Medical Marijuana Legalization of Medical

Medical Marijuana

Legalization of Medical Marijuana

The legalization of medical marijuana has been an issue of passionate debate during recent years. Opponents fear that legalizing marijuana for medical purposes will open the door for legalization across the board, and cite that synthetic versions of the drug work as well or better. Proponents hail it as a wonder drug for a number of medical complaints, and claim that synthetic marijuana does not offer the same relief as the pure form. Based on available research, there appears no true logical reason for allowing medical marijuana to remain an illegal drug.

Archeologists in Taiwan uncovered clay pots from 8000 B.C. that were decorated with strands of hemp (Earleywine 4). Societies have been smoking, eating, making clothes, and trading marijuana for thousands of years. In fact, in 2737 B.C., the Chinese Emperor Sheng Nun declared cannabis as a "superior herb"(Merrett). Roughly a thousand years later, the Scythians, a cannabis-smoking tribe, came through Europe and Asia, introducing a useful tool for harvesting the crop (Merrett). The plant is even mentioned in the Bible: in Exodus, Chapter 30, God instructs Moses to take sweet "kineboison" as one of several ingredients to make holy oil (Merrett). Roman Emperor Nero's surgeon, Dioscorides, praised cannabis for its medicinal properties, and Queen Victoria was known to use it to relieve the discomfort of her period pains (Merrett). In 1901, the Royal Commission released a report declaring it "relatively harmless and certainly not worth banning" (Merrett).

Marijuana's use as a treatment for a variety of illnesses spread from ancient Asia throughout the world, and it consistently appeared in pharmacopoeia and folk medicine as a treatment for pain, seizure, muscle spasm, poor appetite, nausea, insomnia, asthma, and depression (Earleywine 9).

From ancient times to the present, marijuana has received attention in multiple medical reports on its potential to alleviate labor pains, premenstrual symptoms, and menstrual cramps (Earleywine 9). The history of marijuana as medicine is extensive and includes many characters on many continents.

Medicinal use of marijuana began around 2737 B.C. when the mystical Chinese emperor Shen Neng introduced the pharmaceutical uses of the plant for gout, malaria, beriberi, poor memory, and rheumatism (which remains part of modern research) (Earleywine 10). By 1400 B.C., the sacred Indian text Atharvaveda listed marijuana as a holy plant that relieved stress, and in ancient Rome, Pliny the Elder mentioned the plant as a painkilling analgesic (Earleywine 11). Marijuana was being used in the fourth century A.D. during childbirth, since it apparently eased labor pains and increased uterine contractions. This obstetric use, which dates back at least 2,400 years ago, continued into the 1800's, and even today, women in parts of Asia drink marijuana tea to alleviate postpartum distress (Earleywine 11).

In the early 1900's, the Squibb Company offered a cannabis and morphine combination called Chlorodyne for stomach problems, and by the 1930's, Eli Lilly and Parke-Davis marketed medical marijuana products (Earleywine 14). However, the Marijuana Tax Act of 1937, which required a special fee for the transport of marijuana that could reach $100 per ounce, decreased its medical use (Earleywine 14).

Recent developments of medical cannabis and its derivatives concern the treatment of nausea and weight loss associated with chemotherapy and AIDS, and many sufferers have turned to the drug for relief (Earleywine 16). Lily Research Laboratories developed Nabilone, a chemical derivative of one of marijuana's active components, which has the same healing qualities as marijuana, however it has proven toxic with continued use as it apparently builds up in brain tissue, thus preventing long-term prescription (Earleywine 16). Dronabinol, a synthetic version of THC sold under the name Marinol, mimics some of marijuana's therapeutic effects, such as increasing appetite and decreasing nausea, yet many still argue for marijuana's superiority on medical and economic grounds (Earleywine 16). Patients prefer smoked marijuana to this medication because anyone who is vomiting and nauseated often find swallowing a pill difficult, and patients must digest the orally administered dronabinol, thus the effects do not appear as rapidly. Moreover, patients claim that the dosage is easier to modify with smoked marijuana, since after a few puffs and a brief waiting period, they can decide to increase the dose as they see fit, whereas pills do not lend themselves to alteration of dosage (Earleywine 16).

