Debate: Medical marijuana dispensaries

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Are medical marijuana dispensaries a good idea?

Background and context

Medical marijuana dispensaries have been popping up in different places across the United States and in other countries as well. They are designed to supply individuals with medical needs for marijuana, so they are deeply connected with the medical marijuana debate. While connected to this larger debate, dispensaries have their own set of pros and cons to consider. Some of these include whether medical marijuana dispensaries will have negative effects on the communities where they are located. Will crime increase in these areas? Can dispensaries be properly regulated to ensure against fraud, faked prescriptions, or just shady prescriptions for individuals with insignificant or debatably-significant illnesses? Are whole dispensaries required, or should marijuana only be carried in traditional pharmacies? Are they economically beneficial, or can they harm businesses in surrounding communities? These and other questions are addressed below.

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Industry: Should the medical marijuana industry be encouraged?

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Pro

• Marijuana dispensaries are not drug rings Darcy Hughes, who used to manage the dispensary B Green in Los Angeles, said in 2010 after her and other's dispensaries were closed: "It's like treating us like drug dealers. It's not right."[1]

• Medical marijuana dispensaries are professional institutions Jesse McKinley. "Don’t Call It ‘Pot’ in This Circle; It’s a Profession." NYTimes. April 23, 2010: "Like hip-hop, health food and snowboarding, marijuana is going corporate. As more and more states allow medical use of the drug, and California considers outright legalization, marijuana’s supporters are pushing hard to burnish the image of pot by franchising dispensaries and building brands; establishing consulting, lobbying and law firms; setting up trade shows and a seminar circuit; and constructing a range of other marijuana-related businesses."

• Marijuana dispensaries should be regulated, but allowed The answer to the many possible challenges faced by Marijuana dispensaries - including fraudulent prescriptions and crime outside of dispensaries - is regulation. The answer is not to ban dispensaries out right.[2]

• Marijuana is natural; dispensaries should be allowed Cedaredge Town Council Trustee Nancy Sturgill said in 2009: "This [marijuana] is a very natural product, said Sturgill, and I don’t feel confident in denying Cedaredge residents access at this point.”[3]

• Marijuana dispensaries are key to enabling pain relief Art Santa Cruz, a 66-year-old Lansing man, said he would like to open a dispensary. He said he has severe back pain from a military stint in Vietnam or perhaps a car crash: "If it weren't for medical marijuana, I wouldn't be able to sleep. There has to be dispensaries. This is an important issue. The marijuana industry should be allowed to flourish. When pain goes away, I thank God."[4]

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Con

• Marinol pills can be prescribed; Marijuana is unnecessary "The case against medical marijuana." The casual observer. March 31, 2010: "A very basic question that I have is this. THC, the ingredient in marijuana that people are smoking it for, is available in pill form already. Why then do we need to have smoked marijuana available with all the problems that it brings? Marinol is a prescription medicine that can be prescribed by a doctor and dispensed from a controlled pharmacy."

• Medical marijuana prescriptions are often fraudulent "The case against medical marijuana." The casual observer. March 31, 2010: "On January 31, 2010 Christian Thurston published an article in the Denver Post entitled Smoke and Mirrors. Christian is the Medical Director of a substance abuse treatment program in Denver. Christian provided an example of a 19 year old being treated for “Severe Addiction”. This 19 year old walked in to dispensary, gave them $300 and discussed his depression with a “doctor”. He was then given a medical marijuana card. One pregnant woman was given a marijuana card to smoke because of her nausea. Yes, she was told to smoke marijuana during the pregnancy. We have people showing up to work stoned and claiming no foul because the marijuana was “prescribed” for them. We have 18 year olds obtaining a license to smoke joints daily for an ear ache, depression, etc."

• Whole marijuana dispensaries are excessive; pharmacies better. If marijuana dispensaries are indeed about providing marijuana for medical purposes, than entire dispensaries are probably excessive. Instead, why not carry medical marijuana in pharmacies? This would probably reduce the excessive supply and abuses, and would certainly eliminate concerns of shady crowds centering around dispensaries and creating concerns for local communities.

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Crime: Is crime outside of dispensaries manageable?

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Pro

• Crime outside of dispensaries no different then outside banks Cumberland County Sheriff Mark Dion joined the Maine Civil Liberties Union, said on June 17th of 2010: "Medical marijuana is a public health issue, it's not a law enforcement problem. The data from California suggests that the risk of crime outside a dispensary is no greater than what we'd experience at a bank. So I think we should just move forward and exercise the common sense that the voters have demonstrated in repeated votes on this measure."[5]

• Crime surrounds many shops; should not stop dispensaries. Crime surrounds all kinds of legal shops, including strip clubs, banks, supermarkets, and bars. This fact does not mean that these shops should be closed. Nor should it be the case for marijuana dispensaries.

