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DOES MARIJUANA HAVE MEDICAL USES?

By Dr. George Roberson/FOR YOUR HEALTH
Saturday, November 14, 2009 9:29 PM CST

Q: Is there a medical use for marijuana, and if so why is there so much opposition to using it?

A: There is evidence that marijuana has been used medicinally for 4,000 years or more. Even in the United States it was part of the published Pharmacopeia until at least 1942. It was legally available for medical use until 1970 when Congress passed the Controlled Substances Act. Thereafter it was classified as a schedule 1 controlled substance. It is thought to have a high potential for abuse and no medically recognized use had been established.

In 1996 the Compassionate Use Act was passed by popular vote in California. Since then a number of states have sought to make marijuana available for medical conditions. This is usually restricted to qualifying disease states.

Altogether, four states voted by popular referendum or passed laws to provide some degree of legal sanction for the medical use of marijuana. Only in one state (South Dakota in 2006) has a state referendum on this issue failed.

Thirteen other states including Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington have all passed some type of referendum allowing the use of marijuana for medicinal purposes. Its use is more active in some states than in others.

The American Academy of Family Physicians opposes the medical use of marijuana except under strict medical supervision and control and for only specific medical indications.

Even though all these states have tried to liberalize the use of marijuana for medical purposes, the federal government remains firm in its stance that marijuana is a schedule 1 controlled substance and is monitored by the US Drug Enforcement Administration (DEA). The US Food and Drug Administration is also opposed to the medical use of marijuana.

In 2005 a decision was handed down by the U.S. Supreme Court that upheld the right of the federal government to maintain the schedule I classification. The court has also implied that the state decisions regarding marijuana should not be preempted by the federal law. The U.S. Attorney General has indicated that the DEA would not raid dispensaries of marijuana. (Yes I think it's confusing also.)

I suspect the Obama Administration will look more favorably on the issue of medical marijuana than previous administrations.

Although there is a strong suggestion that marijuana is effective in the treatment of chronic pain, spasticity and severe nausea, there are virtually no studies on its medical effectiveness. In addition there are long lists compiled, anecdotally, of effectiveness in such conditions as alcoholism, arthritis, bipolar disorder, asthma, hypertension and the list goes on.

Like any drug there would be reasons to be concerned about the safety profile and any adverse effects. There have been reported cardiovascular and psychogenic effects. Long-term effects of smoking such as lung disease and cancers are unknown. This will take years to document.

It is not ever likely to be freely available for public consumption. Even where legalized, it will remain under strict scrutiny and available by prescription only.

Dr. George Roberson is a general, thoracic, vascular surgeon in Pine Bluff and medical director at Jefferson Regional Medical Center. To have a medical related question answered, write to Medical Reviews, P.O. Box 2916, Pine Bluff, Ark. 71611.

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