Medical Marijuana Opinions

[SL2014]

What do you think about the possible legalization and taxation of Medical Marijuana in the US?

I think that this is a very interesting subject and I like to hear other people's opinions.

Please see my reasons and tell me what you think about each of them. :) Thank you!

My Opinion:

I think that Marijuana should be legalized, taxed and regulated (Like alcohol and tobacco).

Reasons:

1)__ It is VERY beneficial with people with some ailments, and with the lack of dependency and withdrawls is a great alternative to things like narcotic pain medication.

2)__ Taxing Marijuana can be extremely rewarding for the economy, a SINGLE dispensery in northern California paid over $800,000.00 in taxes in a SINGLE year... we could use this money during a recession to avoid cutting costs on government programs that people depend on.

3)__ There are very little downsides to people using marijuana, if it is eaten or used via vaporizor there are ZERO downsides other than the possibility of people driving while impaired, but this danger is exists with everything from Alcohol to NyQuil to Sleep Deprivaiton.

4)__ Not is single death has been recorded exclusively because of the use of marijuana.

5)__ MILLIONS of dollars are spent each year arresting, presecuting and detaining people that have consume, sell, or cultivate marijuana. 70% of the Federal drug enforcement budget goes to enforcing laws reguarding marijuana, the other 30% is divided between Meth, Crack, Heroin, Cocaine, Extacy, Date Rape Drug, Illegal Perscription Drugs, Acid, mushrooms ect.

What do you guys think? Why do you think that it is still Federally illegal, even for medical purposes? What do you think should happen?

[The Mary Janes]

Medicinal Marijuana

The debate over the use of marijuana has been in the spotlight since the 1960s when it was first classified as a schedule 1 drug. Since it obtained its illegal status, patients, physicians, politicians and the general public have been engaged in an all out, knock-down, drag-out war over its use. Individuals who suffer from chronic illnesses, such as cancer and AIDS, suggest that the use of marijuana is therapeutic, as it alleviates symptoms associated with their conditions. Others cling to the drug's original schedule 1 classification, arguing that its addictive nature and negative side effects negate its use as a therapeutic agent. Nonetheless, as the argument continues on a national scale, as it most likely will for years to come, the need for an evaluation of such therapies continues. Here we will discus our personal assumptions, opposing points of view and a recommended solution.

Our Personal Assumptions

As nurses, we feel that treating the patient should be the priority. This includes treating the primary illness, the side effects affiliated with the illness and associated therapies. Unfortunately in a world of endless pharmacological interventions, an infinite list of potential side effects is a threat. Often times as healthcare professionals, we attempt to 'fix' one problem and only result in creating another. The use of medicinal marijuana may prove to be a solution to both rectify and alleviate these problems. Although the specifics concerning the distribution, prescription and administration of marijuana still remain unclear, we believe that marijuana should be used in the medical field. Just like any therapy, there are risks and benefits associated with its use. In this case, we feel that if the therapy enhances the patient's quality of life without causing undue harm or interference with other therapies, there is no reason not to use it. Who are we to withhold this therapy from individuals suffering from chronic illness? We firmly believe that if this therapy had been developed in a laboratory and available in a pill form, there would be no debate surrounding its use. The patient and his/her quality of life should be at the center of this debate, not marijuana.

Pot Pros

Marijuana has been argued to have numerous therapeutic effects for those suffering from chronic illnesses. It has been shown to function as an anti-emetic for those suffering from hepatitis or cancer, decrease intraocular pressure in those with glaucoma, increase appetite and prevent wasting syndrome in those dealing with HIV/AIDS, decrease muscle spasticity in those with multiple sclerosis, and decrease pain in those who suffer from chronic pain, migraines, menstrual cramps and phantom limb pain. In addition to these advantages, marijuana has also been argued to be relatively safe. This assumption is based upon no known cases of lethal overdoses and its less addictive nature than other pharmacological agents, such as muscle relaxants, hypnotics and analgesics (Grinspoon and Bakalar, 1995).

Some argue that the detrimental effects of smoking marijuana negate its other therapeutic effects. Those who are in favor of using marijuana as a medicine, rebuttal, saying that although marijuana smoke carries more tar and particulate than cigarette smoke, less marijuana is needed to achieve the desired affects. This problem could also be addressed if marijuana becomes legalized, through the production of specialized pipes and regulation of medicinal marijuana, thus decreasing this concern among users (Grinspoon and Bakalar, 1995). Others argue that inhaling the drug is more efficient than taking a pill due to the modified absorption and transformation of tetrahydrocannabinol (THC), the active ingredient of marijuana in the body. Inhaling the drug is user friendly because it takes effect more rapidly and that those with chronic illnesses may have difficulties swallowing and digesting a pill (Hugghins and Shah, 1998).