• Medical marijuana is unrelated to crime that surrounds dispensaries. The legitimate place of dispensaries in supplying individuals that suffer from illnesses with access to medicine must be separated from the crime that may or may not surround them. This crime is unrelated to the fundamental mission of medical marijuana dispensaries, so it should not be used against them, just as crime surrounding other legitimate businesses cannot be used to argue against the legitimate purpose of these businesses.

• Raids on marijuana dispensaries have collateral damage Steph Sherer, medical marijuana patient and executive director of Americans for Safe Access (ASA), the nation's largest medical cannabis advocacy organization: "There has been a lot of collateral damage in the federal campaign against medical marijuana patients. We need to stop the prosecutions, bring the prisoners home, and begin working to eliminate the conflict between state and federal medical marijuana laws."[6]

• Marijuana dispensaries will exist whether legal or not. Marijuana dispensaries are popping up in places whether it is legal or not. It is better to legalize and regulate these dispensaries then to let them exist under the radar.

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Con

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Economics: Are these dispensaries economical?

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Pro

• Marijuana dispensaries will create many jobs Aaron Randle is tending to his new shop, Sunnyside Alternative Medicine: "There's a lot of jobs created because of medical marijuana. You have employees that work at the dispensaries, then you have vendors that are getting paid. ... Real estate is booming right now. Warehouses are getting rented out for grow operations."[7]

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Con

• Medical marijuana dispensaries can hurt surrounding businesses. Medical marijuana dispensaries can create an unfortunate local environment for other businesses. Some customers might not want to go to the grocery store right next door to the marijuana dispensary. This is a serious economic consideration.

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Treatment: Is marijuana valuable in treating illnesses?

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Yes

• Marijuana is an effective medicine and treatment for many illnesses Joycelyn Elders, M.D., Former U.S. Surgeon General. Op-ed: Providence Journal. March 26, 2004: "The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS -- or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day."[8]

• Medical benefits of marijuana outweigh potential risks Consumer Reports Magazine. "Marijuana as Medicine - How Strong Is the Science?" May 1997: "Consumer Reports believes that, for patients with advanced AIDS and terminal cancer, the apparent benefits some derive from smoking marijuana outweigh any substantiated or even suspected risks."[9]

• Marijuana can provide patients with significant pain relief Joycelyn Elders, MD Former US Surgeon General. Editorial: Providence Journal. March 26, 2004]: "The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS -- or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day." [10]

• Allowing medical marijuana shows compassion to the suffering Dennis Kucinich, US Representative (D-OH) and 2008 Democratic Candidate for US President, stated on Aug. 9, 2007: "It's a matter between doctors and patients, and if doctors want to prescribe medical marijuana to relieve pain, compassion requires that the government support that. And so as president of the United States, I would make sure that our Justice Department was mindful that we should be taking a compassionate approach."[11]

• General statements in favor of medical marijuana

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No

• Marijuana is not an effective drug for treating illnesses Richard H. Schwartz, MD, physician in Advanced Pediatrics. Letter to the Editor, New England Journal of Medicine. July 14, 1994: "...support of the use of marijuana for medical purposes is scientifically unfounded. There is no evidence that marijuana is superior to ondansetron (Zofran), dexamethasone, or synthetic tetrahydrocannabinol (Marinol) as an antiemetic in patients undergoing chemotherapy. Nor is there scientific evidence to support the use of marijuana for AIDS-associated anorexia, depression, epilepsy, narrow-angle glaucoma, or spasticity associated with multiple sclerosis."[12]

• Evidence is too inconclusive on medicinal value of marijuana Bill Frist, MD Former US Senator (R-TN). ProCon.org. Oct. 20, 2003: "Although I understand many believe marijuana is the most effective drug in combating their medical ailments, I would caution against this assumption due to the lack of consistent, repeatable scientific data available to prove marijuana's medical benefits.

• Unhealthy effects of Marijuana outweigh medical benefits Sanjay Gupta, MD, Chief Medical Correspondent for CNN. "Why I Would Vote No on Pot." Time magazine. Nov. 6, 2006: "Marijuana isn't really very good for you. True, there are health benefits for some patients. [but...] Frequent marijuana use can seriously affect your short-term memory. It can impair your cognitive ability (why do you think people call it dope?) and lead to long-lasting depression or anxiety. While many people smoke marijuana to relax, it can have the opposite effect on frequent users. And smoking anything, whether it's tobacco or marijuana, can seriously damage your lung tissue...Despite all the talk about the medical benefits of marijuana, smoking the stuff is not going to do your health any good."