Furthermore, the pills are markedly more expensive, and a patient may spend from $600 to over $1,000 per month on dronabinol, while natural marijuana cost considerably less (Earleywine 16).

In 1970, the Comprehensive Drug Abuse Prevention and Control Act, which separated substances based on perceptions of their medical utility and liability for abuse, placed marijuana in Schedule I with heroin, mescaline, and LSD, thus making it unavailable for medical use (Earleywine 168). Doctors cannot prescribe it, and possession can lead to harsh penalties, including fines and imprisonment (Earleywine 16).

In contrast, the FDA approved Dronabinol for cancer patients in 1985 and for AIDS patients in 1992, and in 1999, the Drug Enforcement Agency even reclassified Dronabinol from a Schedule II drug to a Schedule III, thereby decreasing much of the paperwork and hassle required for prescribing it (Earleywine 16). Given marijuana's lower cost and potential efficacy, many have challenged its classification in Schedule I, and many physicians and organizations continue to work toward reclassification (Earleywine 16).

Concerning the costs and benefits of marijuana, many evaluators suggest that cannabis must outperform all other available drugs in order to receive approval for treatment. Supporters of this idea prefer established drugs based on the belief that they have lower potential for abuse, while critics accuse drug companies of interfering with marijuana research because of its low potential for increasing their profits, highlighting the fact that approval of other medications usually requires simple evidence of safety and efficacy, not superiority to other drugs (Earleywine 170). For example, the FDA approved fluoxetine (Prozac) based on its ability to relieve depression better than a placebo, and did not require data comparing it to other standard antidepressants. Thus, say proponents, marijuana should only be required to prove efficacy and safety to receive approval for medical use (Earleywine 170). Furthermore, to established efficacy, the price of the drug and side effects contribute to its costs and benefits.

For example, the synthetic version of THC, Dronabinol (Marinol), costs approximately $13 for a 10mg pill, and $8 per pill when purchased in bulk (Earleywine 171). The same 10 mg of THC appears in half of a typical marijuana cigarette, which would cost less than $5 if purchased in bulk on the underground market (Earleywine 172). If the National Institute on Drug Abuse provided the marijuana or if the federal government lifted legal sanctions, the price could fall markedly, thus smoked marijuana is cheaper, and provides a distinct advantage over oral THC and many other drugs (Earleywine 172).

Controlled studies show that cannabinoids can decrease pressure inside the eye for glaucoma patients, alleviate pain, reduce vomiting, enhance appetite, promote weight gain, and minimize spasiticity and involuntary movement, while other studies suggest additional therapeutic effects for asthma, insomnia, and anxiety, however only a few studies have compared cannabinoids to established treatments for these problems (Earleywine 172). Case studies and animal research suggest that marijuana may also help numerous other medical and psychological conditions, including "seizures, tumors, insomnia, menstrual cramps, premenstrual syndrome, Crohn's disease, tinnitus, schizophrenia, adult attention deficit disorder, uncontrollable violent episodes, post-traumatic stress disorder, and surprisingly, drug addiction" (Earleywine 172)

Although a few states have passed legislation approving marijuana prescriptions, possession still violates federal laws even in states that have passed medical marijuana laws, thus local authorities may not prosecute, but federal authorities often do (Earleywine 193). Legal advisors recommend that those seeking marijuana for medical purposes should follow legal channels so as to establish defense in the event the user is arrested. Treatments should begin with THC pill form through a physician's prescription, and any reactions to the drug appear in medical records (Earleywine 193). Then if the synthetic THC does not alleviate the symptoms, patients may apply to the Investigational New Drug program through their physicians. Although the program remains closed, evidence of attempts may help a later defense of medical necessity (Earleywine 193).

