Legalize and Regulate Marijuana

October 27, 2011

 Legalize and Regulate Marijuana

The largest physician group in California has adopted a policy that recommends the legalization and regulation of cannabis, more commonly known as marijuana, or pot. The California Medical Association, the largest physician group in California, adopted this policy unanimously. According to Dr. Hayes, the president of CMA, marijuana needs to be regulated and better controlled “If we don’t know what’s in it we can’t do any scientific evaluation.”   Hays says that to not legalize marijuana would hurt patients more than help them.  
 
Policy Recommendations include:

  • Reschedule medical cannabis in order to encourage research lending to responsible regulation.
  • Regulate recreational cannabis in a manner similar to alcohol and tobacco.
  • Tax cannabis
  • Facilitate dissemination of risks and benefits of cannabis use.
  • Refer for national action.

 

The California Medical Association (CMA) has recognized that the criminalization of marijuana is a failed public health policy. CMA states that effective regulation is possible only if marijuana is rescheduled at the federal level. Very little clinical research or regulation of marijuana exists due to federal laws outlawing it. According to the American Society of Addition Medicine, cannabis should be subject to the scrutiny of the federal Food and Drug Administration's (FDA) regulatory process in order to allow for further clinical research and to work toward standardizing the substance so physicians are no longer required to serve as gatekeepers of a substance that has not been subjected to the scientific process.

Some states are taking the step to simply decriminalize marijuana.  Decriminalization is not, however, the same thing as legalization.  When marijuana is decriminalized it is still illegal to possess it, but violations of the marijuana laws in these jurisdictions are civil rather than criminal cases.  In some ways decriminalization is worse than keeping the status quo since in civil cases citizens do not have the same level of constitutional guarantees and protections found in criminal cases.  Furthermore, merely decriminalizing marijuana on a state-by-state basis is not sufficient to protect the safety of patients because the authority to regulate the substance then is divided among the states instead of having a central authority with such power.  The federal government already has and exercises the most authority to regulate labeling, quality control, and safety, of substances most akin to marijuana, such as alcohol and tobacco.  Having a central authority to regulate marijuana is more likely to ensure the safety of marijuana users. 

Several national organizations have taken policy positions as a means of encouraging additional study of cannabis. Most notably, a Consensus Conference sponsored by the National Institutes of Health (NIH) and a review panel convened by the Institute of Medicine advocated that controlled studies be performed for analgesia, appetite stimulation and cachexia, and nausea and vomiting following chemotherapy. Rescheduling cannabis will allow for further clinical research to determine the utility and risks of cannabis, which will then shape the national regulatory structure for this substance.

The CSA (Council on Scientific and Clinical Affairs) has also concluded that components of medical cannabis may be effective for the treatment of pain, nausea, anorexia, and other conditions. Cannabinoids are presently thought to exhibit their greatest efficacy when implemented for the management of neuropathic pain, which is a form of severe and often chronic pain resulting from nerve injury, disease, or toxicity. The University of California Center for Medicinal Cannabis Research (CMCR) recently reported to the California legislature on the results of a number of studies. Among these, four studies involved the treatment of neuropathic pain and the patients in all four studies demonstrated a significant improvement in pain tolerance after cannabis administration.

In short, the medical field is beginning to understand the significant benefits to legalizing marijuana.  With our current budget deficit's, hopefully our politicians will see the benefit in taxing it as well.  This is a workable and win - win situation.  All we need now are political leaders with the leadership courage to introduce and pass the legislation.