• Legalizing medical marijuana opens door to bad definitions of "pain". People who are addicted to a drug are especially driven to find loopholes. In countries where marijuana has already been introduced for medical purposes, this has been the case. Legalizing marijuana would pose a bad example and trigger pressures for the legalization of other drugs.

• General statements against medical marijuana

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Physician judgement: Should doctors be allowed to judge use of marijuana case-by-case?

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Pro

• State should not override physician judgement on marijuana Dennis Kucinich, US Representative (D-OH) and 2008 Democratic Candidate for US President, stated the following in an Aug. 9, 2007 Democratic presidential forum aired on Viacom's Logo cable network: "It's a matter between doctors and patients, and if doctors want to prescribe medical marijuana to relieve pain, compassion requires that the government support that."[13]

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Con

• Health policy on marijuana should not be decided by individual doctors. Steel industry workers do not make policies regulating steel. In the same way, individual doctors should not make policies on medicine such as marijuana.

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Vs alternatives: Is marijuana a good alternative to other medications?

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Pro

• Marijuana is a safer alternative to many medications Philip Denney, MD, co-founder of a medical cannabis evaluation practice, stated the following in his Nov. 17, 2005, testimony to the Arkansas legislature in support of House Bill 1303: "An Act to Permit the Medical Use of Marijuana": "I have found in my study of these patients that cannabis is really a safe, effective and non-toxic alternative to many standard medications."

• Marijuana is homeopathic alternative to pharmaceutical drugs "Libertarian Party Condemns the Supreme Court Decision Against the Use of Medical Marijuana." The Libertarian Party. June 6, 2005: "The Libertarian Party is a long-standing advocate for individual liberty and believes that Americans should be responsible for their own actions and, in this case, be able to use alternative forms of medication outside of the realm of insurance companies and the pharmaceutical lobby."[14]

• Marijuana is a good alternative medicine to suit individual needs The fact that there are alternatives to medical marijuana for many treatments is not necessarily an argument against medical marijuana. It is always important to have many alternatives, largely due to differing personal preferences, beliefs, and physical reactions to different drugs.[15]

• Marinol is an inadequate alternative to marijuana for some treatments

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Con

• There are less dangerous, equally effective alternatives to marijuana Bill Frist, MD Former US Senator (R-TN). ProCon.org. Oct. 20, 2003: Based on current evidence, I believe that marijuana is a dangerous drug and that there are less dangerous medicines offering the same relief from pain and other medical symptoms."[16]

Bill Frist, M.D. U.S. Senator (R-TN), Correspondence to ProCon.org. October 20, 2003] - "Although I understand many believe marijuana is the most effective drug in combating their medical ailments, I would caution against this assumption due to the lack of consistent, repeatable scientific data available to prove marijuana's medical benefits. Based on current evidence, I believe that marijuana is a dangerous drug and that there are less dangerous medicines offering the same relief from pain and other medical symptoms."[17]

• Marinol is a good substitute for marijuana treatment California Narcotics Officers Association. Official policy statement. "The Use of Marijuana as a Medicine". October 31, 2005 - "Marinol differs from the crude plant marijuana because it consists of one pure, well-studied, FDA-approved pharmaceutical in stable known dosages. Marijuana is an unstable mixture of over 400 chemicals including many toxic psychoactive chemicals which are largely unstudied and appear in uncontrolled strengths."[18]

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Smoked marijuana: Is smoking marijuana necessary to obtain "benefits"?

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Pro

• Smoked marijuana has advantages over chemical break-downs Jacob Sullum, Senior Editor of Reason magazine. "Saying Yes: In Defense of Drug Use." 2003 book: "It's beyond serious dispute that marijuana, which has been used therapeutically for thousands of years, helps relieve nausea and restore appetite. Marinol, a capsule containing THC, is approved by the Food and Drug Administration as a treatment for AIDS wasting syndrome and the side effects of cancer chemotherapy. But smoked marijuana has several advantages over Marinol..."

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Con

• Smoking marijuana is more damaging than taking chemical parts Gabriel Nahas, MD, PhD, Professor Emeritus of Anesthesiology and Medicine at Columbia University. "Marihuana Is the Wrong Medicine." Wall Street Journal. Mar. 11, 1997: "The debate over using marihuana as medicine has been distorted by a basic confusion: the implicit assumption that smoking marihuana is a better therapy than the ingestion of its active therapeutic agent THC or a more effective one than approved medications. This assumption is wrong. THC (also known as Marinol) is an approved remedy that may be prescribed by physicians for nausea and AIDS wasting syndrome. It is safer than marihuana smoke."[19]

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HIV/AIDS: Is marijuana good for treating HIV/AIDS?

