Medical Marijuana

ProCon.org




Last updated on: 5/6/2009 3:06:00 PM PST


Top 10 Pros and Cons
Should marijuana be a medical option?
The PRO and CON statements below give a five minute introduction to the debate on medical marijuana.
(Read more information about our one star to five star Theoretical Expertise System.)
1. Physician Perspectives on
Marijuana's Medical Use
2. Medical Organizations' Opinions
3. US Government Officials' Views
4. Health Risks of Smoked Marijuana
5. Treating AIDS with Marijuana
6. Marijuana use for the Terminally Ill
7. Marijuana vs. Marinol
8. Addictiveness of Marijuana
9. "Gateway" Effect
10. Medical Marijuana Debate and Its
Effect on Youth Drug Use
PRO Medical Marijuana CON Medical Marijuana
1. Physician Perspectives on Marijuana's Medical Use
"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."
-- Joycelyn Elders, MD
Former US Surgeon General
Editorial, Providence Journal
Mar. 26, 2004
"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."
-- Bill Frist, MD
Former US Senator (R-TN)
Correspondence to ProCon.org
Oct. 20, 2003

2. Medical Organizations' Opinions
"ACP urges review of marijuana's status as a
schedule I controlled substance and its
reclassification into a more appropriate schedule,
given the scientific evidence regarding
marijuana's safety and efficacy in some clinical
conditions...

"In an effort to determine whether marijuana, or
drugs derived from marijuana, might be effective
as a glaucoma treatment, the National Eye
Institute (NEI) supported research studies
beginning in 1978... However, none of these
studies demonstrated that marijuana -- or any of
its components -- could lower IOP [intraocular

ACP strongly supports 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. Similarly, ACP strongly urges
protection from criminal or civil penalties for
patients who use medical marijuana as permitted
under state laws."
-- American College of Physicians
"Supporting Research into the Therapeutic Role
of Marijuana," acponline.org
Feb. 15, 2008
pressure] as effectively as drugs already on the
market. In addition, some potentially serious side
effects were noted, including an increased heart
rate and a decrease in blood pressure in studies
using smoked marijuana.

The identification of side effects from smoked
marijuana, coupled with the emergence of highly
effective FDA-approved medications for
glaucoma treatment, may have led to diminished
interest in this research area."

-- National Eye Institute
"Glaucoma and Marijuana Use," nei.nih.gov
Mar. 17, 2009
3. US Government Officials' Views
"The evidence in this record [9-6-88 ruling]
clearly shows that marijuana has been accepted
as capable of relieving the distress of great
numbers of very ill people, and doing so with
safety under medical supervision. It would be
unreasonable, arbitrary and capricious for DEA
to continue to stand between those sufferers and
the benefits of this substance in light of the
evidence in this record."
-- Judge Francis L. Young
DEA Administrative Law Judge
Administrative ruling on Petition to Reschedule
Marijuana
Sep. 1988
"Smoked marijuana damages the brain, heart,
lungs, and immune system. It impairs learning
and interferes with memory, perception, and
judgment. Smoked marijuana contains cancer-
causing compounds and has been implicated in
a high percentage of automobile crashes and
workplace accidents."
-- John Walters
Director, Office of National Drug Control Policy
Syndicated editorial
Mar. 2002

4. Health Risks of Smoked Marijuana
"[T]here is very little evidence that smoking
marijuana as a means of taking it represents a
significant health risk.
Although cannabis has been smoked widely in
Western countries for more than four decades,
there have been no reported cases of lung
cancer or emphysema attributed to marijuana.
I suspect that a day's breathing in any city with
poor air quality poses more of a threat than
inhaling a day's dose -- which for many ailments
is just a portion of a joint -- of marijuana."
-- Lester Grinspoon, MD
Emeritus Professor of Psychiatry
Harvard Medical School
"Puffing Is the Best Medicine,"
"3-4 Cannabis cigarettes a day are associated
with the same evidence of acute and chronic
bronchitis and the same degree of damage to the
bronchial mucosa as 20 or more tobacco
cigarettes a day.
Cannabis smoking is likely to weaken the
immune system. Infections of the lung are due to
a combination of smoking-related damage to the
cells lining the bronchial passage and
impairment of the principal immune cells in the
small air sacs caused by cannabis."
-- British Lung Foundation
"Smoking Gun: The Impact of Cannabis Smoking
on Respiratory Health,"
a publicly disseminated report
Nov. 2002

Los Angeles Times
May 5, 2006
5. Treating AIDS with Marijuana
"Patients receiving cannabinoids [smoked
marijuana and marijuana pills] had improved
immune function compared with those receiving
placebo. They also gained about 4 pounds more
on average than those patients receiving
placebo."
-- Donald Abrams, MD, et al.
"Short-Term Effects of Cannabinoids in Patients
with HIV-1 Infection,"
Annals of Internal Medicine
Aug. 19, 2003
"The most compelling concerns regarding
marijuana smoking in HIV/AIDS patients are the
possible effects of marijuana on immunity.

