Medical Marijuana

ProCon.org

Last updated on: 5/6/2009 3:06:00 PM PST

Top 10 Pros and Cons

Should marijuana be a medical option?

The PRO and CON statements below give a five minute introduction to the debate on medical marijuana.

(Read more information about our one star to five star Theoretical Expertise System.)

1. Physician Perspectives on

Marijuana's Medical Use 2. Medical Organizations' Opinions 3. US Government Officials' Views 4. Health Risks of Smoked Marijuana 5. Treating AIDS with Marijuana

6. Marijuana use for the Terminally Ill 7. Marijuana vs. Marinol 8. Addictiveness of Marijuana 9. "Gateway" Effect 10. Medical Marijuana Debate and Its

Effect on Youth Drug Use

PRO Medical Marijuana CON Medical Marijuana

1. Physician Perspectives on Marijuana's Medical Use

"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

"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

"ACP urges review of marijuana's status as a schedule I controlled substance and its reclassification into a more appropriate schedule, given the scientific evidence regarding marijuana's safety and efficacy in some clinical conditions...

"In an effort to determine whether marijuana, or drugs derived from marijuana, might be effective as a glaucoma treatment, the National Eye Institute (NEI) supported research studies beginning in 1978... However, none of these studies demonstrated that marijuana -- or any of its components -- could lower IOP [intraocular

ACP strongly supports exemption from federal criminal prosecution; civil liability; or professional sanctioning, such as loss of licensure or credentialing, for physicians who prescribe or dispense medical marijuana in accordance with state law. Similarly, ACP strongly urges protection from criminal or civil penalties for patients who use medical marijuana as permitted under state laws."

-- American College of Physicians "Supporting Research into the Therapeutic Role

of Marijuana," acponline.org Feb. 15, 2008

pressure] as effectively as drugs already on the market. In addition, some potentially serious side effects were noted, including an increased heart rate and a decrease in blood pressure in studies using smoked marijuana. The identification of side effects from smoked marijuana, coupled with the emergence of highly effective FDA-approved medications for glaucoma treatment, may have led to diminished interest in this research area."

-- National Eye Institute "Glaucoma and Marijuana Use," nei.nih.gov

Mar. 17, 2009

3. US Government Officials' Views

"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

"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

"[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,"

"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

Los Angeles Times May 5, 2006

5. Treating AIDS with 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

"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

"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

"[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

"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,

"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"

University of Washington Medical Center Muscular Dystrophy Association

website article Oct. 2003

Oct. 31, 2005

8. Addictiveness of 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."

-- 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

"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

"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

"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

the U.K. journal Addiction Dec. 2, 2002

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

"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

"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

PRO Medical Marijuana CON Medical Marijuana

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Statement by Dr. Carlton E. Turner The proponents of Amendment 2 continue to disparage and misconstrue my words and their meaning in an effort to distract from their deceptively worded amendment. Amendment 2 will legalize pot smoking in Florida and smoking pot is not medicine – they know that and frankly this personal attack on me is just a smokescreen. They would have people believe that I said that smoking pot can make someone gay. I didn’t say that almost 30 years or believe it and I don’t today. It’s a ridiculous charge and offensive because nothing could be further from the truth. The comments I made had absolutely nothing to do with sexual orientation. Rather they were made in reference to a wide-ranging discussion about the detrimental effects of drugs on America’s youth and at one point the issue of smoking pot was discussed as well. What I said then was, “I have never said marijuana will make you homosexual. I don’t know why someone made a quantum jump on that.” And I will say unequivocally today that I do not believe smoking pot has anything to do with sexual orientation. In 1986 we were just learning about the effects of AIDS and those of us in policy levels positions were trying to figure out why it was spreading so fast and how to stop it. My comments were aimed in that direction – that the use of illegal drugs and smoking pot could harm someone’s immune system and they could become more vulnerable to AIDS. We didn’t have a lot of research at that point in time and part of my reference was the fact that I had toured drug-treatment facilities and the director at some of these facilities has said that a large percentage of their patients were also homosexual – his words not mine. So my point then was, how is the biological system affected by heavy marijuana use? Nobody denies that smoking illegal drugs is detrimental to one’s immune system and I was simply saying we needed to get more research and counseling for kids in these situations and help parents deal with it. I’m proud of my service to President Ronald Reagan. We came into office with about the highest level of drug and pot smoking in the history of the United States and every year I was there and that President Reagan was in office that percentage decreased.

Source: Don’t Let Florida Go to Pot website: dontletfloridagotopot.com

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FACTS VS. MYTHS MYTH: The Florida amendment proposes marijuana for only serious medical conditions, such

as those suffering from cancer and AIDS.

FACT: The ballot summary states that medical marijuana is only for those with debilitating

diseases, but the ballot definition states that it will be acceptable for “other conditions for which

a physician believes that the medical use of marijuana would outweigh the potential risks for a

patient.” This begs the question: what constitutes a debilitating disease? Other states with

medical marijuana laws have considered migraines, anorexia, muscle spasms, and even

menstrual cramps to be a debilitating disease that is treatable by marijuana—even though all of

these conditions are treated by commonly accepted medical treatments.

MYTH: The Florida amendment requires a physician’s prescription to obtain medical marijuana

from a medically controlled pharmacy.

