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LEGISLATIVE
CHALLENGES

propriate, they can legalize marijuana through a process I call "mob- • Symptoms associated with amyotrophic lateral sclerosis,
rule." I am not convinced this is an appropriate way to legalize a • Chorea and certain neuropsychiatric symptoms associated with
Schedule 1 substance. Huntington’s disease,
If I were to take at face-value all the positive, beneficial claims • Motor system symptoms associated with Parkinson’s disease or
of medical marijuana, there would be a plethora of benefits. In the levodopa-induced dyskinesia,
2017, the National Academies of Sciences, Engineering, and Med- • Dystonia,
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icine issued a report on the benefits and detriments of marijuana • Achieving abstinence in the use of addictive substances,
based on the review of over 10,000 scientific abstracts from mari- • Mental health outcomes in individuals with schizophrenia or
juana health research. They also made 100 conclusions related to schizophreniform psychosis.
the health effects of cannabis and cannabinoid use. One would be-
lieve simply based on over 10,000 abstracts of marijuana use, that And this is by no means, a conclusive list of all of the beneficial
marijuana is a miracle drug that cures almost all diseases including; "claims" of medical marijuana. Anecdotal evidence is a long way
from empirical scientific evidence. That is not to suggest we should
dismiss anecdotal evidence altogether. There may be some empirical
evidence of benefits of some of these claims. Regardless, science
MUST play a role in concluding the effectiveness and safety of any
drug. And as every clinical drug trial has taught us, there are always
side-effects with every approved drug, and we need to understand
the side-effects of marijuana even if there is a true medical benefit.
We also need proper labeling of the detriments and limitations of
any FDA approved drug.
Furthermore, when a pharmaceutical company applies for FDA
approval of a particular drug, they must conduct a number of dou-
ble-blinded clinical drug trials (phase 1-4) in a very controlled man-
• Antiemetics in the treatment of chemotherapy-induced nausea ner to assure the safety of patients while determining whether the
and vomiting, drug actually performs as alleged by the pharmaceutical companies.
• Improvement of patient-reported multiple sclerosis spasticity Double-blinded studies are the gold standards of statistical studies
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symptoms, 1, 2 where neither the investigator nor the subject knows whether they
• Improvement of short-term sleep outcomes in individuals with are receiving a placebo or the active ingredient. Objective tests are
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sleep disturbance associated with obstructive sleep apnea syn- then performed to determine the effect of the drug in treating the
drome, underlying condition. And even if a drug has some moderate suc-
• Fibromyalgia, cess in the treatment of a particular condition, the question is
• Chronic pain, whether the drug is also safe and statistically significant in its effi-
• Increasing appetite and decreasing weight loss associated with cacy. The FDA has high standards , and it is not easy for pharma-
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HIV/AIDS, ceutical companies to obtain approval given the high standards
• Improving symptoms of Tourette syndrome, imposed on pharmaceutical companies. Why would we want to sub-
• Individuals with social anxiety disorders, stitute the FDA process for a ballot measure of approval of a Sub-
• Improving symptoms of posttraumatic stress disorder, stance 1 drug based on a majority rule?
• Traumatic brain injury, Often the proponents of the legalization of marijuana state that
• Intracranial hemorrhage, there is no harm by using marijuana and those that use it "feel bet-
• Improving intraocular pressure associated with glaucoma, ter." I do not doubt the claim of feeling better; however, if that
• Cancers, including glioma, becomes the new standard, we should legalize heroin given the
• Anorexia nervosa, tremendous benefit of "feeling good." Clearly, there is a big dif-
• Symptoms of irritable bowel syndrome, ference between heroin and marijuana; nevertheless, having aver-
• Epilepsy Spasticity in patients with paralysis due to spinal cord age citizens legalize a drug through a ballot measure is not wise
injury, drug policy.
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