Wayne Reiss: Medical Marijuana and the New Reefer Madness
Wednesday, February 12, 2014
In a recent article entitled " MA Med Society President Issues Statement on Pot Dispensaries, " Dr. Ronald Dunlap sounds some of the familiar alarms: cannabis is not medicine, medicine is not smoked, cannabis has not passed FDA approval, dosage is not regulated and controlled. None of these claims withstands scrutiny.
Medical schools fail to instruct students in the basic physiology and function of the endo-cannabinoid system of the human body. Ignorance is not scientific skepticism. As Dr. Sanjay Gupta admitted in his recent documentary "Weed," his previous skepticism of cannabis as medicine was in actuality ignorance of the data which Gupta acknowledges is skewed largely by political agenda.
War on science
The war on cannabis has been a war on physicians and science. Cannabis was used medicinally in China and India for thousands of years. No medicine survives that long if it is ineffective. Prior to cannabis prohibition, it was prescribed by American physicians for 100 years. It was used in 50 percent of all medications, and was sold by pharmaceutical companies such as Bristol Myers Squib, Merck, Parke-Davis, Eli Lilly, and Smith Bros. The AMA opposed its prohibition prophetically predicting in a 1937 congressional hearing that prohibition would obstruct the scientific discovery of its full medical potentiality.
During the first three years of cannabis prohibition Harry Anslinger, head of the Federal Bureau of Narcotics (FBN), prosecuted more than 3,000 AMA physicians for prescribing cannabis. The AMA relented, and in the next decade, Anslinger only prosecuted three physicians. In response to this attack on physicians, medicine and science, in 1945 Mayor LaGuardia commissioned a panel of medical experts which concluded that cannabis was safe and effective medicine and that recreational use should not be prohibited, but despite science and reason the FBN prevailed.
Smoke is not medicine
This claim ignores the fact that cannabis is ingested through many smokeless routes of delivery, including vaporization, tinctures, sublingual sprays, edibles, oils and pills. As to smoking, pharmaceutical medicines have a range of toxic side effects including kidney failure, liver failure, stroke, heart attack and death. (Pharmaceuticals account for over 3 million deaths per year worldwide while marijuana accounts for none.) Nevertheless, physicians regularly weigh benefits against these possible hazards when prescribing medicines.
And what exactly are the hazards of smoking cannabis? Dr. Donald Tashkin, Professor Emeritus of Medicine and Medical Director of the Pulmonary Function Laboratory at UCLA, has been researching cigarette and cannabis smoke for over thirty years. In the largest longitudinal study ever conducted funded by the National Institute of Health, Dr. Tashkin found that even heavy cannabis smoking (one to three joints per day for fifteen years) causes neither cancer nor COPD (emphysema). In fact, heavy cannabis smokers have a lower rate of cancer than the general non-smoking population: a protective effect. Drs. Tashkin and Sanjay Gupta have reported this possible anti-cancerous and anti-tumoral effect. Despite this, the Office of National Drug Control Policy (ONDCP), the National Institute of Drug Addiction (NIDA), and DEA continue to report that cannabis has more carcinogens than tobacco, without also reporting that cannabis does not cause cancer.
Certainly, smoking tobacco is not medicine. But cannabis is not tobacco. Doctors who confuse the two do so despite science, not because of it.
Dose regulation of cannabis
Dr. Lester Grinspoon , Professor Emeritus of Psychiatry at Harvard University Medical School, has been researching cannabis and its medicinal properties since 1967. Dr. Grinspoon explains that when inhaling cannabis (either by smoking or vaporizing), since the effect is almost immediate one can precisely titrate the amount of medicine and ingest only what one needs. When administering THC through the gut (via pills), absorption can take up to one and a half hours and varies greatly between individuals making dosage far less predictable and controllable than inhaled administration. Doctors who criticize prescribing cannabis due to a lack of dose control do not realize that smoking or vaporizing cannabis provides greater, not lesser, dose control.
Why must cannabis pass FDA approval?
There is no legal, medical or ethical reason for cannabis to pass FDA approval. Like cannabis, pharmaceutical drugs such as morphine, penicillin, aspirin and several others never passed FDA approval and became part of the medical pharmacopeia based on anecdotal evidence alone. For these reasons, most politicians and some physicians argue that cannabis cannot be considered medicine (despite hundreds of peer reviewed research to the contrary) until it passes FDA approval yet they make no such claims regarding any pharmaceutical medications which meet the identical criteria. Moreover, aspirin which can cause bleeding of the stomach lining and accounts for hundreds if not thousands of deaths per year would never pass FDA approval today, and none claims it should. Nor do these detractors make similar claims regarding any of the hundreds of other homeopathic medicinal herbs which physicians are free to recommend and are available at most pharmacies.
Who will fund FDA approval?
Double blind control studies necessary for FDA approval cost approximately $200 million, sometimes more. Who will pay this tab? The US government? The head of the ONDCP is mandated by law to oppose all efforts to legalize marijuana for any reason. As reported by the New York Times and the Marijuana Policy Project, NIDA, the sole source of government funding for cannabis research, largely because of the ONDCP mandate, denies funding any research into the medical utility of cannabis and only grants funding of research into the harms of cannabis. The DEA is the sole provider of legal cannabis in the U.S. and has consistently denied providing cannabis or license to grow it for research into its medical efficacy. Without funding and cannabis, FDA approval is impossible.
The federal government actively lobbies to maintain cannabis prohibition, claims it has no medical utility, refuses to fund studies to the contrary, and is the primary obstacle preventing cannabis research and FDA approval. Cannabis prohibition is a war on ideas.
Neither will the pharmaceutical industry fund cannabis FDA approval. Pharmaceutical companies recoup the enormous cost of FDA approval by patenting medicines and selling them exclusively once approved, but plants cannot be patented. Pharmaceutical companies benefit by keeping cannabis, a powerful competitor, illegal because it is cheap (when not prohibited) and successfully treats many diseases and symptoms. Pharmaceutical companies have many economic incentives to maintain cannabis prohibition and have no incentive to fund its FDA approval.
Although there are benefits to be gained from pharmaceutical cannabis extracts, pharmaceutical exclusivity will continue or even inflate the outrageously high price of a dried herb, deprive millions of poor and uninsured a cheap, safe and effective medicine they can grow in their back yards, maintain an unregulated, unsafe black market, and force the sick (and recreational users) to buy on the black market.
It is becoming increasingly clear to Americans that cannabis is good medicine. Warnings to the contrary are grounded in politics, not science; the new refer madness.
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