Although the American Medical Association (AMA) continues to recommend that marijuana be classified as a schedule 1 controlled substance, it asks for more information regarding the use of marijuana and its delivery within patient populations by the National Institutes of Health, as recently as June of 2001. These recommendations included the conductions of clinical research regarding the use of marijuana and the development of a smoke-free inhaled delivery system (History of the American Medical Association (AMA) and Marijuana, 2009). The call for such research from one of the largest professional medical associations is promising for those fighting to legalize marijuana.

An additional article from the authors of the Institute of Medicine's (IOM) report on marijuana, titled "Marijuana and Medicine: Assessing the Science Base," the authors wrote the following statements, published in a 1999 article titled "From Marijuana to Medicine" in Issues in Science and Technology:

"The IOM report, Marijuana and Medicine: Assessing the Science Base, released in March 1999, found that marijuana's active components are potentially effective in treating pain, nausea and vomiting, AIDS-related loss of appetite, and other symptoms and should be tested rigorously in clinical trials. The therapeutic effects of smoked marijuana are typically modest, and in most cases there are more effective medicines. But subpopulations of patients do not respond well to other medications and have no effective alternative to smoking marijuana...

Because the chronic use of marijuana can have negative effects, the benefits should be weighed against the risks...

Most of the identified health risks of marijuana use are related to smoke, not to the cannabinoids that produce the benefits. Smoking is a primitive drug delivery system. The one advantage of smoking is that it provides a rapid-onset drug effect. The effects of smoked marijuana are felt within minutes, which is ideal for the treatment of pain or nausea. If marijuana is to become a component of conventional medicine, it is essential that we develop a rapid-onset cannabinoid delivery system that is safer and more effective than smoking crude plant material."

There are currently fourteen states that have enacted laws that legalize medicinal marijuana. These states include Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington. These states passed legislation as long ago as 1996 (California) and as recently as 2010 (New Jersey). Each state passed on a "yes vote" of at least 55%, an accomplishment for those who hope to see nation wide legislation placed. These states each have their own possession limit for citizens, allowing them as little as 1 oz to as much as 24 oz of usable marijuana. In addition to these fourteen states that have enacted laws that have legalized medicinal marijuana, two additional states, Arizona and Maryland, have passed laws that are favorable towards medical marijuana, but do not legalize it. Maryland's Senate Bill 502, also known as The "Darrell Putman Bill," allows individuals being prosecuted for the use or possession of marijuana to present evidence of medical necessity and physician approval to the court as a mitigating factor. If the court does find that the marijuana is a medial necessity, the maximum penalty is a fine of $100 (ProCon.org, 2010). These states act as beacons for those wishing to one day legalize medicinal marijuana on a national scale.

Marijuana as a medicine continues to cause debate among medical professionals, articles such as this one prove to strengthen the call for further research and legislation. As research continues, we can expect the controversy surrounding the topic to heighten and great lengths to be taken to either prevent or promote the legalization of medicinal marijuana.

Cannabis Cons

Despite marijuana's seemingly endless and flawless effects in treating a variety of patient symptoms, numerous negative effects of using the plant have been documented. Exposure and use of marijuana can cause loss of immune system function, short-term memory, coordination and attention. Unregulated marijuana is often contaminated causing diarrhea and pneumonia among its users, which is especially dangerous for those who are immunocompromised. Prolonged use of the drug may cause emphysema, cancer of the lung, mouth or tongue, hormonal imbalances, reproductive deficits and fetal defects (Hugghins and Shah, 1998). These potentially harmful and fatal side effects cause for further review of marijuana before legalizing it.

In one experiment, mice were infected with pneumonia-causing bacteria. Those mice that were exposed to THC, the active ingredient in marijuana, failed to be able to fight the bacteria and died of septic shock. The control mice that were not exposed to THC were able to fight off the pneumonia causing bacteria and thus became immune to the strain of bacteria (Lowry, 1999). This study proves to be of particular importance as the use of medicinal marijuana is marketed towards those patients who cannot fight infection, including those individuals suffering from cancer, HIV/AIDS and hepatitis.

The numerous side effects are not the only basis of argument for those who are fighting the use of marijuana as medicine. Many claim that those who contend the positive uses of marijuana are wrong. According to one source, marijuana was found to control nausea in only 13% of chemotherapy patients in a clinical trial performed by the IOM, compared to 50% who used traditional drugs already available. The IOM also found marijuana to be ineffective in treating glaucoma for more than a few hours and only mildly capable of treating pain in comparison to codeine (Lowry, 1999).

