Why pot and medicine don’t mix

By William T. Breault

To our state legislators:

You are considering important legislation – HB 2160 – that would establish a “medical” marijuana program in Massachusetts. There have been many half truths and mis-perceptions swirling around this controversial issue. It’s important to set the record straight.

Who really uses “medical” marijuana?

Advocates of the legislation claim that “medical” marijuana helps seriously ill people with cancer or AIDS or glaucoma. They paint a picture of elderly ill people who need it for pain relief. However, “medical” marijuana patient records from California show that 62% [of patients] were between 17 and 35 years of age; and 71% were between ages 17 and 40. Only 2.05% of customers obtained physician recommendations for AIDS, glaucoma or cancer. An extremely high number of people were using “medical” marijuana for other purposes. Source: Report from the San Diego County District Attorney

The bill makes it very easy to get marijuana.

This legislation makes it very easy to get marijuana. If you are over age 18, you can obtain marijuana by claiming to have a “medical condition” and pain or spasms or nausea and receive a medical marijuana card from a physician after a quick examination.

The legislation would permit growing of up to twelve marijuana plants. Marijuana plants can grow to be over six feet tall and can generate many thousands of joints per year. This will create a lot of unregulated marijuana that can be easily diverted to young people. (Chapter 94E sections 2 and 3)
An 18-year-old high school football player who is hurt in a game can get marijuana. A pregnant 18 year old woman can get it if she has nausea in her first trimester. Marijuana use in pregnancy has been linked with birth defects and childhood cancer.

“Medical” marijuana leads to increased access and perceived availability for kids. Perceived availability of drugs is a risk factor predictive of later use. Eight of the ten states with the highest percentage of young people (age 12-25) who used marijuana in the past month were “medical” marijuana states. They are also the majority of states in the top ten for first time marijuana use.

It’s not the only option

If you want a cannabis-based medicine, you do not have to smoke marijuana. There are two FDA approved cannabinoid drugs already approved by the federal Food and Drug Administration – Marinol and Cesamet. The Food and Drug Administration has determined that legalizing smoked
marijuana for medical use is unsafe. The FDA statement is attached. Please read what the FDA says about this issue. Massachusetts should not override the FDA process. It protects vulnerable patients.

This bill could endanger vulnerable patients

There are no established doses for smoked marijuana. It’s unclear how it interacts with other drugs or medical conditions. There is much evidence that smoking marijuana harms sick people.

“Medical” marijuana growing negatively impacts the community

Citizens in “medical” marijuana states have grown tired of the marijuana-related crime, noise and abuse that “medical” marijuana growing brings to their neighborhoods. For example, since California passed its “medical” marijuana law, more than 90 cities and counties in the state have passed moratoriums or bans on the distribution of “medical” marijuana in their communities.

It will increase the fiscal impact on the state budget

The Massachusetts Department of Public Health will have to create a complicated and expensive new bureaucracy to regulate physicians, patients, and the confidentiality requirements in the bill (sections 4 and 5). The bureaucracy goes on and on.

Massachusetts should not model other states’ experiences. Other states have experienced:* increased crime
* increased substance use
* decreased perception of the harm of marijuana by youth and adults
* increased drug trafficking
* and an overall acceptance of the use of marijuana for many other reasons than the purported medicinal purpose.

There are many national medical organizations opposed to smoked marijuana as medicine. They include:
The American Medical Association
The National Multiple Sclerosis Society
The American Glaucoma Society
The American Academy of Ophthalmology
The American Cancer Society
The National Eye Institute
The National Institute for Neurological Disorders and Stroke
The Food and Drug Administration (FDA)

The anecdotal reports

The anecdotal reports regarding “medical” marijuana are not reliable medical evidence because the claimed benefits were not independently verified and do not reflect double-blind controls. The anecdotal reports may also be inaccurate due to the emotional expectancy of the person using marijuana and the placebo effect. In some cases there may be deliberate exaggeration for ideological reasons.

While we strive to be a compassionate society, there must be a balance between alleviating or managing pain and creating a system that potentially does more harm than good. The road that medical marijuana legislation is traveling is laden with potholes.

Claims have been advanced asserting smoked marijuana has a value in treating various medical conditions. Some have argued that herbal marijuana is a safe and effective medication and that it should be made available to people who suffer from a number of ailments upon a doctor’s recommendation, even though it is not an approved drug.

Marijuana is listed in schedule I of the Controlled Substances Act (CSA), the most restrictive schedule. The Drug Enforcement Administration (DEA), which administers the CSA, continues to support that placement and FDA concurred because marijuana met the three criteria for placement in Schedule I under 21 U.S.C. 812(b)(1) (e.g., marijuana has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision).

Furthermore, there is currently sound
evidence that smoked marijuana is harmful. A past evaluation by several Department of Health and Human Services (HHS) agencies, including the Food and Drug Administration (FDA), Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institute for Drug Abuse (NIDA), concluded that no sound scientific studies supported medical use of marijuana for treatment in the United States, and no animal or human data supported the safety or efficacy of marijuana for general medical use. There are alternative FDA-approved medications in existence for treatment of many of the proposed uses of smoked marijuana.

FDA is the sole Federal agency that approves drug products as safe and effective for intended indications. The Federal Food, Drug, and Cosmetic (FD&C) Act requires that new drugs be shown to be safe and effective for their intended use before being marketed in this country. FDA’s drug approval process requires well-controlled clinical trials that provide the necessary scientific data upon which FDA makes its approval and labeling decisions. If a drug product is to be marketed, disciplined, systematic, scientifically conducted trials are the best means to obtain data to ensure that drug is safe and effective when used as indicated. Efforts that seek to bypass the FDA drug approval process would not serve the interests of public health because they might expose patients to unsafe and ineffective drug products. FDA has not approved smoked marijuana for any condition or disease indication.

A growing number of states have passed voter referenda (or legislative actions) making smoked marijuana available for a variety of medical conditions upon a doctor’s recommendation. These measures are inconsistent with efforts to ensure that medications undergo the rigorous scientific scrutiny of the FDA approval process and are proven safe and effective under the standards of the FD&C Act. Accordingly, FDA, as the federal agency responsible for reviewing the safety and efficacy of drugs, DEA as the federal agency charged with enforcing the CSA, and the Office of National Drug Control Policy, as the federal coordinator of drug control policy, do not support the use of smoked marijuana for medical purposes.

Bill Breault is the director of the Main South Alliance for Public Safety

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