Ten years ago today, the use of medical marijuana went from fringe to mainstream.
March 17, 2009 marks the 10-year-anniversary of the publication of the Institute for Medicine's landmark study on medical cannabis: Marijuana and Medicine: Assessing the Science Base. At the time this report was commissioned, in response to the passage of California's Compassionate Use Act of 1996, many in the public and the mainstream media were skeptical about pot's potential therapeutic value. The publication of the Institute for Medicine's findings—which concluded that marijuana possessed medicinal properties to treat and control pain and to stimulate appetite—provided the issue with long-overdue credibility, and began in earnest a political discourse that continues today.
Of course, much has changed over the past 10 years. For starters, a total of 13 states, encompassing some 72 million Americans, now allow for the medical use of cannabis under state law. In California, several clinical trials have been conducted over the past months demonstrating that inhaled cannabis can significantly reduce hard-to-treat neuropathic pain in patients with HIV and spinal cord injury.
Following the publication of the Institute for Medicine's report, scientific interest into the therapeutic properties of cannabis skyrocketed. A keyword search using the terms "cannabis, 1999" in the National Library of Medicine's PubMed website reveals just 427 scientific journal articles published on the subject during that year. Perform this same search for the year 2008, and one will find over 2,100 published scientific studies.
Whereas researchers in the 1970s, 80s, and 90s primarily assessed cannabis's ability to temporarily alleviate various disease symptoms, scientists today are exploring the potential role of medical marijuana to treat disease itself.
Of particular interest, scientists are investigating marijuana's capacity to moderate autoimmune disorders such as multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease, as well as their role in the treatment of neurological disorders such as Alzheimer's disease and Lou Gehrig's disease.
Investigators are also studying the anti-cancer activities of cannabis, which has been shown to halt malignant tumor growth in animals. Arguably, these later trends represent far broader and more significant applications for cannabinoid therapeutics than the Institute for Medicine's researchers could have imagined just 10 years ago.
We've also discovered alternative ways to safely, effectively, and rapidly deliver pot's therapeutic properties to patients. Writing in 1999, the Institute for Medicine concluded, "Except for the harms associated with smoking, the adverse effects of marijuana are within the range of effects tolerate for other medications." The authors went on to recommend the development of "rapid-onset cannabinoid [marijuana] formulations."
Today, such rapid onset delivery systems exist in the form of vaporizers, devices which heat cannabis to a temperature where active vapors form but below the point of combustion where noxious smoke and associated toxins are produced. In 2007, investigators at San Francisco General Hospital assessed this technology and concluded: "Vaporization of marijuana does not result in exposure to combustion gasses...and [was] preferred by most subjects compared to marijuana cigarettes. The [vaporizer] device is an effective and apparently safe vehicle for THC delivery."
As hundreds of thousands of Americans have begun using marijuana under their doctor's supervision, we've learned other lessons as well. First, we've affirmed that medical cannabis is remarkably safe. For example, in 2008 investigators at McGill University in Montreal reviewed over 30 years of data on marijuana and "did not find a higher incidence rate of serious adverse events associated with medical cannabis use" compared to those who never used the drug.
We've also discovered that restricted patient access to medicinal cannabis will not necessarily result in higher use rates among young people. In fact, since the passage of Proposition 215, the use of pot by young people has fallen at a greater rate than the national average.
And finally we've learned—much to the chagrin of our opponents—that in fact the sky will not fall. Rates of hard drug use and drugged driving have not increased in California, and our social value system has not "gone to pot."
So what can we expect over the next 10 years? Only time will tell, but one thing is certain: The use of medical cannabis is here to stay. It is time for our federal laws to reflect this reality, and it is time for our politicians to regulate marijuana like other accepted prescription medicines.
By Paul Armentano
March 17, 2009