Reports of opportunistic fungal and bacterial
pneumonia in AIDS patients who used marijuana
suggest that marijuana smoking either
suppresses the immune system or exposes
patients to an added burden of pathogens.

In summary, patients with preexisting immune
deficits due to AIDS should be expected to be
vulnerable to serious harm caused by smoking
marijuana."
-- Institute of Medicine Report
Marijuana and Medicine: Assessing the Science
Base
Mar. 1999

6. Marijuana For the Terminally Ill
"Consumer Reports believes that, for patients
with advanced AIDS and terminal cancer, the
apparent benefits some derive from smoking
marijuana outweigh any substantiated or even
suspected risks.
In the same spirit the FDA uses to hasten the
approval of cancer drugs, federal laws should be
relaxed in favor of states' rights to allow
physicians to administer marijuana to their
patients on a caring and compassionate basis."
-- Consumer Reports
Editorial
May 1997
"[T]he use of marijuana [for the terminally ill] can
no longer be considered a therapeutic
intervention but one of several procedures used
to ease the ebbing of life of the terminally ill.
But for this purpose doctors should prescribe
antiemetic and analgesic therapies of proven
efficacy, rather than marijuana smoking.
This therapeutic course is not based on
bureaucratic absolutism, political correctness, or
reflexive ideology - but on scientific knowledge
and the humane practice of medicine."
-- Gabriel Nahas, MD, PhD
Editorial, Wall Street Journal
Mar. 1997

7. Marijuana vs. Marinol
"There are really no other medications that have
the same mechanisms of action as marijuana.
Dronabinol (Marinol) is available by prescription
in capsules, but has the distinct disadvantage of
containing only synthetic delta-9-
tetrahydrocannabinol (THC) which is only one of
many therapeutically beneficial cannabinoids in
the natural plant."
-- Gregory T. Carter, MD
Co-director, MDA/ALS Center,
"Marinol differs from the crude plant marijuana
because it consists of one pure, well-studied,
FDA-approved pharmaceutical in stable known
dosages. Marijuana is an unstable mixture of
over 400 chemicals including many toxic
psychoactive chemicals which are largely
unstudied and appear in uncontrolled strengths."
-- California Narcotics Officers Association
Official policy statement "The Use of Marijuana
as a Medicine"

University of Washington Medical Center
Muscular Dystrophy Association
website article
Oct. 2003
Oct. 31, 2005
8. Addictiveness of Marijuana
"For some users, perhaps as many as 10 per
cent, cannabis leads to psychological
dependence, but there is scant evidence that it
carries a risk of true addiction. Unlike cigarette
smokers, most users do not take the drug on a
daily basis, and usually abandon it in their
twenties or thirties.
Unlike for nicotine, alcohol and hard drugs, there
is no clearly defined withdrawal syndrome, the
hallmark of true addiction, when use is stopped."
-- Colin Blakemore, PhD
Chair, Dept. of Physiology, University of Oxford
(U.K.), and
Leslie Iversen, PhD
Professor of Pharmacology, Oxford University
Editorial, The Times (U.K.)
Aug. 6, 2001
"This study validated several specific effects of
marijuana abstinence in heavy marijuana users,
and showed they were reliable and clinically
significant.
These withdrawal effects appear similar in type
and magnitude to those observed in studies of
nicotine withdrawal [...]
Craving for marijuana, decreased appetite, sleep
difficulty, and weight loss reliably changed
across the smoking and abstinence phases.
Aggression, anger, irritability, restlessness, and
strange dreams increased significantly during
one abstinence phase, but not the other."
--Alan J. Budney, PhD et al.
Professor, University of Arkansas Center for
Addiction Research
"Marijuana Abstinence Effects in Marijuana
Smokers Maintained in Their Home
Environment"
Archives of General Psychiatry
Oct. 2001

9. "Gateway" Effect
"We've shown that the marijuana gateway effect
is not the best explanation for the link between
marijuana use and the use of harder drugs.
An alternative, simpler and more compelling
explanation accounts for the pattern of drug use
you see in this country, without resort to any
gateway effects. While the gateway theory has
enjoyed popular acceptance, scientists have
always had their doubts. Our study shows that
these doubts are justified.[...]

