The Con Side
The only thing worse than the pro-medical marijuana side of this argument is the Con side. It’s good that they acknowledge marijuana’s side effects, but they do it in a quixotic way that covers up an obvious agenda of greed and control. The convenient Con side conclusion: Since marijuana has side effects and it isn’t a pharmaceutical drug, the solution is to use dangerous, expensive and known pharmaceutical drugs that they happen to sell.
The Con side has its arguments. Some of them don’t hold water in my view. Where that is the case, I’ll make parenthetical remarks. Let’s look at the Con arguments:
- Marijuana damages the brain, heart, lungs, and immune system. It impairs learning. It interferes with memory, perceptions, fertility and judgment. Smoked marijuana contains cancer-causing compounds. It’s involved in a high percentage of automobile crashes and workplace accidents.
- Opponents believe that legalizing the medical use of marijuana sends the wrong message to kids.
- Those against medical marijuana say that medical marijuana is a front for recreational legalization.
- They argue that both adults and teens who claim medical use are actually using it for recreational pleasure.
- The official U.S. government position currently states marijuana has "no accepted medical use" and "has a high potential for abuse."
- Some patients, physicians, medical organizations and politicians opposed to medical marijuana believe that marijuana has not been FDA-approved because it is too dangerous to use.
- Opponents argue that that various FDA-approved drugs make the medical use of marijuana unnecessary. This view is summed up in the following often quoted statement from Bill First, M.D, U.S. Senator: "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." Correspondence to ProCon.org, October 20, 2003 (Come on, Bill, there’s lots of consistent, repeatable scientific data regarding marijuana’s medical benefits.)
- Medical marijuana’s risks are still unclear. (If the risks aren’t clear after 4000 years of clinical trials, what exactly do they suggest?)
- Opponents believe that it's not compassionate to allow sick people to use dangerous drugs that might harm them. They argue that's why the United States has an FDA research and approval process.
- A frequently quoted statement from the FDA website in August 2004 in a section titled "Protecting Consumers, Promoting Public Health" says: "At the heart of all FDA's regulatory activities is a judgment about whether a new product's benefits to users will outweigh its risks. Science-based, efficient risk management allows the agency to provide the most health promotion and protection at the least cost to the public. No regulated product is totally risk-free, so these judgments are important. FDA will allow a product to present more of a risk when its potential benefit is great, especially for products used to treat serious, life-threatening conditions."
8/04 FDA. (Although this seems to be a strong argument for medical marijuana, opponents of medical marijuana frequently use this statement as ammunition against it.)
- The Drug Abuse Warning Network (DAWN), an organization that works with emergency departments (ED) nationwide, reported that marijuana was the second most frequently mentioned illicit drug in emergency room visits during 2002. Cocaine was #1.
According to DAWN, there were 119,474 marijuana ED mentions during 2002. This was significantly more than the 110,512 in 2001. While marijuana ED mentions were statistically unchanged from 2001 to 2002, they have risen 164% since 1995 (@45,259 mentions) and 24% since 2000 (@96,426 mentions.) Almost 16% of the marijuana ED mentions in 2002 involved patients ages 6–17, 31% involved 18–25 year-olds, 21% involved 26–34 year-olds, and 32% involved individuals 35 years of age and older. (A factor that isn’t mentioned here, but must be an important one, is that marijuana gets stronger over time because of more controlled and intensive growing practices.)
DAWN also collects information on deaths involving drug abuse. In one report they identified and submitted by 128 death investigation jurisdictions in 42 metropolitan areas across the United States. Cannabis ranked among the 10 most common drugs in 16 cities, including Detroit (74 deaths), Dallas (65), and Kansas City (63). Marijuana is very often reported in combination with other substances; in metropolitan areas that reported any marijuana in drug abuse deaths, an average of 79 percent of those deaths involved marijuana and at least one other substance.
(This is another often-quoted passage on the Con side. But when they say that marijuana ranks among the 10 most common drugs involved in drug-related fatalities, I wonder how many drugs there are that people use to get high, anyway? Are they including prescription drugs? Or just illicit drugs? I don’t know about you, but I really have to stretch my imagination to come up with 10 different drugs that people use recreationally. If you take a moment to tally up the possibilities, this figure actually makes marijuana appear to be very safe in the big picture.)
- Opponents insist that the harm of smoking is too great to ignore. Marijuana contains some of the same, and sometimes even more, of the cancer-causing chemicals found in tobacco smoke. Studies show that someone who smokes five joints per week may be absorbing as many cancer-causing chemicals as someone who smokes a full pack of cigarettes every day.
- They argue further that danger of second-hand smoke by marijuana smokers may be just as harmful as second-hand tobacco smoke.
