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Medical Marijuana: A Grass Roots Debate

The Obstacles to Research, Regulation & Relief

Forty states now allow for medical treatment that derives from some form of the marijuana plant. Unfortunately, marijuana remains classified as a Schedule I drug, so the federal government considers the plant illegal, and states must decide how to regulate their medical-marijuana programs.

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Twenty-three states and District of Columbia legalized the use of the marijuana plant for medical purposes. Seventeen other states allow for treatment through cannabidiol oil (CBD), which is a component of marijuana. At least 275 million Americans live in a state that passed a medical-marijuana law.

Unfortunately, marijuana still is classified as a Schedule I drug (the same classification as heroin) under the Controlled Substances Act. The federal government says marijuana is illegal to distribute, manufacture or possess in the United States, so federal agencies provide no guidance for state medical-marijuana programs.

Consequently, every state that legalizes medical marijuana comes up with its own regulations. As a result, wide variances and contradictions exist in possession limits, the medical conditions that qualify for medical marijuana, the cost of registry cards, the cost of marijuana, the number of licensed dispensaries in each state that sell marijuana and in what form that it can be sold. (For a look at the differences among state regulations, see, “How The States Vary.”)

Consumer advocates, doctors and scientists say observational studies and small clinical trials show the drug’s medical efficacy. Marijuana dulls the brain activity that’s thought to cause epileptic seizures, relieves glaucoma discomfort, decreases muscle spasticity in diseases such as multiple sclerosis, slows the wasting symptoms of AIDS, reduces nausea that’s associated with chemotherapy, eases anxiety disorders and chronic pain, and helps people who have at least 60 other related conditions and diseases.

“The research that exists is at least promising enough that we should be doing a lot more,” says John Hudak of Brookings Institution, which conducts independent policy research. Hudak co-wrote “Ending the U.S. government’s war on medical-marijuana research” in 2015.

No one knows for sure which diseases and conditions marijuana might treat effectively, because scant robust, double-blind clinical studies exist. That’s because, as a Schedule I drug, marijuana is considered to have no accepted medical use, and it’s difficult to conduct clinical studies that might prove its effectiveness. Approval by Food and Drug Administration would require trials on thousands of subjects to determine the benefits and risks of medical marijuana, according to National Institute on Drug Abuse (NIDA), which is funded by Congress, and trials aren’t allowed without federal government approval.

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Opponents, which include law-enforcement agencies, drug-treatment and drug-testing companies, anti-smoking groups, prison corporations and conservative legislators, say research isn’t conclusive, legal medications make medical marijuana unnecessary, and medical marijuana lacks FDA approval.

“When you talk about drug task forces or narcotics officers and their trade associations, these are people whose jobs rely on being able to investigate and arrest people for marijuana-related offenses,” says Mason Tvert of Marijuana Policy Project (MPP), which is the largest marijuana-policy reform organization in the United States.

According to American Civil Liberties Union, half of all drug arrests each year in the United States are related to marijuana, and police made 8.2 million marijuana arrests between 2001 and 2010. In December 2014, Congress passed the Rohrabacher-Farr amendment, which mandated that Justice Department stop using federal funds to prevent states from implementing their own “laws that authorize the use, distribution, possession or cultivation of medical marijuana.” However, experts say Drug Enforcement Agency (DEA) continued to pursue federal criminal actions against medical-marijuana businesses and customers. In October 2015, a California federal judge ordered DEA to stop harassing the medical-marijuana industry. In other words, it’s been a long struggle to get law-enforcement agencies to stop impeding progress in medical-marijuana states.

“If you take marijuana out of the equation, there’s far less justification for the size of their budget or the number of people on their payroll,” Tvert says. “If marijuana is legal for adults, the number of people referred to the treatment centers by the criminal justice system will fall.”

Federal law prohibits doctors from prescribing marijuana. Instead, doctors only can “recommend” marijuana to patients who qualify under certain medical conditions that are approved by each state. Because no federal oversight exists, it falls to each state’s health department to decide what conditions qualify.

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