The American Legion wants the federal government to change course on marijuana
The Washington Post - Christopher Ingraham -9/8/2016
The American Legion, a group representing 2.4 million U.S. military veterans, has called on Congress to remove marijuana from Schedule 1 of the federal Controlled Substances Act and "reclassify it in a category that, at a minimum will recognize cannabis as a drug with potential medical value."
In a resolution passed at the Legion's annual convention last week, the organization said it hopes that better research into marijuana and an official acknowledgment of its potential medical benefits will hasten the development of new treatments for post-traumatic stress disorder and traumatic brain injuries, ailments that have plagued veterans returning from the wars in Iraq and Afghanistan.
The Legion's resolution, published online by Marijuana.com, noted that the federal Drug Enforcement Administration recently approved the country's first randomized, controlled trial using whole-plant, smoked marijuana to treat PTSD symptoms. That study will be conducted by Sue Sisley, an Arizona researcher who tried for nearly a decade to get a green light for the research but struggled to find an academic institution to sponsor it. The University of Colorado ultimately agreed to fund the research.
During an address at the Legion's convention in Cincinnati, Sisley told members that "veterans are exhausted and feel like guinea pigs; they’re getting desperate” and that traditional medications didn't seem to be providing adequate relief to many vets suffering from PTSD.
The DEA recently reaffirmed its decades-old policy of classifying marijuana among the most dangerous drugs, citing its "high potential for abuse" and "no currently accepted medical use." That position has faced increasing criticism from federal and state lawmakers, physicians,researchers and even some law enforcement groups.
Medical marijuana is extremely popular with voters: A June Quinnipiac University poll found that 89 percent supported the use of marijuana with a doctor's recommendation. Aseparate survey by the Iraq and Afghanistan Veterans of America found that 68 percent of responding members supported legalizing medical marijuana in their state, and 75 percent said that the Department of Veterans Affairs should allow medical marijuana as a treatment option.
A DEA position paper from 2013 states that "smoked marijuana has not withstood the rigors of science — it is not medicine, and it is not safe."
The stark difference in how doctors and the government view marijuana
The Washington Post - By. Christopher Ingraham - 8/29/16
Nathaniel P. Morris is a resident physician at Stanford Hospital specializing in mental health. He recently penned a strongly worded op-ed for ScientificAmerican.com on the differences between how some in the medical community view marijuana and how the federal government regulates it.
"The federal government's scheduling of marijuana bears little relationship to actual patient care," he wrote in the essay published last week. "The notion that marijuana is more dangerous or prone to abuse than alcohol (not scheduled), cocaine (Schedule II), methamphetamine (Schedule II), or prescription opioids (Schedules II, III, and IV) doesn't reflect what we see in clinical medicine."
Here's Morris' money quote:
For most health care providers, marijuana is an afterthought.
We don't see cannabis overdoses. We don't order scans for cannabis-related brain abscesses. We don't treat cannabis-induced heart attacks. In medicine, marijuana use is often seen on par with tobacco or caffeine consumption — something we counsel patients about stopping or limiting, but nothing urgent to treat or immediately life-threatening.
He contrasts that with the terrible effects of alcohol he sees in the emergency room every day, like car crash victims and drunk patients choking on their own vomit. Morris points out that excessive drinking causes 88,000 deaths per year, according to the CDC.
The medical and research communities have known for some time that marijuana is one of the more benign substances you can put in your body relative to other illicit drugs. A recent longitudinal study found that chronic, long-term marijuana use is about as bad for your physical health as not flossing. Compared to alcohol, it'svirtually impossible to overdose on marijuana alone. On a per-user basis, marijuana sends fewer people to the emergency room than alcohol or other drugs.
The scientific consensus was best captured in a 2010 study in the Lancet, which polled several dozen researchers working in addiction and drug policy. The researchers rated commonly used recreational drugs according to the harm they pose to individuals who use them, as well as the harm they pose to society as a whole. Here's what their results looked like:
DEA Wins the Battle but Is Losing the War on Marijuana
Alternet - Gabrielle Gurley - 08/24/2016
The U.S. Drug Enforcement Administration’s refusal to decontrol marijuana has raised the hackles of doctors, patient advocacy groups, cannabis entrepreneurs, and potheads almost everywhere. Under the agency’s recent directive, marijuana remains an illegal, controlled substance like heroin and LSD that has no medical value. But unlike most federal regulations, the DEA move will have little to no effect on state-level marijuana politics.