- "Marijuana smoking produces inflammation, edema, and cell injury in the tracheobronchial (that means throat and lungs in medicalese) mucosa of smokers and may be a risk factor for lung cancer."
Journal of Respiratory Cell and Molecular Biology June, 1999
- Marijuana’s side effects (such as dysphoria, tachycardia, motor and coordination impairment) are too great for the potential benefits for the illnesses it’s used for.
- Opponents of medical marijuana argue that if marijuana suppresses the immune system, then people with compromised immune systems shouldn’t take it.
- Many opponents argue that smoked marijuana has no reliable dosage. (This problem has been solved by the U.S. National Institute on Drug Abuse (NIDA), which grows and distributes a contamination-free source of cannabis with consistent and predictable potency.)
- In January 2004 the head of psychiatry at the U.K.'s Institute of Psychiatry told the U.K.Times that inner-city psychiatric services were nearing a crisis point, with up to 80% of all new psychotic cases reporting a history of cannabis use. (I believe this is a very important point. This may be because marijuana induces schizophrenic brain wave patterns (Hiroshi Ujike, et al.) It’s possible that marijuana could synergize with pre-existing psychosis and bring borderline or sub-clinical individuals over the edge into full-blown psychosis. If this were shown to be true, it would be a good case for a contraindication in these individuals.)
- Marijuana, opponents claim, is addictive and leads to harder drug use. This is known as the Gateway Effect. Those against medical marijuana claim that one of marijuana's most harmful consequences is its potential role in leading to the use of other illegal drugs like cocaine and heroin.
(Although proponents of medical marijuana poo-poo the Gateway Effect of marijuana, the effect is real. In fact, it’s one of marijuana’s uses among shamans. Marijuana opens the doors to all kinds of possibilities, including stimulating a curiosity to see what other drugs are like. On the other hand, opponents of medical marijuana turn the Gateway Effect into a treacherous slippery slope that ends in the tragedy of hard drug addiction without fail. This is not true.)
- Some opponents of medical marijuana site a lack of meaningful research on the subject, or that available research comes down on the Con side:
“The 1961 U.N. Single Convention on Narcotic Drugs,” says Kemal Kurspahic, spokesman for the UN's Office for Drug Control and Crime Prevention, “does not allow marijuana for any medical use at this time. While using marijuana for medical purposes could not be excluded, the scientific research in several countries so far has not produced conclusive evidence of medical usefulness of marijuana. As long as there is no scientific evidence approved, for example, by the World Health Organization, marijuana remains listed among strictly controlled substances as stated in the convention."
1/02 United Nations.
(In 1961? Why on earth would you refer all the way back to a report from 1961? If you’re going to play that game, why not hunt down medieval, biblical and even prehistoric injunctions against marijuana? By 2002 there was a very significant body of medical research demonstrating the medical usefulness of marijuana. Also, what do they consider conclusive evidence, and what are their qualifications to assess what that would be? In addition, he fails to mention that the illegality of marijuana makes it difficult or impossible to perform research in many countries. This poses a major stumbling block to international scientific consensus on the subject.)
- Opponents state that the federal government's 1999 IOM Report expresses that there is little future in smoked marijuana as a medically approved medication. The study concluded that smoking marijuana is not recommended for the treatment of any disease condition.
(There is little future because pharmaceutical companies can’t patent, market and control marijuana. Their conclusion isn’t medical, it’s financial. This is the issue behind the issue, but we’ll get to that later.)
Along these same lines, the U.S. DEA told ProCon.org in a 1/2/02 email:
"Any determination of a drug's valid medical use must be based on the best available science undertaken by medical professionals. The Institute of Medicine (under the National Academy of Sciences) conducted a comprehensive study in 1999 to assess the potential health benefits of marijuana and its constituent cannabinoids. The study concluded that smoking marijuana is not recommended for the treatment of any disease condition. In addition, the effects of cannabinoids studied are generally modest, and in most cases, there are more effective medications currently available. For those reasons, the Institute of Medicine concluded that there is little future in smoked marijuana as a medically approved medication."
The American Medical Association's (AMA) policy on Medical Marijuana, amended June 2001, says:
"The 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."
- Opponents of medical marijuana argue that proposals to fund medical marijuana research go through the same peer review process that’s available to any other drug for research. (Implicit in this process is a financial pro and con assessment for the investor, which comes up very heavily weighted on the side of the consumer in the case of marijuana. Why would a company research and promote a product that anybody can grow at home for free? There’s nothing evil behind it, it’s just good business sense.)
- The government can only support the most promising studies with the funds they have. Medical marijuana has to contend with other research proposals, ostensibly so that medicine can progress the most for society overall. (If this ‘Medicine for the People’ motto were really true, medicine would be very different than what it is today.)