On June 6, 2005, the United States Supreme Court ruled in a 6-3 decision in Gonzales vs. Raich, that it is within the constitutional powers of Congress "to prohibit the local cultivation and use of marijuana in compliance with California law" (St. John). The decision was based on Article 1, section 8 of the U.S. Constitution that states that "Congress shall have power" to "make all laws which shall be necessary and proper" to "regulate commerce...among the several states" (St. John). Author of the majority opinion, Supreme Court Justice John Paul Stephens argued that it was reasonable to expect that locally grown marijuana would leak into the national black market, thus Congress has the right to prohibit local growth and use of the narcotic (St. John). Thus, based on the Court's ruling, the federal government can prosecute anyone who possesses marijuana for medicinal purposes, even in states where such use is legal (Henderson). Although the decision does not invalidate laws in the 11 states that have approved medical marijuana, it does prevent protection from prosecution of users and doctors who prescribe the drug (Henderson).

The 11 states that have legalized medical marijuana use include Arkansas, Arizona, California, Colorado, Hawaii, Michigan, Nevada, Oregon, Rhode Island, Vermont, and Washington (Medical). Eight states did so through the initiative process, while Hawaii's law was enacted by the legislature and signed by the governor in 2000. Vermont's law was enacted by the legislature and passed without signature in 2004, while Rhode Island's law was enacted by overriding the governor's veto in January 2006 (Medical). From 1978 to 1997, 35 states and the District of Columbia passed legislation recognizing the medicinal value of marijuana. These states include: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Missouri, Maryland, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington, West Virginia, and Wisconsin (Medical).

In 1999, the Institute of Medicine issued a report on medical marijuana, stating, "The accumulated data indicate a potential therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation" (Medical). Upon examining the question whether medical use would lead to an increase of use among the general population, the report concluded that:

At this point there are no convincing data to support this concern. The existing data are consistent with the dea that this would not be a problem if the medical use of marijuana were as closely regulated as other medications with abuse potential...this question is beyond the issues normally considered for medical uses of drugs, and should not be a factor in evaluating the therapeutic potential of marijuana or cannabinoids" (Medical).

The report noted that marijuana was not a completely benign substance and did have a variety of effects, however apart from the harms associated with smoking, "the adverse effects were within the range of effects tolerated for other medications" (Medical). Based on all 15 studies, the report did note that regular cannabis users performed worse on memory tests, yet the magnitude of the effect was very small.

The small magnitude of effect sizes from observations of chronic users of cannabis suggests that cannabis compounds, if found to have therapeutic value, should have a good margin of safety from a neurocognitive standpoint under the more limited conditions of exposure that would likely obtain in a medical setting" (Medical).

Yet, despite the established medical value of marijuana, physicians are not allowed to prescribe it, however they are permitted to prescribe cocaine and morphine (Medical).

Numerous organizations have endorsed medical access to marijuana, including: the American Academy of Family Physicians, American Bar Association, American Society of Addiction Medicine, AIDS Action Council, British Medical Association, the Institute of Medicine, Consumer Reports Magazine, Kaiser Permanente, Lymphoma Foundation of America, National Association of Attorneys General, New England Journal of Medicine, to name but a few (Medical). Other organizations have favorable positions (unimpeded research) on medical marijuana, including the Institute of Medicine, The American Cancer Society, American Medical Association, Australian Commonwealth Department of Human Services, Federation of American Scientists, and the National Academy of Sciences (Medical).

In 1988, the Drug Enforcement Administration's Chief Administrative Law Judge, Francis L. Young ruled:

Marijuana, in its natural form, is one of the safest therapeutically active substances known....[T]he provisions of the [Controlled Substances] Act permit and require the transfer of marijuana from Schedule I to Schedule II. It would be unreasonable, arbitrary and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance...In strict medical terms marijuana is far safer than many foods we commonly consume. For example, eating 10 raw potatoes can result in a toxic response. By comparison, it is physically impossible to eat enough marijuana to induce death. Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care" (Medical).