This report is an analysis of Marijuana and the positive effects on its enacting. The report states the history and takes a critical viewpoint of legalization and marijuana and the states responses to it. The paper concludes with the recommendations highlighting both the positive and the negative aspect combined together. I would like to thank my Professor and my fellow supervisors for providing insights and a helping hand while preparing this report.
The legalization of marijuana for medicinal purposes is viewed by many as one of the worst things that we could do. There are many reasons that people feel that marijuana should not be legalized for medical uses. Marijuana is an illegal substance and until that is changed; prescribing it is against the law. In the article, “Federal Foolishness and Marijuana”, Dr. Jerome Kassirer wrote that, “Attorney General Janet Reno announced that physicians in any state who prescribe the drug could lose the privilege of writing prescriptions, be excluded from medicare and Medicaid reimbursements, and even be prosecuted for a federal crime”.
Government officials are not the only ones to object to the legalization of marijuana. Another objection to the legalization of marijuana is shown in “Marijuana for the Sick”, where it is pointed out that many parents object to the legalization of marijuana for medical uses. Their objections come from a reasonable concern that there has been an increase in the use of marijuana by teenagers. Their concern is expanded since the marijuana of today is much more potent than the marijuana of a few decades ago. Also, the Federal Health and Drug enforcement officials feel that by legalizing marijuana, they would be sending the wrong message to young people (Bakalar & Grinspoon, 2007). Another concern regarding the legalization of marijuana for medicinal purposes is that there is strong evidence that shows that regular use of marijuana for long periods of time could cause severe lung damage (Gwynne, 2009). If the use of marijuana could damage a patient's lungs, then the risk could outweigh the benefit. The strongest point that many make opposing the legalization of marijuana is that there just is no clear evidence that smoking marijuana can help an individual who is ill (Abrams, Child & Mitchell, 2005).
History of Marijuana and its use in medical field
The history of the beneficial use of marijuana is a long one. Marijuana is one of the oldest drugs known to man, the use of which has been documented as far back as 2700 B.C. in a Chinese manuscript (Bakalar & Grinspoon, 2007) Although no actual studies were performed at the time, the simple fact that marijuana had been used for such an extensive period of time, shows that it can be used as a beneficial substance in helping those who are ailing. There has been research done in more recent times on the effectiveness of marijuana. Many reports are in favor of utilizing medical marijuana. In 1839, a respected member of the Royal Academy of Science, Dr. W. B. O'Shaugnessy, was one of the first in the medical profession, who presented positive facts dealing with marijuana and medicine (Bakalar & Grinspoon, 2007). In one Journal of American Medical Association article, “Marijuana as Medicine, a Plea for Reconsideration” stated that from 1840 to 1900, more than one hundred articles by American and European medical journals were published that showed the therapeutic uses of marijuana.
Now recall the first criteria for a drug to be considered a controlled substance – it must have a high potential for abuse. In 1975 the Drug Policy Advisor in the Nixon Administration defined “drug abuse” as “the use, usually by self-administration, of any drug in a manner that deviates from the approved medical or social patterns within a given culture” (Abrams, Child & Mitchell, 2005). Marijuana has little risk of abuse under this definition. Most marijuana users use the drug only occasionally for recreational or social purposes (much like alcohol), but among the minority who use it daily, an even smaller minority develop a dependence, and they are often still able to stop using it without difficulty. This would indicate that marijuana might not fall under the first criteria – but there are still two more to go.
The second and third criteria for a controlled substance require for it to have no recognized medicinal value, and no accepted method for safe usage. Again, marijuana meets neither of these. Modern research has shown that marijuana has a wide variety of medical uses, such as in relieving pain and nausea induced by cancer chemotherapy, stimulating appetite in AIDS patients, and reducing intraocular pressure in people with glaucoma (“Myths and Facts”). Medical marijuana has also been endorsed by many respected professionals, among them Congressman Ron Bakalar & Grinspoon, 2007 of Texas, who is also a licensed physician and OB/GYN:”As a physician, I of course support the right of doctors and patients to decide for themselves what treatments are appropriate, without interference from the federal government […]The idea that [the federal government] is attacking sick people and the doctor-patient relationship is criminal” (Bakalar & Grinspoon, 2007).
