By Paul Armentano NORML Deputy Director
Cannabis is too dangerous to recommend as a medicine
The cannabis plant and its biologically active constituents, known as cannabinoids, possess an impressive safety profile compared to other conventional therapeutic agents. According to the National Academy of Sciences, Institute of Medicine marijuana possesses an estimated dependence liability of less than ten percent. This percentage is approximately the same as anxiolytic drugs and far lower than that of many other licit prescription drugs or recreational substances, like alcohol (15 percent) and tobacco (32 percent). Cannabinoids are relatively non-toxic and possesses no lethal overdose potential. As acknowledged by no less than the DEA’s own administrative law judge, “Marijuana, in its natural form, is one of the safest therapeutically active substances known to man.”
Medical marijuana hasn’t yet been subjected to adequate scientific study
Cannabis has been consumed for spiritual, medicinal, and recreational purposes for thousands of years, thus providing society with ample empirical evidence of the plant’s relative safety and efficacy. Moreover, despite the US government’s nearly century-long prohibition of the herb, marijuana is nonetheless among the most studied biologically active substances of modern times. A search on PubMed, the repository for all peer-reviewed scientific papers, using the term “marijuana” yields more than 21,000 scientific studies referencing the plant and/or its constituents, nearly half of which have been published within the past decade. This sum is greater than the total number of scientific papers available for ibuprofen, Ritalin, hydrocodone, Adderall, and Oxycodone combined.
There aren’t sufficient clinical trials evaluating marijuana’s safety and efficacy as a medicine
A review of the available literature identifies over 100 controlled studies worldwide, involving thousands of subjects, evaluating the safety and efficacy of cannabis or individual cannabinoids. By contrast, most FDA-approved pharmaceuticals are approved based on only two pivotal trials.
A recent review of FDA-approved medical marijuana concluded, “Based on evidence currently available the Schedule I classification (for cannabis) is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”
No major medical or health organizations support medical marijuana access
Numerous medical and health organizations – such as the American Nurses Association, the American Public Health Association, and the Epilepsy Foundation of America – support allowing qualified patients to legally access to cannabis therapy. Most practicing physicians do too. According to survey data by WebMD/Medscape, nearly 70 percent of doctors, including over 80 percent of oncologists and hematologists, acknowledge the therapeutic qualities of cannabis and 56 percent agree that it should be a legal option for patients.
Medical cannabis laws and/or dispensaries are associated with increased crime
Not so concludes a study published in 2014 the scientific journal PLoS ONE. Investigators tracked crime rates across all 50 states in the years between 1990 and 2006, during which time 11 states legalized medical cannabis access. Authors reviewed FBI Uniform Crime Report data to determine whether there was any association between the enactment of medical pot laws and rates of statewide criminal activity, specifically the number of reported crimes involving homicide, rape, robbery, assault, burglary, larceny, and auto theft. They concluded, “The central finding gleaned from the present study was that MML (medical marijuana legalization) is not predictive of higher crime rates and may be related to reductions in rates of homicide and assault. … [T]hese findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.”
Similarly, a 2012 federally commissioned study reported that the establishment of cannabis dispensaries is not associated with elevated rates of either violent crimes or property crimes. It concluded, “There were no observed cross-sectional associations between the density of medical marijuana dispensaries and either violent or property crime rates in this study. These results suggest that the density of medical marijuana dispensaries may not be associated with crime rates.”
Medical cannabis laws are associated with increased marijuana use by adolescents
Wrong again. Most recently, researchers at Rhode Island Hospital and Brown University assessed the impact of medical cannabis laws over a 20-year period by examining trends in self-reported drug use by high schoolers in a cohort of states before and after legalization. Investigators compared these trends to geographically matched states that had not adopted medical marijuana access laws during this time. They determined, “[O]ur study of self-reported marijuana use by adolescents in states with a medical marijuana policy compared with a sample of geographically similar states without a policy does not demonstrate increases in marijuana use among high school students that may be attributed to the policies. … [C]oncerns about (medical marijuana laws) ‘sending the wrong message’ may have been overblown.”
