Medical Marijuana 101. Ed Rosenthal

reaction or if it is due to the patient’s mental state.

      Many people have deep-seated fears about using marijuana because of the criminality associated with it. This fear alone can raise your heartbeat. As with many medicines, marijuana affects everybody a bit differently. Marijuana is not a good option for some people, just as with all medicines.

      Another potential concern when considering marijuana as medicine is that it is an herb, and if you did not grow it yourself you don’t know how it was grown. Unhygienic practices, such as the use of chemical pesticides, leave harsh residues on the plant that are dangerous to ingest or inhale. Molds and fungus also pose a risk to some patients. For these reasons it’s best to know where your medicine is coming from. Chapter 4 discusses these issues in more detail.

      Any substance can be unsafe if used incorrectly or abused and marijuana is no different. Its effect on some users make them incapable of driving a car, operating machinery, or executing other tasks that require a high level of concentration. Marijuana should always be used in a responsible and controlled setting. If you adhere to basic safety protocols and manage your dosage effectively, you will have a completely safe experience.

       Why then is marijuana illegal?

      In 1937, the Marihuana Stamp Tax Act made the commercial cultivation, distribution, and use of marijuana and hemp products illegal in the United States without first obtaining a government-issued tax stamp. Since the authorities issued very few stamps, the Stamp Tax Act effectively outlawed marijuana. Thirty-three years later Congress passed the Controlled Substances Act (CSA), enacted into law as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. The CSA, among other things, created legislation surrounding banned drugs including marijuana and commissioned the Drug Enforcement and Food and Drug Administrations (DEA and FDA) to create “schedules” to classify all drugs. Marijuana was classified a Schedule I substance, which is described as a drug with “a high abuse potential and no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use of the drug or other substance under medical supervision.” This classification, which places marijuana in the same category as heroin and a long list of other opiates is incorrect and unjust. Marijuana has a myriad number of medical applications and despite overwhelming evidence to the contrary, federal lawmakers do not yet recognize the therapeutic values of marijuana.

      Some states have passed legislation permitting medical use of marijuana under controlled circumstances. The situation is fluid and more states are passing ballot initiatives and enacting legislation to legalize and or decriminalize the medical use of marijuana. Many states have enacted laws to set up and regulate marijuana distribution systems for patients to access marijuana as a prescribed medicine. It is your responsibility as a patient to know the laws that govern the medical use of marijuana in your area—courts in a state that does not recognize medical marijuana will probably not be sympathetic if you are arrested for marijuana possession and claim it was for medicinal purposes.

      As time goes on and more people demand safe access to medical marijuana, it will be increasingly difficult for the federal government to continue the criminalization of its medical use. Additionally, in every election cycle new states legalize it, which puts more pressure on the federal government to loosen the prohibition of marijuana.

      One might reasonably conclude that marijuana’s illegality is clearly a mistake. Yet an unwise law is a law nonetheless, and all medical marijuana users must act with caution when obtaining and using their medicine. Chapter 9 addresses your legal rights as a medical marijuana patient.

       What do doctors say about medical marijuana?

      Many doctors agree that marijuana possesses viable medicinal properties, but because many other doctors are unaware of current medicinal marijuana studies, they hesitate to recommend it as medicine, even where it is legal. Increasingly, however, doctors and organizations are recognizing the therapeutic medical benefits of marijuana in the face of experience and a growing body of research.

      In fact, most major medical organizations, including the American Medical Association (AMA) and the American College of Physicians (ACP), endorse the rescheduling of marijuana to reflect its medicinal properties and to open the door to further research. The American Public Health Association (1995) and the American Nurses Association (2003) are also both strong supporters of patient access to marijuana.

      The ACP stated, “[We] urge review of marijuana’s status as a Schedule I controlled substance and reclassification into a more appropriate schedule, given the scientific evidence regarding marijuana’s safety and efficacy in some clinical conditions. ... Given marijuana’s proven efficacy at treating certain symptoms and its relatively low toxicity, reclassification would reduce barriers to research and increase availability of cannabinoid drugs to patients who have failed to respond to other treatments.”

      The AMA adopted the report “Use of Marijuana for Medicinal Purposes” from the Council on Science and Public Health (CSAPH). The report affirms marijuana has medicinal values and calls for expanded research in this area. It concludes “short term controlled trials indicate that smoked cannabis reduces neuropathic pain, improves appetite, and caloric intake especially in patients with reduced muscle mass, and may relieve spasticity and pain in patients with multiple sclerosis.” In 2010, the AMA called for a review of the Schedule I status of cannabis in order to advance its use as a medicine.

      For a current list of supporting organizations including health care professionals, visit the Patients Out of Time Web site, a totally volunteer organization, at www.MedicalMarijuana.com. There are hundreds on their current list. If your doctor is uninformed or has a knee-jerk response to your questions, seek out a doctor more familiar with marijuana therapies before deciding if it is right for you.

       Is there credible research on marijuana as a medicine?

      Yes. Reliable studies have been conducted to determine the efficacy of marijuana as a medicine. In the United States only a few institutions have been allowed to pursue research, because of the Schedule I status of the plant. The results of studies at one of these institutions, the Center for Medical Marijuana Research at the University of California San Diego, found it to be an effective treatment for pain and spasms associated with multiple sclerosis and other neurological afflictions. In Canada the McGill University Health Centre reported similar results in a study published in the Canadian Medical Association Journal. The study confirmed that people suffering from chronic neuropathic pain from nerve injury found relief by using controlled dosages of smoked marijuana. They also reported improved moods and better sleep. Both studies validated that low doses of the cannabinoid THC provided good results with minimal psychoactive side effects.

      Over 6,500 peer reviewed reports in international medical journals confirm marijuana’s medicinal value. These publications addressed the various effects of marijuana use including its capacity to retard cancer cell growth, its ability to alleviate the pain and nausea of chemotherapy, and the effectiveness of different delivery methods. Some clinical studies have been disregarded as invalid because they were not sanctioned FDA-approved clinical studies. However, the U.S. federal government has long stifled any significant amounts of “approved” research in this field. One way the government impedes research is by controlling the supply of marijuana used in these studies.

      It is virtually impossible to pursue research into marijuana because of the circular and nonsensical rules imposed by the U.S. government. To be allowed to do marijuana research, one must have a government grant; to get a government grant, one must do pilot research; to do pilot research, one must have marijuana; to get marijuana in the laboratory, one must have a government grant.

      Researchers and institutions must have the proper Schedule I accreditations to be allowed even to possess such “dangerous compounds,” and the DEA regulates such licensure with an equally restrictive attitude. Researchers