Since Colorado and Washington state green-lighted recreational marijuana in 2012, the DEA has gotten swamped by a tidal wave of legalization campaigns across the country for recreational and medical marijuana. Most states have moved fast, first, to allow doctors and patients who suffer from diseases like cancer and conditions like chronic pain to be able to use marijuana without the omnipresent threat of arrest and prosecution. But states, especially ones that already have medical marijuana, have also picked up the pace toward complete legalization for a simpler reason: beaucoup tax dollars.
To date, 26 states have legalized or decriminalized marijuana. There are a plethora of ballot initiatives on tap for voters to weigh in on this November. Initiatives in Arizona, California, Maine, Massachusetts, and Nevada would legalize possession of specific amounts of marijuana and cultivation of a certain number of plants. (The Massachusetts question also proposes to tax the substance like alcohol.) Arkansas, Florida, Montana, and North Dakota will consider legalizing or expanding access to medical marijuana. Several other states are awaiting the outcomes of conflicts over access to the ballot for marijuana initiatives.
Taxpayers may nix other tax increases, but they embrace sin taxes on marijuana. Though marijuana sales in states new to the industry can be slow going, recreational marijuana tax revenues can run into the hundreds of millions of dollars. Colorado has made an airtight case for marijuana revenues. The state takes in a 2.9 percent retail and medical marijuana sales tax, but more importantly, it takes in a 10 percent retail marijuana special sales tax and a 15 percent marijuana excise tax, as well as application and license fees for both retail and medical marijuana. In June, Colorado took in nearly $16.8 million in taxes and other fees compared to nearly $10.8 million in 2015, a whopping 55 percent increase.
In 2014, Colorado recreational marijuana businesses tallied nearly $700 million in sales, while the state took in $76 million in taxes. Last year was even better: Colorado took in $135 million in fee and tax revenues on nearly $1 billion in sales. The good citizens of the Centennial State even rejected a $66 million tax refund plan; instead, the monies stayed in state coffers and went to school construction, law enforcement and substance-abuse programs, and other budget line items.
Future recreational marijuana revenues are a major selling point in the states that have marijuana ballot questions.Nevada would slap marijuana sales with a 15 percent excise tax on top of the state’s 10 percent sales tax; projected tax annual revenues are nearly $465 million.
Overall, the DEA directive will have little impact on the booming industry. Meanwhile, a recent Ninth Circuit Court of Appeals decision may make medical marijuana dispensary owners breathe a little easier. The court ruled last week that the U.S. Department of Justice cannot prosecute people who comply with their state laws on medical medical marijuana sales.
The DEA decision did relax regulations on using marijuana plants in medical research (a sticking point that has long frustrated the medical community), which will allow scientists to cultivate plants in DEA-approved facilities. Medical marijuana use may be flourishing but doctors and other medical professionals have had to forge ahead without the rigorous research and clinical protocols that usually accompany new drug regimes, which can take years.
Currently, there is only one DEA-approved medical research facility in the country at the University of Mississippi. But researchers have a long list of issues with accessing the Ole Miss cannabis, including finding that the university cannot offer enough varieties of the plant which complicates testing. Some researchers have even complained that the university’s marijuana was inferior and did not compare favorably to products that can obtained in states were marijuana is legal. (Nor are they convinced that the DEA plans to make life easier for researchers to set up their own facilities.)
There are also more dollars for states in the economic development opportunities to be had in research and development. After Ohio’s Republican Governor John Kasich signed medical marijuana legislation into law in June, officials in Johnstown, a small town north of Columbus, gave the go-ahead for more marijuana businesses to set up shop.
The community already has one marijuana business (a manufacturer of equipment that uses a carbon dioxide separation process to separate oils from marijuana and other types of plants.) now headquartered at a nearly empty office park. The owner of that firm, Apeks Supercritical, has visions of a $500 million medical marijuana research and development campus. Johnstown may even corner the the R&D market since other Ohio communities are not keen on marijuana dispensaries. (At the other end of spectrum, even behemoths like Microsoft want in.)