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Yes

• Marijuana improves immune system functions in patients with HIV Donald Abrams, M.D., et al. "Short-Term Effects of Cannabinoids in Patients with HIV-1 Infection". Annals of Internal Medicine. August 19, 2003 - "Patients receiving cannabinoids [smoked marijuana and marijuana pills] had improved immune function compared with those receiving placebo. They also gained about 4 pounds more on average than those patients receiving placebo."[20]

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No

• Marijuana damages the immune system; risky for HIV/AIDS sufferers U.S. Institute of Medicine Report. Marijuana and Medicine: Assessing the Science Base. March, 1999 - "The most compelling concerns regarding marijuana smoking in HIV/AIDS patients are the possible effects of marijuana on immunity. Reports of opportunistic fungal and bacterial pneumonia in AIDS patients who used marijuana suggest that marijuana smoking either suppresses the immune system or exposes patients to an added burden of pathogens. In summary, patients with preexisting immune deficits due to AIDS should be expected to be vulnerable to serious harm caused by smoking marijuana."

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Psychological disorders: Can marijuana help treat marijuana?

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Yes

• Marijuana can help treat bipolar disorders: Scientists and mentally-ill sufferers of bipolar disorder have independently made the discovery that cannabis can improve this medical condition, whether mania or depression. It may also reduce side effects of other drugs used in its treatment, such as Lithium, Carbamazepine (Tegretol) or Valproate (Depakote). Moreover, 30-40% of patients with bipolar disorder are not consistently helped by or cannot tolerate standard medications.

• Marijuana can curb psychotic symptoms in people with schizophrenia

• It is a myth that marijuana use can cause schizophrenia

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No

• There are psychological consequences to smoking marijuana. A number of studies have reported that the negative effects of smoking marijuana for people with psychological problems are profound. This is most significantly in young women, where rates of mental health problems were many times higher in daily cannabis users.

• Cannabis causes higher rates of depression and anxiety problems. Cannabis also triggers the onset or relapse of schizophrenia in predisposed people and also exacerbates the symptoms generally.

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Treating the terminally ill: Can marijuana use help the terminally ill cope with their illness?

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Yes

• Marijuana helps the terminally ill cope with their ebbing life. Because smoked marijuana can give rapid relief from great suffering to some patients, quickly improving such patients' comfort and mental outlook, the terminally ill can still maintain their human dignity and suffer less.

• The benefits of marijuana for the terminally ill outweigh risks Consumer Reports. Editorial. May, 1997: "Consumer Reports believes that, for patients with advanced AIDS and terminal cancer, the apparent benefits some derive from smoking marijuana outweigh any substantiated or even suspected risks. In the same spirit the FDA uses to hasten the approval of cancer drugs, federal laws should be relaxed in favor of states' rights to allow physicians to administer marijuana to their patients on a caring and compassionate basis."[21]

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No

• Alternatives to marijuana should be used to ease the terminally ill Gabriel Nahas, MD, PhD. Editorial, Wall Street Journal. Mar. 1997: "[T]he use of marijuana [for the terminally ill] can no longer be considered a therapeutic intervention but one of several procedures used to ease the ebbing of life of the terminally ill. But for this purpose doctors should prescribe antiemetic and analgesic therapies of proven efficacy, rather than marijuana smoking. This therapeutic course is not based on bureaucratic absolutism, political correctness, or reflexive ideology - but on scientific knowledge and the humane practice of medicine."[22]

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Health: Is marijuana harmless enough to be considered a medicine?

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Yes

• Marijuana might have some toxicity, but so do other drugs. Almost all drugs are chemicals that have some side-effects. Marijuana, therefore should not be alienated for this reason.

• The health risks of smoking marijuana are relatively minor Lester Grinspoon, M.D., Emeritus Professor of Psychiatry, Harvard Medical School. "Puffing Is the Best Medicine," Los Angeles Times. May 5, 2006. - "[T]here is very little evidence that smoking marijuana as a means of taking it represents a significant health risk. Although cannabis has been smoked widely in Western countries for more than four decades, there have been no reported cases of lung cancer or emphysema attributed to marijuana. I suspect that a day's breathing in any city with poor air quality poses more of a threat than inhaling a day's dose -- which for many ailments is just a portion of a joint -- of marijuana."[23]

• Marijuana is only unhealthy or risky when abused. The problem with illegalizing marijuana is that it lumps the most moderate of uses of marijuana in with the worst of abuses. Just like with alcohol, there are scales of use that fall within responsible to irresponsible to abusive categories. The responsible use of marijuana might involve the recreational use of the drug a couple of times a year and in very small doses, such as, a single toke. Does it make sense for such innocuous levels of consumption to be illegal? No. And, yet, in states where marijuana is illegal, such levels of consumption are illegal. Instead of this system, marijuana should be legally regulated like alcohol on the basis of abuse in circumstances where it has the potential to threaten other citizens, such as before driving or operating machinery.

