Medical Marijuana: Government Restrictions vs. Medical Necessity

    It is often called pot, weed, Mary Jane, reefer, grass, ganja. Marijuana is a greenish grey mixture of the dried, shredded mix of leaves, flowers, stems, and seeds, usually from Cannabis sativa or Cannabis indicia plant, according to samhsa.org. Both are common subspecies of the hemp plant, which is common throughout the world. According to the National Institute on Drug Abuse marijuana contains over 60 chemical compounds mainly delta 9, also called tetrahydrocannabinol.

    Florida will soon be voting on Amendment 2 which determine the legalization of medical marijuana. Amendment 2 states, "Allows medical use of marijuana for individuals with debilitating medical conditions as determined by a licensed Florida physician. Allows caregivers to assist patients’ medical use of marijuana. The Department of Health shall register and regulate centers that produce and distribute marijuana for medical purposes and shall issue identification cards to patients and caregivers." Florida requires a supermajority (60%) for a voter initiated ballot to pass. While six states passed legislation by a simple majority (greater than 50%), since 1999 five states have passed with supermajority. Florida’s Office of Economic and Demographic Research(ODER) estimates for patients, if Amendment 2 passes, are extremely low. Amendment 2 seems likely to pass, but the OEDR's low estimates will leave many Floridians 'out in the cold'.
    According to US National Library of Medicine and the National Institutes of Health, the use of cannabis as a medical agent has a long history in both folk and professional medicine. Its modern era began in 1839, when O’Shaughnessy described the use of crude cannabis preparations in India for the treatment of muscle spasms and convulsions. According to an excerpt from Harold Kalant's book "Drugs Society and Personal Choice", later observations recorded its use in Indian folk medicine for the relief of a wide variety of disease symptoms, including pain, diarrhea, fever, anxiety, sleeplessness and lack of appetite. O’Shaughnessy sent samples of Indian cannabis to London, where they were analyzed and used to prepare standardized extracts that were incorporated into the British and American pharmacopoeias of recognized drugs and medicinal preparations, leading to the wide use of cannabis in medical practice in many parts of the world.
There are two forms of marijuana have been used for Medical purposes:
1.) A synthetic form, dronabinol (Marinol), which is taken orally.
2.) Smoked marijuana.
    Both forms contain the psychoactive ingredient THC. Of the two forms, smoked marijuana was believed to be more effective than the synthetic oral form and could also be sold for recreational purposes.
    In the U.S., the drug’s medical use was cut down in 1970, when the Controlled Substance Act listed marijuana as a substance with no medical value and with a high potential for abuse. In June 2011,the Drug Enforcement Administration (DEA) denied a petition to reschedule the controversial case of medical marijuana. The Department of Justice declared that selling, cultivation and distribution of marijuana is against federal law and that individuals engaging in these activities are subject to enforcement actions.
    Marijuana is not just a problem in the United States, it also it talked about frequently in other countries around the world. Cannabis is illegal in India by Narcotics Drugs and Psychotropic Substances Act. Cannabis that is sold as ‘Bhang’ belongs to the cannabis indica variety, which is different from cannabis sativa (the amounts of THC varies)which in illegally distributed globally. According to criminal.findlaw.com, penalties for simple possession range from a fine of less than $100 and/or a few days in jail to thousands of dollars and several years in state prison for the same offense. Imprisonment can be waived if the offender opts for rehabilitation and anti-addiction treatments.
    The Compassionate Care Center in New York says, marijuana and cancer have focused both on the ability of medical marijuana to alleviate symptoms of chemotherapy and the potential for cannabinoids to reduce the growth of certain types of cancer. Cannabinoids exert alleviating effects in cancer patients by preventing nausea, vomiting and pain and by stimulating appetite. Cannabinoids may stop many kinds of cancers from growing and spreading, including pancreatic, lung, leukemic, melanoma, oral, lymphoma and other kinds of cancer. In accordance to multiple sclerosis: effectiveness of medical marijuana and its derivatives in reducing spasticity and pain in multiple sclerosis (MS) patients. Medical marijuana has also been effective in treating both the symptoms of HIV/AIDS and the side effects of some of the antiretroviral medications used to treat it.
     According to preventdisease.com, medical marijuana has been able to treat more than 300,000 cases of migraines that conventional medicine couldn't. Numerous studies have affirmed the pain relieving effects of medical marijuana. According to Americans for Safe Access, recent research suggests that cannabis may also be useful for patients with irritable bowel syndrome or Crohn’s disease. Medical marijuana also has an acute bronchodilator effect in both asthmatic and non-asthmatic individuals. Medical marijuana is generally safe and well-tolerated, though, like any medication, it poses some risks.
    Much like many medication commercial, read these risks aloud in a monotone voice from the fine print below:
    Medical marijuana may have effects on the respiratory system or impair psychomotor skills. Frequent marijuana use can seriously affect your short-term memory, impair your cognitive ability, and diminish your decision making ability. Medical marijuana carries a risk of abuse and addiction. Studies have shown that marijuana tar contains 50% more phenols than tobacco tar. Marijuana (smoked) can also be contaminated by microorganisms and fungi, which can cause possible infections.
    According to Peter A. Clark, the author of "The Ethics of Medical Marijuana: Government Restrictions vs. Medical Necessity", the "administration" believes that marijuana is illegal drug which remains unproven in terms of safety or effectiveness. They contend that marijuana is a ‘gateway drug’ that leads to more serious drug use. Legalization of marijuana for medical purposes will send the wrong message to the public, and in particular to the children, that marijuana is acceptable for recreational use and even beneficial.
    The problem with that argument is that "the administration" has no say and cannot obstruct a patient's decisions especially if it is a lawful act that is approved by a physician. Patients have the right to expect from their physicians, full disclosure and discussion of all available treatment options. Denying a patient knowledge of and access to a therapy that relieves pain and suffering, especially when the patient has a terminal disease, violates the basic duty of a physician. The basic question is does the value of relieving pain and suffering outweigh the evil of the potential harmful effects of the smoke and the possibility of a scandal?
    Seriously ill patients have the right to effective therapy. To deny them access to such therapies is to deny them the dignity and respect all persons deserve. Physicians have the medical responsibility to provide adequate relief from both pain and suffering in order to give their patients an acceptable quality of life. Failure to offer an effective therapy would violate the basic ethical principle of non-maleficence. To allow a patient to suffer needlessly, when this suffering can be relieved, is like doing direct harm to the patient. As future pediatrician this hits close to home because, it should always be your responsibility to, first, do no harm.
     The possible damage to an individual’s lungs is a legitimate health concern, however the patients who would benefit from the smoked marijuana are suffering from terminal illness and the treatments they are undergoing also have toxic effects. The point is that benefits of the treatment outweighs the burden. The focus should be on encouraging the government to direct its research resources towards the development of alternative methods of delivering cannabinoids in the form of patches, capsules and inhalers.
     The administration’s concern is that legalizing medical marijuana could lead to the possibility of more serious drug use. But this has not occurred in other prescription psychoactive drugs (e.g. morphine, codeine) and there is no evidence that it would occur with marijuana. Unless marijuana is regulated by the proper medical and pharmaceutical authorities, there is the possibility that the needy patients will resort to black market marijuana. Which could lead to legal prosecution and could jeopardize their health and safety.
    Continued research is needed to maximize its therapeutic effects and minimizing its adverse effects and I will continue to research this even deeper and in the future  will most likely look at it from a more psychological and moral standpoint rather than just strictly medical and ethical perspectives.