Marijuana has been both steadily decriminalized and legalized for medical purposes in the United States since the Compassionate Use Act of 1996, where Californians voted to allow the use of marijuana with the guidance of a physician for the alleviation of symptoms for various medical diagnoses. Since that time there has existed a battle between the federal and State governments stemming from the federal governments blunt opposition towards the substance. Nevertheless, other States have since followed California’s lead and have also legalized its use for medical purposes.
Whether or not marijuana has therapeutic effects is becoming more evident with the coming years. Clearly, it has physiologic effects on both the mind and the body. Its active ingredient, tetrahydrocannabinol (THC), is a cannabinoid that exerts its effects on the brain through its binding to cannabinoid receptors. Cannabinoids are neurotransmitters, and like other neurotransmitters can be used for therapeutic effects. For example, the neurotransmitter dopamine is used to treat Parkinson’s disease (in the form of L-Dopa), which is caused by a deficiency of dopamine within the brain, and opiods, such as morphine, are used for analgesic properties. THC’s neurotransmitter effects show potential for future therapies and the molecule could help create similar drugs with different properties.
Although there exists this potential for marijuana to be used pharmacologically, we still do not know enough about it for it to be ethically made legal. All FDA-approved drugs that go on the market are tested through Phase I, II and III clinical trials before they are approved for release. These phases are extremely important as they help determine not only side effects but also dosages and other vital information required for optimum benefits and minimum risks. Without this sort of knowledge, patients can be harmed from over or under-usage, unexposed side effects, or potential adverse combinations with other pharmaceuticals.
These sorts of clinical trials, and large long-term studies have never been performed for marijuana. Ultimately, the federal government is to blame for this. As I write this, marijuana is a Schedule I substance according to the Controlled Substance Act that came into effect in 1970, along with heroin, cocaine, peyote and a multitude of extremely detrimental substances. Schedule I substances are defined to have “no current medical use.” If the United States government is to remain consistent with their legislature, they should surely drop marijuana to a Schedule II drug because research has shown it to have a multitude of potential health benefits, as well as side-effects.
The problem with marijuana being a Schedule I substance is that drugs of this legal caliber have a much stricter set of rules and circumstances for clinical testing. It is much more difficult for a research institution to study the effects of a Schedule I drug than it is for it to study a completely new drug synthesized in the laboratory. By definition, the same laws for researching heroin apply to researching marijuana, but researching a cholesterol-lowering drug or an anti-depressant is legally much easier. What this ultimately leads to is an inability for academia to research marijuana and study its effectiveness and proper dosages.
To counter the federal governments rigid stance on marijuana, 14 States have broken accordance with federal laws and allowed marijuana to be legal for medicinal uses anyway. This has created a sticky situation where the federal government is inconsistent with its own laws by refusing to reclassify drugs as new evidence deems them therapeutic, and individual States counteract this with their own inconsistency by allowing drugs with inadequate research confirming their efficacy to be medicinally legalized. Two wrongs don’t make a right. On top of all of this is the indecency of physicians who prescribe marijuana with inadequate clinical evidence to do so.
The lack of proper research on medical marijuana is evident through the completely different dosages that individual States recommend for their patients. A recent New England Journal of Medicine article about this very same subject has detailed information about the inconsistencies of marijuana dosing between different States. For example, Alaska allows patients a maximum of 1 ounce per month but Washington State allows 24 ounces and as high as 15 personal plants. Furthermore, the potency and quality of the plants themselves are undetermined and unregulated. Obviously, such guidelines are not based on any resounding proof or evidence of efficacy but rather politics alone. This exemplifies a completely unscientific approach that is necessary in modern medicine.
As of right now, medical marijuana is an alternative medicine that puts not only the patient and the doctor, but entire States, on thin ice legally. More importantly, however, if marijuana is to be used as a prescribed medicine it has to be researched as intensively as other drugs on the market. To do this requires a change in its classification from a Schedule I to a Schedule II drug by the federal government. Until then, its usage for medical purposes will continue to be unethical and potentially dangerous to patients.