Prior to its criminalization in 1937, marijuana was openly sold in stores and pharmacies for its medicinal properties (Annas, 2007). Today, many people suffering from illness use marijuana medicinally despite its illegality, and risk arrest in doing so. Doctors in states with some form of medical marijuana regulation (such as Oregon and California) routinely prescribe marijuana to their patients in amounts that they deem as safe and appropriate. If practicing doctors can advise their patients with methods for safe, medicinal usage of marijuana, then the federal government needs to recognize that the drug does not fall under the second or third criteria for controlled substances.
Legalization of Marijuana
Marijuana has already been legalized for medical use by both California and Arizona. In order to be passed, these laws required a majority vote by the public and by Congress that favored the legalization of marijuana. In 2001, eighty percent of the San Francisco voters approved of legalizing marijuana, and seventy-seven percent of Santa Cruz voters also agreed. Since these laws were passed, there is proof of support for the legalization of marijuana for medicinal purposes. California and Arizona may be the only states that have legalized marijuana for medicinal purposes, but they are not the only states that have considered the legalization of medicinal marijuana. “Massachusetts, had previously passed laws that permitted their citizens to use marijuana for medical purposes under some circumstances” (Annas, 2007). Many states have passed laws that lessen the prosecution of those doctors who prescribe marijuana (Bakalar & Grinspoon, 2007). There have also been many polls showing that the public favors the use of marijuana for medical purposes (Annas, 2007). With all of this support for legalizing marijuana, it is only a matter of time before the prosecution of doctors for prescribing marijuana and patients for using marijuana as medicine ceases.
Another powerful supporting factor for the legalization of marijuana is the endorsement of physicians. During a random survey of the American Society of Clinical Oncology, one thousand thirty-five members responded with surprising results (Brookhiser, 2007). Almost half of the doctors said that they would prescribe marijuana if it were legal, and forty-four percent of them said that they had already recommended it to a patient (Brookhiser, 2007). If there are doctors who are recommending marijuana, even at the risk of prosecution, it is obvious that they strongly believe that it can be very useful in the treatment of their patients. In addition, almost two thirds of the doctors also agreed that marijuana was an effective anti-emetic (Brookhiser, 2007). This is important because of the life-threatening dehydration that can accompany emesis, which is usually known as vomiting. Doctors are allowed to prescribe narcotics for pain relief, such as morphine and meperdine, which have been known to cause death during overdose, yet they are not allowed to prescribe marijuana as a medicine, even though marijuana has never been known to kill anyone (Annas, 2007).
Scientists have discovered that the reason that marijuana is so effective in treating many of the symptoms of the terminally ill is because of a chemical called THC, which is the main active ingredient in marijuana. Even though science has found a way to make a synthetic THC, marketed as Marinol (Brookhiser, 2007), it is extremely expensive, and it does seem to cause higher levels of depression and anxiety (Brookhiser, 2007). Other side effects of the synthetic THC are extreme dizziness and unsteady gait (Gwynne, 2009). These side effects alone may be difficult to deal with, but many of these patients are already dealing with harmful side effects from the medicines they are taking for the treatment of their illness. They should not have to take a pill that is supposed to relieve them of side effects that causes additional side effects.
Another negative aspect of Marinol that is experienced by patients and documented by doctors is that the synthetic THC and the THC from marijuana react differently in the body. There is also “a convincing body of research, some of it now two decades old, shows that smoked marijuana suppresses nausea better than Marinol pills and with fewer side effects” (Gwynne, 2009). Also, many patients are combatting nausea and vomiting, and it can be difficult for them to keep the expensive Marinol pill down (Gorman, 2008). If terminally ill patients have tried many different treatments, which have not been successful, and find that smoking marijuana helps them with their symptoms, with fewer side effects, and less expensively, then the patients should legally be able to have the option to make that choice.
Cancer patients have found marijuana to be very effective in treating the side effects of chemotherapy. In an article in Time, “Marijuana: Where There's Smoke, There's Fire”, cancer patient Jo Daly, has described her experience with chemotherapy as a “nuclear implosion” of nausea. She went on to discuss feeling a burning pain under the nails of her fingers and toes. After she had tried many different alternatives to relieve her pain, she tried marijuana which seemed to be the only drug effective in relieving her pain. Jo Daly is not the only one to find marijuana effective in relieving the discomforts of chemotherapy. During the late seventies, and mid-eighties, six states performed research on how well marijuana operated on combating chemotherapy related nausea and vomiting (Abrams, Child & Mitchell, 2005).