Other studies correlate the relationship between marijuana and schizophrenia. Two patient populations are at a particular risk of developing schizophrenia related to the use of marijuana: those under the age of 21 and persons with a specific genetic makeup. A 1987 study established a link between the drug, age of use and schizophrenia. Those who had used the drug heavily before the age of 18 were six times more likely to be diagnosed with schizophrenia than those who had never used marijuana previously. An additional study performed in 2007, those who used marijuana had a greater risk for psychotic episodes. Those individuals who have one bad COMT gene, the gene linked to schizophrenia, were more likely to experience psychosis after using marijuana. In addition those individuals with two bad COMT genes were ten times more likely to develop psychosis after using marijuana (Cramer, 2008).

Beyond the clinical deficits and potentially harmful side effects caused by marijuana, some argue that the use of marijuana as medicine is only propaganda for drug legalization. In a report released by the IOM, many individuals who use "medical" marijuana have a history of recreational drug abuse and more than 50% have tested positive for cocaine or amphetamines (Lowry, 1999). This opens the door to the "slippery slope" of drug legalization, thus running the risk of exploiting the chronically ill in efforts to legalize the general use of marijuana, leading to harder drug use and a multitude of daily problems. These problems include difficulty prosecuting drug cases, driving under the influence of marijuana, drug screening difficulty and using medical marijuana use as a defense (Hugghins and Shah, 1998).

Recommended Solution

Although there seems to be more than enough information to persuade the average citizen one way or another, more research is necessary before the legalization of marijuana as medicine should occur. Just like many drugs available in the medical industry today, marijuana affects some individuals differently than others. Due to this, a considerable amount of research is needed on the benefits and adverse side effects before it can be safely prescribed to and used by patients or a specific solution can be drafted. We believe this research should be government mandated and funded in efforts to finalize this seemingly endless circle of debate. With information gained from government-funded research, steps should be taken to control and regulate marijuana in the aspects of distribution, dosage, potency and method of consumption. This would allow for the medical distribution and administration of marijuana, as it was when it was readily available before the institution of The Marijuana Tax Act of 1937. Because so much research and work continues to be required surrounding the use of medicinal marijuana, it is difficult to formulate an exact recommended solution. Thus, we believe the first step to the solution is gaining more information.

Marijuana, despite its ability to alleviate individuals' symptoms from specific painful illnesses, has yet to receive legislation surrounding its use in all fifty states. Marijuana usage in patients with cancer and Aids has been extensively studied and determined a safe and effective treatment option. However, the government, we feel, is attempting to prevent the recreational usage of cannabis and thus placing patients in a difficult situation. In order to combat the government controlled issue, options have been suggested in order to help deal with the problem. One option includes removing marijuana from the controlled substance list. By placing marijuana on another scheduled medication list, doctors could more easily prescribe the potentially useful substance. "Patients want to take marijuana and a significant percentage of doctors want to prescribe it. There is good evidence that marijuana is more effective then oral THC for some patients. Because marijuana is effective, sufficiently safe, and endorsed by a significant percentage of the relevant medical community. . . " (Barnes, 2000).

Although illegal, street marijuana is readily available across the United States, the need for further research and legislation surrounding the use of medical marijuana continues. According to a report from the American Medical Associations (AMA), one of the strongest organizations of collaborating physicians in the United States, they are urging that marijuana's status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines, and alternate delivery methods (American Medical Association, 2009).

Here we have analyzed the benefits of the controversial drug, including increasing the quality of life of the chronically ill by alleviating symptoms, and the detriment that can be caused by its use to those who are young and vulnerable. Despite the form it takes, whether it is pill or herb, considerably more research is required before it can be safely implemented into medical regimens.

References

14 Legal Medical Marijuana States. (2010, January 26). Medical Marijuana ProCon.org. Retrieved March 31, 2010, from http://medicalmarijuana.procon.org/view. resource.php?resourceID=000881

American Medical Association. (2009). Reports of the Council on Science and Public Health. Retrieved April 4, 2010, from American Medical Association - Physicians, Medical Students Patients (AMA)

Barnes, R.E. (2000). Refer Madness: Legal and Moral Issues Surrounding The Medical Prescription of Marijuana. Bioethics. Vol.14 Number1 16-41

Benson, J., Watson, S., & Joy, J. (1999). From Marijuana to Medicine. Issues in Science and Technology, Volume Unknown. Retrieved November 22, 2009, from Issues in S and T, Spring 1999, From Marijuana to Medicine

Cramer, D. (2008). Medical marijuana or reefer madness?. Alive: Canadian Journal of Health & Nutrition, (304), 43-45.

