The state of Texas is deciding whether to embrace medical marijuana as approved policy, perhaps in the spirit of Gov. Rick Perry's receptivity to "states' rights" on marijuana. While the Legislature will have several bills to consider by 2015, an important question remains unanswered: Is medical marijuana really what it seems - a compassionate response to genuine suffering? Or is it a bait-and-switch move by drug legalizers?
Supporters cite the suffering of those with serious illnesses, such as HIV/AIDS, as the reason for their project. And they readily tout a list of medical conditions that they think will generate public concern. For instance, marijuana is claimed to treat glaucoma, and even rare forms of childhood epilepsy.
But medical scientists know that marijuana has not been proven safe and effective. The American Glaucoma Society has written: "There is no scientific basis for marijuana's use in treatment," and there is evidence that it could actually do damage.
And in the journal of the American Epilepsy Society we read: "Marijuana itself has major shortcomings as an epilepsy treatment ... evidence for efficacy in treating seizures does not meet the necessary standard to recommend it to patients." Worse, researchers state that "marijuana use or withdrawal could potentially trigger seizures in susceptible patients."
It's true that studies are ongoing, and there is excitement over the potential of a substance found in marijuana, cannabidiol, to be more beneficial than the intoxicating compound, THC. Anecdotes have surfaced concerning efficacy for seizures, but clinical trials have yet to validate these reports. It is easy to understand the hopes of parents wishing to help their suffering child. But marijuana is unproven as an appropriate response, and, as with any proposed medication, scientific results must drive the decisions.
Are medical marijuana advocates playing on public sympathy in order to advance their political agenda? It often seems that way, particularly when their argument takes this form: "Cannabidiol might be a valuable therapeutic substance for a rare form of childhood epilepsy. Therefore, we demand that legislators give everybody a smoked weed full of high-potency THC."
Beyond the absence of evidence of medical value, marijuana itself is a source of major risk, both for its effects as a compound, and for the impact of the dispensaries on communities.
The THC found in marijuana has been called a neurotoxin and has been linked to damaged IQ. As two Yale University psychiatrists wrote in the Journal of the American Medical Association last month, "The potential harms associated with medical marijuana need to be carefully considered. No other prescription medication is smoked … furthermore, there is evidence that marijuana exposure is associated with an increased risk of psychotic disorders in vulnerable individuals."
In Colorado, where marijuana is flooding the streets following legalization, the percentage of THC has soared to unprecedented levels through deliberate cultivation. The THC has gained at the expense of the potentially useful cannabidiol; lab analysis shows this compound remains but a small percentage of the product. The ratio of the intoxicating compound to the potentially beneficial one stands contrary to the claim that "it's all about the medicine."
As for the dispensaries, many in law enforcement believe that medical marijuana, while masking itself as a compassionate intervention, has become a front for drug trafficking. In Colorado, parents and the medical community argue that the slippery slope from medical to recreational legalization was in fact planned, whereby medical compassion was enlisted as the first deliberate wedge to gain wider access to the drug.
We know that the marijuana dispensaries serve as a substantial source of "diverted" marijuana going to high school students. Last year, the "Monitoring the Future" national survey of youth found, of those living in medical marijuana states, fully 34 percent of drug-using 12th-graders pointed to a medical "card holder" as a source for their drug.
In sum, we learn that careless use of marijuana can actually make things worse for patients. Second, there is a need for more research of potential value and potential risks, but it must be done by proper standards of medical evidence. Third, there is evidence that "medical" marijuana actually leads to greater illicit drug use, particularly by youth.
Approve medical marijuana? Legislators in Texas would do well to follow the ancient adage of medicine: "First, do no harm."