Their studies concluded that marijuana an extremely effective way to deal with the side effects of chemotherapy (Abrams, Child & Mitchell, 2005). “Prevention and control of nausea and vomiting is paramount in the treatment of cancer patients” (Annas, 2007). The reason that nausea and vomiting needs to be controlled is that, “These can result in serious metabolic derangements, nutritional depletion, deterioration of a patient's physical and mental status, withdrawal from potentially useful and curative antineoplastic treatment, and degeneration of self-care and functional ability” (Annas, 2007). For cancer patients it is very important to control their nausea and vomiting and marijuana seems to be able to accomplish this. It seems reasonable to allow patients the option and make medical marijuana available for their use.
Marijuana has also been found useful for treating patients with AIDS. It seems that marijuana can positively help AIDS patients in several ways. Some ways that marijuana can help is by relieving stress and depression, eliminating nausea, reducing pain, and fighting the AIDS wasting syndrome by enhancing the appetite (Gorman, 2008). Even though there are many treatments, AIDS patients who are in the final stages of the disease still suffer greatly. The legal options for these AIDS patients are the human growth hormone, another type of hormone called Megace, and the synthetic THC pill, Marinol (Gwynne, 2009). These are the only FDA approved drugs for treating AIDS wasting syndrome, but some patients say that these are not adequate substitutes for marijuana (Gwynne, 2009).
It was said by one patient on Marinol that, “All it did was make me groggy without enhancing my appetite.”, but marijuana has been found to increase the appetites of AIDS patients. “AIDS activists and the doctors who treat the disease report that marijuana is also useful for suppressing the nausea that's a side effect of several anti AIDS drugs” (Gwynne, 2009). Another vital concern when dealing with an AIDS patients is their immune system. However, when studying HIV-positive men who used marijuana, it was determined that the marijuana did not seem to accelerate the deterioration of their immune systems (Gorman, 2008). This is another important consideration in treating this deadly disease.
Summary & Conclusion
There are many different viewpoints on the use of marijuana as a medicine. These different points of view result in many important issues regarding the use of an illegal drug for medicinal use. Even though there are many people who are against legalizing marijuana for medical purposes, there are just as many who feel that if used correctly, marijuana can be an essential part of treating serious diseases. For centuries marijuana has been used to help those who are in need of effective pain relief. There are many doctors and patients, who feel that the usefulness and effectiveness of marijuana is being overlooked.
As a result, many doctors are recommending the use of marijuana, regardless of the possible legal issues. Many patients, who are suffering from cancer, multiple sclerosis, and AIDS, have discovered that marijuana is a drug that provides them with much needed relief and they are using marijuana regardless of the consequences. In basic terms “Marijuana may have long term adverse effects and its use may presage serious addictions, but neither long-term side effects nor addictions is a relevant issue in such patients” (Bakalar & Grinspoon, 2007) While advocating the legalization of marijuana as a recreational drug would be detrimental to society, its effectiveness for medicinal uses is clear and needs to be seriously considered.
Abrams, Donald I., M.D., Child, Carrol C., R.N., M.S., Mitchell, Thomas F., M.P.H. 2005. Marijuana, the AIDS Wasting Syndrome, and the U.S. Government. The New England Journal Of Medicine, Vol.333 No 10.
Annas, George J. 2007. Refer Madness — The Federal Response to California's Medical Marijuana Law. The New England Journal Of Medicine, Vol.337 No 6
Bakalar, James B., M.D., Grinspoon, Lester, M.D. 2007. Marijuana as Medicine: A Plea for Reconsideration. Journal of the American Medical Association, Vol.273 No 23
Brookhiser, Richard. 2007. Lost in the Weed. U.S. News & World Report.
Gorman, Mary, R.N. 2008. Medicinal Use of Marijuana. American Journal of Nursing, Vol.97 No 11.
Gwynne, Peter. 2009. Medical Marijuana Debate Moving Toward Closure. The Scientist. Retrieved from (http://www.the-scientist.com/article/display/17474/) on November 11, 2009.