State officials can work around Uncle Sam since many Americans have come to believe that pot has important medical benefits and is not as dangerous as a drug like heroin. That means that the DEA is now confronted with a paradox: There is new and entirely appropriate alarm about the opiate abuse crisis nationwide. However, the agency has obliterated the old canard that marijuana was a “gateway” drug to hard drugs. It makes no sense for the DEA, other federal agencies, and state and local law enforcement to continue enforcing existing restrictions on pot as they grapple with a far more serious opioid epidemic.
States are the laboratories of democracy, so it is no surprise that the federal government has failed to keep up with regulating the pot industry. But this November, the feds could fall even further behind. As more states legalize marijuana, the DEA will have think hard about how the agency continues to prosecute its war on a drug that is a medical and fiscal lifesaver in most of the 50 states. To his great credit President Obama has made headway on Cuba normalization, relief for Dreamer kids, and entente with Iran. But this issue continues to demand more federal law enforcement attention than it should. Perhaps his successor will finally leash the DEA and get real on marijuana.
Linc Chafee pushed DEA to reconsider cannabis
RI Future - By. Bob Plain - 08/13/16
The federal government might be comfortable equating marijuana to heroin, crack and meth, but Rhode Island isn’t. At least it wasn’t when Linc Chafee was our governor. The Drug Enforcement Administration’s recentheadline-grabbing decisionto keep cannabis as a Schedule 1 drug was the result of a request from the Chafee administration in 2011.
In a July 19 letter to Governor Gina Raimondo, Chuck Rosenberg, the acting administrator of the DEA, wrote, “On November 30, 2011, your predecessors, The Honorable Lincoln D. Chafee and The Honorable Christine O. Gregoire, petitioned the Drug Enforcement Administration (DEA) to initiate rulemaking proceedings under the rescheduling provisions of the Controlled Substances Act (CSA),” according to the federal register. “Specifically, your predecessors petitioned the DEA to have marijuana and “related items” removed from Schedule I of the CSA and rescheduled as medical cannabis in Schedule II.”
The DEA, it should be noted, disagreed, writing to Raimondo, “Based on the HHS evaluation and all other relevant data, the DEA has concluded that there is no substantial evidence that marijuana should be removed from Schedule I.” It cited three main reasons: “Marijuana has a high potential for abuse. Marijuana has no currently accepted medical use in treatment in the United States. Marijuana lacks accepted safety for use under medical supervision.” An editorial in today’s New York Times proves false each of those three reasons. The DEA was also responding to a request from the governor of Washington and a citizen of New Mexico.
While governor of Rhode Island, Chafee signed legislation to decriminalize less than an ounce of marijuana. But he declined to push Rhode Island to become the first state on the East Coast to tax and regulate marijuana. As a presidential candidate earlier this year, there was some reason to believe Chafee was considering campaigning as a pro-pot candidate after he said his position on full federal legalization would “evolve during the campaign.”
Governor Raimondo has taken a similar tack on taxing and legalizing marijuana as Chafee did during his tenure. “I could see Rhode Island eventually getting there, but I’m not going to rush,” she said in March. On medical marijuana, she pushed legislation that added a per-plant tax to patients who don’t grow their own.
Rhode Island has the highest per capita marijuana users in the nation and a recent poll found 55 percent of Rhode Islanders favor legalization. A different poll found 53 percent of Americans favor legalization.
Marijuana to remain illegal under federal law, DEA says
USA Today - By. Donna Leinwand Leger - 8/11/2016
Marijuana advocates who hoped the cascade of states moving to legalize medical marijuana would soften the federal stance on the drug faced disappointment Thursday as the Drug Enforcement Administration announced it will keep marijuana illegal for any purpose.
Marijuana will remain a Schedule 1 substance under the Controlled Substances Act. Substances in Schedule 1 are determined by the Food and Drug Administration to have no medical use. States that allow marijuana for medical use or legalize recreational use remain in defiance of federal law.
The announcement to be published Friday in the Federal Register relaxes the rules for marijuana research to make it easier for institutions to grow marijuana for scientific study. The DEA currently authorizes just one grow facility in Mississippi.
In reaching its conclusion, the DEA said a Health and Human Services evaluation shows marijuana has no ‘‘currently accepted medical use’’ because "the drug’s chemistry is not known and reproducible; there are no adequate safety studies; there are no adequate and well-controlled studies proving efficacy; the drug is not accepted by qualified experts; and the scientific evidence is not widely available."