• There is no evidence that marijuana decreases cognitive functions A 15-year John Hopkins University study published in May 1999 found "no significant differences in cognitive decline between heavy users, light users, and non-users of cannabis."

• Marijuana is no more harmful than tobacco and alcohol Although cannabis does indeed have some harmful effects, it is no more harmful than legal substances like alcohol and tobacco. As a matter of fact, research by the British Medical Association shows that nicotine is far more addictive than cannabis. Furthermore, the consumption of alcohol and the smoking of cigarettes cause more deaths per year than does the use of cannabis (e.g. through lung cancer, stomach ulcers, accidents caused by drink driving etc.). The legalisation of cannabis will remove an anomaly in the law whereby substances that are more dangerous than cannabis are legal whilst the possession and use of cannabis remains unlawful.

• Marijuana can have a beneficial mind-altering effect if used right Marijuana use can alter one's perception of reality or consciousness. The alteration need not be thought of as spiritual or religious to be respected for what it is; a fresh look on a reality that we are programed as humans to perceive only in a particular manner. Marijuana can help humans perceive that complex reality from simply a different perspective, which can benefit our appreciation for that reality and our unique and limited perceptions of it. With this more intelligent approach to marijuana consumption, it is easy to argue that mental, perceptual, and societal benefits exist.

• Weighing marijuana's "mind-expansion" against its costs is subjective. Who can say that marijuana use is "worth it" or "not worth it"? Many individuals strongly believe that marijuana use has a "mind expanding" effect that makes the health costs worth it. Other disagree. But can the government or anyone conclude for us all that "it's not worth it"? No. With so much subjectiveness involved, marijuana should not be illegal.

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No

• Smoking marijuana is generally very unhealthy Sanjay Gupta, MD, Chief Medical Correspondent for CNN. "Why I Would Vote No on Pot." Time magazine. Nov. 6, 2006: "Marijuana isn't really very good for you. True, there are health benefits for some patients. [but...] Frequent marijuana use can seriously affect your short-term memory. It can impair your cognitive ability (why do you think people call it dope?) and lead to long-lasting depression or anxiety. While many people smoke marijuana to relax, it can have the opposite effect on frequent users. And smoking anything, whether it's tobacco or marijuana, can seriously damage your lung tissue...Despite all the talk about the medical benefits of marijuana, smoking the stuff is not going to do your health any good."

• Marijuana smoke is highly damaging to the lungs British Lung Foundation. "Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health," a publicly disseminated report November, 2002 - "3-4 Cannabis cigarettes a day are associated with the same evidence of acute and chronic bronchitis and the same degree of damage to the bronchial mucosa as 20 or more tobacco cigarettes a day."

• Smoking marijuana impairs the immune system - British Lung Foundation. "Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health," a publicly disseminated report. November, 2002 - "Cannabis smoking is likely to weaken the immune system. Infections of the lung are due to a combination of smoking-related damage to the cells lining the bronchial passage and impairment of the principal immune cells in the small air sacs caused by cannabis."[24]

• Marijuana use increases the risk of psychosis "Marijuana may increase psychosis risk, analysis says". CNN.com. July 27, 2007: "Using marijuana seems to increase the chance of becoming psychotic, researchers report in an analysis of past research that reignites the issue of whether pot is dangerous."

• Marijuana impairs brain functions Many researches conclude that marijuana impairs short-term memory, cognition, and motivations.
• Marijuana smoke is highly damaging to the lungs Marijuana smoke is more potent than cigarette smoke, with some researches concluding that the negative effect of one joint is equivalent to a pack of cigarettes.

• Marijuana use impairs hormone production It is frequently cited that marijuana use leads to reductions in sperm levels. This reduction in hormone levels is a major cost of marijuana use.

• Marijuana use has been linked to various birth challenges "Why Marijuana Should Remain Illegal". New York Times, Letter to Editor. February 26, 1994: "THC and marijuana smoke have been directly linked to miscarriage, in-utero fetal death, stillbirth and infant death just after birth, along with behavioral and biological abnormalities of offspring."

• That marijuana is herbal does not mean it is safe Some argue that marijuana is "OK" because it's "natural", "herbal", or "comes from the earth". But, on these criteria, poisons would be considered "OK" to consume.

• Marijuana use can lead to cancer Just like with cigarettes, the intake of carcinogens in marijuana risks causing cancer.

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Addictiveness: Is marijuana non-addictive? Does this matter?

