There is widespread global discussion about the use of cannabis for medical purposes. Discussion on legalizing marijuana continues despite the fact that many nations have already approved the use of marijuana for medical purposes. Researchers maintain that by legalizing marijuana we raise the risk of adolescents failing to see the harm and danger of using such substance.[1] Those in favor of legalizing marijuana argue that it is economically, practical and medically beneficial.

According to some researchers who are against the legalization, the fact is that the concept of ‘medical marijuana’ did not originate from those in the medical profession, but rather through a drug legalization lobby. These lobby groups generally focus on ‘smoked’ marijuana as the vehicle for administering cannabis. World-wide, there are many well-informed government authorities who are continuing to stand firm against such pro-drug lobby groups. For example, in Australia, the Therapeutic Goods Administration does not endorse the use of marijuana for medical use, nor does the Drug Enforcement Agency (DEA) in the United States.[2]

The medical marijuana advocates stress that the core issue is protecting seriously ill patients from arrest and jail. The key issue is not that patients and advocates are trying to make a “new drug” available. Rather, the goal is to protect from arrest and imprisonment the hundreds of thousands of patients who are already using marijuana, as well as the doctors who are recommending such use. Patients for whom the standard, legal drugs are not safe or effective are left with two terrible choices continue to suffer, or obtain marijuana illegally and risk suffering such consequences as an insufficient supply of marijuana due to prohibition-inflated prices or scarcity; impure, contaminated, or chemically adulterated marijuana purchased from the criminal market; and arrests, fines, court costs, property forfeiture, incarceration, probation, and criminal records.

Should medical marijuana be legalized?

Regulation, availability and treatment

The argument in favor of legalizing medical marijuana is that it can just be bought with doctor prescription, but those opposing it claim that people can grow marijuana by themselves. Barnes, in his analysis and argument of why medical marijuana should be available expounds on several of the arguments against medical marijuana. First, the federal government has a responsibility to its citizens to continue prohibiting its use on any level if marijuana is a dangerous substance. Second, the use of marijuana has not been sufficiently tested to understand the full effects. Third, because marijuana grows naturally throughout the United States, “purity and potency of the drug cannot be adequately controlled”.[3] Fourth, the normal procedure of using double-blind test for drugs is not available because no placebo could be used to imitate marijuana’s effects.

Barnes also identifies the strongest, or at least the most frequently used argument against the legalization of marijuana for medical use as the signal it sends about the safety of marijuana for recreational use. Joffee and Yancey extrapolate information about the possibility of adolescent recreational marijuana use by looking at adolescents’ use of alcohol and tobacco, two drugs legalized for adult recreational use but illegal for the use of minors under the age of 21 and 18 respectively. They point out that alcohol and tobacco are used by adolescents more frequently than any other drugs. They state, “Legalization of marijuana could decrease adolescents’ perceptions of the risk of use and increase their exposure to this drug”.[4]

Although opponents to the legalization of marijuana have strong arguments to support their stance, proponents of legalization also make a strong case for their positions. Carden calls the war on drugs an “economic, moral, and cultural disaster”.[5] He states that “Marijuana prohibition has been a terrible mistake that has ruined far too many lives”. Carden argues that the laws against the use of marijuana, rather than the drug itself, is the source of the problems related to marijuana use.

Medical marijuana advocates state that it helps with many medical issues but the opponents argue that there are treatments already in place to help with what marijuana can treat. Those in favor of marijuana legalization consider the practical uses of marijuana to be a legitimate reason for its legalization especially for medical use.[6] Barnes also states that the government has “an obligation to facilitate” the research concerning the possible medical benefits associated with of the use of marijuana.[7] Medical uses of marijuana include the treatment of intraocular pressure from glaucoma, nausea and vomiting (usually associated with chemotherapy), pain management, spasticity associated with multiple-sclerosis, and wasting syndrome in AIDS patients.

Safety issues

Although there are opinions that addiction level is lower or nonexistent, some believe that side effects can be very negative, such as brain cell loss, overeating, lung issues. Some believe the public may not be aware of all the health issues related to the use of marijuana and state that marijuana “can be addictive, it can diminish intelligence, it impairs driving and it can trigger anxiety and psychological illnesses”.[8] Some studies show that despite all the warnings about using marijuana, there are no major health threats to definitely rule out legalization. Morgan, Rothwell, Atkinson, Oliver, and Curran[9] found that while under the influence of marijuana, individuals exhibited an increase of state schizotypy, symptoms associated with psychosis as well as an increase in semantic priming or hyper-priming. The study showed that when no longer under the influence of marijuana, users showed no difference in levels of state schizotypy compared to the control group; however, the increased hyper-priming remained higher for the marijuana users than for that of the control group.[10] They also point to a study that links hyper-priming to creativity and suggest further studies to determine whether any correlation exist between marijuana use and creativity. Bourgois states that despite the warnings about the extreme behavioral effects of marijuana use “few significant health or behavioral threats” have been shown to actually exist.[11]

