Medical marijuana: 8 questions in search of an evidence base
Starting as a seedy, possible root cause of drug abuse, marijuana has branched out and grown into a redwood-sized recreational drug industry not unlike the tobacco industry.
If marijuana-derived agents prove useful in easing human suffering, we should all champion their use, provided the medical evidence is there with the research to support it properly. But “medical” marijuana advocates have intentionally circumvented the due process of scientific investigation.
Pediatricians and other frontline healthcare professionals are often bombarded with questions regarding marijuana and its medical implications. Much is said and written about marijuana as a medicinal agent, but even after decades of press coverage, aggressive advocacy by some groups, and even development of prescription products (which, by the way, are usually not first-line treatment for any medical condition), marijuana’s true medical usefulness is still somewhat obscure. Charlotte’s Web is one such marijuana product that has gotten much press as one case study regarding an epileptic child.
If one reads or watches the lay media, the impression may be given there is a conspiracy to cover up a miracle cure for everything that ails us as medical consumers. This is compounded by mistrust of drug companies and the government by some.
All of us should think about these issues in a macro sense and investigate them further.
A few questions
An evolutionary social process has transformed the public perception of marijuana from an abused, illegal street drug into a “medically” desirable psychoactive agent, complete with tax-revenue and profit-generating possibilities. How did that come about? Where is it heading? Maybe we should ask some questions. We could start with the following:
1. If marijuana presents genuine possibilities as a breakthrough drug for treatment of many disease states, why was the process of showing safety and effectiveness through the standard [US Food and Drug Administration] investigative protocol largely circumvented? You may recall that a similarly unconventional chain of events led to the Dietary Supplement Health and Education Act of 1994 for herbals, which do not fall under the same regulations governing pharmaceutical drugs.
2. If distributing marijuana is illegal under federal law, why are states allowed to sanction the distribution of a federally illegal drug in felony quantities without enforcement?
3. The [US Drug Enforcement Administration (DEA)] falls within the administrative branch of the federal government with power to change marijuana’s classification from a schedule I drug, which would help facilitate research on its efficacy and safety as a medicinal agent. Why has the DEA not sought reclassification?
4. If marijuana is truly “medicinal,” why is it distributed through dispensaries by people who have no medical training when it carries all the dangers of side effects and drug interactions similar to those of vetted [prescription] and [over-the-counter] medications?