Top 10 Pros & Cons
Should marijuana be a medical option?






1. Physician Perspectives on Marijuana's Medical Use

"There is now promising research into the use of marijuana that could impact tens of thousands of children and adults, including treatment for cancer, epilepsy and Alzheimer's, to name a few. With regard to pain alone, marijuana could greatly reduce the demand for narcotics and simultaneously decrease the number of accidental painkiller overdoses, which are the greatest cause of preventable death in this country... Marijuana is a medicine, that should be studied and treated like any other medicine."

Sanjay Gupta, MD
Medical Correspondent for CNN
"It's Time for a Medical Marijuana Revolution," cnn.com
Apr. 20, 2016


"[T]here really is no such thing as medical marijuana... The dangers and risks of marijuana use are well-known by the scientific community, even if they are downplayed by corporate interests wishing to get rich off of legalization. Apathy, lost productivity, addictive disease, deterioration in intellectual function, motor vehicle accidents, and psychosis are all among the negative outcomes. All from a product that has no demonstrated benefit. For nearly all conditions for which marijuana has purported benefits, we already have existing medications - safe medications - demonstrated to have value."

Stuart Gitlow, MD, MPH, MBA
Former President of the ASAM Board of Directors
Testimony to the Senate Committee on the Judiciary
July 13, 2016


 
2. Medical Organizations' Opinions on Medical Marijuana

"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...

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
Confirmed as current position on Aug. 18, 2016


"The American Academy of Ophthalmology - the world's largest association of eye physicians and surgeons - is reminding the public that it does not recommend marijuana or other cannabis products for the treatment of glaucoma. Based on analysis by the National Eye Institute and the Institute of Medicine, the Academy finds no scientific evidence that marijuana is an effective long-term treatment for glaucoma, particularly when compared to the wide variety of prescription medication and surgical treatments available. Ophthalmologists also caution that marijuana has side effects which could further endanger the user's eye health."

American Academy of Ophthalmology
"American Academy of Ophthalmology Reiterates Position that Marijuana is Not Proven Treatment for Glaucoma," aao.org
June 27, 2014


 
3. US Government Officials' Views on Medical Marijuana

"I'm on record saying that not only do I think carefully prescribed medical use of marijuana may in fact be appropriate and we should follow the science as opposed to ideology on this issue, but I'm also on record as saying that the more we treat some of these issues related to drug abuse from a public health model and not just from an incarceration model, the better off we're going to be."

Barack Obama, JD
44th President of the United States
WEED 3: The Marijuana Revolution, CNN
Apr 20, 2015


"[T]here is currently sound evidence that smoked marijuana is harmful. A past evaluation by several Department of Health and Human Services (HHS) agencies, including the Food and Drug Administration (FDA), Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institute for Drug Abuse (NIDA), concluded that no sound scientific studies supported the safety or efficacy of marijuana for general medical use. There are alternative FDA-approved medications in existence for treatment of many of the proposed uses of smoked marijuana...

Accordingly, FDA, as the Federal agency responsible for reviewing the safety and efficacy of drugs, DEA as the Federal agency charged with enforcing the CSA, and the Office of National Drug Control Policy, as the federal coordinator of drug control policy, do not support the use of smoked marijuana for medical purposes."

US Food and Drug Administration (FDA)
"Inter-Agency Advisory Regarding Claims That Smoked Marijuana is Medicine," fda.gov
Apr. 20, 2006


 
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,"
Los Angeles Times
May 5, 2006


"Marijuana smoke, like tobacco smoke, is an irritant to the throat and lungs and can cause a heavy cough during use. It also contains toxic gases and particles that can damage the lungs. Marijuana smoking is associated with large airway inflammation, increased airway resistance, and lung hyperinflation, and regular marijuana smokers report more symptoms of chronic bronchitis than nonsmokers. Smoking marijuana may also reduce the respiratory system's immune response, increasing the likelihood of the user acquiring respiratory infections, including pneumonia. One study found that frequent marijuana smokers used more sick days that other people often because of respiratory illnesses."

National Institute on Drug Abuse (NIDA)
"What Are Marijuana's Effects on General Physical Health?"
drugabuse.gov
Mar. 2016


 
5. More Physician Perspectives on Medical Marijuana

"A day doesn't go by where I don't see a cancer patient who has nausea, vomiting, loss of appetite, pain, depression and insomnia. [Marijuana] is the only anti-nausea medicine that increases appetite. I could write six different prescriptions, all of which may interact with each other or the chemotherapy that the patient has been prescribed. Or I could just recommend trying one medicine."

Donald Abrams, MD
Professor of Clinical Medicine at the University of California, San Francisco
"Marijuana Is a Wonder Drug When It Comes to the Horrors of Chemo," newsweek.com
July 22, 2015


"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


 
6. Marijuana and Pain

"[R]esearch further documents the safety and efficacy of medicinal cannabis for chronic pain. Cannabis has no known lethal dose, minimal drug interactions, is easily dosed via orally ingestion, vaporization, or topical absorption, thereby avoiding the potential risks associated with smoking completely...

Natural cannabis contains 5-15% THC but also includes multiple other therapeutic cannabinoids, all working in concert to produce analgesia..."

