Christensen 1
Kami Christensen
Professor Dursema
English 1010
31 July 2015
Medical Marijuana
Marijuana has been used for medical indications since the mid-19th Century (Bostwick).
It had been provided by physicians in the U.S. for a multitude of ailments from 1930 to 1970,
when the US government deemed it a schedule I drug without medical worth (Bostwick). In
1970 the use of any marijuana, medical or non-medical, became illegal in the US by federal law
(Bostwick). As of 2015, 23 states in the US currently have determined medical marijuana legal
and again, seen to have value for medical use (Hill). While medical marijuana is becoming more
widely recognized in the US, the guidelines and monitoring of use is becoming fewer and fewer.
Even though it may not be easy or even impossible to access a medical marijuana card in some
states, the states that provide cards are loosening regulations year after year. This becomes a
problem due to the fact that the medical benefit of marijuana is under studied and the adverse
effects are under recognized with use. The use of medical marijuana should be limited to
prescription only due to need for guidelines and better monitoring, evidences of only few
benefits, and the number of adverse effects.
In the recent years, medical marijuana cards have been given more freely than
prescriptions without much regulation or verification of need. Among the 23 states that allow the
legal access to medical marijuana, the laws only differ on the amount of marijuana it is legal to
possess and in what form (Hill). There are no laws in place on how often a medical marijuana
cardholder can replenish their supply nor guidelines on daily amount of use. Prescription
Christensen 2
medications however, must state the exact name(s) of the medication, strength, dosage, when to
use, duration of use, reason for use, and guidelines of use. Medical marijuana does not require
the same guidelines. Due to the lack of federal legality of medical marijuana, cardholders are
provided marijuana from dispensaries and not pharmacies (Hill). Those working in dispensaries
are not certified, licensed, or educated on implications of adverse effects caused by the use of
marijuana. Those purchasing marijuana from dispensaries are not limited to form, percentage of
substance, or frequency of purchase. In some states medical marijuana cardholders are even
permitted to grow their own plants in their private residences. This provides cardholders with
unlimited amount of use and minimal to no regulations.
Dispensaries have limited regulation along with cardholders. Clinical testing has shown
that the marijuana is frequently mislabeled in dispensaries. Testing has shown quite often
labeling listing contents of marijuana much higher or lower than the actual content in the
packaging (Schwenk). Some of these items are made in store and the dispensary does the
labeling themselves. The regulation is clearly limited as shown by amounts listed and actual
amounts given have shown a large discrepancy in research testing (Schwenk). Even
manufactures of over the counter medications such as Tylenol are regulated by the Food and
Drug Administration (FDA) mandates to list ingredients and amount of active ingredient on
every label.
The FDA has approved only 2 forms of medical marijuana for use of nausea and
vomiting associated with cancer chemotherapy as well as for increasing appetites in wasting
syndromes caused by HIV or cancer (Hill). However medical marijuana cards do not limit
cardholders to use these two FDA approved forms. Physicians give recommendations for
medical marijuana cards for multiple reasons including: cancers, seizures, severe pain, severe
Christensen 3
nausea, etc. (Whiting). Some states allow physicians to decide a multitude of other medical
conditions that merit the medical marijuana card without valid research or verification of
efficacy for said ailments.
Marijuana is among the most widely used illicit drug in the US (Bostwick). As the
legality of medical use has increased, so has the illicit drug use (Hill). Through multiple research
studies, it is learned there is quality to moderate evidence of benefit of medical marijuana use for
nausea and vomiting caused by chemotherapy, severe/chronic pain, neuropathic pain, and
spasticity from multiple sclerosis (D’Souza). Even though cardholders are able to use medical
marijuana for things such as hepatitis C, Chrohn’s disease, Parkinson’s, anxiety disorders, sleep
disturbances, depression, and Tourrette’s syndrome, the evidence of benefit is of low quality and
shows little to none in multiple research studies (D’Souza). In fact, marijuana has been shown to
makes some of the ailments worsened in clinical trials (Whiting).
Hallucinations, disorientation, confusion, impaired balance, euphoria, dizziness,
nausea, vomiting, dry mouth, fatigue, drowsiness, and somnolence are among the most
common of side effects caused from marijuana (Whiting). It is interesting to note that one
of the uses of medical marijuana is to relieve nausea, yet it is among the most common side
effects. Acutely, marijuana is known to cause short-term memory loss, decreased
coordination, and impaired judgment (Hill). If use of marijuana is done through smoking,
the adverse effects increase compared to the use of oils and edible forms of marijuana.
Smoking 3 to 4 “joints” would be compared to smoking 20 cigarettes per day in terms of
causing chronic bronchitis and lung cancer (McCance 70). From a reproductive standpoint,
the instances of low birth weights, frequency of childhood leukemia, and increased
infections are increased among children of marijuana users (McCance 70). Marijuana use
Christensen 4
also shows evidence to cause decreases in sperm motility, fertility, and testosterone levels
(McCance 70).
Marijuana is said to be non-addictive in many arguments for legalization. However
the use in adolescents and adults is shown to be addictive and causes potential significant
problems in social, educational, and work relations for users (Hill). There is also increasing
evidence that long-term use is linked to increases cases of anxiety, depression, and
psychotic illnesses (Hill).
Because of the inconsistencies in regulation, adverse effects, and limited benefits of
medical marijuana, the same laws and guidelines as prescription medications should
mandate the distribution and use of medical marijuana. With guidelines set in place and a
decreased chance for abuse, the benefits could be better studied and better maintained for
those in need. Licensed prescribers should only be allowed to distribute prescription for
marijuana medication after other failed trials with FDA approved medications. Medical
marijuana should only be distributed by licensed, educated professionals with the capacity
to provide all the necessary information to users such as side effects and recommended
dosing. All those prescribed marijuana should first be assessed for substance abuse
disorders, anxiety disorders, lung disease, psychotic disorders, and mood disorders prior to
being candidates for the prescription. Last of all, only FDA approved forms of marijuana
derivatives should be prescribed due to lack of testing on other forms of use.
Christensen 5
Works Cited
Bostwick, J. Michael. “Blurred Boundaries: The Therapeutics and Politics of Medical
Marijuana.” Mayo Clinic Proceedings 87.2 (2012): 172-186. Web. 30 July 2015.
D'Souza, Deepak Cyril, and Mohini Ranganathan. "Medical Marijuana: Is the Cart Before the
Horse?" JAMA 313.24 (2015): 2431-2432. Web. 27 July 2015.
Hill, Kevin P. "Medical Marijuana for Treatment of Chronic Pain and Other Medical and
Psychiatric Problems: A Clinical Review." JAMA 313.24 (2015): 2474-2483. Web. 27
July 2015.
McCance, Kathryn L., and Sue E. Huether. “The Cell.” Pathophysiology: The Biologic Basis for
Disease in Adults and Children. 7th ed. St. Louis: Elsevier, 2014. Print.
Schwenk, Thomas L. “What Evidence Supports Marijuana Use for Medical Indications?”
Journal Watch (2015): n. pag. Web. 27 July 2015.
Whiting, Penny F. et al. “Cannabinoids for Medical Use: A Systematic Review and Metaanalysis.” JAMA 313.24 (2015): 2456-2473. Web. 30 July 2015.