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The Future of Marijuana

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					Healthy Outcomes, Inc.



       The Future of Marijuana                    marijuana (have you ever used marijuana?)
                                                  and the current use (have you used
           By Marilyn G. Belmonte                 marijuana in the past month?) has begun to
               June 21, 2012                      increase again after many years of steady
                                                  decline. This shows us that prevention
                                                  efforts in Massachusetts were working until
This year, voters will be asked to decide the     the vote to decriminalize marijuana.
fate of marijuana in Massachusetts. There
are two distinct sides on this topic. The                                   Marijuana Use Among MA High School
PRO side is funded by a handful of                                                        Students,
                                                                                       YRBS 2003-2011
billionaires who want marijuana to be the
                                                                      100
next big industry in our country. The CON
                                                                                                                2003   2005
side has little funding because prevention




                                                Percent of students
                                                                       80
relies on grant money that has been cut back
                                                                       60
since 9/11. Money is important for a                                         47 45
                                                                                     41 43 43                   2007   2009
successful campaign. But for the voting                                40                       28 2625 27 28
process to be fair, every voter needs to know
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all the facts.                                                                                                  2011
                                                                        0
                                                                             Lifetime use       Current use
Teen Marijuana Use
The annual Partnership Attitude Tracking          Why are we seeing this rise in teen
Study (PATS), released in late April 2012,        marijuana use? Surveys show that teen
showed that past-month use of marijuana           perception of harm from marijuana use has
rose from 19 percent in 2008, to 27 percent       been dropping since states have begun
in 2011. Nearly half of teens (47 percent)        legalizing marijuana for self-proclaimed
have used marijuana in their lifetime – a 21      medical use. The general perception is that
percent increase since 2008. Two out of           medicines are safe, therefore if some states
every five teens (39 percent) have tried          consider marijuana to be medicine, then
marijuana in the past year, up from 31            marijuana must be safe.
percent in 2008. Nearly one in 10 teenagers
smoke marijuana at least 20 times a month,
an increase of 80% since 2008.                    Driving Under the Influence

                                                  Rates of alcohol-impaired driving or “drunk
                                                  driving” have dropped over the past decade
                                                  in part due to messages from law
                                                  enforcement and Mothers Against Drunk
                                                  Driving (MADD). But most people are not
                                                  aware that drug-impaired driving is on the
                                                  rise.
Since Massachusetts decriminalized
marijuana in a 2008 ballot vote (the law took     The National Highway and Traffic Safety
effect in January 2009), our state has seen a     Administration reports that on any given
rise in youth marijuana rates. According to       weekend in this country, more people drive
the 2011 Massachusetts Youth Risk                 under the influence of drugs than alcohol.
Behavior Survey, the lifetime use of

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In fact, their study of 48 contiguous states     enough research to confirm if THC is solely
found that of drivers who were tested for        responsible for easing symptoms, or another
drugs and alcohol, 2.2% were driving over        drug found in the plant.
the legal limit of alcohol but 16.3% tested      Plants have been used for medicinal
positive for drugs.                              purposes for centuries. But today the drugs
                                                 are extracted from plants and made into
DUI means “Driving Under the Influence of        medicine. Aspirin is derived from willow
drugs and/or alcohol”. It is illegal to drive    tree bark. When a doctor tells a patient to
after smoking marijuana or while smoking         take two aspirin, the doctor is not
marijuana. A recent survey asked high            recommending that the patient chew on tree
school students where they most commonly
                                                 bark.
smoke marijuana. The most common place
reported was in the car. Teens and adults        Atropine, used for some heart problems, is
may be unaware that driving under the            made from the deadly nightshade plant.
influence of marijuana is illegal even in        Codeine and morphine, prescribed for pain
states that have passed a law legalizing its     relief, are made from the opium poppy plant
use for so-called medical reasons. This is       which also gives us the illegal drug, heroin.
because marijuana impairs reflexes,              Digitoxin, prescribed for heart problems, is
coordination, and vision. Regardless of the      made from the lovely foxglove plant which
amount possessed by the driver, if a driver is   is poisonous if eaten. Scopolamine is used
“high”, the driver will be arrested for DUI.     for motion sickness and derived from the
                                                 hallucinogenic Jimson Weed. Ephedrine
                                                 and pseudoephedrine for the relief of cold
                                                 symptoms is made from ma-huang which
                                                 causes heart attacks and stroke in high
                                                 doses.
                                                 All of these drugs were extracted from
                                                 plants then tested for their effectiveness,
                                                 safety and dosage. Once properly tested, the
                                                 drugs were formulated into medications
                                                 such as oral pills, transdermal patches, or
Natural Medicine                                 injection liquids that can be easily
                                                 manufactured for consistency of quality and
Marijuana is a plant and thus natural versus     dosage. Marijuana has not yet been
man-made drugs in a laboratory. But the          adequately tested like all of our other
marijuana plant contains more than 60            medicines.
different drugs. One of the drugs found in
marijuana, delta-9-tetrahydrocannabinol          Official Medical Opinion
(THC), makes people feel “high” when they
smoke it. Some people believe that the THC       The American Medical Association (AMA)
in marijuana helps cancer patients deal with     is the largest medical association in the
the nausea and loss of appetite caused by        country. Its mission is to promote medicine
chemotherapy; helps relieve the pressure         for the betterment of public health, to
inside the eye caused by glaucoma; relieves      advance the interests of physicians and their
the pain of migraine headaches; and helps        patients, to lobby for legislation favorable to
with other ailments. But there has not been      physicians and patients, and to raise money