"There is no evidence that there is a consensus among qualified experts that marijuana is safe and effective for use in treating a specific, recognized disorder," the report added.
"At this time," the DEA concluded, "the known risks of marijuana use have not been shown to be outweighed by specific benefits in well-controlled clinical trials that scientifically evaluate safety and efficacy."
On other points, the DEA report noted marijuana has a "high potential" for abuse and can result in psychological dependence. It said around 19 million individuals in the U.S. used marijuana monthly in 2012 and that contemporaneous studies showed around 4.3 million individuals met diagnostic criteria for marijuana dependence.
It did not find, however, that marijuana is a "gateway drug."
"Little evidence supports the hypothesis that initiation of marijuana use leads to an abuse disorder with other illicit substances," the report said.
The decision signals a difficult road ahead for legalization efforts, said Kevin Sabet, president of Smart Approaches to Marijuana and a former Obama administration drug advisor. Companies that seek to use marijuana as medicine will have to go through the same rigorous scientific evaluation as traditional pharmaceutical drugs.
"This is a vindication for science and for people who have said to go slow," Sabet said. "I think it’s a bad day for legalization efforts and a good day for scientists."
The DEA's decision ignores the public will and patients' experience with the medical benefits of marijuana, says Tom Angell, chairman of Marijuana Majority, which advocates for removing marijuana from the drug scheduling restrictions. Congress should bar DEA and other federal agencies from interfering with the implementation of state marijuana laws, Angell said.
"President Obama always said he would let science — and not ideology — dictate policy, but in this case his administration is upholding a failed drug war approach instead of looking at real, existing evidence that marijuana has medical value," Angell said. "A clear and growing majority of American voters support legalizing marijuana outright and the very least our representatives should do is let states implement their own policies, unencumbered by an outdated ‘Reefer Madness’ mentality that some in law enforcement still choose to cling to."
At least eight states will consider marijuana issues in the November election. Voters in Arizona, California, Massachusetts, Maine and Nevada will consider full legalization. Arkansas and Florida have medical marijuana measures on their ballots. Montana voters will consider a measure to restore the state's medical marijuana law after legislative and judicial actions curtailed the law.
Although the federal law trumps the state laws, the DEA has not taken aggressive action in states that have opted to legalize medical marijuana or small amounts of marijuana for recreational use. The Justice Department reserved its right to challenge state laws if public health or safety problems emerge or if the states fail to enact strict regulations to control marijuana use and sale.
DEA: Marijuana Seizures Decline In 2015
Norml - By. Paul Armentano - 8/3/16
WASHINGTON, DC — Seizures of indoor and outdoor cannabis crops by the US Drug Enforcement Administration (DEA) fell in 2015, according to annual data compiled by the US Drug Enforcement Administration.
According to the DEA’s Domestic Cannabis Eradication/Suppression Statistical Report, agents eradicated 4.25 million marijuana plants nationwide in 2015. That total is slightly less than the total reported by the agency for the year 2014 (4.3 million) and continues to the ongoing decline in eradication totals since 2010, when the agency reportedeliminating some 10.3 million plants.
As in past years, DEA eradication efforts largely focused on California. Of the total number of plants seized nationwide by the DEA in 2015, 62 percent were in California.
Only about 7 percent of all plants seized by the DEA were from indoor grows.
The DEA reported making some 6,300 arrests in conjunction with their cannabis eradication efforts — a total that mirrors 2014 figures. By contrast, the agency reported making nearly 10,000 marijuana arrests in 2010 and 8,500 arrests in 2011.
DEA and police raid Westford family home in marijuana oil bust, arrest six
Boston.com By Nik DeCosta-Klipa
Four Westford family members, along with two family friends, were arrested Wednesday on a litany of drug charges after federal and local law enforcement raided their 3,855-square-foot home in a marijuana oil lab bust.
According to the Middlesex District Attorney’s office, Westford police and a Drug Enforcement Administration drug lab team arrived at the Mountain View Lane home at 8 a.m. to execute a search warrant.
Upon arrival, officials said they found a large basement lab manufacturing butane honey oil, a yellow honey-like substance which contains a more potent level of THC, the active ingredient in marijuana.
