Last weekend, the Board of Trustees of the California Medical Association (CMA) voted to adopt a white paper calling for marijuana legalization. Though they are still contemplating their decision, the California Society of Addiction Medicine is considering following suit. The CMA reasoned that existing "medical marijuana" laws have thrust physicians in an impossible position -- one they never wanted or asked for. They are forced to be the legal gatekeepers, whose "recommendation" allows an individual to use, cultivate or otherwise obtain marijuana for medical purposes. They correctly point out that doctors need to know the composition of a medication and how much of it is in each dose; otherwise, they cannot ethically advise a patient whether (and how) to use it. Marijuana from dispensaries is usually not standardized or quality-controlled, varies widely in potency, and can contain dangerous pesticides and microorganisms. So doctors are in dangerous and unknown territory.
The CMA has decided that the solution is completely to legalize marijuana for all purposes, both medical and recreational, and then study it. But this is backwards. With no other modern medication have we taken this approach. Can you imagine if we made some new psychoactive substance -- say Spice, K-2, or "bath salts"-- fully legal before researching it? A great deal of harm would be caused before we had the data. This is why products go first through the FDA process -- to collect information on risks and benefits, to ensure batch-to-batch consistency, to identify an effective dose, etc.
Furthermore, the raw marijuana plant material -- itself containing hundreds of unknown components -- has not met FDA's standards of safety and efficacy. But that does not mean marijuana has no medicinal value. Indeed, the FDA has determined that some constituents of marijuana do, and they are available today in pill form. Should we stop there? Of course not. Research is also investigating other safe delivery methods for these types of medications and the Drug Enforcement Administration has granted hundreds of licenses to researchers investigating the possible medical value of components within marijuana.
The National Institutes of Health funds a number of these studies. Research into how components of marijuana may affect our brains and bodies is an exciting area of science. But we don't smoke opium to reap the benefits of morphine, nor do we chew willow bark to receive the effects of aspirin. Similarly, we should not have to smoke marijuana to get potential therapeutic effects from its components. Could the feds speed up the approval process for safe, marijuana-based medications and ensure that our scientific resources are adequately allocated as such? Of course they could, and I hope they will.
Similarly, could our current marijuana laws be updated so that people who use it are not denied social benefits for their whole life and rammed through a criminal justice system that may not always have their best interests in mind? Yes, but that is a far cry from advocating for legalization.
But medical marijuana as it stands today, in California and many other states, has turned into a sad joke. A recent study found that the average "patient" was a 32-year-old white male with a history of drug and alcohol abuse and no history of a life-threatening disease. Further studies have shown that very few of those who sought a recommendation had cancer, HIV/AIDS, glaucoma, or multiple sclerosis. We are also beginning to see a link between medical marijuana and increased drug use in states, according to a few recent, exhaustive studies.
No country in the world has fully legalized marijuana, though many have experimented with reducing or eliminating criminal penalties for mere possession. In the Netherlands, high-potency marijuana has been reclassified as hard drug, and its sale will be prohibited in "coffee houses." So what is the solution to getting the doctors out of their dilemma? Stick to the rules. Real medications must be fully studied, then approved by the FDA, then made available to patients by prescription.
Medical groups -- themselves understandably increasingly impatient with both the current scientific process for medication approval and the political process that puts them in a tough bind -- should focus their angst on speeding up that effort. Legalizing marijuana, however, and risking large increases in use and addiction, represents a hasty solution sure to compromise both the public health and safety.
Dr. Sabet served from 2009-2011 as the senior policy advisor to President Obama's drug czar, Gil Kerlikowske. He can be reached through www.kevinsabet.com.
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Legalize Marijuana, Legal Weed, Marijuana Facts
NORML.org - Working to Reform Marijuana Laws
Why We Should Not Legalize Marijuana - CNBC
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You write: " They correctly point out that doctors need to know the composition of a medication and how much of it is in each dose; otherwise, they cannot ethically advise a patient whether (and how) to use it. Marijuana from dispensaries is usually not standardized or quality-controlled, varies widely in potency, and can contain dangerous pesticides and microorganisms. So doctors are in dangerous and unknown territory."