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Yes

• Marijuana is not addictive There is no evidence that marijuana physically addictive. While it may be psychologically addictive, in the sense that people like it and want to do it again, this is little different than alcohol. But, certainly, cigarettes are more addictive than marijuana. And, since cigarettes are physically addictive and yet legal, should addictiveness really be a barometer for a substance's illegality? No. Colin Blakemore, Ph.D. Chair, Dept. of Physiology, University of Oxford (U.K.), and Leslie Iversen, Ph.D., Professor of Pharmacology, Oxford University. Editorial, The Times (U.K.). August 6, 2001 - "For some users, perhaps as many as 10 per cent, cannabis leads to psychological dependence, but there is scant evidence that it carries a risk of true addiction. Unlike cigarette smokers, most users do not take the drug on a daily basis, and usually abandon it in their twenties or thirties. Unlike for nicotine, alcohol and hard drugs, there is no clearly defined withdrawal syndrome, the hallmark of true addiction, when use is stopped."

• Due to low addiction rates, marijuana is good for medical use. Marijuana is the best drug to be put into medical use since it was ranked lowest for withdrawal symptoms, tolerance and dependence (addiction) potential. It ranked close to caffeine in the degree of reinforcement and higher than caffeine and nicotine only in the degree of intoxication.

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No

• Marijuana is addictive There are many studies that demonstrate a "dependency" relationship evolving between individuals and marijuana. Alan J. Budney, Ph.D. et al., Professor, University of Arkansas Center for Addiction Research. "Marijuana Abstinence Effects in Marijuana Smokers Maintained in Their Home Environment". Archives of General Psychiatry. October, 2001. - "This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal [...] Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other."[25]

• Repeated use of marijuana leads to psychological cravings for it. Marijuana by definition meets the criteria for an addictive drug; animal studies suggest marijuana causes physical dependence, and some people report withdrawal symptoms.

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Individual liberty: Should individuals be at liberty to use marijuana?

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Yes

• Individuals have right to pursue what they believe are best treatments. Individuals have a right to pursue treatments that they believe are in their best interest, and which do not come into conflict with the rights of other patients. Medical marijuana qualifies as a such a treatment, which many believe is best for their ailments, and so should be allowed to pursue.

• State should not override doctor-patient decisions on marijuana Dennis Kucinich, US Representative (D-OH) and 2008 Democratic Candidate for US President, stated the following in an Aug. 9, 2007 Democratic presidential forum aired on Viacom's Logo cable network: "It's a matter between doctors and patients, and if doctors want to prescribe medical marijuana to relieve pain, compassion requires that the government support that."[26]

• People should be free to use marijuana as long as it harms no one else People should be at liberty to treat their bodies how they want to. Indeed, people are allowed to eat and drink to their detriment and even death, so why shouldn't they be able to harm themselves with marijuana use? This is, of course, assuming that their use does not harm anyone else. This means, as with substances such as alcohol or cigarrettes, that regulations be put in place to ensure that one individual's consumption of marijuana does not violate the liberties of another citizen. If this is achievable with alcohol and cigarettes, it seems achievable with marijuana.

• The choice to use marijuana should be based on individual experience Marijuana induces different experiences in different individuals; some of these experiences are great, some are terrible and harmful. Individuals should be free to choose to use marijuana or not, depending on their relative experience.

• Illegal medical marijuana forces sufferers to purchase on the black market. Presently, cannabis is sold by dealers who have connections with the underworld. The legalization of cannabis will help facilitate the sale of the drug in establishments like Amsterdam’s "coffee houses". This will shift the sale of cannabis away from the criminal underworld. The severance of this ‘criminal link’ will ensure that the users of the drug no longer need to come into contact with organized crime.

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No

• The State is justified in protecting individuals from themselves Even if marijuana's effects were isolated to the individual, there is room for the state to protect individuals from harming themselves. This is why it is illegal to commit suicide or to, in some places, not wear a seat belt. If marijuana's effects are seen as clearly harmful, the state can justly protect its citizens from it.

• Marijuana use directly threatens other's liberties. Various risks to other citizens are greatly enhanced by marijuana use. Because marijuana impairs judgement and motor skills in various ways, people on a high who attempt to drive or operate heavy machinery risk other people's lives or health. Impaired judgement from marijuana use also has the potential to lead to violent encounters.

• Marijuana's public health costs violate tax-payer liberties. Marijuana, due to its negative effects on overall health, will be a burden on taxpayers that have to foot the bill for these higher health care costs.

• Legalizing medical marijuana would make roads more dangerous. People smoking marijuana, even medically, are a risk on the road.

• Marijuana is not a threat to society only because it is illegal The National Center on Addiction and Substance Abuse: "Drugs are not a threat to American society because they are illegal; they are illegal because they are a threat to American society."[27]

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Abuse: Is medical marijuana likely to result in abuse and further drug-use?