FACT: No prescription is required to obtain medical marijuana. A patient only needs a

“physician certification” from a licensed Florida physician. Physician certifications are not

formal prescriptions accepted by reputable pharmacies; they are simply written recommendations

that can be used to buy marijuana at storefront dispensaries.

MYTH: The Florida amendment requires parental consent for a minor to obtain medical

marijuana.

FACT: The amendment allows a teenager to get a recommendation for medical marijuana

without the consent of a parent. The amendment allows a teenager to get a recommendation for

medical marijuana without the consent of a parent. Although Florida law requires consent when

treating minors, the amendment gives immunity (both civil and criminal) to physicians who issue

a recommendation to use marijuana. Other states have tighter requirements when it comes to

recommending to minors, such as requiring the physician to explain the risks and harms

associated with marijuana use and/or multiple physician assessments.

MYTH: Smoking marijuana is the only way to receive the medicinal properties of the plant.

FACT: Some components in marijuana have medicinal properties, but we shouldn’t smoke the

plant in order to derive those benefits; just as we do not smoke opium to get the benefits of

morphine. In states with medical marijuana laws, the average user is a male in his 30s with no

terminal illness and a history of drug abuse (TJ O’Connel, Long term marijuana users seeking

medical cannabis in California). Less than 5% of registered users in states allowing medical

marijuana have cancer or AIDS (Who’s Really Smoking, Save Our Society From Drugs, April

2014 ). Residents of states with medical marijuana laws have abuse and dependence rates nearly

twice as high as states with no such laws (M. Cerda, Medical marijuana laws in 50 states).

MYTH: Marijuana is harmless.

FACT: Today’s marijuana is far more potent than in decades past. In the 1960s and 70s, THC

levels of marijuana smoked by baby boomers averaged around 1%, increasing to just under 4%

in 1983, and almost tripling in the subsequent 30 years to around 11% in 2011. Regular

marijuana use, started in adolescence and continued into adulthood, can result in a loss of up to 8

IQ points. (Meier, et al. Persistent cannabis users show neuropsychological decline from

childhood to midlife.)

MYTH: Marijuana legalization will help the economy.

FACT: Marijuana legalization will increase public costs. For every $1 in alcohol and tobacco tax

revenue, society loses $10 in social costs from accidents all the way to health damage (National

Institute on Alcohol Abuse and Alcoholism). States such as Colorado have projected tax revenue

of $134 million for the fiscal year but have only produced 3.5 million in the first month,

prompting the Governor to ratchet back his projection to $20 million.

Source: From May 15 news release from United for Care rebutting Vote No on 2 campaign

assertions about Amendment 2. The assertions can be viewed and read on www.voteno2.org.

“The website and video are both filled with half-truths, distortions and outright lies,” said Ben

Pollara, Campaign Manager of United for Care. “Floridians deserve a debate based on the facts, not

disingenuous scare tactics.”

\CLAIM: In reference to the availability of medical marijuana, the website asserts “anyone who

wants pot will get it.”

FACT: This is simply not true. In their decision placing Amendment 2 on the November ballot, the

Florida Supreme Court affirmed that only patients with “debilitating” diseases and medical

conditions would qualify for medical marijuana.

CLAIM: “Teens will be able to legally purchase pot without their parents’ consent.”

FACT: Wrong again. In order to purchase medical marijuana, you would need a doctor’s

recommendation. Under Florida law, barring a few extenuating circumstances, physicians are not

allowed to provide medical treatment to minors without parental or guardian consent, so this is a

groundless concern.

CLAIM: Amendment 2 will lead to a “pill mill”-like scenario in Florida. “Pot docs” will “spring up

next to restaurants, schools, churches and supermarkets.”

FACT: Look no further than the State of Florida to see that this claim is baseless. The State of

Florida’s office of Economic and Demographic Research has already addressed this issue. They have

said the physician examination requirement, the application process with the Department of Health,

the regulatory structure that would be implemented by that same body and subsequent protective laws

that may be passed by the legislature would make this scenario extremely unlikely. (See pages 10 -11

of OEDR Financial Information Statement http://edr.state.fl.us/Content/constitutional-

amendments/2014Ballot/UseofMarijuanaforCertainMedicalConditions/CompleteFinancialInformation

Statement.pdf)

CLAIM: The website further contends that “felons-even drug dealers” would be able to qualify as

caregivers in order to administer medical cannabis to severely ill patients.

FACT: This claim requires the reader to assume that the state will implement Amendment 2 in an

irresponsible way. If the amendment is passed, the Florida Department of Health will be tasked with

issuing detailed regulations regarding qualification requirements for caregivers. During that process

United for Care will fight alongside any organization that, like us, is concerned about making sure

nobody with a record of dealing drugs can become a qualified caregiver.

Powered by over 10,000 volunteers, United for Care is the largest organization in Florida urging

voters to vote "yes" on Amendment 2. United for care is a non-partisan campaign with an on-the-

ground presence in 18 communities across the state including campaign offices in Miami, Tampa

and Orlando.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

The Great Drug DebateBy Elizabeth Kastor Washington Post Staff WriterThe Washington Post (1974-Current file); Oct 22, 1986; pg. C1

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.