marijuana | Social, Cultural & Behavioral Issues in PHC & Global Health

Posts Tagged ‘marijuana’

Marijuana remains a Class I controlled substance in federal law, denoting it as a drug with high abuse potential and no acceptable medical use. However, it is legal for medical use in 29 states and the District of Columbia, and is legal for recreational use as well in 8 states and the District of Columbia. States are under enormous pressure to enact marijuana legalization laws due to widespread public support for the policy change and public disdain for the current federal classification, which is seen as irrational and duplicitous given the much laxer legal status of more dangerous substances such as alcohol and tobacco.

This is not to say that marijuana is not dangerous. As an internist and pediatrician, I am keenly aware of marijuana’s potential negative effects on adolescent and adult health and development, the potential for addiction, and the finding of increased marijuana-related traffic accidents in states with legal recreational use. But it is important to note that, unlike other Schedule I substances, rates of physical addiction are much lower, overdose nearly nonexistent, and no change in rates of fatal traffic accidents has been observed. Marijuana is by no means benign, but it is regulated out of proportion to its potential for harm.

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Activists on the marijuana issue used to typically fall into three camps: legalize it, legalize medical use, or keep it banned. But increasingly, the two extreme views are more prominent in the public arena. Marijuana is not a black-and-white issue. It can be beneficial, and it can be harmful. Current federal policy listing marijuana as a substance with no acceptable medical use is not consistent with evidence supporting significant efficacy in pain states, multiple sclerosis, and other conditions. Furthermore, maintaining its illegal status at the federal level does nothing to prevent state legalization, while it does prevent adequate research so that smart, evidence-based policies and regulations can be enacted.

I believe the federal government should reclassify marijuana as a Schedule III substance: a drug with potential for abuse less than the drugs in Schedules I and II, with currently accepted medical use in treatment, and with moderate or low risk of physical dependence but high risk of psychological dependence. This would be consistent with current evidence, would allow research study while continuing regulatory restrictions, and may also reduce pressures on states to legalize recreational use. Marijuana reclassification would allow the federal government to stay engaged and help control the discussion around the benefits and risks of marijuana use, rather than sitting idly by as an unrelenting wave of legalization sweeps across the nation.

A bipartisan bill has been proposed in the House of Representatives calling for marijuana rescheduling. Call your representative to support this evidence-based policy change.

Tags:Drug Policy, drug use, marijuana
Posted in Drug Abuse | 4 Comments »

Medical Marijuana Changing the Face of Medicine

March 6, 2015

Marijuana’s medicinal uses can be traced back as early as 2737 B.C., when the emperor of China touted cannabis tea for therapeutic reasons. While medical marijuana is approved in 23 states and the District of Columbia, this substance is still deemed a Schedule I controlled substance that is not “currently acceptable for medical use” and has a “high potential for abuse.” However, here in the United States the legalization of this substance for medicinal purposes are still taboo and it is especially difficult to do high-quality studies on its medicinal effects in the U.S. due to this stigma. There is a market and a gap that marijuana as a therapy could fill. There are many people interested in the use of marijuana as a medical therapy – this includes physicians, pharmaceutical companies, politicians and patients.

Treatment options
The benefits of medical marijuana have been strongly documented by scientists via research. Two synthetic compounds, based upon the chemical form of THC, have been approved by the FDA. Nabilone and dronabinol are being used to the treatment of chemo-induced nausea and vomiting, and have been found to be as effective as current anti-nauseous medications. Research has proved inhalation of cannabis is just as effective as ingestion of these pills. Researchers are also exploring the effects of a lesser known cannabis related product, cannabidol, for the treatment of intractable epilepsy. For pain, marijuana has been documented to provide relief related to multiple sclerosis- related spatisity and peripheral neuropathy. The primary psychoactive compound in marijuana is THC, or tetrahydrocannabinol. THC targets the CB1 receptor, found primarily in the brain. The CB1 receptor activates to quiet the response to pain or noxious chemicals. Marijuana and THC have also been identified as provided relief for patients with debilitating anxiety and other psychiatric conditions.

Decrease substance abuse
The current pain management systems has an alarming number of associated iatrogenic overdoses and addictions. Pain management with THC could be an effective alternative that helps treat pain and decreases the number of people addicted to pain medications. In comparison to the standards of care for pain management, opiods outperform THC, but are still able to provide comfort to patients with chronic or acute pain.

Call to Action
The entire concept that something fairly cheap and readily assessable could be harvested to treat some very debilitating diseases. The stigma associated with the legalization and acceptance of medical marijuana is hindering the full potential of this drug as a medical therapy and it could change the world of medicine.