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Yes

• Legalizing medical marijuana is not legalizing recreational use Bernard Rimland, PhD, Founder of the Autism Society of America (ASA). "Medical Marijuana: a Valuable Treatment for Autism?" Autism Research Review International. 2003: "It is important to keep in mind the distinction between legalizing marijuana for medical uses, which has been done in some states, and 'recreational' drug use which is illegal throughout the U.S.

• Medical marijuana is usually not seriously abused Philip Denney, MD, co-founder of a medical cannabis evaluation practice, stated the following in his Nov. 17, 2005 testimony to the Arkansas legislature in support of House Bill 1303, "An Act to Permit the Medical Use of Marijuana": "We have seen very minimal problems with abuse or dependence, which at worst are equivalent to dependence on caffeine."[28]

• Potential for abuse should not halt legitimate marijuana use. Philip Denney, MD, co-founder of a medical cannabis evaluation practice, stated the following in his Nov. 17, 2005 testimony to the Arkansas legislature in support of House Bill 1303, "An Act to Permit the Medical Use of Marijuana": "While a substance may have some potential for misuse, in my opinion, that's a poor excuse to deny its use and benefit to everyone else."[29]

• Doctors should be trusted to check abuse of medical marijuana Robert DeLorenzo, MD, PhD, MPH, Professor of Neurology in the Virginia Commonwealth University School of Medicine. University press release: "Marijuana and Its Receptor Protein in Brain Control Epilepsy." Sep. 30, 2003: "Individuals both here and abroad report that marijuana has been therapeutic for them in the treatment of a variety of ailments, including epilepsy. But the psychoactive side effects of marijuana make its use impractical in the treatment of epilepsy. If we can understand how marijuana works to end seizures, we may be able to develop novel drugs that might do a better job of treating epileptic seizures."[30]

• There is little evidence that Marijuana is a gateway drug If marijuana was a gateway drug, you would expect to see high numbers of marijuana consumers also being, for instance, cocaine users. But, this correlation does not really exist. In America, for every roughly one hundred marijuana user, there is only one cocaine user.

• Legalizing medical marijuana does not increase use and abuse Mitch Earleywine, Ph.D., Associate Professor of Psychology, State University of New York at Albany Karen O’Keefe, Esq. Attorney & Legislative Analyst. Marijuana Policy Project Report. "Marijuana Use by Young People: The Impact of State Medical Marijuana Laws". September, 2005. - "While it is not possible with existing data to determine conclusively that state medical marijuana laws caused the documented declines in adolescent marijuana use, the overwhelming downward trend strongly suggests that the effect of state medical marijuana laws on teen marijuana use has been either neutral or positive, discouraging youthful experimentation with the drug."[31]

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No

• Medical marijuana will be abused by druggies Medical marijuana has a high likelihood of being abused. This is one of the main criteria of the FDA's decisions in regards to legalizing drugs for medical uses. Medical marijuana's potential for abuse exists mainly due to its substantial use as a recreational drug, which creates the potential that, for example, individuals will obtain or produce false prescriptions or IDs, or that they will illicitly sell Marijuana obtained via a prescription.

• Marijuana is a gateway drug U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA press release on their report. "Initiation of Marijuana Use: Trends, Patterns and Implications". August 28, 2002. - "A new federal report released today concludes the younger children are when they first use marijuana, the more likely they are to use cocaine and heroin and become dependent on drugs as adults.[...] Increases in the likelihood of cocaine and heroin use and drug dependence are also apparent for those who initiate use of marijuana at any later age".

• Medical marijuana can act as a gateway drug to harder ones Peter Provet, PhD, President and Chief Executive Officer at the Odyssey House, Letter to the editor of the New York Times. Apr. 26, 2006: "As a treatment provider, I support the Food and Drug Administration's dismissal of medical benefit from marijuana. Regardless of the heated political debate that swirls around this issue, the fact remains that despite the Institute of Medicine's claim to the contrary, for people vulnerable to addictive disease, marijuana is a gateway drug that leads to the use of more dangerous drugs like cocaine and heroin. Not everyone who smokes marijuana will necessarily become an addict. But why open the gate to increased use for the sake of unproven medical benefits when we already know the harm that marijuana inflicts on millions of Americans."[32]

• Legalizing medical marijuana may cause crime and safety problems Jerry Dyer, MS, Fresno Chief of Police and President of the California Police Chief's Association. Apr. 16, 2008 letter to Deputy Director of the Illinois Association of Chiefs of Police: "Based on the almost 12 years of medical marijuana experience in the state of California it is our observation that it has been destructive to lives and communities. Passage of any form of medical marijuana anywhere in our nation is bad public policy and will cause crime and public safety problems."[33]

• Legalizing medical marijuana normalizes drug, increases use Andrea Barthwell, M.D. Former Deputy Director, White House Office of National Drug Control Policy (ONDCP). Chicago Tribune editorial. February 17, 2004. - "By characterizing the use of illegal drugs as quasi-legal, state-sanctioned, Saturday afternoon fun, legalizers destabilize the societal norm that drug use is dangerous. They undercut the goals of stopping the initiation of drug use to prevent addiction.... Children entering drug abuse treatment routinely report that they heard that 'pot is medicine' and, therefore, believed it to be good for them."