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for medical education. The AMA released a        formula that will allow patients to receive
formal position statement that more              the drug without the harmful effects of
“adequate and well-controlled studies of         smoking.
marijuana and related cannabinoids are
needed” and marijuana’s status as a              Cannabinoid-Related Medications
Schedule I controlled substance should be
“reviewed with the goal of facilitating the      Legalization of marijuana for use in
conduct of clinical research and                 “medical” situations may not be necessary.
development of cannabinoid-based                 Currently there are several legal, synthetic
medicines, and alternate delivery methods”.      forms of THC used as prescription
In other words, we need to reclassify            medicines. Pharmaceutical drugs have been
marijuana to make it more readily available      developed with similar chemicals as those
to scientists and conduct much needed            found in the marijuana plant. Some
research before deciding how to use              researchers have used their understanding of
marijuana for medical purposes.                  how the brain processes cannabinoids to
                                                 develop drugs which follow the same
 The AMA goes on to say that their               pathways as marijuana. Marinol and
statement “should not be viewed as an            Dronabinol contain man-made THC and are
endorsement of state-based medical               widely prescribed by doctors to relieve the
cannabis programs, the legalization of           nausea and vomiting associated with
marijuana, or that scientific evidence on the    chemotherapy for cancer patients and to
therapeutic use of cannabis meets the current    assist with loss of appetite with AIDS
standards for a prescription drug product”.      patients. Nabilone, Cesamet, Cannabinor
Since smoking is unhealthy and linked to         and Dexanabinol contain a synthetic drug
disease, the AMA recommends the                  similar to THC for those same purposes.
“development of a smoke free delivery
system for marijuana or delta-9-
tetrahydrocannabinol (THC) to reduce the
health hazards associated with the
combustion and inhalation of marijuana”.




                                                 Sativex is the latest prescription cannabinoid
                                                 medication and the only natural THC
                                                 product developed from raw marijuana. It is
                                                 a mouth spray that delivers a precise dose of
Medical experts are interested in research on
                                                 chemical compounds derived from natural
the marijuana plant before they will consider
                                                 extracts of the cannabis plant. Sativex
marijuana as a medicine. This research is
                                                 contains two cannabinoids: THC (delta-9-
needed to determine which cannabis
                                                 tetrahydrocannabinol) and CBD
chemicals are effective for specific ailments;
                                                 (cannabidiol). It has been approved for
to determine safe doses for patients of all
                                                 medical use in the United Kingdom, Canada,
ages; to test for possible side effects that
                                                 New Zealand and eight European countries.
doctors need to monitor; and to design a

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Sativex is in advanced clinical trials in the   Then the drug company sends CDER the
U.S. and may see FDA approval by the end        proof that the drug is safe and effective for
of 2013.                                        its intended use. A team of physicians,
                                                chemists, pharmacologists, and scientists
It is important to note that this formula is    reviews the company's data and proposed
effective at delivering the medication          labeling. This review is independent and
without the “high” of smoking marijuana.        unbiased. If the review establishes that a
In fact, the main difference between all the    drug's health benefits outweigh its risks, the
above prescription drugs and marijuana is       drug is approved for sale. The center doesn't
that the legal prescriptions do not include     actually test drugs itself, although it does
the “high”.                                     conduct limited research in quality, safety,
                                                and effectiveness standards.
                                                Smoked marijuana has not been passed as
The FDA Standards for Medicines
                                                safe by the FDA. The FDA has determined
                                                that “marijuana has a high potential for
American consumers benefit from having
                                                abuse, has no currently accepted medical use
access to the safest and most advanced
                                                in treatment in the United States, and has a
pharmaceutical system in the world. The
                                                lack of accepted safety for use under
U.S. Food and Drug Administration's Center
                                                medical supervision”. Past evaluation of
for Drug Evaluation and Research (CDER)
                                                smoked marijuana by several Department of
evaluates new drugs before they can be sold.
                                                Health and Human Services agencies,
The center's evaluation process makes sure
                                                including the Food and Drug Administration
that medications are safe for patients and
                                                (FDA), Substance Abuse and Mental Health
provide doctors the information they need to
                                                Services Administration (SAMHSA) and
use medicines wisely. CDER ensures that
                                                National Institute for Drug Abuse (NIDA),
drugs, both prescription and over-the-
                                                concluded that “no sound scientific studies
counter, both brand-name and generic, work
                                                supported medical use of marijuana for
correctly and that their health benefits
                                                treatment in the United States, and no
outweigh their known risks.
                                                animal or human data supported the safety
                                                or efficacy of marijuana for general medical
Drug companies seeking to sell a drug in the
                                                use”.
United States must first test the new drug.
Before a drug can be tested in people, the      Until research has been completed and
drug company conducts animal tests to           approved by the FDA that compounds in
discover if it is likely to be safe and work    marijuana are safe and effective for medical
well in humans. Next, a series of tests in      use, marijuana can not be considered a
people is begun to determine whether the        medicine in this country. There is no legal,
drug is safe and provides a real health         scientific or medical basis for the term
benefit.                                        “medical marijuana”. Some states are filing
                                                legal suits to prevent the term from being
                                                used until the medical community authorizes
                                                it.
                                                Marijuana Dispensaries
                                                In those states that have legalized marijuana
                                                for self-reported medical use, any resident
                                                can obtain marijuana for almost any

