Puff the Magic Dragon

Shades of Peter, Paul, and Mary! I live in Arizona. As you may have noticed, over the past few years, Arizona has gained a reputation as a maverick state. In spite of the beautiful desert landscape, the inspiring sunsets, the wonderful weather, and the diversity of people, that assessment may be right.

Arizona voters, by a narrow margin, last year approved medical marijuana for use by people with chronic or debilitating diseases. This makes Arizona the 15th state to have approved a medical marijuana law (although, with 841,346 in favor and 837,005 opposed, it was not a huge mandate). California was the first in 1996, and since then 13 other states and the District of Columbia have followed. It is interesting to note that no other controlled pharmaceutical substance on the market has been made available to the public for medical purposes through an election process.

Many believed that this was an opportunity to set an example for the rest of the country on what a good medical marijuana program looks like, while others felt it was just another sign of the decline of our society. The Arizona law allows patients with conditions such as cancer, AIDS, and hepatitis C, and any other “chronic or debilitating” disease that meets guidelines, to grow plants or to buy 2.5 oz of marijuana every two weeks. Patients must obtain a recommendation from their physician and register with the department of health services. The law allows for only one dispensary per 10 pharmacies in the state, which currently equates to 124 marijuana dispensaries.¹

As you can imagine, this issue has polarized many factions both for and against legalization of medical marijuana. Former US Surgeon General Joycelyn Elders, MD, said, “The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting, and other symptoms caused by such illnesses as multiple sclerosis, cancer, and AIDS—or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.”²

Yet former US Senator Bill Frist (a physician) said, “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.”³

The American College of Physicians has supported medical marijuana and “urges an evidence-based review of marijuana’s status as a Schedule I controlled substance to determine whether it should be reclassified to a different schedule. This review should consider the scientific findings regarding marijuana’s safety and efficacy in some clinical conditions, as well as evidence on the health risks associated with marijuana consumption, particularly in its crude smoked form.”4 The ACP also says they strongly support exemption from federal criminal prosecution, civil liability, or professional sanctioning, such as loss of licensure or credentialing, for physicians who prescribe or dispense medical marijuana in accordance with state law.⁴

By contrast, the American Medical Association has yet to support medical marijuana as a pharmaceutical agent. The US Drug Enforcement Agency maintains that medical marijuana is an illegal substance—yet clinicians have the right to prescribe it in 15 states and are protected under state statutes.

Backers of medical marijuana have argued that thousands of patients face a terrible choice of suffering with a serious or even terminal illness or going to the illegal market for marijuana. The measure in Arizona, much like those in the other states, was opposed by all of Arizona’s sheriffs and county prosecutors, the governor, the state attorney general, and many other politicians. Yet when the people spoke, the law passed … barely.

Many feel these laws will increase crime around dispensary locations, lead to more people driving while impaired, and eventually lead to legalized marijuana for everyone—and therefore would have very dire effects on a number of levels.

In an effort to determine whether marijuana, or drugs derived from marijuana, might be effective as a glaucoma treatment, the National Eye Institute supported research studies beginning in 1978. None of these studies, however, demonstrated that marijuana could lower intraocular pressure as effectively as drugs already on the market. Some potentially serious side effects were noted, including an increased heart rate and a decrease in blood pressure in studies examining smoked marijuana.⁵

Unfortunately, clinical research trials to evaluate the effectiveness of marijuana to treat certain conditions have been restrictive and limited. Until marijuana is downgraded from a Schedule I drug of the Controlled Substances Act, widespread clinical trials are unlikely to happen.

If we really want a conclusive answer as to whether marijuana is valuable for symptom management, it should be evaluated using the same standards as other controlled medications. Is this more a scientific/medical issue or a political issue? With strong supporters on each side of the debate and a fairly new administration, the arguments for and against the legalization of marijuana are certainly hot topics.

What do you think? Email me at PAEditor@qhc.com.

References
1.  Lee MYH. Arizona medical marijuana proposed rules released. Arizona Republic. December 16, 2010. www.azcentral.com/news/election/­azelections/articles/2010/12/16/20101216arizona-medical-marijuana-­proposed-rules.html. Accessed February 22, 2011.

2. Elders J. Myths about medical marijuana [editorial]. Providence Journal. March 26, 2004.

3. Frist B. Email correspondence to ProCon.org; October 20, 2003. Medicalmarijuana.procon.org/view.resource.php?resourceID=000141. Accessed February 22, 2011.

4. American College of Physicians. Supporting research into the therapeutic role of marijuana [position paper]. 2008. www.acponline.org/advocacy/where_we_stand/other_issues/­medmarijuana.pdf. Accessed February 22, 2011.

5. National Eye Institute. Glaucoma and marijuana use [NEI statement]. www.nei.nih.gov/news/statements/marij.asp. Accessed February 22, 2011.