- Science should take this issue out of the political arena and put it back in the laboratory, where researchers and medical professionals can do what they do best.
Then there are the legal arguments:
- The American Medical Association recommended in June 2001 that marijuana be retained in Schedule I of the Controlled Substances Act, signifying that it believes marijuana has no medical use in the United States.
- Opponents of medical marijuana state that there are both wealthy individuals and organizations from outside of the medical community that want to use medical marijuana as part of a legalization agenda. They argue that these individuals and groups “hoodwink the voters” into believing false claims about medical marijuana.
- Those on the Con side believe that citizens shouldn’t have the right to vote on medical issues. They argue that the FDA system is the foundation of medicine in this country, and that the medical and scientific communities have procedures to establish what is safe, sound and effective medicine. Marijuana has not been approved as a drug using these procedures. They say that until there’s an agreement among the national community of experts, there’s no legitimate legal or medical use for marijuana.
- Opponents declare that state voter initiatives defeat the purpose of the FDA process of protecting the public through an allegedly science-based medical hierarchy. According to critics of medical marijuana, medicine doesn’t just happen by popular vote.
- Those against medical marijuana argue that there are many safer, legal and more effective anti-nausea agents than marijuana, such as Marinol, Compazine, Tigan, Metaclopramide, Zofran and Kytril. (Except that they often aren’t safer, cheaper, more effective or tolerable for the patient than marijuana. But they are legal with a prescription.)
- Opponents claim that marijuana's legislated use as a prescription drug circumvents standard drug safety protocols and is not the standard of care.
- The U.S. Department of Health and Human Services (HHS) considers marijuana to be a Schedule 1 Controlled Substance. That means that it has no currently accepted medical use in treatment in the United States and has a high potential for abuse.
- Opponents state that the FDA has not approved a new drug application for marijuana because the known risks of marijuana use outweigh any potential benefits.
-Critics of medical marijuana say that just because the FDA approved Marinol in 1985 and declared that synthetic THC is a safe and effective medicine for the treatment of nausea and vomiting, that doesn’t mean that marijuana is a medicine. (The old coming-up-with-opposite-conclusions-from-the-same-data-trick!)
Then there are the enforcement issues:
- Drug Enforcement Administration (DEA) special agent in charge Javier Pena stated in a 7/28/05 article "Bush's War on Pot" published in Rolling Stone magazine:
"We can't disregard the federal law. The Supreme Court reiterates that we have the power to enforce the federal drug laws - even if they are not popular. We're going to continue to do that."
- The U.S. Department of Justice Memorandum of Law in opposition to Plaintiffs-Appellants in Raich v. Ashcroft says: "Because, as we have shown, the Controlled Substances Act is a proper exercise of Congress' authority under Article I..., any challenge to that authority on the ground that it infringes on rights founded in state law and reserved by the Ninth Amendment (or Tenth Amendment) necessarily 'must fail.'"
12/10/02 U.S. Department of Justice
- The International Association of Chiefs of Police (IACP) released resolutions that officially expressed the group's opposition to the propositions in Arizona and California to legalize medical marijuana.
-Opponents of medical marijuana quote the California Narcotics Officer's Association (CNOA), who say, "The overriding objective behind this [medical marijuana] movement is to allow a minority (less than five percent) of our society to get 'stoned' with impunity. This small minority is willing to put our citizens at risk from all the negative and disastrous effects caused to and by those who are intoxicated. What we don't need in this society is more intoxicated people on our highways, in workplaces, schools, colleges, or in our homes."
1995 CNOA
(I agree. Nobody has the right to put someone else in danger because they’re loaded. A remedy for this could be a legal cannabinoid blood level backed up with a meaningful disciplinary protocol.)
My Perspective
All of the opposition’s arguments would be nullified if:
1) People using medical marijuana did so under a physician’s care,
2) the attending physician paid attention to the patient who is using medical marijuana under their care, and
3) the attending physician modified the medication if problems became apparent.
Feedback with the doctor is an essential part of a patient’s healing process. This has become a rarity in modern medicine, and it’s responsible for many problems. This is an issue that needs to be remedied regardless of what happens with medical marijuana.
Almost none of the strong harmful side effects of marijuana happen instantly. The exception to this rule is marijuana’s tendency to induce schizophrenic brainwave patterns. With this exception, marijuana’s deleterious side effects, apart from the high itself, take time to happen.
If the attending physician paid attention to her/his patient and did her/his job effectively, they could increase, decrease or moderate the patient’s medication as it was needed. If that’s not what’s happening, then maybe that issue should get more serious attention than it has.
There are serious problems with the medical marijuana system as it stands now. I don’t see transgressions of this system happening with patients as much as with some of the doctors who are involved. Too many Pot Docs write prescriptions for anybody who walks through their door. Why wouldn’t people abuse that opportunity?