Inhaling medical cannabis significantly damages the lungs
According to a 2012 study published in the Journal of the American Medical Association, subjects exposed to moderate levels of cannabis smoke over an extended period of time do not experience the sort of significant pulmonary harms associated with tobacco smoking. “Our findings suggest that occasional use of marijuana … may not be associated with adverse consequences on pulmonary function,” the study concluded. Further, the long-term inhalation of pot smoke is not associated with increased incidents of lung-related cancers. According to the results of the largest case-controlled study ever to investigate the matter, ganja smoking is not associated with higher incidences of cancers of the lung or upper aero-digestive tract, even among subjects who reported smoking more than 22,000 joints over their lifetime. Summarizing the study’s findings to the Washington Post, the study’s lead researcher, Dr. Donald Tashkin of the University of California at Los Angeles affirmed: “We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use. What we found instead was no association at all, and even a suggestion of some protective effect.”
No medicine is smoked
Yet patients inhale many conventional medications, such as anti-asthma drugs. These patients inhale conventional medications for largely the same reasons as do medical cannabis smokers: they require rapid onset of therapeutic drug effect, they desire the flexibility to self-regulate their dosage depending on the circumstances, and the medication they are administering lacks lethal overdose potential.
Further, clinical studies assessing the efficacy of vaporization as a cannabinoid delivery device have determined it to be a safe alternative to smoking, concluding: “Vaporization of marijuana does not result in exposure to combustion gases and [was] preferred by most subjects compared to marijuana cigarettes. … [It] is an effective and apparently safe vehicle for THC delivery.”
There is no legitimate need for medical cannabis because Marinol is already available by prescription
Marinol/dronabinol is an FDA-approved synthetic version of a single isolated compound in cannabis. Consequently, Marinol lacks dozens of other identified, therapeutically active components available in the plant, as well many of the terpenes present in pot. It possesses poor bioavailability compared to inhaled plant cannabinoids, and its mood-altering effects tend to be far more dysphoric compared go inhaled cannabis. When given the choice between Marinol and whole-plant cannabis, the majority of patients choose the herbal alternative.
Cannabis isn’t medicine because the FDA has not approved its therapeutic use
The FDA evaluates patented, synthetic products developed by private companies. It generally does not evaluate naturally occurring botanical products such as cannabis. That is not to say that cannabis, in particular a standardized variety of the plant, could not arguably meet the conventional FDA standards of safety and efficacy. Humans have consumed cannabis for thousands of years and it possesses adequate safety profile. Further, its therapeutic utility is demonstrated in numerous controlled trials. Arguably, by any objective analysis, cannabis and cannabinoids exceed the FDA’s existing standards for safety and efficacy.
This is a persuasive essay designed for me to convince a specific audience to take my position on a public issue. The Audience Statement clarifies my targeted audience and clarifies my objectives in the essay.
Because polls indicate that the majority people who are the same age as me share my point of view on medicinal marijuana, it serves little purpose to appeal to them. Rather my essay is designed to appeal to my parents’ generation, or adults between the ages of 35 and 60. The goal is to persuade them that the values they care about are compatible with the legalization of marijuana and incompatible with keeping marijuana criminalized. My essay is written as if it is being verbally presented to a group of these adults at a town meeting. The goal is to persuade them that legalizing marijuana use is the correct policy.
Why Marijuana Should Be Decriminalized
A common stereotype of citizens who oppose the criminalization of marijuana caricatures these people as lazy, unintelligent drug addicts. This caricature distorts arguments in favor of marijuana decriminalization which come from citizens who care deeply about the criminal justice system, public health, and socioeconomic mobility. While some citizens exclusively support decriminalizing the use of marijuana for medicinal purposes, others argue that the recreational use of marijuana should also be a legal act. By making these arguments, proponents of marijuana’s decriminalization reveal the logical fallacies embedded in the arguments of those in favor of maintaining the current drug laws. The idea that people should abstain from marijuana use is a valid proposition, but it incorporates a question of value that is irrelevant to the question of policy at hand. While opponents of decriminalization base their argument on the premise that current drug policy eases social and economic problems, data shows that this policy exacerbates the problems they intend to resolve. To improve public health and the criminal justice system, state and federal governments should decriminalize the medicinal and recreational uses of marijuana.
