My post about “medical marijuana” stirred a lot of comments, some of them approving, the vast majority hostile and vituperative -- and one or two actually threatening. So, let me try this again. As I wrote, I think decriminalization of marijuana is worth debating.
I have no objection to letting AIDS patients and other truly desperately ill people smoke marijuana if it makes them feel better. I have no objection to the administration of THC, pot’s active ingredient, in properly tested and dosed pharmaceuticals. What I do object to, strongly, is the claim that smoked marijuana is some sort of wonder cure with a multiplicity of proven, but officially repressed, therapeutic uses.
There’s a good survey of the literature on the American Cancer Society’s Website; it calls the research findings “mixed”:
The most in-depth investigation into the medical use of marijuana was authorized by the U.S. Government in 1997....
First, it found that scientific data indicate that cannabinoids, particularly THC, have some potential to relieve pain, control nausea and vomiting, and stimulate appetite. Cannabinoids probably affect control of movement and memory, but their effects on the immune system are unclear. It found that some of the effects of cannabinoids, such as reduced anxiety, sedation, and euphoria, may be helpful for certain patients and situations and undesirable for others. Based on the many studies reviewed, researchers also found that smoking marijuana delivers harmful substances and may be an important risk factor in the development of lung diseases and certain types of cancer. The IOM stated that because marijuana contains a number of active compounds, it cannot be expected to provide precise effects unless the individual components are isolated.
The National Multiple Sclerosis Society’s Website offers this:
There is a very real need for additional therapies to treat stubborn and often painful symptoms of MS. However, based on the studies to date -- and the fact that long-term use of marijuana may be associated with significant, serious side effects -- it is the opinion of the National Multiple Sclerosis Society's Medical Advisory Board that there are currently insufficient data to recommend marijuana or its derivatives as a treatment for MS symptoms. Research is continuing to determine if there is a possible role for marijuana or its derivatives in the treatment of MS. In the meantime, other well tested, FDA-approved drugs are available (including baclofen and tizanidine) to reduce spasticity in MS.
Why does this bug me so much? It always bugs me when some group of true believers tries to foist its views on the public in the guise of science (e.g., "creation science"). This is especially pernicious when it involves selling phony remedies for real diseases (or real drugs for phony diseases). Yes, the Food and Drug Administration is a highly imperfect agency. But it’s all we’ve got -- and a considerable advancement over the deadly unregulated market, which the Pure Food and Drugs Act replaced more than a hundred years ago. I don’t know what you call it when a doctor “recommends” smoking a dried plant (perhaps under a brand name like “Afghan Gold Seal”) at a lounge where the dosage and purity of the active ingredient cannot be systematically controlled. It sure doesn’t sound like medicine to me. Of course, laws like California’s, which, in practice, permit people to get pot for practically any purported malady under the sun, show that the medical rationale is a cover for recreational use. I note that a Denver alternative newspaper recently posted an ad for a “medical marijuana" reviewer.
“Medical marijuana” is obviously a Trojan horse for legalization of pot as a recreational drug. In a democracy, people should pursue their policy objectives openly, not under false pretenses. In that respect, I thought that the attorney general created a certain amount of inevitable confusion when he announced his non-prosecution policy toward consumers and sellers of pot under state “medical marijuana” laws, while continuing to pursue large-scale traffickers and growers. Is marijuana a sometimes-therapeutic substance, as the AG implied by referring to “medical marijuana” smokers as “patients,” and those who provide pot to them as “caregivers” following "treatment regimens?" Or does pot have “no currently accepted medical use in treatment in the United States” as federal law provides -- and, I would add, the evidence suggests? To be sure, the Justice Department's directive to prosecutors focused on individuals with "cancer or other serious illnesses" who are complying with state law. But since many people who don't have cancer or anything close to it are getting high under medical pretenses, plenty of ambiguity remains.
By Charles Lane
October 23, 2009