Medical Marijuana - Should Marijuana Be a Medical Option?

PRO Medical Marijuana

Proponents for the legal use of medical marijuana argue that marijuana has "accepted medical use in treatment in the US," and that it would easily meet the FDA criteria over "whether a new product's benefits to users will outweigh its risks." Marijuana, they claim, is a safe and effective treatment for dozens of conditions, such as cancer, AIDS, multiple sclerosis, pain, migraines, glaucoma, and epilepsy. Proponents say that thousands of yearly deaths from legal prescription drugs could be prevented if medical marijuana were legal.

CON Medical Marijuana

Opponents of medical marijuana argue that marijuana has not been FDA-approved because it is too dangerous to use, and that various FDA-approved drugs make the use of marijuana unnecessary. Marijuana, they claim, is addictive, leads to harder drug use, injures the lungs, harms the immune system, damages the brain, interferes with fertility, impairs driving ability, and sends the wrong message to kids. They say that medical marijuana is a front for drug legalization, and that people who claim medical use are actually using it for recreational pleasure.

1. Physician Perspectives on Marijuana's Medical Use

PRO Medical Marijuana

"The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS - or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day."

Joycelyn Elders, MD
Former US Surgeon General
Editorial, Providence Journal
Mar. 26, 2004

CON Medical Marijuana

"Although I understand many believe marijuana is the most effective drug in combating their medical ailments, I would caution against this assumption due to the lack of consistent, repeatable scientific data available to prove marijuana's medical benefits.

Based on current evidence, I believe that marijuana is a dangerous drug and that there are less dangerous medicines offering the same relief from pain and other medical symptoms."

Bill Frist, MD
Former US Senator (R-TN)
Correspondence to ProCon.org
Oct. 20, 2003

2. Medical Organizations' Opinions

PRO Medical Marijuana

"The American Public Health Association:

• Encourages research of the therapeutic properties of various cannabinoids and combinations of cannabinoids;
• Encourages research on alternative methods of administration to decrease the harmful effects related to smoking; and
• Urges the Administration and Congress to move expeditiously to make cannabis available as a legal medicine where shown to be safe and effective and to immediately allow access to therapeutic cannabis through the Investigational New Drug Program."

American Public Health Association
Medical Marijuana Policy Statement
Jan. 1995

CON Medical Marijuana

"The American Medical Association (AMA) calls for further adequate and well-controlled studies of marijuana and related cannabinoids in patients who have serious conditions for which preclinical, anecdotal, or controlled evidence suggests possible efficacy and the application of such results to the understanding and treatment of disease.

The AMA recommends that marijuana be retained in Schedule I of the Controlled Substances Act pending the outcome of such studies."

American Medical Association
Official Policy Statement
June 2001

3. US Government Officials' Views

PRO Medical Marijuana

"The evidence in this record [9-6-88 ruling] clearly shows that marijuana has been accepted as capable of relieving the distress of great numbers of very ill people, and doing so with safety under medical supervision. It would be unreasonable, arbitrary and capricious for DEA to continue to stand between those sufferers and the benefits of this substance in light of the evidence in this record."

Judge Francis L. Young
DEA Administrative Law Judge
Administrative Ruling on Petition to Reschedule Marijuana
Sep. 1988

CON Medical Marijuana

"Smoked marijuana damages the brain, heart, lungs, and immune system. It impairs learning and interferes with memory, perception, and judgment. Smoked marijuana contains cancer-causing compounds and has been implicated in a high percentage of automobile crashes and workplace accidents."

John Walters
Director, Office of National Drug Control Policy
Syndicated Editorial
Mar. 2002

4. Health Risks of Smoked Marijuana

PRO Medical Marijuana

"[T]here is very little evidence that smoking marijuana as a means of taking it represents a significant health risk.

Although cannabis has been smoked widely in Western countries for more than four decades, there have been no reported cases of lung cancer or emphysema attributed to marijuana.

I suspect that a day's breathing in any city with poor air quality poses more of a threat than inhaling a day's dose -- which for many ailments is just a portion of a joint -- of marijuana."

Lester Grinspoon, MD
Emeritus Professor of Psychiatry
Harvard Medical School
"Puffing Is the Best Medicine,"
Los Angeles Times
May 5, 2006

CON Medical Marijuana

"3-4 Cannabis cigarettes a day are associated with the same evidence of acute and chronic bronchitis and the same degree of damage to the bronchial mucosa as 20 or more tobacco cigarettes a day.

Cannabis smoking is likely to weaken the immune system. Infections of the lung are due to a combination of smoking-related damage to the cells lining the bronchial passage and impairment of the principal immune cells in the small air sacs caused by cannabis."

British Lung Foundation
"Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health,"
A Publicly Disseminated Report
Nov. 2002

5. Treating AIDS with Marijuana

PRO Medical Marijuana

"Patients receiving cannabinoids [smoked marijuana and marijuana pills] had improved immune function compared with those receiving placebo. They also gained about 4 pounds more on average than those patients receiving placebo."

Donald Abrams, MD, et al.
"Short-Term Effects of Cannabinoids in Patients with HIV-1 Infection,"
Annals of Internal Medicine
Aug. 19, 2003

CON Medical Marijuana

"The most compelling concerns regarding marijuana smoking in HIV/AIDS patients are the possible effects of marijuana on immunity.

Reports of opportunistic fungal and bacterial pneumonia in AIDS patients who used marijuana suggest that marijuana smoking either suppresses the immune system or exposes patients to an added burden of pathogens.

In summary, patients with preexisting immune deficits due to AIDS should be expected to be vulnerable to serious harm caused by smoking marijuana."

