Medical Marijuana Legalization and Patient Suffering Relief

Introduction

Patients with illnesses that cause significant suffering—such as cancer, AIDS, and others—often find themselves in a difficult dilemma: whether to give up and die, or to accept treatment that can make one wish death would come sooner. The treatments for some of these illnesses can make a patient feel more ill than the illness itself. Chemotherapy and other treatments are universally known for their ability to induce life-threatening vomiting and loss of appetite. For many years, the belief that smoking marijuana eases such symptoms has circulated widely.

Whether it is nausea from chemotherapy, loss of appetite associated with AIDS, or the complications of glaucoma, patients have had to decide whether to obey the law and suffer or break the law and relieve their symptoms by using marijuana. Recently, pressure has increased to legalize the use of marijuana for medicinal purposes. Patients who choose to use it to treat their symptoms must worry about arrest, about setting a poor example for their children, and about being judged negatively by their doctors. These concerns add stress to the already difficult life of a seriously ill patient. The central question is: will the legalization of marijuana ease patient suffering?

History of Medical Marijuana Legislation

The history behind the fight to legalize marijuana is a long one. For many decades, seriously ill patients were forced to seek relief through illegal channels. They had to find drug dealers, hope they would not be caught, and pray that no one they knew discovered what they were doing (Levinson n. pag.). In recent years, the medical community listened to patients' needs and developed a pill containing THC—the active compound in the marijuana plant. Unfortunately, studies concluded that the pill form does not work with the same effectiveness as smoking the plant itself.

Patients who want the drug legalized have offered several arguments in support of their position, including:

Drug laws have resulted in a black market that has led to increased violence and property crimes (Levinson n. pag.). Keeping drugs illegal has encouraged corruption among politicians and law enforcement officials (Levinson n. pag.). Laws passed to curb drug use have not significantly reduced demand. Legalizing drugs would have minimal impact on current levels of use because users already purchase the drugs they want at a price. Legalization would allow money spent on drug law enforcement to be reallocated to fighting other crimes (Levinson n. pag.). Taxing legalized drugs would provide additional revenue to the government. If drugs were made legal, otherwise law-abiding citizens who use them would not be subject to harsh drug law enforcement. Drug smuggling would not be a problem if drugs were legal. Under legalization, users would not have to worry about receiving adulterated substances or contracting illnesses related to drug use, such as AIDS or hepatitis (Levinson n. pag.). Foreign experiments with legalization have been successful (Levinson n. pag.).

Several states have worked to legalize marijuana for medical use. California and Arizona were the first two states to consider medical marijuana prescriptions (Gillespie n. pag.). "The medical-use initiatives carried the day due not to any nascent push for wide-scale legalization but to the huge reservoir of sympathy people have for desperately ill patients and chronic pain sufferers" (Gillespie n. pag.).

California moved forward with legislation that was ultimately vetoed by then-Governor Pete Wilson. That bill would have allowed patients to possess, grow, and consume marijuana if a doctor recommended it would ease their suffering and symptoms. Specifically, it would have allowed patients to possess, grow, and consume marijuana on a doctor's "recommendation" that "the person's health would benefit from the use of marijuana" in treating terminal illnesses such as cancer (Gillespie n. pag.), "chronic pain," or—and this is what gave opponents the most difficulty—"any other illness for which marijuana provides relief." Proposition 215 also stipulated that a patient's "primary caregiver"—defined as "the individual designated by the person who has consistently assumed responsibility for the housing, health, or safety of that person"—would not be subject to criminal sanctions. Doctors who recommended marijuana use would similarly be exempt from punishment or other forms of retribution, such as the loss of state medical licenses (Gillespie n. pag.).

The legislation was ultimately blocked by the governor, putting suffering patients back at square one. They were again faced with the choice of breaking the law and seeking illegal sources or enduring their symptoms—sometimes to the point of abandoning treatment and dying.