Shades of Peter, Paul, and Mary! I live in Arizona. As you may have noticed, over the past few years, Arizona has gained a reputation as a maverick state. In spite of the beautiful desert landscape, the inspiring sunsets, the wonderful weather, and the diversity of people, that assessment may be right.

Arizona voters, by a narrow margin, last year approved medical marijuana for use by people with chronic or debilitating diseases. This makes Arizona the 15th state to have approved a medical marijuana law (although, with 841,346 in favor and 837,005 opposed, it was not a huge mandate). California was the first in 1996, and since then 13 other states and the District of Columbia have followed. It is interesting to note that no other controlled pharmaceutical substance on the market has been made available to the public for medical purposes through an election process.

Many believed that this was an opportunity to set an example for the rest of the country on what a good medical marijuana program looks like, while others felt it was just another sign of the decline of our society. The Arizona law allows patients with conditions such as cancer, AIDS, and hepatitis C, and any other “chronic or debilitating” disease that meets guidelines, to grow plants or to buy 2.5 oz of marijuana every two weeks. Patients must obtain a recommendation from their physician and register with the department of health services. The law allows for only one dispensary per 10 pharmacies in the state, which currently equates to 124 marijuana dispensaries.¹

As you can imagine, this issue has polarized many factions both for and against legalization of medical marijuana. Former US Surgeon General Joycelyn Elders, MD, said, “The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting, and other symptoms caused by such illnesses as multiple sclerosis, cancer, and AIDS—or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.”²

Yet former US Senator Bill Frist (a physician) said, “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.”³

The American College of Physicians has supported medical marijuana and “urges an evidence-based review of marijuana’s status as a Schedule I controlled substance to determine whether it should be reclassified to a different schedule. This review should consider the scientific findings regarding marijuana’s safety and efficacy in some clinical conditions, as well as evidence on the health risks associated with marijuana consumption, particularly in its crude smoked form.”4 The ACP also says they strongly support exemption from federal criminal prosecution, civil liability, or professional sanctioning, such as loss of licensure or credentialing, for physicians who prescribe or dispense medical marijuana in accordance with state law.⁴

By contrast, the American Medical Association has yet to support medical marijuana as a pharmaceutical agent. The US Drug Enforcement Agency maintains that medical marijuana is an illegal substance—yet clinicians have the right to prescribe it in 15 states and are protected under state statutes.

Backers of medical marijuana have argued that thousands of patients face a terrible choice of suffering with a serious or even terminal illness or going to the illegal market for marijuana. The measure in Arizona, much like those in the other states, was opposed by all of Arizona’s sheriffs and county prosecutors, the governor, the state attorney general, and many other politicians. Yet when the people spoke, the law passed … barely.

Many feel these laws will increase crime around dispensary locations, lead to more people driving while impaired, and eventually lead to legalized marijuana for everyone—and therefore would have very dire effects on a number of levels.

In an effort to determine whether marijuana, or drugs derived from marijuana, might be effective as a glaucoma treatment, the National Eye Institute supported research studies beginning in 1978. None of these studies, however, demonstrated that marijuana could lower intraocular pressure as effectively as drugs already on the market. Some potentially serious side effects were noted, including an increased heart rate and a decrease in blood pressure in studies examining smoked marijuana.⁵

Unfortunately, clinical research trials to evaluate the effectiveness of marijuana to treat certain conditions have been restrictive and limited. Until marijuana is downgraded from a Schedule I drug of the Controlled Substances Act, widespread clinical trials are unlikely to happen.

If we really want a conclusive answer as to whether marijuana is valuable for symptom management, it should be evaluated using the same standards as other controlled medications. Is this more a scientific/medical issue or a political issue? With strong supporters on each side of the debate and a fairly new administration, the arguments for and against the legalization of marijuana are certainly hot topics.

What do you think? Email me at PAEditor@qhc.com.

References
1.  Lee MYH. Arizona medical marijuana proposed rules released. Arizona Republic. December 16, 2010. www.azcentral.com/news/election/­azelections/articles/2010/12/16/20101216arizona-medical-marijuana-­proposed-rules.html. Accessed February 22, 2011.

2. Elders J. Myths about medical marijuana [editorial]. Providence Journal. March 26, 2004.

3. Frist B. Email correspondence to ProCon.org; October 20, 2003. Medicalmarijuana.procon.org/view.resource.php?resourceID=000141. Accessed February 22, 2011.

4. American College of Physicians. Supporting research into the therapeutic role of marijuana [position paper]. 2008. www.acponline.org/advocacy/where_we_stand/other_issues/­medmarijuana.pdf. Accessed February 22, 2011.

5. National Eye Institute. Glaucoma and marijuana use [NEI statement]. www.nei.nih.gov/news/statements/marij.asp. Accessed February 22, 2011.