Far from a new, unproven innovation in the field of medicine, marijuana has been used for medicinal purposes for over four thousand years with positive results. Its earliest known medical use was in 2737 B.C., when the Chinese Emperor Shen Nung described the therapeutic applications of cannabis in his compendium of Chinese medicinal herbs (Amar). This drug has been used as a treatment for pain relief, earaches, childbirth, and other medical purposes in Asia, the Middle East, the eastern coast of Africa, and India for over four thousand years to the present day (Stack). In the 18th century, American medical journals advocated the usage of marijuana to treat inflamed skin, incontinence, and venereal disease (Stack). After Dr. William O’Shaughnessy found that marijuana eased pain and various symptoms of rheumatism, rabies, cholera, and tetanus, he sparked its popular use to England and the United States throughout the eighteenth and nineteenth centuries (Stack). It was only when the U.S. government enacted several taxes and prohibitions on drugs in the twentieth century that the misconceptions surrounding marijuana spread. The recent uses for marijuana in treating ailments validate the extensive historical use of this drug and invalidate contemporary misconceptions about it. Because marijuana has such an extensive history of medical usefulness, it is illogical to deny its ability to treat symptoms of many diseases. Nevertheless, the U.S. Food and Drug Administration posted an Inter-Agency Advisory which fallaciously argued that “no animal or human data supported the safety or efficacy of marijuana for general medical use” (U.S. Food and Drug Administration). It is valid to say that marijuana has some side effects on people who use it, but false to suggest that there are no occasions when it benefits a patient more than it harms him. In making this argument, the FDA conveniently ignores 4,000 years of medical history which prove it wrong.
Evidence shows that marijuana’s positive health benefits ease pain and save lives, making the argument for its decriminalization an argument for the rights of patients. One prominent official, Joycelyn Elders, the former U.S. Surgeon General argues, “The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting, and other symptoms caused by such illnesses as multiple sclerosis, cancer, and AIDS—or by the harsh drugs sometimes used to treat them” (Elders). When governments choose to prohibit patients from seeking cures for ailments and impose unnecessary suffering, they violate the human right to “a standard of living adequate for the health and well-being of himself and of his family” (Universal). For instance, up to 20% of cancer patients die from a dramatic loss of fat and muscle tissue called wasting, a process that can be reversed through marijuana use. Karen O’Keefe, an attorney and Legislative Analyst for Marijuana Policy Project, argues, “With roughly 20% of all cancer deaths caused by wasting, it is cruel and senseless to criminalize the doctor-advised use of a safe, effective, and widely available treatment” (O’Keefe). The alleged benefit of appeasing society’s misconceptions regarding marijuana is negligible compared to the cost of death or severe pain imposed on patients in need of medical treatment. If governments are willing to permit drugs like Valium, Amphetamine, Methadone, Ketamine, OxyContin, Xanax, and Hydrocodone to be used as acceptable medical treatments, it is illogical to prohibit marijuana. In contrast to these drugs, there is no evidence showing that marijuana is responsible for a single death from overdose (Marijuana). By decriminalizing it, there is everything to gain and almost nothing to lose.