Gregory T. Carter, MD
Co-director, MDA/ALS Center,
University of Washington Medical Center
"The Argument for Medical Marijuana for the Treatment of Chronic Pain," Pain Medicine
May 2013


"There is no scientific evidence that the effect of marijuana in diminishing pain is related to any specifically identified analgesic effect. That it unequivocally does produce short-term CNS [central nervous system] euphoria, which alleviates some pain centrally, best explains its mechanism for both reducing pain short-term during the period of influence as well as causing the euphoria associated with addictive drugs of abuse. Additionally, there is no scientific evidence that long-term use of medicinal marijuana is either effective or safe for the treatment of chronic pain... [T]here are many analgesic medications available to patients and physicians that have been proven and established in the practice of medicine, through sound scientific clinical research, to be more effective and safer for the treatment of chronic pain than medical marijuana."

Gregory Bunt, MD
"Marijuana Is Not Good Medicine," Pain Medicine
May 2013


 
7. Marijuana vs. Marinol

"Opponents of medical marijuana often point to dronabinol, the synthetic version of one of marijuana's active ingredients that is available in pill form. The use of only one active ingredient makes dronabinol less effective than medical marijuana. Many ailments respond better to a combination of marijuana's active ingredients rather than just one. In addition, because dronabinol is a pill, it is difficult for people with nausea and vomiting to swallow. Finally, like any medication that's swallowed, dronabinol takes a long time to digest and have its effects. Inhaled marijuana vapors can work markedly faster."

Mitch Earleywine, PhD
Associate Professor of Psychology at University at Albany at the State University of New York,
"Medical Marijuana Benefits," CBSNews.com
Mar. 5, 2009


"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"
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


"[T]he evidence clearly indicates that long-term marijuana use can lead to addiction. Indeed, approximately 9% of those who experiment with marijuana will become addicted (according to the criteria for dependence in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]. The number goes up to about 1 in 6 among those who start using marijuana as teenagers and to 25 to 50% among those who smoke marijuana daily. According to the 2012 National Survey on Drug Use and Health, an estimated 2.7 million people 12 years of age and older met the DSM-IV criteria for dependence on marijuana... There is also recognition of a bona fide cannabis withdrawal syndrome (with symptoms that include irritability, sleeping difficulties, dysphoria, craving, and anxiety), which makes cessation difficult and contributes to relapse... [E]arly and regular marijuana use predicts an increased risk of marijuana addiction, which in turn predicts an increased risk of the use of other illicit drugs. As compared with persons who begin to use marijuana in adulthood, those who begin in adolescence are approximately 2 to 4 times as likely to have symptoms of cannabis dependence within the 2 years after first use."

Nora D. Volkow, MD
Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health
"Adverse Health Effects of Marijuana Use,"
New England Journal of Medicine
June 5, 2014


 
9. "Gateway" Effect

"[T]he vast majority of people who use marijuana never progress to using other illicit drugs, or even to becoming regular marijuana consumers... The principal connection between marijuana and other illicit drugs mostly involves the nature of the market, not the nature of the high. In the Netherlands, where the marijuana market has been quasi-legal and regulated for decades, marijuana use is less prevalent than in the United States, and those who do consume marijuana are less likely to use other illicit drugs... Perhaps most important, new evidence now indicates that the proliferation of medical marijuana laws and dispensaries around the United States is strongly associated with fewer people dying from overdoses involving heroin and pharmaceutical opioids. The most likely reason is that people are finding marijuana more helpful than opioids in managing different types of pain."

Ethan Nadelmann, JD, PhD
Executive Director of Drug Policy Alliance
"Fears of Marijuana's Gateway Effect Vastly Exceed the Evidence," nytimes.com
Apr. 26, 2016


"Marijuana use is positively correlated with alcohol use and cigarette use, as well as illegal drugs like cocaine and methamphetamine. This does not mean that everyone who uses marijuana will transition to using heroin or other drugs, but it does mean that people who use marijuana consume more, not less, legal and illegal drugs than do people who do not use marijuana.

People who are addicted to marijuana are three times more likely to be addicted to heroin.

The legalization of marijuana increases availability of the drug and acceptability of its use. This is bad for public health and safety not only because marijuana use increases the risk of heroin use."

Robert L. DuPont, MD
President of the Institute for Behavior and Health
"Marijuana Has Proven to Be a Gateway Drug," nytimes.com
Apr. 26, 2016


 
10. Medical Marijuana Use by Kids

"The average number of anti-epileptic drugs (AEDs) tried before using cannabidiol-enriched cannabis was 12. Sixteen (84%) of the 19 parents reported a reduction in their child's seizure frequency while taking cannabidiol-enriched cannabis. Of these, two (11%) reported complete seizure freedom, eight (42%) reported a greater than 80% reduction in seizure frequency, and six (32%) reported 25-60% seizure reduction. Other beneficial effects included increased alertness, better mood and improved sleep. Side effects included drowsiness and fatigue. Our survey shows that parents are using cannabidiol-enriched cannabis as a treatment for children with treatment-resistant epilepsy."

Brenda E. Porter, MD et al.
Associate Professor, Stanford University Medical Center
Director of Clinical Research, Privateer Holdings
"Report of a Parent Survey of Cannabidiol-Enriched Cannabis Use in Pediatric Treatment-Resistant Epilepsy," Epilepsy & Behavior
Dec. 29, 2013


"Marijuana use in pediatric populations remains an ongoing concern, and marijuana use by adolescents has known medical, psychological, and cognitive side effects. Marijuana alters brain development, with detrimental effects on brain structure and function, in ways that are incompletely understood. Furthermore, marijuana smoke contains tar and other harmful chemicals, so it cannot be recommended by physicians."

American Academy of Pediatrics
"The Impact of Marijuana policies on Youth: Clinical, Research, and Legal Update,"
Technical report
Mar. 2015