Why Legalization Will Reduce Patient Suffering

While it has long been clear that chemical compounds found in the marijuana plant offer potential for medical use, smoking the raw plant is a method of delivery supported neither by law nor by recent scientific consensus. The Food and Drug Administration's approval process, which seeks to ensure the purity of chemical compounds in legitimate drugs, sets the standard for medical validation of prescription drugs as safe and effective (McDonough n. pag.). Diametrically opposed to this long-standing safeguard is the push through state ballot initiatives to advocate the use of a smoked plant for treating an unspecified number of ailments (McDonough n. pag.). It is a tribute to the power of political activism that popular vote has, in some cases, displaced objective science in advancing what would be the only smoked drug in America under the guise of medicine.

Several studies on the delivery system of marijuana have been conducted. The reports indicate that pain, vomiting, and nausea are specific symptoms that marijuana can alleviate (McDonough n. pag.). This constitutes positive evidence that the legalization of marijuana could reduce the suffering of patients with serious health conditions (McDonough n. pag.).

Another area of interest is the treatment of eye disorders such as glaucoma. In research on glaucoma, the effect of marijuana on intraocular pressure—the cause of optic nerve damage that characterizes glaucoma—was explored, and smoked marijuana was found to reduce this pressure (McDonough n. pag.). However, the NIH report failed to find evidence that marijuana can "safely and effectively lower intraocular pressure enough to prevent optic nerve damage" (McDonough n. pag.). The report concluded that the mechanism of action of smoked marijuana or THC in pill form on intraocular pressure is not yet known and called for further research (McDonough n. pag.).

Another way that legalization could reduce patient suffering is through appetite stimulation, which is an important factor in the treatment of both AIDS and cancer. In addressing appetite stimulation and wasting related to AIDS, the NIH report recognized the potential benefit of marijuana. However, the report also noted a lack of pertinent data. Researchers pointed out that the evidence available, although plentiful, is largely anecdotal, and that "no objective data relative to body composition alterations, HIV replication, or immunologic function in HIV patients are available" (McDonough n. pag.).

The reports and studies nonetheless indicate that smoked marijuana works to alleviate symptoms that cause patients to suffer, suggesting that legalization could ease that suffering. As one summary noted: "Cannabinoids in marijuana do show potential for symptom management of several conditions" (McDonough n. pag.). While concluding that marijuana's active ingredients are potentially effective in treating intractable pain, chemotherapy-induced nausea, and anorexia caused by AIDS wasting syndrome, an Institute of Medicine (IOM) report stopped short of fully endorsing the use of marijuana for medical purposes (Drug Czar Proven Wrong n. pag.).

Conclusion

As advances in medical science continue to extend the lives of seriously ill patients, the choice to continue treatment often falls to the patient. The effects of treatment can be debilitating. Those who live with chronic pain can become worn down and decide to give up the fight. Many find relief in the use of marijuana but must worry about the legal risks they take each time they purchase or use the drug. While marijuana alleviates physical symptoms, its illegal status creates significant emotional problems and stress as patients struggle with the moral weight of their decision.

Legalization of marijuana for medical use would provide a reduction in suffering not only because it would relieve physical symptoms such as nausea, appetite loss, and eye pressure, but also because it would free seriously ill patients from the burden of legal worry. For patients already facing life-threatening illness, that relief—both physical and emotional—could be profound.

References

Drug Czar Proven Wrong: Marijuana's Medical Benefits Supported by Scientific Evidence. Marijuana Policy Project. (accessed April 27, 2004).

Gillespie, Nick. "Prescription: Drugs. (Medical Use of Illegal Drugs)." Reason, February 1, 1997.

"IOM Report Sends Mixed Signals on Use of Marijuana as Medicine." Alcoholism & Drug Abuse Weekly, March 22, 1999.

Levinson, Martin H. "An Extensional Approach to Drug Legalization." ETC.: A Review of General Semantics, June 22, 2003.

McDonough, James R. "Marijuana on the Ballot: Medical Community Divided over Therapeutic Use of Drug." Policy Review, April 1, 2000.

Marijuana Policy Project. (accessed April 27, 2004).