The common assumption that marijuana has the same level of addictive qualities as drugs like cocaine or heroin has been proven false by medical studies. After he co-founded a medical cannabis evaluation practice, Dr. Phillip Denney said, “I have found in my study of these patients that cannabis is really a safe, effective and non-toxic alternative to many standard medications. There is no such thing as an overdose. We have seen very minimal problems with abuse or dependence, which at worst are equivalent to dependence on caffeine” (Denney). The image of a marijuana overdose appeals to people with limited knowledge about drugs, as they are familiar with overdoses on hard drugs like heroin and cocaine. Because the FDA erroneously classifies marijuana as a Schedule 1 drug, as it does with heroin and cocaine, the common person is increasingly likely to overestimate the side effects of marijuana and be ignorant to the relative safety in using this drug for medical reasons. Denney’s assertion that there is no such thing as an overdose is correct, but it is important to note that habitual overconsumption of marijuana will produce undesirable symptoms. David Sack, an opponent to the legalization of marijuana, is wise to cite medical studies which demonstrate that the drug can impair the nervous system’s control over bodily functions including memory, attention, disposition, arousal, motivation, perception, appetite, and sleep (Sack). The effects on people who consume excessive amounts of marijuana are a good reason to avoid habitual overconsumption of the drug, but Sack fails to make a compelling case the drug is so dangerous that it should be denied to patients whose lives could depend on it. Legal prescription drugs can also have harmful long-term effects if a person consumes too much of them, but the manner in which they help treat symptoms of medical conditions makes them desirable when used in moderation. Like legal prescription drugs available on the market, marijuana should be classified as a Schedule 2 drug by the FDA in accordance with its relatively low medical risk compared to hard drugs. The fact that marijuana has side effects proves that it is the norm among drugs, not the exception.
Like prohibitions on medicinal marijuana, the prohibitions on recreational marijuana have either been ineffective or counterproductive regarding public health, economic, and social issues. Despite the fact that marijuana arrests have increased from 2 to 86.5 per hour in the time period between 1965 and 2011, polls consistently indicate that usage rates have not decreased (Marijuana). Moreover, the Journal of Public Health Policy states, “citizens who live under decriminalization laws consume marijuana at rates less than or comparable to those who live in regions where the possession of marijuana remains a criminal offense” (Marijuana). Without evidence supporting their claim that criminalizing marijuana can change Americans’ drug consumption, the opponents of decriminalizing marijuana promote the misconception that marijuana is a gateway drug. This idea says marijuana per se does not create public danger, but it causes people who consume marijuana to use more dangerous drugs like heroin or cocaine. The biggest flaw with this argument is evident in a survey from the U.S. Department of Health and Human Services, which explains that “more than 76 million Americans have admittedly tried marijuana. The overwhelming majority of these users did not go on to become regular marijuana users, try other illicit drugs, or suffer any deleterious effects to their health” (Marijuana). There are certainly some individuals who initially used marijuana and later used other illicit drugs, but there is no evidence suggesting these individuals are anything close to a majority of marijuana users. Even if the premise of the “gateway drug” argument is to be accepted, the effects of criminalizing marijuana have proven to be counterproductive as “rates of hard drug use (illicit drugs other than marijuana) among emergency room patients are substantially higher in states that have not decriminalized marijuana use” (Marijuana). The premise that marijuana is a gateway drug is inconsistent with the argument against legalizing it. If the “gateway drug” argument were true, then its proponents should also support the repeal of the prohibition against marijuana because of the lower rate of its use and the lower rate of hard drug use in states that have decriminalization laws. The laws which prohibit marijuana use are merely a gateway to an inefficient and counterproductive social experiment in the name of public safety.
The absence of benefits from criminalizing recreational uses of marijuana is less alarming than the costs incurred through the criminal justice system and the excessive burden imposed on those convicted for marijuana offenses. According to the Federal Bureau of Investigation, “police arrest more Americans per year on marijuana charges than the total number of arrestees for all violent crimes combined, including murder, rape, robbery and aggravated assault” (Marijuana). Residents of cities with particularly high crime rates should be concerned that the resources of their local law enforcement agencies are being spread too thin to deal with violent crimes. In the 1990s, the annual cost of arresting and prosecuting individuals for marijuana violations was between $7.5 billion and $10 billion, and it has increased since then (Marijuana). The prohibition on marijuana imposes an opportunity cost on taxpayers who could otherwise spend or save the money for purposes of their own choosing, or on governments which could otherwise use more resources for prosecuting violent crimes. Even more outlandish than the cost imposed on taxpayers and law enforcement is the draconian set of penalties imposed on individuals who violate marijuana laws. Federal law dictates that individuals possessing a marijuana cigarette or less can be given maximum penalties of a one-year prison sentence and a $10,000 fine, the same penalty for individuals arrested on heroin or cocaine offenses (Marijuana). In several states, marijuana offenders may even receive maximum sentences of life in prison (Marijuana). Considering that the only impact of recreational marijuana usage might be a slight increase in cost from health problems pertaining to marijuana use that are no greater than the health problems arising from many legal drugs, it is alarming that the punishments for this act are often equivalent to crimes resulting in deaths of other people. When a state’s criminal justice system allows those convicted of rape, manslaughter, assault, or other violent crimes to potentially receive a lighter sentence than someone convicted of possessing marijuana, the justice system fails to uphold the principle that the punishment should fit the crime.
