The Medical Marijuana Mystery

By Brian J. Rosenberg

In 2001, Supreme Court Justice Clarence Thomas wrote a majority opinion contending that marijuana has “no currently accepted medical use.” In the United States, this is true, but one cannot be sure whether this is because marijuana truly has no medical use, or simply because marijuana’s medical benefits have not yet been proven.

In the coming weeks, Justice Thomas and the Supreme Court will again hear a case involving marijuana. This pivotal suit tests the California law which legalizes marijuana use for critically ill patients. The federal government will argue that federal law—which classifies marijuana as an illegal substance—takes precedence over California law.

Unfortunately, the justices’ role is to interpret the law, not to decide whether it is wise or misguided. Thus, this case is more of a test of federalism than an assessment of the medical utility of marijuana. Nevertheless, if the government did attempt to make an impartial examination of the latter, it would be hard pressed to make an informed decision, as it would be forced to rely on contradictory, even faulty scientific evidence.

Both sides of the issue, from the national campaign to vilify the drug to the significant counter-culture that supports it are versed in volumes of scientific data that appear to support their views, but both positions are scientifically unjustifiable.

A cursory examination of the current scientific literature reveals confusion and lack of consensus over whether marijuana has a valid medical use, even over whether it harms its users at all. Dr. Howard Shaffer, the editor of Psychology of Addictive Behaviors and Associate Professor and Director of the Division on Addictions at Harvard Medical School, wrote in an e-mail “The scientific community is fractured on the medical use issue. Some argue that medical marijuana can be very useful for dealing with the symptoms of certain diseases or the treatment side effects. Others argue that we already have drugs…with the fundamental ingredient of marijuana. The argument is that some people indicate that smoked marijuana is more effective than the pharmaceutical form.”

The only way to move beyond the hype, propaganda, and unsubstantiated claims, is for the government to commit to an objective, scientific investigation of marijuana.

The government’s history of promoting research on the medical benefits of marijuana is questionable at best. In February of 1997, a National Institutes of Health-sponsored workshop concluded that “in order to evaluate various hypotheses concerning the potential utility of marijuana in various therapeutic areas, more and better studies would be needed.” In March of 1999, the Institute of Medicine published a report that came to the same conclusion. Basically, the government acknowledged its ignorance.

In 2001, the Department of Health and Human Services published a report recommending that marijuana remain a Schedule I drug, meaning it has no acceptable medicinal uses and represents a high risk of abuse. However, in preparing this report the government glossed over contradictory studies and even caveats in the articles that they did cite. For example, in arguing that marijuana is dangerous because of a “proven” potential for abuse in humans, the report discounts numerous self-medication studies of animals that do not indicate a potential for abuse. The report also fails to acknowledge the problems inherent in conducting controlled research on humans who use marijuana, such as the tendency of street marijuana to be laced with other substances, or the fact that marijuana users frequently use other drugs. Additionally, most of the studies that the Department of Health and Human Services cited were cross-sectional and not longitudinal studies, meaning that there is little evidence to show that cannabis use is detrimental to its users in the long run.

From the little research conducted thus far, two drugs—which use a synthetic version of the main active ingredient in marijuana—have been approved by the Food and Drug Administration (FDA) and are currently on the U.S. market. Yet there are hundreds of other compounds in botanical, or smoked, marijuana; their effects have never been fully explored. Until they are, the government’s assertion that marijuana does not have a legitimate medical use rests on faulty conclusions.

To be fair, a mechanism for government funding of cannabis research exists, but it is insufficient. Research-grade marijuana is available for “well-designed studies” through the Department of Health and Human Services. Still, the government is far from encouraging this sort of research, and there are many bureaucratic hurdles that must be cleared before such research can be undertaken. According to Dr. Shaffer, these obstacles significantly inhibit scientific interest and effort towards understanding the medical applications of marijuana. “There is some research going on regarding medical marijuana, but it is limited,” said Shaffer. “Scientists need special permission from the government…The application process does not make it easy to study the plant.”

The only way to make informed decisions on how marijuana should be used is to ground those decisions in hard scientific fact. Currently, a critical mass of data that would incontrovertibly support or refute marijuana’s medical use is simply not available. The government should devote funds to finding a scientifically sustainable answer to these pressing questions. Until then, any laws or decisions pertaining to marijuana are bound to be grounded in hype, myth and mystique.

Brian J. Rosenberg ’08, a Crimson editorial comper, lives in Stoughton Hall.