Access to medical marijuana: Federal law in the United States supports the use of Marinol and Cesamet but does not support the use of other forms of marijuana for medicinal purposes. There are some conflicts, however, between state and federal law in the United States. By 2008, twelve states had passed legislation legalizing medical marijuana in one way or another. In some cases, there were state-level rules governing possession of dried forms of the drug and/or plants in varying quantities for patients and care providers; in others, circumstances varied county by county. Many required users of medical marijuana to obtain the drug in certain ways and/or maintain registration for medical purposes. Rules varied from country to country as well. Holland, for instance, permitted use of marijuana by the public for any purpose in establishments called coffee shops. Even in Holland, however, there were strict guidelines on where it could be used, the amount permitted to be given to each user or to be present in each shop, and other matters, such as the impact of the coffee shop on the surrounding community.
Medicinal effects and uses: Marinol and Cesamet address appetite problems, as well as nausea and its associated vomiting. In terms of nausea, they are used typically in individuals undergoing chemotherapy for cancer, and particularly in individuals who have not responded to other forms of treatment for those conditions. In terms of appetite, they are used typically in clients with acquired immunodeficiency syndrome (AIDS) to combat a loss of appetite and its associated weight loss. Other, diverse conditions have been reported as potentially benefiting from medical marijuana, including Alzheimer’s disease, anorexia, cancer, chronic or debilitating pain, cramping, Crohn disease, glaucoma, human immunodeficiency virus (HIV), multiple sclerosis, seizures, muscle spasms, and wasting syndrome (cachexia). This list does not include all conditions that varying state laws recognize as eligible for marijuana use. Many of the states that have legalized medical marijuana have, as part of the law, clauses that either allow the list of treatment-eligible conditions to be amended or are open-ended and subject to physician approval. Scientific reports continue to generate speculation about conditions that may receive benefit from treatment, such as depression. Use of marijuana for all of these conditions, however, remains the subject of great debate and is illegal in most states.
Controversies of medical marijuana: Despite the fact that synthetic THC and THC derivatives serve medical purposes, and despite the fact that twelve states allowed the use of marijuana for medicinal purposes as of 2008, medical marijuana is a controversial topic. Opponents of medical marijuana are quick to point out that Marinol and Cesamet exist as pharmaceuticals regulated by the Food and Drug Administration (FDA) and are adequate to cover the conditions most often treated with marijuana. Proponents of medical marijuana counter that those drugs do not work well for everyone and that they are only to be used for certain conditions. In the light of pain and suffering caused by other conditions, they argue, why not allow medical marijuana use? Again, opponents answer that other viable treatments exist that are better to try as treatment options, that the evidence for marijuana’s efficacy in treating these other conditions is weak, and that there are strong social, physical, mental, and behavioral cons to the use of marijuana and its alternative forms.
Typical cons cited are posed in terms of short-term and long-term risks. In the short term, these may include memory and learning difficulties, panic, anxiety, coordination problems, and impaired problem solving. In the long term, these may include problems related to addiction, such as abuse or dependence, motivational problems, daily cough, phlegm problems, respiratory problems, impact on the immune system, and possibly cancer. Proponents argue that the pros outweigh the cons and that, despite evidence that some may consider weak, this method of treatment for such debilitating conditions deserves further study.
The debate continues, however, from state to state and country to country. Future studies focusing on the risk impacts of marijuana use are to be expected. Expanding the use of Marinol to other conditions may be on the horizon. The fight to allow studies examining the utility of marijuana for treating health conditions faces continued struggles in the United States and elsewhere.
Bibliography
Earleywine, Mitch. Understanding Marijuana: A New Look at the Scientific Evidence. New York: Oxford University Press, 2002.
Gerber, Rudolph Joseph. Legalizing Marijuana: Drug Policy Reform and Prohibition Politics. Westport, Conn.: Praeger, 2004.
Rosenthal, Ed, and Steve Kubby. Why Marijuana Should Be Legal. New York: Thunder’s Mouth Press, 2003.
Russo, Ethan B., and Franjo Frotenhermen, eds. Handbook of Cannabis Therapeutics: From Bench to Bedside. Binghamton, N.Y.: Haworth Press, 2006.
Russo, Ethan B., Melanie Dreher, and Mary Lynn Mathre, eds. Women and Cannabis: Medicine, Science, and Sociology. Binghamton, N.Y.: Haworth Press, 2002.
Selvanathan, Saroja, and Eliyathamby A. Selvanathan. The Demand for Alcohol, Tobacco, and Marijuana: International Evidence. Burlington, Vt.: Ashgate, 2005.
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