they don't really want to. A perhaps surprisingly large portion of the patients at marijuana dispensaries, a.k.a. patient collectives, are young (48% between ages 18 and 34), and are primarily not the stereotypical cancer patients (1.5%) or AIDS patients (1.6%) seeking help with nausea that one might have thought of. The state remedied this discrepancy (or rather sidestepped it) by legalizing recreational marijuana in 2016.
- Damage to the optic nerve, leading to eye damage and ultimately
becoming blind being a person with blindnessseeing with a dog and white cane.
- Not just THC, but CBD, CBN and who knows what else.
- Under the U.S. Controlled Substances Act, cocaine is classified under Schedule II, meaning it has a recognized medical use. Evidently, medical marijuana doesn't count.
- NIH page on medical marijuana
- Medical Marijuana for Treatment of Chronic Pain & Other Medical and Psychiatric Problems: A Clinical Review (JAMA. 2015 Jun 23-30;313(24):2474-83. doi: 10.1001/jama.2015.6199.)
- Cannabinoids for Medical Use: A Systematic Review and Meta-analysis (JAMA. 2015 Jun 23-30;313(24):2456-73. doi: 10.1001/jama.2015.6358.)
- Michigan Medical Marijuana
- see here for a collection
- Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study (Clin Neuropharmacol. 2014 Mar-Apr;37(2):41-4. doi: 10.1097/WNF.0000000000000016.)
- The case for medical marijuana in epilepsy (Epilepsia. 2014 Jun;55(6):783-6. doi: 10.1111/epi.12610. Epub 2014 May 22)
- Medical marijuana in neurology (Expert Rev Neurother. 2014 Dec;14(12):1453-65. doi: 10.1586/14737175.2014.985209.)
- A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men (Brain Res. 2012 Jan 11;1431:46-52. doi: 10.1016/j.brainres.2011.11.001. Epub 2011 Nov 7)
- The opioid epidemic spurs a search for new, safer painkillers: Scientists test alternative drugs that relieve pain without the dangers of opioids by Laurel Hamers (1:00pm, May 30, 2017) Science News.
- Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D by Ashley C. Bradford & W. David Bradford (2006) Health Aff. vol. 35 no. 7 1230-1236. doi: 10.1377/hlthaff.2015.1661.
- Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010 by Marcus A. Bachhuber et al. (2014). JAMA Intern. Med. 174(10):1668-1673. doi:10.1001/jamainternmed.2014.4005.
- Washington Post article
- In fact, pharmaceutical-grade THC has been sold under the brand name Marinol for a while
- Also schedule II, used in ADHD and narcolepsy
- ,Also schedule II, once used as an anesthetic
http://www.kdvr.com/news/kdvr-us-attorney-some-colo-pot-dispensaries-too-close-to-schools-20120112,0,1857488.storyno story at this link
- US Attorney on targeting some, but not all, medical marijuana businesses
- Court decision link
- Illnesses Treatable with Medical Cannabis United Patients Group
- An Analysis of Applicants Presenting to a Medical Marijuana Specialty Practice in California by Helen Nunberg et al. J. Drug Policy Anal. 2011 Feb; 4(1): 1. doi: 10.2202/1941-2851.1017.