Medical Marijuana Measures Make Waves

States have been legalizing medical use of marijuana since 1996, when California passed a ballot initiative, yet the idea remains controversial. The statutes of the initiative in the ballot allow wide leeway for doctors to decide when to write marijuana recommendations. This conversation is set to grow with New Jersey having recently become the 14th state to allow therapeutic use of marijuana. This could be followed by other states, such as Illinois and New York, which are considering new laws.

States’ rules on growing and dispensing medical marijuana vary. Some states license specialized dispensaries, which can range from small storefronts to bigger operations that feel more like pharmacies. Typically, they have security procedures to limit walk-in visitors. The U.S. Department of Justice has said it will not generally prosecute ill people under doctors’ care whose use of the drug complies with state rules.

Opponents of legalization say laws permitting marijuana use may spur a wider cultivation and use of the drug by people without serious medical conditions. Advocates of medical marijuana laws say very ill patients may benefit from the drug and should be able to access it with a doctor’s permission. They argue that some patients may get better results from marijuana than from prescription drugs.

Research results suggest marijuana can help patients of managing neuropathic pain, caused by certain types of nerve injury, and in bolstering appetite and treating nausea, for instance in cancer patients undergoing chemotherapy.

For those that benefit from medical use, positive effects include increased appetite, better sleep and treatment of nausea, often in cancer patients, as well as to encourage weight gain in HIV and AIDS patients. However, some have exhibited undesirable side effects, such as a racing heart, paranoia and short-term memory loss.

One major issue surrounding the use of marijuana for medical purposes is that because it is not regulated by the Food and Drug Administration, there is no way to check the potency and quality or to standardize dosages.

For those researchers that want to study the effect of marijuana, and its main ingredient, THC, the problem is getting funding. A recent American Medical Association (AMA) review found fewer than 20 randomized, controlled clinical trials of smoked marijuana for all possible uses. These involved around 300 people in total, resulting in less evidence than is required for a pharmaceutical to be marketed in the U.S.

Meanwhile, the AMA review said three controlled studies with 43 participants showed a “modest” anti-nausea effect of smoked marijuana in cancer patients undergoing chemotherapy. A trial of 50 AIDS patients published in Neurology in 2007 found that 52% of those who smoked marijuana reported a 30% or greater reduction in pain while 24% of those who got placebo cigarettes reported the same lessening of pain.

An analysis published in Lancet in 2007 linked marijuana use to a higher rate of psychotic conditions, such as schizophrenia, but there was no data to suggest causation, versus a correlation. Other possible issues include dependence, though it is not as addictive as nicotine or alcohol, says Columbia University Medical School Professor Margaret Haney. Smoked marijuana may also risk lung irritation, but a large 2006 study published in Cancer Epidemiology, Biomarkers & Prevention found no link to lung cancer.

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