The harms caused by cannabis toxins to both physical and mental health have been widely documented. Some of the most recent research is summarized in this section. Over 1,500 toxic chemicals have been identified in the smoke of cannabis, including carbon monoxide, carcinogens and irritants. These all greatly affect the body’s respiratory and cardiovascular systems in a similar manner to the known effects of smoking tobacco. A study of marijuana smoke found ammonia at levels up to 20-fold greater than that found in tobacco, hydrogen cyanide at concentrations 3-5 times those in tobacco smoke, and confirmed the presence of known carcinogens and other chemicals implicated in respiratory diseases.[12]

In a paper entitled Chronic Toxicology of Cannabis[13], Reece et al states that there is evidence for the implication of cannabis in various psychiatric, respiratory, cardiovascular, and bone pathologies. The reports of social disruption, as a consequence of widespread cannabis use within a number of communities, are of substantial concern. The features associated with chronic cannabis use imply that a clear public health cautionary message is warranted along the lines employed for other environmental intoxicants such as tobacco, which should be targeted strategically to young and otherwise vulnerable populations. Chronic cannabis use also has oncogenic, teratogenic and mutagenic effects, all of which depend upon dose and duration of use. The following facts, as listed in the same reference, are not controversial in that they are settled in the epidemiological and scientific literature:

• The long-term smoking of cannabis is associated with numerous respiratory complaints and numerous psychiatric disorders.
• Cannabinoids are known to shut down synaptic transmission between neurons which accounts for its sedative effects.
• Since synaptic function and traffic intensity rates are coupled to synaptic structure and
• Neuronal network architecture, cannabis use in key developmental periods is believed to alter brain microstructure and network function accounting for the various neuropsychiatric deficits, especially when cannabis exposure occurs in key developmental periods such as adolescence and intrauterine growth.
• Cannabis is associated with driving under the influence of cannabis (DUIC) and high rates of motor vehicle accidents and fatalities.
• Adolescent cannabis use has been shown repeatedly by long-term longitudinal human studies to be associated with a gateway effect, increasing the use of other hard drugs in later life; and of severely impairing the long-term life trajectory, reducing the attainment of normal life goals such as marriage, and long-term productive employment.

Other effects which have been demonstrated in the literature include:

• effects of genetic and chromosomal damage,
• damage to cellular metabolism and mitochondrial energy production,
• alteration of the appetite control mechanism,
• association with eight cancers,
• various circulatory disorders including heart attack, impaired fertility and germ cell defects,
• when exposure occurs in utero, association with many congenital abnormalities including cardiac septal defects, anotia, anophthalmos, gastroschisis and anencephaly.

Cost and substitutions

Concerning the cost, although marijuana is cheaper than some medicine, some argue that depending on the dose and quality marijuana can get more expensive. Relatively cheap marijuana would be a uniquely economical intoxicant. For only one-half dollar per day, a pothead could nurse a whopping ten-joint per day habit. It may be doubted whether public opinion would tolerate so low a price for marijuana. On one hand, it would invite extensive abuse. Parents would no doubt object against making a serious marijuana habit so affordable for their young. Moreover, cheap pot would also pose a serious challenge to the alcohol industry, a powerful political interest, whose products are over ten times as expensive. In order to make legalization politically palatable, it would almost certainly be necessary to raise the price through taxation or regulation. In a legalized market, the easiest way to maintain marijuana prices would appear to be through some form of excise tax, as presently imposed on alcohol and tobacco. Another way to control the market would be to tax or regulate cultivation.

The opponents claim that there are many pills made from marijuana which are legal, but there is also the argument that the effects are not as strong as when smoking it. According to Barnes, marijuana is no longer necessary with the advent of synthetic TCH. On the other hand, as THC, the component responsible for marijuana’s “high,” is sold as the prescription pill, but people who use the pill find that it commonly takes an hour or more to work, while vaporized or smoked marijuana takes effect almost instantaneously. They also find that the dose of THC they have absorbed (in the pill form) is often either too much or too little. Marijuana contains about 80 active cannabinoids in addition to THC. Research has shown that these other compounds contribute significantly to marijuana’s therapeutic effects. For example, cannabidiol (CBD) has been shown to have anti-nausea, anti-anxiety, and anti-inflammatory actions, as well as the ability to protect nerve cells from many kinds of damage. CBD also moderates THC’s effects so patients are less likely to get excessively “high.” Other cannabinoids naturally contained in marijuana have also shown significant therapeutic promise. Finally, thousands of patients continue to break the law to obtain marijuana, even though they could legally use the THC pill. Why would they risk arrest and prison to use something that doesn’t work?