Institute of Medicine Report
Marijuana and Medicine: Assessing the Science Base
Mar. 1999

6. Marijuana For the Terminally Ill

PRO Medical Marijuana

"Consumer Reports believes that, for patients with advanced AIDS and terminal cancer, the apparent benefits some derive from smoking marijuana outweigh any substantiated or even suspected risks.

In the same spirit the FDA uses to hasten the approval of cancer drugs, federal laws should be relaxed in favor of states' rights to allow physicians to administer marijuana to their patients on a caring and compassionate basis."

Consumer Reports
Editorial
May 1997

CON Medical Marijuana

"[T]he use of marijuana [for the terminally ill] can no longer be considered a therapeutic intervention but one of several procedures used to ease the ebbing of life of the terminally ill.

But for this purpose doctors should prescribe antiemetic and analgesic therapies of proven efficacy, rather than marijuana smoking.

This therapeutic course is not based on bureaucratic absolutism, political correctness, or reflexive ideology - but on scientific knowledge and the humane practice of medicine."

Gabriel Nahas, MD, PhD
Editorial, Wall Street Journal
Mar. 1997

7. Marijuana vs. Marinol

PRO Medical Marijuana

"There are really no other medications that have the same mechanisms of action as marijuana. Dronabinol (Marinol) is available by prescription in capsules, but has the distinct disadvantage of containing only synthetic delta-9-tetrahydrocannabinol (THC) which is only one of many therapeutically beneficial cannabinoids in the natural plant."

Gregory T. Carter, MD
Co-director, MDA/ALS Center,
University of Washington Medical Center
Muscular Dystrophy Association
website article
Oct. 2003

CON Medical Marijuana

"Marinol differs from the crude plant marijuana because it consists of one pure, well-studied, FDA-approved pharmaceutical in stable known dosages. Marijuana is an unstable mixture of over 400 chemicals including many toxic psychoactive chemicals which are largely unstudied and appear in uncontrolled strengths."

California Narcotics Officers Association
Official policy statement "The Use of Marijuana as a Medicine"
Oct. 31, 2005

8. Addictiveness of Marijuana

PRO Medical Marijuana

"For some users, perhaps as many as 10 per cent, cannabis leads to psychological dependence, but there is scant evidence that it carries a risk of true addiction. Unlike cigarette smokers, most users do not take the drug on a daily basis, and usually abandon it in their twenties or thirties.

Unlike for nicotine, alcohol and hard drugs, there is no clearly defined withdrawal syndrome, the hallmark of true addiction, when use is stopped."

Gregory T. Carter, MD
Colin Blakemore, PhD
Chair, Dept. of Physiology, University of Oxford (U.K.), and
Leslie Iversen, PhD
Professor of Pharmacology, Oxford University
Editorial, The Times (U.K.)
Aug. 6, 2001

CON Medical Marijuana

"This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant.

These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal [...]

Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other."

Alan J. Budney, PhD et al.
Professor, University of Arkansas Center for Addiction Research
"Marijuana Abstinence Effects in Marijuana Smokers Maintained in Their Home Environment"
Archives of General Psychiatry
Oct. 2001

9. "Gateway" Effect

PRO Medical Marijuana

"We've shown that the marijuana gateway effect is not the best explanation for the link between marijuana use and the use of harder drugs.

An alternative, simpler and more compelling explanation accounts for the pattern of drug use you see in this country, without resort to any gateway effects. While the gateway theory has enjoyed popular acceptance, scientists have always had their doubts. Our study shows that these doubts are justified.[...]

The people who are predisposed to use drugs and have the opportunity to use drugs are more likely than others to use both marijuana and harder drugs. Marijuana typically comes first because it is more available."

Andrew Morral, PhD
Researcher, Rand Corporation
Press release discussing his study published in the U.K. journal Addiction
Dec. 2, 2002

CON Medical Marijuana

"A new federal report released today concludes the younger children are when they first use marijuana, the more likely they are to use cocaine and heroin and become dependent on drugs as adults.[...]

Increases in the likelihood of cocaine and heroin use and drug dependence are also apparent for those who initiate use of marijuana at any later age."

US Substance Abuse and Mental Health Services Administration (SAMHSA)
SAMHSA press release on their report;
"Initiation of Marijuana Use: Trends, Patterns and Implications"
Aug. 28, 2002

10. Medical Marijuana Debate and Its Affect on Youth Drug Use

PRO Medical Marijuana

"While it is not possible with existing data to determine conclusively that state medical marijuana laws caused the documented declines in adolescent marijuana use, the overwhelming downward trend strongly suggests that the effect of state medical marijuana laws on teen marijuana use has been either neutral or positive, discouraging youthful experimentation with the drug."

Mitch Earleywine, PhD
Associate Professor of Psychology, State University of New York at Albany
Karen O’Keefe, Esq.
Attorney & Legislative Analyst, Marijuana Policy Project
Report, "Marijuana Use by Young People:
The Impact of State Medical Marijuana Laws"
Sep. 2005

CON Medical Marijuana

"By characterizing the use of illegal drugs as quasi-legal, state-sanctioned, Saturday afternoon fun, legalizers destabilize the societal norm that drug use is dangerous. They undercut the goals of stopping the initiation of drug use to prevent addiction.... Children entering drug abuse treatment routinely report that they heard that 'pot is medicine' and, therefore, believed it to be good for them."

Andrea Barthwell, MD
Former Deputy Director, White House Office of National Drug Control Policy (ONDCP)
Chicago Tribune editorial
Feb. 17, 2004