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Economics: Is legalizing medical marijuana economically wise?

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Yes

• Legalizing medical marijuana will reduce state spending. The cost of battling marijuana distribution and possession is exorbitant. By legalization for medicinal purposes, producers of marijuana can opt to sell the cannabis through legal channels and do not need to be caught, prosecuted, or jailed- all things that require taxpayers money. A Harvard University professor of economics, Jeffrey Miron, calculated legalizing marijuana would save $7.7 billion annually in money spent on enforcing dope laws.The case for legal pot use

• Legalizing medical marijuana will increase state revenue. Having it a legal product, the government can tax the marijuana and increase state revenue. Harvard's Miron estimates that tax revenue for legalized pot would run about $2.4 billion annually if it were taxed like all other goods.The case for legal pot use
• More money for other sectors The money that the government saves from not having to enforce laws to prohibit marijuana, along with the extra tax income from legal sales, can be allocated to more important sectors like education and health-- i.e. better management of funds, better economics.

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No

• Medical marijuana should not be allowed just to grow state revenue Alberto Torrico. "Opinion: Medical marijuana needs closer regulation." Mercury News. November 15th, 2009: "a decision to legalize a powerful drug in order to balance our budget would be a critical mistake and would jeopardize public safety. Even in the midst of this fiscal crisis, we need to focus on providing safe medicine, not just grasping for any available revenue source."

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Pro/con resources

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Yes

• "Editorial: Way is clear for medical marijuana in Mass." Boston Globe. October 29, 2009
• Bruce Mirken. "The Case For Medical Marijuana." Forbes. August 17, 2009
• Bill Richardson, MA, Governor of New Mexico. "Governor Bill Richardson Urges Action on Medical Marijuana Bill." Feb. 7, 2007:
• "Libertarian Party Condemns the Supreme Court Decision Against the Use of Medical Marijuana." The Libertarian Party. June 6, 2005:
• Andrew Weil, MD, Director of Integrative Medicine at the University of Arizona College of Medicine. "Stop the Federal War on Medical Marijuana." San Francisco Chronicle. June 6, 2002
• American Public Health Association.

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No

• Sanjay Gupta, MD, Chief Medical Correspondent for CNN. "Why I Would Vote No on Pot." Time magazine. Nov. 6, 2006
• Wayne Roques, former President of Drug Watch International. "Medical Marijuana Pain Sufferers Who Smoke for Relief Want to End Stigma of Breaking Law." Miami Herald. April 8th, 1993.
• The American Academy of Ophthalmology. "Assessment of Marijuana in the Treatment of Glaucoma." May 2003
• Drug Watch International. "Position Statement on Marijuana for Medical Use." July 30, 2001
• The Eagle Forum, a conservative interest group. "Facts You Need To Know About ... Marijuana."
• American Medical Association
• The US Institute of Medicine.

See also

• Debate: Legalization of Marijuana
• Debate: Decriminalizing marijuana possession
• Debate: Medical marijuana

External links

• Smoking pot no big deal?" Washington Post. November 16, 2009
• Medical Marijuana Debate at Opposing Views
• The science of medical marijuana
• Pro and con medical marijuana
• MAPS: medical marijuana research
• Canadian Medical Marijauna Associatio
• Canada's Official Medical Marihuana Resource Websit
• Argumente fur eine realistische Drogenpolitik (Arguments for a realistic drug policy)
• Associazione per la Cannabis terapeutica (Association for therapeutic marijuana)
• International Association for Cannabis as Medicine (IACM)
• Jesse McKinley. "Don’t Call It ‘Pot’ in This Circle; It’s a Profession." NYTimes. April 23, 2010
• Susan Vela. "Lansing might regulate pot dispensaries." Lansig State Journal. May 6th, 2010

Books

• Cannabis in Medical Practice: A Legal, Historical and Pharmacological Overview of the Therapeutic Use of Marijuana : Mary Lynn Mathre
• Cannabis : Howard Sooley
• The Healing Magic of Cannabi : Beverly Potter
• Is Marijuana the Right Medicine for You: A Factual Guide to Medical Uses of Marijuana : Bill Zimmerman