CONCLUSION

In conclusion, the following facts argue in favor of the opponents. The long term smoking of cannabis is associated with numerous respiratory complaints and numerous psychiatric disorders. Cannabinoids are known to shut down synaptic transmission between neurons which accounts for its sedative effects. Since synaptic function and traffic intensity rates are coupled to synaptic structure and neuronal network architecture, cannabis use in key developmental periods, such as adolescence and intrauterine growth, is believed to alter brain microstructure and network function accounting for the various neuropsychiatric deficits. Cannabis is associated with driving under the influence of cannabis (DUIC) and high rates of motor vehicle accidents and fatalities. Long-term longitudinal studies have repeatedly shown that adolescent cannabis use is associated with a gateway effect increasing the use of other hard drugs in later life, and of severely impairing the long-term life trajectory reducing the attainment of normal life goals such as marriage, and continuing productive employment. Other effects which have been demonstrated in the literature include genetic and chromosomal damage, harm to cellular metabolism and mitochondrial energy production, alteration of the appetite control mechanism, association with eight cancers, various circulatory disorders including heart attack, and impaired fertility and germ cell defects.

Many health and medical associations support medical access to marijuana but do not advocate broader reform of the drug laws. In fact, half of the people who support medical marijuana actually oppose the full legalization of marijuana. While spending time and money testing and producing pharmaceutical versions of these chemicals may someday produce useful drugs, it does nothing to help patients now. Given the current state of research, it will be years before any new cannabinoid drugs reach pharmacy shelves. Why should seriously ill patients have to risk arrest and jail for years while awaiting new pharmaceuticals which may or may not ever be available? Also, a large and growing body of scientific evidence demonstrates that the health risks associated with marijuana are actually relatively minor. Besides that, all medicines have some negative side effects. Therefore, the question is this: Do the benefits outweigh the risks for an individual patient? Such decisions should be made by doctors and patients, not the criminal justice system. Patients should not be criminalized if their doctors believe that the benefits of using medical marijuana outweigh the risks.

REFERENCES

1. Barnes, R. E. (2000). Reefer madness: Legal & moral issues surrounding the medical prescription of marijuana. Bioethics, 14(1), 16-41.

2. Baxter, J.H., Baker, H. M., Reece, S. A. (2013). The Use of Cannabis for Medical Purposes. The journal of global drug policy and practice, vol. 7, no. 2.

3. Bourgois, P. (2008). The mystery of marijuana: Science and the U. S. war on drugs. Substance Use and Misuse, 43(3/4), 581-583, p. 581.

4. Carden, A. (2012). Isn’t it high time we legalize marijuana? Forbes, August 16.

5. Hendricks, L., et al. (2013). The Pros and Cons of. Marijuana. National Forum Journal of Counseling and Addiction, 2 (1).

6. Joffe, A., Yancy, W. S. (2004). Legalization of marijuana: Potential impact on youth. Pediatrics, 113 (6), 632-638.

7. Morgan, C. J., et al. (2010). Hyper-priming in cannabis users: A naturalistic study of the effects of cannabis on semantic memory Psychiatry Research, 176(2-3), 213-218.

8. Reece, S. A. (2009). Chronic toxicology of cannabis. Clinical toxicology, Vol. 47, No. 6., 517-524.

9. Sieczkowski, C. (2012). Washington may approve marijuana sales for customers over 21 in nation’s first state-licensed shops. The Huffington Post, October 12.

[1] Joffe, A., Yancy, W. S. (2004). Legalization of marijuana: Potential impact on youth. Pediatrics, 113 (6), 632-638.

[2] Baxter, J.H., Baker, H. M., Reece, S. A. (2013). The Use of Cannabis for Medical Purposes. The journal of global drug policy and practice, vol. 7, no. 2.

[3] Barnes, R. E. (2000). Reefer madness: Legal & moral issues surrounding the medical prescription of marijuana. Bioethics, 14(1), 16-41, p. 24.

[4] Joffe, A., Yancy, W. S. (2004). Legalization of marijuana: Potential impact on youth. Pediatrics, 113 (6), 632-638, p. 632.

[5] Carden, A. (2012). Isn’t it high time we legalize marijuana? Forbes, August 16.

[6] Hendricks, L., et al. (2013). The Pros and Cons of. Marijuana. National Forum Journal of Counseling and Addiction, 2 (1).

[7] Barnes, R. E. (2000). Reefer madness: Legal & moral issues surrounding the medical prescription of marijuana. Bioethics, 14(1), 16-41, p. 38.

[8] Sieczkowski, C. (2012). Washington may approve marijuana sales for customers over 21 in nation’s first state-licensed shops. The Huffington Post, October 12.

[9] Morgan, C. J., et al. (2010). Hyper-priming in cannabis users: A naturalistic study of the effects of cannabis on semantic memory function. Psychiatry Research, 176(2-3), 213-218.

[10] Ibid.

[11] Bourgois, P. (2008). The mystery of marijuana: Science and the U. S. war on drugs. Substance Use and Misuse, 43(3/4), 581-583, p. 581.

[12] Baxter, J.H., Baker, H. M., Reece, S. A. (2013). The Use of Cannabis for Medical Purposes. The journal of global drug policy and practice, vol. 7, no. 2.

[13] Reece, S. A. (2009). Chronic toxicology of cannabis. Clinical toxicology, Vol. 47, No. 6., 517-524