A physician is supposed to work at a higher level. The state empowers physicians to be gatekeepers. That power allows them to judge who is going to benefit from using a drug and who might abuse it. The doctors themselves are the ones who are setting the boundary conditions for what happens in this field.
It doesn’t take a rocket scientist to diagnose 98% of the cases we’re talking about here. If a physician doesn’t have the skills to make that determination with reasonable accuracy then maybe s/he should go into research and get out of the clinical setting. If they flagrantly abuse their gatekeeper privilege just to make money and endanger the community by doing so, maybe they should try stamping out license plates for a while.
If being too stoned in public presents a danger to society, it would be easy to establish a legal cannabinoid blood-level along with a meaningful disciplinary protocol just like we have now for alcohol.
If we keep this issue where it’s supposed to be, which is regulated, legal marijuana for the sole purpose of medication in those who really need it, there’s really no problem. The problems arise when we start expanding the issue and future tripping on all of the things that might happen if medical marijuana becomes a fully accepted medical protocol.
That leads us to my next point. There’s another issue that’s more central to this argument that the public isn’t privy to. The issue is that medical marijuana forces us to consider that a non-pharmacological substance may be a drug. This idea is the Pandora’s box of the pharmaceutical industry. That’s why it gets manipulated away from our public understanding by legal and informational sleight-of-hand. Why? Because medical marijuana could change the definition of medicine. If a non-pharmaceutical substance can be a drug, what does that mean and what could it lead to? With that change comes a shift in the parameters of control for those who have lorded over the medical field, especially drugs, since the inception of the AMA. This isn’t good or bad, but it is the issue...
This article was some of the original material that went on to become
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the Effects of Cannabis
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Peter Cohen’s
Medical Marijuana: The Conflict Between Scientific Evidence and Political Ideology. Part One of Two examines the legal, political, policy, and ethical problems raised by the recognition of medical marijuana.
Are you on board with the
Board of Medical Marijuana Enforcement ?
Which is more immoral? Distracted driving or smoking marijuana?
Read this article for a reality check on the magnitude of the marijuana industry...
It’s a fact that too much
medical marijuana is getting diverted to non-medical use, especially to teens...
And it’s a fact that teen use of cannabis is
marked by its irresponsibility...
Dr. David Sack questions the true value of medical marijuana in his article
is marijuana good medicine?
and in his article
Marijuana: The New Snake Oil? he outlines many of the strongest points of the con argument. However, my opinion is that he places too strong an emphasis on cannabis passing FDA standard testing procedures. The reason I’m critical of this viewpoint is that my clinical experience with cannabis has shown me that the FDA standards would prove to be pitifully insufficient for this very complex substance.
I advocate here and elsewhere that researchers who are trained in the orientations and methodologies of Traditional Chinese Medicine be included in such testing procedures so that we can get a more realistic clinical view of the effects of all substances...
Willie Nelson makes the same mistake here that so many cannabis advocates do when he offers himself up as evidence for the lack of side effects in really long-term marijuana use. Willie, different people have different body types, psychological makeups and many other factors that will determine how they will fare with this drug...
States that decriminalize marijuana are seeing
dramatic increases in children requiring medical intervention...
In the
Denver area, nearly 74% of adolescents in substance abuse programs have used someone else's medical marijuana, have an earlier age of regular marijuana use, more marijuana abuse and dependence symptoms, and more conduct disorder symptoms compared with those who did not use medical marijuana.
The effects of pro-cannabis propaganda on world culture, particularly youth, are far-ranging and deeply effective...
Legalization of marijuana is raising marijuana exposure to very young children -age 5 and younger- by stunning levels...
Government policy changes shift the use of medical marijuana
About 86 percent of the people who report using marijuana for medical purposes also use the drug recreationally...
What’s the impact of the new marijuana laws so far? Rising rates of marijuana use, lowered perception of marijuana's dangers in children, increased hospitalizations related to marijuana and so much more. How long does this experiment need to go on?
Wildly varying data from study to study is endemic in the cannabis culture and the science surrounding it...
Although 14 of the nation's 24 medical marijuana programs are essentially nonmedical in practice, they enrolled more than 99 percent of overall participants...
Unfortunately, legalization of marijuana leads to increased unintentional pediatric exposure to marijuana...
Such as after medical marijuana became legal in Massachusetts, cannabis-related poison control calls involving children and teenagers doubled...
For extensive details on how to balance and optimize the effects of cannabis using Traditional Chinese Medicine, please refer to
Marijuana Syndromes
How to Balance and Optimize
the Effects of Cannabis
With Traditional Chinese Medicine
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