I work in a biomedical research lab in an MMJ state. We have a license from the DEA that covers Schedule I controlled drugs. However, the DEA told us in no uncertain terms that we were not permitted to analyze cannabis in our lab for any purposes. Seems analyzing peoples body fluids for cannabis is OK -- that is meant to harm them. However, try to offer the kind of quality control to which you refer and the DEA will yank one's license. Helping out MMJ patients isn't OK by the DEA, only enabling their persecution gets approval.
So spare me the lecture, Mr. ONDCP.
Can you imagine if we made some new psychoactive substance -- say Spice, K-2, or "bath salts"-- fully illegal before researching it? I wonder which of these two actions is more absurd....
Spectroscopic/chromatographic fingerprints & biological assays enable highly personalized cannabinoid profiles ensuring efficacy and patient safety, as well as allowing individualized strain selection for patients. Tests are cheap and reliable, and already an industry standard for USP botanicals.
Therapeutic potentials of cannabinoids found in marijuana can be delivered in controlled doses by non-toxic delivery systems. Cannabis is the least toxic of all pain relieving medications. The risk benefit profile of marijuana as a whole plant is far superior to any other chemical drug in existence.
Although cannabis is variable between cultivar-types, single strains of cannabis can be highly standardized. Current technology provides affordable tests for purity, quality, potency and consistency for all botanical drugs including cannabis. Procedures for standardized botanical products have already been formalized by the FDA in the U.S. providing a blueprint for regulatory approval and quality control of botanical medicines.
Barriers are not matters of science, rather those of politics and law. The Office of Medicinal Cannabis of the Dutch government provides highly standardized quality cannabis and has done so for years.
Pharmaceutical products appeals to regulatory authorities, yet herbal cannabis is still the gold standard in terms of efficacy and numbers of satisfied patients.
Or drink coffee for the caffeine or eat oranges for the vitamin C or drink beer for the alcohol.
If ordinary Americans could grow a little marijuana in their own back yards, it would be about as valuable as home-grown tomatoes. Let's put the criminals out of business and get them out of our neighborhoods. Let's let ordinary Americans grow a little marijuana in their own back yards.
You can email your Congressperson and Senators at http://www.usa.gov/Contact/Elected.shtml to discuss HR 2306, the bill that would repeal Federal prohibition.
And a big THANK YOU to the courageous, freedom loving legislators, governors, and countless others who are working so hard to bring this through! You’re doing a great patriotic service for all of America!
Here's one way that IT IS REALLY WORKING: Arresting the criminals and collecting a fee from registered growers (and bringing in thousands of dollars to support the county budget); what a great plan! This is the way to build a better America! http://www.pbs.org/wgbh/pages/frontline/2011/07/the-pot-republic-one-sheriffs-quietly-radical-experiment.html
According to Title VII Office of National Drug Control Policy Reauthorization Act of 1998: H11225:
Responsibilities. –The Director– [...]
(12) shall ensure that no Federal funds appropriated to the Office of National Drug Control Policy shall be expended for any study or contract relating to the legalization (for a medical use or any other use) of a substance listed in schedule I of section 202 of the Controlled Substances Act (21 U.S.C. 812) and take such actions as necessary to oppose any attempt to legalize the use of a substance (in any form) that–
is listed in schedule I of section 202 of the Controlled Substances Act (21 U.S.C. 812); and
has not been approved for use for medical purposes by the Food and Drug Administration;
Quoting any former ONDCP employees will result in more lies,,more false science and skewed statistics. Please research the supporters of the war on drugs and you will find their vested interests.
"Similarly, could our current marijuana laws be updated so that people who use it are not denied social benefits for their whole life and rammed through a criminal justice system that may not always have their best interests in mind? Yes, but that is a far cry from advocating for legalization." Actually that IS one of the main reasons to legalize marijuana. Prohibition has destroyed countless more lives than drugs themselves.
"Legalizing marijuana, however, and risking large increases in use and addiction, represents a hasty solution sure to compromise both the public health and safety." Did this happen in the Netherlands where marijuana was de facto legalized? How about Portugal? How about usage rates and addiction rates of marijuana in states with medical marijuana? Why do studies show that marijuana usage goes down in those areas?