The process, in which butane liquid is put through marijuana buds, to create the yellow honey-like drug, also known as hash oil or dabs, can potentially cause hazardous or fatal explosions, according to the New England DEA head Michael J. Ferguson.
Husband and wife Bradley Heath Sr., 63, and Diane Heath, 61, as well as their son Bradley Heath II, 22, and daughter Linley Heath, 28, were charged with possession with intent to distribute and the manufacturing of a Class C substance, as well as conspiracy to violate drug laws.
The Heath son, who allegedly sold the drug under the name “Gold Street Extracts,” was also charged with distribution of a Class C substance, possession with intent to distribute a Class D substance, possession of a Class B substance, and operating a motor vehicle with a suspended license, according to officials.
Ayer District Court Judge Michael Brooks set Bradley Heath II’s bail at $30,000 cash on this case and detained him without bail on a probation violation from a previous case. Bail for the other three Heath family members was set at $500.
Westford resident Lyndsey Holston, 20, who police said is Bradley Heath II’s girlfriend, was also arrested in the case for manufacturing, distrbuting, and possessing with intent to distribute a Class C substance, as well as a conspiracy charge. Her bail was set at $1,000.
Twenty-two-year-old Groton resident Prachi Joglekar, a friend of Linley Heath, was also arrested for possessing with intent to distribute and manufacturing a Class C substance, as well as conspiracy charge. Joglekar’s bail was set at $500.
The defendants pleaded not guilty Wednesday. All six due back in court June 27.
“Their alleged lab operations compromised the safety and security of their neighbors, as well as the law enforcement officials who arrested the suspects today,” Middlesex District Attorney Marian Ryan said in a statement.
Medical marijuana legalized in Pa.
By Julia Terruso, Staff Writer philly.com
HARRISBURG - Hundreds of cheering families, legislators and patients watched Gov. Wolf sign a medical marijuana bill into law Sunday afternoon, many hopeful at last for relief from debilitating pain, seizures and other medical conditions.
Allie Delp watched from her mother's lap, purple sunglasses strapped around her wide blue eyes to protect them from the light. Large crowds are tough for Allie. The 4-year-old suffers from Dravet syndrome, a severe seizure disorder, and most days she stays in the dimly lit, cool comforts of her home to avoid triggers. Today was too important not to make the drive from Ford City, said Allie's mother, Amanda Delp.
"It feels like a dream. It really does," Delp said. "If you would have asked me four years ago if I would be advocating for medical marijuana, I would have told you it's just people wanting to get high. It took my daughter for me to open my eyes and realize it can save people."
A row away from Allie, Robert Billhime Jr., 45, sat with his girlfriend and 6-week-old napping son, Aspen. Multiple back surgeries left Billhime addicted to painkillers three years ago. He lost his job, his home. Addiction nearly cost him his life, he said. "If it wasn't for the cannabis I wouldn't be here. I won't go back. I won't be an addict," he said wiping a tear from his eye and looking down at his son.
Billhime called the day a huge step in the right direction but said discrimination and misunderstanding persist. "It's still not going to change the bigotry already in the legal system. If you're a cannabis user, legal or not, you're prejudged simply because you refuse to be an addict."
Billhime said he almost lost custody of his children because the family court judge ordered he take a drug test while he was using cannabis for back pain. He had supervised visitations for six months.
In the packed rotunda Sunday there were hundreds of stories like these. People trying to make it through their pain, determined, loving parents doing whatever they could - and then some for their kids. Wearing green for cannabis - and purple, for epilepsy awareness - they erupted in cheers as Wolf signed the bill into law.
Wolf thanked the advocates, particularly the mothers who brought their kids to rally at the Capitol to give a face to the people the legalization would benefit.
"When you have people who represent a cause as eloquently and in as heartfelt a way as the advocates for this has done, it shows we can get something done that means something," Wolf said. "We're not responding to a special interest here; we're not responding to someone who makes campaign contributions - we're responding to people who are telling us there is a real human need here in Pennsylvania."
There was much congratulating among legislators for bipartisan work on the bill.
"We won!" Sen. Mike Folmer (R., Lebanon), who rallied Republicans, said to a roar as he took the podium. "This is your day!"
