In Favor of the Legalization of Medical Marijuana

“You have to go to the doctor. You have to be diagnosed with the debilitating disease or medical condition. You have to get that diagnosis in writing. You have to send that written diagnosis to the Department of Health and wait for the department to send you an identification card in order to become a medical marijuana patient. You can’t just walk into your doctor’s office, walk out and buy marijuana.”  — Ben Pollara of United for Care, speaking in favor of Florida’s Amendment 2

You may be surprised by my position here, but this issue is one of those rarities where my libertarian streak shines through. Of course, it would really be apparent if I argued for the legalization of marijuana and/or other recreational drugs across the board. I’m still pondering this and gathering reports pro & con, but at this point I’m not quite ready to go that far. Too many things in the negative column. But, marijuana for legitimate medicinal purposes? Absolutely.

woman-smoking-marijuana-140121Marijuana/cannabis should not be vilified outright, simply because some people use it as a mind-altering “drug” and other, violent people make money cultivating and selling it. It is an herb, a plant put here on this planet by God. Like most things, it can be used for good or for ill. Like many plants of various sorts, it has certain uses, certain effects, and can be modified for other uses or to increase or reduce certain effects. That is part of the wonder of God’s creation, which He has provided for our benefit, and I believe He wants us to use the minds He gave us to learn and develop new things — including treatments for medical conditions.

Marijuana is still a federally illegal substance, but 23 states (plus D.C. and Guam) have medical marijuana programs and 12 more are considering it. (It is also legal for recreational use in 4 states and D.C., as of this writing.) There are many concerns about legalizing cannabis for any reason, and some believe that even legalizing it for medical use will still lead to the “unintended consequences” of long-term health and societal ills. Pot has long been considered a “gateway drug” leading to the use of more serious (i.e., more dangerous and expensive) drugs. But, marijuana has issues of its own, too. For example, it is highly addictive and causes intellectual impairment (e.g., cognitive decline, poor attention and memory, decreased IQ), which in turn lead to lower educational attainment and/or employment problems. On an even more serious note, marijuana can cause mental illness (including paranoia), sometimes leading to suicide (e.g., teens who smoke pot are 7x more likely to attempt suicide), suppression of the immune system, and lung-related health problems. Of course, the more immediate effects of marijuana use include panic/anxiety, increased heart rate (and, therefore, chance of heart attack), sensory distortion, slowed reflexes, and poor coordination, all of which can result in traffic-related and other accidents.

Most concerns, though, are really more applicable to a general legalization of marijuana, when large numbers of people would be using it, which leads to matters of broader socio-economic impact, public health & safety, employee drug-testing, etc., and appropriate laws for dealing with those who commit anything from driving a vehicle to serious crimes while under the influence and/or seeking “funding”. I am only recommending a very limited legalization for very specific purposes.

Proponents point to studies indicating, for instance, that legalization of marijuana even just for medical use has led to reduced beer sales (by 5%) and fewer traffic fatalities (by almost 9%). On the other hand, pot-positive traffic fatalities in Colorado have doubled since voters legalized pot there in late 2012. On the other other hand, overall traffic fatalities in Colorado have gone down since 2007. Keep in mind, this is in a state which has legalized marijuana for recreational use, not just medical use. Advocates also point out that a comparison of CDC surveys indicates that the feared increase in pot use by teens apparently did not happen in medical marijuana states, which makes sense if the state programs are set up in a way to ensure only those with serious medical conditions have access to the (legal) marijuana. Also, the Journal of the American Medical Association (JAMA) reports an overall 25% drop in fatalities associated with prescription drugs taken for chronic pain in states where medical marijuana is available as an alternative.

But, probably the strongest argument in favor of legalizing medical marijuana is the relief from pain and suffering that would be available to many thousands of people with serious medical conditions who now cannot find that relief, or can only at exorbitant prices, or with terrible side effects.

I suppose legal medical marijuana could lead to “long-term health and societal ills”, and the pro-cannabis activists certainly see it as a stepping stone to broader legalization. But, that is why it needs to be closely regulated and monitored, much like other controlled substances with medical applications that people can get only with a doctor’s prescription. (See quote at top of post.)

I don’t know all the details of the recently proposed Compassionate Access, Research Expansion and Respect States (CARERS) Act, but I like what I hear and think something like this is definitely needed. The bipartisan bill would legalize medical marijuana at the federal level, reclassifying marijuana from Schedule I (under the Controlled Substances Act of 1970) to Schedule II. So, while still recognizing its highly addictive nature and potential for abuse, the law would also recognize its medicinal value, grouping it with narcotics like morphine and codeine and stimulants like amphetamines and methamphetamines. Beyond that, of course, it is up to each individual state to decide how they want to handle the specifics. (See “Legality of cannabis by U.S. jurisdiction”.) But, at least those growing, selling, and buying cannabis products will no longer be raided by federal law enforcement.

On the state side, some people & programs prefer to only allow a certain number of cannabis producers to grow in their state. I think this is a mistake for economic reasons, since it smacks of state-run cartels, hinders entrepreneurship and free-market competition, and benefits an ongoing black market. Sales should be handled only by doctor’s offices, hospitals, pharmacies, and other closely-monitored, licensed dispensaries. Sales taxes on cannabis products should not be prohibitively high, complicated, or inconsistent.

Medical-Cannabis1Any state legislation to establish a legal market and infrastructure for medical marijuana must be tightly-written to ensure that it is not easy to get cannabis in just any form, from just anybody, for just about anything. Despite assurances from people like Ben Pollara (see quote above), this was the problem with Florida’s Amendment 2, which I reluctantly had to vote against in Nov. 2014. Non-smokable forms are preferable (e.g., pills, vapors, oils), but states should probably allow the smoking of raw cannabis in some cases, if it is indeed the best way to treat medical conditions, as some claim.

Any cannabis product should only be sold to an adult (age determined by state). When the patient is a minor, it should be administered or supervised by a parent, legal guardian, or medical professional. I don’t believe illegal sales/distribution or possession — either by a dispensary owner/employee, an authorized patient, or an individual who got their hands on someone else’s supply — should ever be a felony, but that should still be up to the individual states. A reasonable fine and replacement of the product (or retail price thereof) seems fair punishment for civil violations and unclassified (or lesser) misdemeanors; community service would be preferable to jail time (and is less costly for the state), except maybe for repeat offenders. By and large, these are not violent offenses, after all.

Marijuana use must be restricted to a limited list of the most serious diseases and debilitating medical conditions, the symptoms of which have been shown by authorized testing to ease from the use or application of some form of cannabis. Things like leg cramps, stress, and trouble sleeping — which some people currently use it for — should NOT be on such a list. Those which would be on it include forms of severe epilepsy (e.g. Dravet Syndrome); multiple sclerosis; Parkinson’s Disease; various cancers; glaucoma; HIV/AIDS; severe pain, severe nausea, cachexia (i.e., dramatic weight loss and muscle atrophy) from other conditions.

When dealing with extreme pain and disability from conditions like these, possibly even the threat (or promise) of death, the physical dangers and consequences of “smokin’ pot” seem negligible by comparison. I know that if I or a close relative was diagnosed with one of those debilitating conditions that has proven responsive to some form or derivative of cannabis, I would at least want the option to be available without threat of federal prosecution. Assuming production and dispensation are tightly (but fairly) controlled, I see no moral/ethical, economic, or pragmatic reason why it shouldn’t be.

UPDATE 3/17/2015: Debra J. Saunders at Townhall.com has a good article about the CARERS Act and who in the Senate (and White House?) might support it: “Medical Marijuana Bill Lost in Smoke”.

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