By: James Davis
I’m only posting the conclusion to the articel due to its length. If you want to read it in its entirety click on http://www.mayoclinicproceedings.org/article/S0025-6196(11)00021-8/fulltext
Given cannabis’ worldwide use for thousands of years for medical and spiritual purposes, the contemporary American tumult over medical marijuana seems peculiar and misguided. Despite cannabis being part of the US pharmacopeia through much of the 19th and early 20th centuries, a federal government deeply suspicious of mind-altering substances began imposing restrictions on its prescription in the late 1930s, culminating in 1970 when the US Congress classified it as a Schedule I substance, illegal, without redeeming qualities.
Despite its illegality, cannabis has in the latter half of the 20th century become the most abused illicit substance in the United States. For most individuals, recreational cannabis use is essentially harmless, a rite of passage ending as young people settle into careers and adult intimate relationships.20, 109, 110 For 10%, however, the drug becomes addictive, its relaxing properties transforming into a constant need that interferes with interpersonal and occupational advancement. For an even smaller proportion—those with a predisposition toward psychotic illness—it may abet the earlier emergence of psychosis and a rockier illness course if use persists.
Prohibition notwithstanding, cannabis’ recognized medical uses never went out of favor in alternative medicine circles. Its therapeutic properties have been particularly favored by former recreational users familiar with its psychoactive effects, some of whom blur boundaries by continuing to use it recreationally. In the 1980s, it was found effective for treating severe nausea induced by cancer chemotherapy and cachexia in AIDS patients. The first cannabinoid-based pharmaceuticals—dronabinol and nabilone—came into medical use in 1985. Without an understanding of how these medications worked, they were prescribed empirically. As the mysteries of the endocannabinoid system were unraveled during ensuing decades, however, a rationale for both its recreational and sweeping medical effects has emerged.
The natural next step—pharmaceutical development—has been thwarted by the federal government’s seeming unwillingness to have new scientific discovery supplant long-standing ideology. Bureaucratic hurdles not erected for other potential pharmaceuticals continue to interfere with legitimate cannabis research. The federal government instituted its 1970 ban in the absence of scientific evidence supporting its position. It maintains the ban, despite scientific evidence suggesting that cannabis could have positive effects on the many organ systems endocannabinoid activity modulates.
Although remaining at risk of arrest on federal charges, medical users have increasing latitude as more and more states endorse botanical cannabis. In defiance of a federal ban that appears increasingly irrational, 16 states and the District of Columbia have legalized botanical cannabis’ medical use. Without a federal umbrella, regulations lack any state-to-state uniformity about what constitutes acceptable indications, appropriate prescriber-patient relationships, or legitimate means of acquiring botanical cannabis. In such states, physicians who prescribe medical marijuana are susceptible to prosecution under the same statutes as drug dealers.111 Public approval and political expediency rather than scientific data drive the continued implementation of these state laws.
Like alcohol imbibers during the prohibition era in the United States, recreational users continue to smoke cannabis illicitly, as they have always done. Because of this modern-day prohibition, opportunities to further study marijuana’s risks and benefits and develop new pharmacotherapies are squandered. In passing their own regulations endorsing medical marijuana use, states defy the federal government. In each of these instances, boundaries among the legal, social, and medical realms blur. Depending on context, marijuana can thus be panacea, scourge, or both.
It is high time for the federal government to acknowledge and accept this “both-ness” by reclassifying marijuana so that it has the same status as certain opiates and stimulants. The Schedule II classification of these pharmaceuticals countenances not only a healthy respect for their addictive potential but also a robust appreciation for their medicinal value.112 By forcing marijuana to languish as a Schedule I drug with a “high potential for abuse, no accepted medical use, and no accepted safety for use in medically supervised treatment,”104 the federal government thumbs an illogical nose at contemporary public sentiment, recent scientific discoveries, and potentially head-to-toe therapeutic breakthroughs. This reclassification would be a first step toward reconciling federal and state law and permitting long-stifled research into a potential trove of therapeutic applications to commence.