Democratic Sen. Daylin Leach, who represents parts of Delaware and Montgomery Counties, recalled introducing a medical marijuana bill in 2010 and failing to find a single cosigner. "The pain of illness touches us all eventually and so we all united to defeat [pain] . . . We worked together, we studied, we begged, we cajoled and we argued - and we convinced our fellow legislators to join us."
The law allows people suffering from 17 specified conditions - including cancer, epilepsy, multiple sclerosis, and seizures - to access medical marijuana in pill, oil, or ointment form at dispensaries statewide.
The Department of Health is expected to oversee what will become a new industry in Pennsylvania, with dozens of dispensaries, hundreds of workers and potentially thousands of patients. Patients would use identification cards, after receiving a doctor's prescription, to access marijuana from one of 150 dispensaries statewide. All dispensaries would be licensed by the state and face intense regulation.
Getting the system up and running could take more than 18 months before a patient can actually access medical marijuana. A provision in the bill allows families with children under 18 to obtain medical marijuana from other states where it is legal without fear of prosecution.
Temporary regulations are also expected to be written to permit adults access if they can demonstrate they suffer from one of the 17 conditions listed in the legislation.
Delp hopes to use that provision to get Allie cannabis oil in the near future. Her daughter has as many as 80 seizures a month, she said. One in five children with Dravet doesn't live to adulthood, Delp said. Many are mentally challenged and require care the rest of their lives.
"Cannabis not only gives us hope to help control the seizures, but there are children in legal states where it's been shown to help their cognition," Delp said. "Maybe she'll be able to catch up, lead a normal life."
Allie is an active tomboy (she did barefoot laps around the rotunda before the bill-signing got under way). She doesn't know to avoid triggers for the seizures that threaten her life.
"She loves riding her four-wheeler, chasing her sisters around, just being a kid," Delp said. "This - it won't solve everything - but it gives us hope, and we need hope."
By Dan Nosowitz on January 12, 2016
Legalization of cannabis is generally moving quite a bit faster than research on how cannabis actually affects the body; scientists who have been hamstrung by the law from studying the plant are still, despite its increasing legality, subject to the same laws.
That scientists are playing catch-up is basically unavoidable; all it takes to overturn a law is a vote, but adequate research can take years or decades. This is an important ongoing story; news regularly comes that we don’t really have any idea what’s in cannabis products, let alone how the body metabolizes it all. In place of decades of research (which other substances, like alcohol, have), cannabis has hearsay and guesswork.
A significant step forward was announced last month by the Drug Enforcement Administration (DEA) to address a problem regularly felt by scientists studying cannabidiol, a cannabis extract. Cannabidiol researchers are subject to all kinds of regulations because marijuana and all its derivatives remain listed as a Schedule I drug by the Controlled Substances Act, written way back in 1970. That means that the DEA has control over any scientists wishing to study any of those substances, and the DEA maintains an awfully tight grip on them.
Until now, any researchers wishing to study cannabidiol would have to be certified by both the FDA (because cannabidiol research falls under the heading of new drug research) and the DEA. The latter decides who is fit to study cannabidiol and exactly how much they’re allowed to possess.
This is a problem because if a researcher changes the scope of his or her investigation, or simply runs out of cannabidiol, they’re required to apply via a written application to the DEA for more material. This process can take weeks or months, delaying or even outright disabling the study. It’s one of those little red tape things that can actively harm our understanding of a substance used by a huge percentage of the population.
The DEA’s announcement changes all that, stating that any researcher who is previously approved to study cannabidiol can do away with that extra application process: If you’re approved to study it, you can have as much as you need, when you need it. And with any luck, this will free up researchers to learn more about marijuana and its extracts as laws banning them are steadily lifted throughout the country.
VIA Modern Farmer
The acting head of the Drug Enforcement Administration claimed that smoking marijuana has “never been shown to be safe or effective as a medicine.” That’s false: though information is limited on the topic, several studies have found smoked marijuana has medical benefits and mostly mild side effects.