Grinspoon, L., & Bakalar, J. (1995). Marihuana as medicine: a plea for reconsideration. Journal of the American Medical Association, 273, 1875-1876.

History of the American Medical Association (AMA) and Marijuana. (2009, February 2). Medical Marijuana. Retrieved November 20, 2009, from medicalmarijuana.procon.org/viewanswers.asp?questionID=000088

Hugghins, S., & Shah, M. (1998). The Debate Drags On. New Physician, Unknown Volume, 11-12.

Lowry, C. (1999). 'Medical' Marijuana Is a Dangerous Fraud. 21st Century Science & Technology , Volume Unknown, 16-17.

[ruralnurs]

"By placing marijuana on another scheduled medication list, doctors could more easily prescribe the potentially useful substance".

But then insurance companies, and taxpayers (you and I) will be paying for some one to get high. If it needs to be legal, don't make it a medicine, let people that want it buy their own.

As I believe I mentioned in an earlier post, I am a prescriber and have a significant number of chronic pain patients, some terminal and some not. And I live in a state hat has legal medical marijuana. I have NEVER seen a person that is on pain controlling medication that gets a "green card" (what they call it here), REDUCE the amount of pain medications they take.

I don't care if people smoke pot (except children, pregnant woman and the mentally ill) but I don't buy that it is for pain because they still want all the pain meds. It may make them feel better, lift mood, help them sleep, whatever, but I don't believe it controls pain. If even one person that got his/her green card after being on lortabs for back pain would tell me, "You know I still have plenty left over since I have been using my medical marijuana" I would be a believer, but I don't believe I will ever hear that statement. People like to get high, period.

[GalRN]

I did a research paper on the medical uses in college and used Grinspoon as a major source. He and other sources say that marinol is not the same as MJ because it contains only THC. MJ has over 600 active ingredients. Some of them are useful as well, and I've heard that marinol makes ppl more anxxious and on edge than MJ.

From personal experience- My grandmother died of cancer in 1984 when I was 9. She insisted on chemo til the end, something I would not have done given the fact that it was more toxic then and I feel that her last months were spent vomiting and had very little quality of life. She must've had her reasons.... Chemo is not as toxic now anyways- and palliative doses are given when they will help, not hurt from what I understand.

Anyway, she tried marinol and it caused major anxiety. She was so anxious that she couldn't eat, so she didn't take it after the first few times. I don't know where it came from- my family is very conservative, but in thatl ast week of her life someone gave her 2 joints. She smoked them. We have home video of her eating a meatball sub and enjoying it, and I remember that it was the only time in the last 6 months of her life when she was able to be my grandma. I did't know why b/c I was 9 but found out later that the MJ was what made her eat- she told my mom that she felt so much better and was not as physically weak simply b/c she ate.

So, medical marijuana is something that certain pts should not be denied. Ppl with AIDS, cancer, and people with glaucoma that is not relieved by traditional meds. I've heard it slows the progression of MS as well. HOWEVER, I am a travel nurse and my last contract was in CA. I stayed with my sister (who doesn't smoke it regularly) and got to know a lot of her friends. It seems that everyone in San Fran knows someone with a medical card and that they use them as a source. Her friend was getting it for carpal tunnel syndrome- that's pushing it. However, he and his friends were not getting arrested, just stoned. One arrest related to MJ can ruin someones career way more than smoking it responsibly and not driving or showing up at work high. There were no illegal dealers in the picture and the risk of doing business with the black market is what causes a lot of the violence linked to drugs.

I don't smoke it anymore- last time I did I could hardly remember my own name, so my opinion is not coming from someone who wants it legal so that it will benefit them.

It should be available to those whom it is documented to help and more research needs to be done to find out what the other ingredients are and how they mitigate the side effects of marinol, also to have valid research re: it's use for other conditions.

As far as non medical use, I thing they should legalize it and regulate the hell out of it. Even taxed it would be cheaper that off the street and if regulated smokers would know that they weren't getting stuff mixed with other drugs.

I think that you should be nailed for driving on it or other things associated with alcohol for example. I do not advocate use of it if it endangers others. Right now it is more dangerous b/c of the illegal part. Regulate it, sell it to ppl over 21, and I still think it's less harmful than alcohol. It can cause cancer when smoked in joint form but there are ways to introduce it to someones system other than inhaling the smoke.

[ruralnurs]

A doc in Montana getting in trouble for prescribing practices in relation to MMJ (AKA the "Green card" here).

http://www.flatheadbeacon.com/articles/article/whitefish_doctor_fined_over_medical_marijuana_clinic/17859/