The people who are predisposed to use drugs
and have the opportunity to use drugs are more
likely than others to use both marijuana and
harder drugs. Marijuana typically comes first
because it is more available."
-- Andrew Morral, PhD
Researcher, Rand Corporation
Press release discussing his study published in
"A new federal report released today concludes
the younger children are when they first use
marijuana, the more likely they are to use
cocaine and heroin and become dependent on
drugs as adults.[...]
Increases in the likelihood of cocaine and heroin
use and drug dependence are also apparent for
those who initiate use of marijuana at any later
age"
--US Substance Abuse and Mental Health Services
Administration (SAMHSA)
SAMHSA press release on their report;
"Initiation of Marijuana Use: Trends, Patterns
and Implications"
Aug. 28, 2002

the U.K. journal Addiction
Dec. 2, 2002
10. Medical Marijuana Debate and Its Effect on Youth Drug Use
"While it is not possible with existing data to
determine conclusively that state medical
marijuana laws caused the documented declines
in adolescent marijuana use, the overwhelming
downward trend strongly suggests that the effect
of state medical marijuana laws on teen
marijuana use has been either neutral or
positive, discouraging youthful experimentation
with the drug."
-- Mitch Earleywine, PhD
Associate Professor of Psychology, State
University of New York at Albany
Karen OKeefe, Esq.
Attorney & Legislative Analyst, Marijuana Policy
Project
Report, "Marijuana Use by Young People:
The Impact of State Medical Marijuana Laws"
Sep. 2005
"By characterizing the use of illegal drugs as
quasi-legal, state-sanctioned, Saturday afternoon
fun, legalizers destabilize the societal norm that
drug use is dangerous. They undercut the goals
of stopping the initiation of drug use to prevent
addiction.... Children entering drug abuse
treatment routinely report that they heard that
'pot is medicine' and, therefore, believed it to be
good for them."
-- Andrea Barthwell, MD
Former Deputy Director, White House Office of
National Drug Control Policy (ONDCP)
Chicago Tribune editorial
Feb. 17, 2004

PRO Medical Marijuana CON Medical Marijuana


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Statement by Dr. Carlton E. Turner


The proponents of Amendment 2 continue to disparage and misconstrue my
words and their meaning in an effort to distract from their deceptively
worded amendment. Amendment 2 will legalize pot smoking in Florida and
smoking pot is not medicine they know that and frankly this personal attack
on me is just a smokescreen.

They would have people believe that I said that smoking pot can make
someone gay. I didnt say that almost 30 years or believe it and I dont today.
Its a ridiculous charge and offensive because nothing could be further from
the truth.

The comments I made had absolutely nothing to do with sexual orientation.
Rather they were made in reference to a wide-ranging discussion about the
detrimental effects of drugs on Americas youth and at one point the issue of
smoking pot was discussed as well.

What I said then was, I have never said marijuana will make you homosexual.
I dont know why someone made a quantum jump on that.

And I will say unequivocally today that I do not believe smoking pot has
anything to do with sexual orientation.

In 1986 we were just learning about the effects of AIDS and those of us in
policy levels positions were trying to figure out why it was spreading so fast
and how to stop it.

My comments were aimed in that direction that the use of illegal drugs and
smoking pot could harm someones immune system and they could become
more vulnerable to AIDS. We didnt have a lot of research at that point in time
and part of my reference was the fact that I had toured drug-treatment
facilities and the director at some of these facilities has said that a large
percentage of their patients were also homosexual his words not mine.

So my point then was, how is the biological system affected by heavy
marijuana use? Nobody denies that smoking illegal drugs is detrimental to
ones immune system and I was simply saying we needed to get more research
and counseling for kids in these situations and help parents deal with it.