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Healthy Outcomes, Inc.



symptom because the state laws are not             dispensaries. Their professional licenses
written to confine marijuana only for the          can be revoked for breaking federal law by
seriously ill. The wording of the laws list        selling an illegal drug. The dispensary or
cancer, glaucoma and HIV but also list “any        “pot shop” requires a simple form to be
other illness” which leaves the law open to        completed. Then a “marijuana card” is
interpretation.                                    issued by the state to patients which allows
                                                   them to visit any pot shop and purchase a
                                                   variety of strains of marijuana.
                                                   Pot shops can sell marijuana to patients in
                                                   large quantities. So-called “medical”
                                                   marijuana laws state that patients can
                                                   possess up to a 60-day supply. However,
                                                   these state laws do not specify how much
                                                   equals a 60-day supply. If a person claims
                                                   to need 3 joints a day, and there is an
                                                   average of 60 joints per ounce, that means a
                                                   60-day supply equals 3 ounces or 180 joints.

The process of obtaining marijuana in states
with legal marijuana for self-proclaimed
illnesses is fairly simple. First, patients need
to find a doctor who will recommend
marijuana. Since it is not a prescription
drug, doctors can not prescribe marijuana,
only recommend the use. Most doctors do
not recommend marijuana for their patients.
                                                   Marijuana is not the only thing sold in these
In Oregon, only 10 doctors made
                                                   pot shops. They also sell hashish, pot pipes,
recommendations for all the marijuana
                                                   pot grinders, bongs, and small pot plants to
patients in the state. Doctors willing to
                                                   take home. These state laws allow people to
recommend marijuana advertise to
                                                   grow their own marijuana plant if a person
communities through billboards, flyers and
                                                   lives an inconvenient distance from a
the internet.
                                                   dispensary. That “inconvenient” distance is
                                                   also not clarified in the state law.




Then patients take this written
recommendation to a state marijuana
dispensary. Local pharmacies do not sell           Dispensaries also sell food laced with
marijuana. Pharmacists and other medical           marijuana. Cookies, brownies, cakes,
professionals do not work at marijuana

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Healthy Outcomes, Inc.



candy, sodas, all infused with THC are for        So why is there a movement to legalize
sale. The pot shops usually offer customers       marijuana to be used as a medicine instead
a comfortable sitting area to relax and enjoy
smoking marijuana and eating marijuana-
laced food.


The Legalization of Marijuana
An important issue to clarify is that
marijuana is an illegal, DEA-Schedule I
controlled substance. That means that if          of outright legalization? Is the United States
every state in America passes a law allowing      ready for the legalization of marijuana? A
the legal use of marijuana for self-reported      May 2012 poll shows rising support: 56% of
medical issues, marijuana will remain an          voters polled said they would support
illegal drug. The conflict between federal        legalizing marijuana.
law that bans the use of marijuana, and state     Decriminalization laws and so-called
law that allows the use of marijuana, causes      “medical marijuana” laws have softened the
problems between our federal government           public’s perception of marijuana. These
and our state employees. In fact, the MA          laws were designed by highly paid
Department of Public Health will be               marketing experts to dilute our concerns
mandated to oversee the marijuana                 about marijuana. Studies prove that as the
dispensary program in our state if this law       perceived risk in smoking marijuana
passes. Employees of the DPH will be              increases, the rate of use decreases.
subject to arrest for breaking federal law.       Conversely, as perceived risk decreases, the
Companies that require drug testing because       use of marijuana increases.
they have a drug-free workplace policy, will
still be able to fire employees for failing
their drug test even if they have a state
marijuana card. More than 6,000
companies, industries and professions
require a pre-employment drug test. Laws
legalizing marijuana for “medical” use may
make people unemployable.
Employees that drive school buses or other
transportation will lose their jobs if they use
marijuana because it is illegal to drive
impaired by alcohol or drugs. If a person is
disabled in a car accident where they were
found to be driving under the influence of
marijuana (DUI), their disability insurance is
voided. Supreme Court cases have held up          In Massachusetts, we are now facing a very
these statutes because marijuana is an illegal    important decision that will affect our future
drug and federal law always takes precedent       and our children’s future. Your vote needs
over state law.                                   careful consideration. Vote wisely



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