Chuck Rosenberg spoke with reporters on the day that the DEA released its 2015 National Drug Threat Assessment. According to CBS News, he said he is bothered by the idea that marijuana is considered medicinal:
Rosenberg, Nov. 4: What really bothers me is the notion that marijuana is also medicinal — because it’s not. We can have an intellectually honest debate about whether we should legalize something that is bad and dangerous, but don’t call it medicine — that is a joke. …
There are pieces of marijuana — extracts or constituents or component parts — that have great promise. But if you talk about smoking the leaf of marijuana — which is what people are talking about when they talk about medicinal marijuana — it has never been shown to be safe or effective as a medicine.
First of all, it is incorrect to suggest that “smoking the leaf of marijuana” is “what people are talking about” with regard to medicinal marijuana. There are approved forms of the drug (or synthetic versions of its compounds) that come in pill form and do not need to be smoked or inhaled.
Secondly, even the smoked form of the drug indeed has been shown to be both safe and effective as a medicine, though only in a limited number of small studies. A review and meta-analysis of medical marijuana studies, published in the Journal of the American Medical Association in June, looked at 79 trials in total, but smoked cannabis was examined in only a few of them. Still, evidence regarding the smoked form of the drug does exist.
For example, one study published in the journal Neurology in 2007 looked at the effect of smoked cannabis on HIV-associated sensory neuropathy, a potentially painful condition affecting nerves in the hands, feet, and other parts of the body. Fifty patients were randomly assigned to either smoke cannabis or placebo cigarettes that looked identical, and were evaluated based on self-reported measures of daily and chronic pain.
After five days, the smoked cannabis reduced daily pain by 34 percent, while placebo only reduced it 17 percent. The very first cannabis cigarette smoked reduced chronic pain substantially, while the first placebo had very little effect. The study also found no serious adverse events were reported during the trial.
A second study, published in 2008 in Neuropsychopharmacology, also found benefit with smoked cannabis for the same medical condition. In this case, 28 patients completed two separate five-day treatment periods, separated by a two-week washout period; in one, they smoked cannabis cigarettes four times daily for five days, and in the other they smoked placebo cigarettes. Pain was evaluated using the Descriptor Differential Scale, which allows patients to use certain words to describe pain intensity; researchers use those descriptions to assign a pain score. The study found that 46 percent of cannabis smokers achieved at least a 30 percent reduction in pain, compared to only 18 percent of placebo smokers.
The side effects again were mostly mild, two patients did experience “treatment-limiting” toxicities. These included one episode of “cannabis-induced psychosis” and one intractable smoking-related cough during cannabis treatment. The symptoms resolved when the treatment was stopped. The authors noted an important point regarding smoked marijuana: “Smoking is not an optimal delivery system. Long-term use of smoked cannabis is associated with symptoms suggestive of obstructive lung disease, and although short-term use is not, many individuals cannot tolerate smoking.”
The beneficial effects of smoked marijuana are not limited to only HIV-associated neuropathy. Another study, published in 2012 in the Canadian Medical Association Journal, looked into its use to control spasticity in 30 patients with multiple sclerosis. This study again had patients experience both actual cannabis cigarettes and a placebo, and it again found more benefit with the cannabis.
In this study, patients had much greater reductions in spasticity with the drug than without it; this was measured using something called the modified Ashworth scale, which is a well-validated tool assigning point values based on muscle tone, range of motion, and other factors. Pain also diminished more, based on the Visual Analog Scale, with cannabis. There were no serious adverse events reported.
Obviously, these studies do not represent a particularly large body of evidence for smoked cannabis. In fact, the JAMA review concluded: “Further studies evaluating cannabis itself are also required because there is very little evidence on the effects and AEs  of cannabis.”
Studying medicinal effects of marijuana in general is difficult in the U.S., thanks to its inclusion on the federal list of “schedule 1” drugs. Those drugs, which include heroin, LSD, and a few other dangerous drugs, are “defined as drugs with no currently accepted medical use and a high potential for abuse,” according to the DEA.
However, the JAMA review also specifically noted that at least some such evidence does exist: “[T]here was moderate-quality evidence to suggest that cannabinoids may be beneficial for the treatment of chronic neuropathic or cancer pain (smoked THC and nabiximols).” Nabiximols is a cannabis extract delivered as a mouth spray.
“Very little evidence” is not the same as “never been shown to be safe or effective as a medicine,” as Rosenberg claimed. There is in fact evidence of smoked marijuana’s beneficial effects and safety.
Editor’s Note: SciCheck is made possible by a grant from the Stanton Foundation.