Not only do drug laws distribute a huge burden on society in general, but this burden is distributed far more severely on minority citizens than on their white counterparts. The manner in which racial bias affects the enforcement of drug laws undermines the ideal of equality under the law. According to the U.S. Government’s Substance Abuse and Mental Health Data Archive, 76% of marijuana consuming adults are white, while 11% are black (Substance Abuse and Mental Health Data Archive). Despite this, blacks are arrested at a higher rate for marijuana than whites in 90% of U.S. counties, and blacks are arrested at a rate twice as high as the arrest rate for whites in 64% of those counties (Substance Abuse and Mental Health Data Archive). Because of the steep sentences and penalties for marijuana offenses, black Americans convicted of marijuana offenses face a disproportionate burden of achieving economic stability through employment compared to their white counterparts. Moreover, federal benefits including federal financial student aid and public housing can be withheld from marijuana offenders, so the disproportionately high numbers of blacks who are arrested on marijuana charges are confronted with a continuation of a racialized cycle of poverty (Marijuana). While not overtly a racist policy in theory, marijuana prohibitions, as they are practiced, reinforce economic inequities along racial lines by making black Americans pay a steeper cost than white Americans. Racial equality, along with economic opportunity and advancements in the prosecution of violent crimes, is threatened by the existence of the current laws which regulate marijuana. The flaws of prosecuting marijuana offenses so extensively are not worthy of the sacrifice of these ideals by the American people.
The current framework of marijuana prohibitions is responsible for inefficiencies in the criminal justice system and unfair burdens faced by individuals prosecuted under these laws. The proposal in which states and the federal government decriminalize medical uses of marijuana is an admirable idea which appeals to the pathos of the American public by offering assistance to sick persons in need of access to this drug. Nevertheless, the problems inflicted by marijuana laws cannot be completely solved unless laws prohibiting the recreational use of marijuana are repealed as well. Until then, taxpayers who pay for the enforcement of modern laws and the nonviolent drug users who receive extreme punishments shoulder an excessive cost in return for very little benefit to society, if there is any benefit at all. It is time to refute the misconception that decriminalizing marijuana is a barrier to socioeconomic opportunity, safety, and public health. This will allow the American public to realize that decriminalization is truly the gateway to a society more reflective of its ideals.
Amar, Mohamed Ben. “Cannabinoids in medicine: A review of their therapeutic potential.” Journal of Ethno-Pharmacology 105 (2006): 1-25. Print.
Denney, Phillip. “An Act to Permit the Medical Use of Marijuana.” Arkansas General Assembly. Arkansas State Capitol Building, Little Rock, AR. 17 Nov. 2005. Testimony to the Legislature.
Elders, Joycelyn. “Myths About Medical Marijuana.” The Providence Journal. Americans for Safe Access, 26 Mar. 2004. Web. 26 Mar. 2013. http://americansforsafeaccess.org/section.php?id=344
“Marijuana Decriminalization Talking Points.” The National Organization for the Reform of Marijuana Laws. NORML, 10 Mar. 2003. Web. 1 Apr. 2013. http://norml.org/pdf_files/NORML_decriminalization_talking_points.pdf
O’Keefe, Karen. “Re: Should Marijuana Be A Medical Option?” Message to procon.org. 21 Sep 2005. E-mail.
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United States. Food and Drug Administration. “For Immediate Release: Inter-Agency Advisory Regarding Claims That Smoked Marijuana Is A Medicine.” Silver Spring, MD: GPO, 20 Apr. 2006.
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“The Universal Declaration of Human Rights.” United Nations. 2013. Web. 1 Apr. 2013. http://www.un.org/en/documents/udhr/index.shtml