Medical Marijuana: What's the Point?


Hit & Run commenters sometimes express skepticism about the medical marijuana movement, saying either that it's a cover for people who want to get high or that it concedes too much by acknowledging the government's authority to dictate who may use which drugs for what purposes. Since the House of Representatives is expected to vote today on the Hinchey-Rohrabacher amendment, which would bar the DEA from spending money on raids, seizures, and arrests aimed at stopping the medical use of cannabis in states where it's legal, now is a good time to recall why this cause is important:

1) The basic right to control one's body and the substances that enter it surely includes the right to use marijuana (or any other home remedy) for symptom relief, even that is not all it includes.

2) The DEA's medical marijuana raids violate the Constitution, which gives states the authority to decide their own policies regarding intrastate production, sale, and consumption of marijuana. As Justice Clarence Thomas has noted, a reading of the Commerce Clause that's broad enough to encompass a marijuana plant on a cancer patient's windowsill in California is broad enough to encompass just about anything. More narrowly, it's hard to imagine how serious experiments with drug policy reform can occur as long as the federal government insists on imposing one uniform set of rules on the entire country.

3) Although the main use of marijuana in this country is recreational, the drug indisputably has medical applications, including relief of pain, nausea, and muscle spasms. Many patients find that smoked marijuana works better for them than the FDA-approved alternatives, including the synthetic THC capsule Marinol, largely because it acts instantly, allows easy dosage control, and does not require swallowing (and keeping down) a pill. Some report that oral THC, processed by the liver, has more disturbing psychoactive effects than THC absorbed into the bloodstream via the lungs. Consuming the whole plant also provides cannabinoids in addition to THC that may have a synergistic effect or provide independent benefits. (Here's a detailed comparison [PDF] of smoked marijuana and Marinol from The Oregon Medical Marijuana Guide.)

4) In addition to Marinol (whose approval by the FDA shows that  the government recognizes THC's medical utility), an oral cannabis spray, Sativex, is moving toward FDA approval. It seems likely that pharmaceutical companies also will eventually sell inhalers that deliver fast-acting, precise doses of THC and other useful cannabinoids without the potentially harmful combustion products associated with smoking (although patients already can avoid those toxins and carcinogens by using vaporizers). At that point, the medical argument for marijuana will evaporate. But patients who get relief from marijuana should not have to wait until then. (Some of them will no longer be alive.) Even after adequate pharmaceutical alternatives are available, some patients may prefer to grow their own, whether to save money or because they believe (rightly or wrongly) that whole-plant preparations are superior.

5) Even if medical marijuana is ultimately replaced by cannabinoid inhalers, the struggle to allow its use has undermined the credibility of drug warriors by revealing them as cruel fanatics and by showing that they grossly exaggerate the hazards posed by cannabis. When scientists consider the side effects of marijuana as a medicine, as the Institute of Medicine did in the 1999 report commissioned by Clinton administration drug czar Barry McCaffrey, they incidentally contradict the government's anti-pot propaganda, which in turn discredits other official warnings about drugs.