Im proud of my service to President Ronald Reagan. We came into office with
about the highest level of drug and pot smoking in the history of the United
States and every year I was there and that President Reagan was in office that
percentage decreased.
Source: Dont Let Florida Go to Pot website: dontletfloridagotopot.com
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FACTS VS. MYTHS
MYTH: The Florida amendment proposes marijuana for only serious medical conditions, such
as those suffering from cancer and AIDS.
FACT: The ballot summary states that medical marijuana is only for those with debilitating
diseases, but the ballot definition states that it will be acceptable for other conditions for which
a physician believes that the medical use of marijuana would outweigh the potential risks for a
patient. This begs the question: what constitutes a debilitating disease? Other states with
medical marijuana laws have considered migraines, anorexia, muscle spasms, and even
menstrual cramps to be a debilitating disease that is treatable by marijuanaeven though all of
these conditions are treated by commonly accepted medical treatments.
MYTH: The Florida amendment requires a physicians prescription to obtain medical marijuana
from a medically controlled pharmacy.
FACT: No prescription is required to obtain medical marijuana. A patient only needs a
physician certification from a licensed Florida physician. Physician certifications are not
formal prescriptions accepted by reputable pharmacies; they are simply written recommendations
that can be used to buy marijuana at storefront dispensaries.
MYTH: The Florida amendment requires parental consent for a minor to obtain medical
marijuana.
FACT: The amendment allows a teenager to get a recommendation for medical marijuana
without the consent of a parent. The amendment allows a teenager to get a recommendation for
medical marijuana without the consent of a parent. Although Florida law requires consent when
treating minors, the amendment gives immunity (both civil and criminal) to physicians who issue
a recommendation to use marijuana. Other states have tighter requirements when it comes to
recommending to minors, such as requiring the physician to explain the risks and harms
associated with marijuana use and/or multiple physician assessments.
MYTH: Smoking marijuana is the only way to receive the medicinal properties of the plant.
FACT: Some components in marijuana have medicinal properties, but we shouldnt smoke the
plant in order to derive those benefits; just as we do not smoke opium to get the benefits of
morphine. In states with medical marijuana laws, the average user is a male in his 30s with no
terminal illness and a history of drug abuse (TJ OConnel, Long term marijuana users seeking
medical cannabis in California). Less than 5% of registered users in states allowing medical
marijuana have cancer or AIDS (Whos Really Smoking, Save Our Society From Drugs, April
2014 ). Residents of states with medical marijuana laws have abuse and dependence rates nearly
twice as high as states with no such laws (M. Cerda, Medical marijuana laws in 50 states).
MYTH: Marijuana is harmless.
FACT: Todays marijuana is far more potent than in decades past. In the 1960s and 70s, THC
levels of marijuana smoked by baby boomers averaged around 1%, increasing to just under 4%
in 1983, and almost tripling in the subsequent 30 years to around 11% in 2011. Regular
marijuana use, started in adolescence and continued into adulthood, can result in a loss of up to 8
IQ points. (Meier, et al. Persistent cannabis users show neuropsychological decline from
childhood to midlife.)
MYTH: Marijuana legalization will help the economy.
FACT: Marijuana legalization will increase public costs. For every $1 in alcohol and tobacco tax
revenue, society loses $10 in social costs from accidents all the way to health damage (National
Institute on Alcohol Abuse and Alcoholism). States such as Colorado have projected tax revenue
of $134 million for the fiscal year but have only produced 3.5 million in the first month,
prompting the Governor to ratchet back his projection to $20 million.
Source: From May 15 news release from United for Care rebutting Vote No on 2 campaign
assertions about Amendment 2. The assertions can be viewed and read on www.voteno2.org.
The website and video are both filled with half-truths, distortions and outright lies, said Ben
Pollara, Campaign Manager of United for Care. Floridians deserve a debate based on the facts, not
disingenuous scare tactics.
\CLAIM: In reference to the availability of medical marijuana, the website asserts anyone who
wants pot will get it.
FACT: This is simply not true. In their decision placing Amendment 2 on the November ballot, the
Florida Supreme Court affirmed that only patients with debilitating diseases and medical
conditions would qualify for medical marijuana.
CLAIM: Teens will be able to legally purchase pot without their parents consent.
FACT: Wrong again. In order to purchase medical marijuana, you would need a doctors
recommendation. Under Florida law, barring a few extenuating circumstances, physicians are not
allowed to provide medical treatment to minors without parental or guardian consent, so this is a
groundless concern.
CLAIM: Amendment 2 will lead to a pill mill-like scenario in Florida. Pot docs will spring up
next to restaurants, schools, churches and supermarkets.
FACT: Look no further than the State of Florida to see that this claim is baseless. The State of
Floridas office of Economic and Demographic Research has already addressed this issue. They have
said the physician examination requirement, the application process with the Department of Health,
the regulatory structure that would be implemented by that same body and subsequent protective laws
that may be passed by the legislature would make this scenario extremely unlikely. (See pages 10 -11
of OEDR Financial Information Statement http://edr.state.fl.us/Content/constitutional -
amendments/2014Ballot/UseofMarijuanaforCertainMedicalConditions/CompleteFinancialInformation
Statement.pdf)
CLAIM: The website further contends that felons-even drug dealers would be able to qualify as
caregivers in order to administer medical cannabis to severely ill patients.
FACT: This claim requires the reader to assume that the state will implement Amendment 2 in an
irresponsible way. If the amendment is passed, the Florida Department of Health will be tasked with
issuing detailed regulations regarding qualification requirements for caregivers. During that process
United for Care will fight alongside any organization that, like us, is concerned about making sure
nobody with a record of dealing drugs can become a qualified caregiver.
Powered by over 10,000 volunteers, United for Care is the largest organization in Florida urging
voters to vote "yes" on Amendment 2. United for care is a non-partisan campaign with an on-the-
ground presence in 18 communities across the state including campaign offices in Miami, Tampa
and Orlando.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
The Great Drug Debate
By Elizabeth Kastor Washington Post Staff Writer
The Washington Post (1974-Current file); Oct 22, 1986;
pg. C1
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.