Shades of Peter, Paul, and Mary! I live in Arizona. As you may have noticed, over the past few years, Arizona has gained a reputation as a maverick state. In spite of the beautiful desert landscape, the inspiring sunsets, the wonderful weather, and the diversity of people, that assessment may be right.

Arizona voters, by a narrow margin, last year approved medical marijuana for use by people with chronic or debilitating diseases. This makes Arizona the 15th state to have approved a medical marijuana law (although, with 841,346 in favor and 837,005 opposed, it was not a huge mandate). California was the first in 1996, and since then 13 other states and the District of Columbia have followed. It is interesting to note that no other controlled pharmaceutical substance on the market has been made available to the public for medical purposes through an election process.

Many believed that this was an opportunity to set an example for the rest of the country on what a good medical marijuana program looks like, while others felt it was just another sign of the decline of our society. The Arizona law allows patients with conditions such as cancer, AIDS, and hepatitis C, and any other “chronic or debilitating” disease that meets guidelines, to grow plants or to buy 2.5 oz of marijuana every two weeks. Patients must obtain a recommendation from their physician and register with the department of health services. The law allows for only one dispensary per 10 pharmacies in the state, which currently equates to 124 marijuana dispensaries.¹

As you can imagine, this issue has polarized many factions both for and against legalization of medical marijuana. Former US Surgeon General Joycelyn Elders, MD, said, “The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting, and other symptoms caused by such illnesses as multiple sclerosis, cancer, and AIDS—or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.”²

Yet former US Senator Bill Frist (a physician) said, “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.”³

The American College of Physicians has supported medical marijuana and “urges an evidence-based review of marijuana’s status as a Schedule I controlled substance to determine whether it should be reclassified to a different schedule. This review should consider the scientific findings regarding marijuana’s safety and efficacy in some clinical conditions, as well as evidence on the health risks associated with marijuana consumption, particularly in its crude smoked form.”4 The ACP also says they strongly support exemption from federal criminal prosecution, civil liability, or professional sanctioning, such as loss of licensure or credentialing, for physicians who prescribe or dispense medical marijuana in accordance with state law.⁴

By contrast, the American Medical Association has yet to support medical marijuana as a pharmaceutical agent. The US Drug Enforcement Agency maintains that medical marijuana is an illegal substance—yet clinicians have the right to prescribe it in 15 states and are protected under state statutes.

Backers of medical marijuana have argued that thousands of patients face a terrible choice of suffering with a serious or even terminal illness or going to the illegal market for marijuana. The measure in Arizona, much like those in the other states, was opposed by all of Arizona’s sheriffs and county prosecutors, the governor, the state attorney general, and many other politicians. Yet when the people spoke, the law passed … barely.

Many feel these laws will increase crime around dispensary locations, lead to more people driving while impaired, and eventually lead to legalized marijuana for everyone—and therefore would have very dire effects on a number of levels.

In an effort to determine whether marijuana, or drugs derived from marijuana, might be effective as a glaucoma treatment, the National Eye Institute supported research studies beginning in 1978. None of these studies, however, demonstrated that marijuana could lower intraocular pressure as effectively as drugs already on the market. Some potentially serious side effects were noted, including an increased heart rate and a decrease in blood pressure in studies examining smoked marijuana.⁵

Unfortunately, clinical research trials to evaluate the effectiveness of marijuana to treat certain conditions have been restrictive and limited. Until marijuana is downgraded from a Schedule I drug of the Controlled Substances Act, widespread clinical trials are unlikely to happen.

If we really want a conclusive answer as to whether marijuana is valuable for symptom management, it should be evaluated using the same standards as other controlled medications. Is this more a scientific/medical issue or a political issue? With strong supporters on each side of the debate and a fairly new administration, the arguments for and against the legalization of marijuana are certainly hot topics.

What do you think? Email me at PAEditor@qhc.com.

References
1.  Lee MYH. Arizona medical marijuana proposed rules released. Arizona Republic. December 16, 2010. www.azcentral.com/news/election/­azelections/articles/2010/12/16/20101216arizona-medical-marijuana-­proposed-rules.html. Accessed February 22, 2011.

2. Elders J. Myths about medical marijuana [editorial]. Providence Journal. March 26, 2004.

3. Frist B. Email correspondence to ProCon.org; October 20, 2003. Medicalmarijuana.procon.org/view.resource.php?resourceID=000141. Accessed February 22, 2011.

4. American College of Physicians. Supporting research into the therapeutic role of marijuana [position paper]. 2008. www.acponline.org/advocacy/where_we_stand/other_issues/­medmarijuana.pdf. Accessed February 22, 2011.

5. National Eye Institute. Glaucoma and marijuana use [NEI statement]. www.nei.nih.gov/news/statements/marij.asp. Accessed February 22, 2011.