Sounds like this guy is working for Big Pharma.
Totally misleading. If you want to study botanical cannabis in human populations for specific medical issues, you’ll be waiting for DEA/HHS/NIDA approval for years and put through unwarranted screenings and road blocks. So few researchers have been granted licenses for these types of studies. Let's say you wanted to explore the health benefits of locally cultivated strains, or you wanted to produce botanical material yourself to give to patients—it’s a NO-NO in our current framework.
“But we don't smoke opium to reap the benefits of morphine, nor do we chew willow bark to receive the effects of aspirin.†-- if you ever get into ICU, and you get refractory diarr.hea, see if they do you some help and prescribe you TINCTURE of OPIUM, aka Pangeoric. Used all over the country in hospitals and pharmacies right now. It’s schedule II. It’s not FDA-approved. It is prescribed and it works. It is a botanical preparation of opium sap. You may not have known this, but that is the benefit of a medical training when discussing medicines…
“Could the feds speed up the approval process for safe, marijuana-based medications…†-- yeah, there’s this one cannabis-based medicine that is from England. The company has its own cannabis production facility which they started from seeds they imported from Holland with the UK gov’t’s blessings!(Pt3end)
The pill is extremely expensive, which makes Big Pharma happy. It takes an hour to start working, as opposed to almost instant effect by inhalation of smoke or vapor. Many people stop using it because of disturbing mental effects that they don't get with marijuana. And how are people with raging nausea supposed to keep a pill in their stomachs for an hour?
"Similarly, we should not have to smoke marijuana to get potential therapeutic effects from its components."
You don't. You can vaporize the active components without burning the plant material. You can also eat it and apply it topically.
"But medical marijuana as it stands today, in California and many other states, has turned into a sad joke."
The federal position that marijuana has no medical value and is a harmful recreational drug is a much sadder joke. Almost 80% of Americans believe that marijuana should be available medically. 50% believe it should be legalized outright, for any purpose a free American might want to use it.
"No country in the world has fully legalized marijuana, though many have experimented with reducing or eliminating criminal penalties for mere possession."
The US forced this world-wide prohibition. You can hardly look to their prohibitions as a reason to continue this American tragedy.
Mr. Sabet, loyal federal flunkey that he is, fails to mention that every request for research cannabis from the NIDA is turned down unless it is a study looking for harms. No one, no matter how qualified, can get the material needed to study cannabis for its medical benefits.
Cannabis is not a "modern medication". It is a traditional herbal folk remedy that has been used safely for 5,000 years without a single casualty. The FDA doesn't certify herbal remedies. Cannabis shouldn't be "scheduled" at all.
"Furthermore, the raw marijuana plant material -- itself containing hundreds of unknown components -- has not met FDA's standards of safety and efficacy."
Aspirin is considered a "safe" drug, but 15 times the normal dose can kill you. Hundreds die from aspirin ODs every year. Cannabis has never killed anyone, but it is estimated that it would take 20,000 to 40,000 times the normal dose to be fatal. More graphically, that would be 1,500 pounds consumed in 15 minutes. How much safer does it have to be?
The study cited above was published by the biased Harm Reduction Journal, a group whose function is that of propping up current drug laws.
I wouldn't call the Harm Reduction Journal prohibitionist, although just as harm reduction accepts that people use drugs and attempts to reduce the harm associated with it, harm reduction also accepts that countries prohibit some drugs, and attempts to reduce the harm associated with prohibition, thus "enabling" prohibition in a manner of speaking.
The study Sabet cited did indeed find that the average patient seeking a recommendation from one doctor in California was a 32 year old male with a history of drug "abuse" and no history or life-threatening illness.
What Sabet left out is that these patients appear to be self-medicating emotional, psychological and neurological problems, ADHD, PTSD, anxiety, depression, etc., mostly inflicted in the womb or during formative years, that their earlier drug "abuse" was also self-medication and that the vast majority use nothing but cannabis now as a substitute for much more problematic alcohol, opiates and pharmaceuticals.