Educational Fact Sheet: Medical Marijuana
8/23/10
Disclaimer:
The W-ONE Legislative Committee, as an educational service to its membership, develops fact sheets to
provide information on previous or potential legislative issues. A W-ONE approved “Educational Fact
Sheet” does not present a position for or against the issue.
Introduction:
Cannabis preparations have been used as a remedy for thousands of years. The use of this plant in
traditional medicine has been documented in a range of countries, extending from China to the rest of
the world. It is used for the treatment of strained muscles, convulsions, asthma, depression, pain,
nausea and vomiting or as an appetite stimulant. At this time the possible medical applications of the
plant or its natural or synthetic pharmacologically active agents are tightly restricted both for ethical and
legal reasons.
Research:
There have been many studies done on the use of medical marijuana and results differ from study to
study which unfortunately does not help either side in this debate.
The American Academy of Pain Medicine in 2009 printed a study done by researchers from Spain and
Japan on the use of marijuana for medical purposes. They found evidence of efficacy in the use of
marijuana for patients with chronic pain, and also found it helpful in the treatment of nausea and
vomiting in patients undergoing chemotherapy. Yet they also found a high number of serious adverse
events in the short term, principally associated with the central nervous system, including: effects on
cognitive function, motor function and alterations in perceptions. Their conclusion was that use of
marijuana for pain control would entail more risk than benefit.
In another study done by a group from the Department of Anesthesiology from the University of San
Diego, they wanted to study the effect of smoked marijuana on pain. What they found was that in low
doses the marijuana had no effect on pain, with medium doses it significantly reduced pain and in high
doses it actually increased the pain. They felt that they cannot advocate a place for using the drug in the
treatment of pain due to more information needed about abuse potential, tolerance, efficacy in
neuropathic pain, and safety issues of inhaled marijuana. Concern over the clinical use of inhaled
marijuana are health related issues that result from the delivery method; long term use has been shown
to be associated with increased respiratory symptoms suggestive of chronic lung disease and also
digestive cancers. They too found concerns with some side effects as they relate to psychotropic
effects, such as depressed mood.
The UCLA School of Medicine conducted a study in 1997 on 243 marijuana smokers over an 8 year
period. They reported the following: Findings from the long term study of heavy, habitual marijuana
smokers demonstrated that neither the continuing or intermittent smokers exhibited any significantly
different rates of decline in lung function as compared to those individuals who never smoked
marijuana.
In an article from the Canadian Medical Association Journal, they referenced a research study that was
done by the Australian National Health and Medical Research Council. What this council found in their
study was that the short term use of marijuana for medical purposes had an acceptable safety profile.
They found that most of the adverse events were not serious; dizziness was the most common of these.
Thus, they felt that short term use for symptom relief of nausea and vomiting in cancer treatment and
for the relief of acute pain would be acceptable. Since their trials were of short duration (8-12 months)
they felt they could not comment of use of marijuana for long term use such as in chronic disorders like
MS.
Summary of Pros and Cons
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Pros
Marijuana is effective at relieving nausea and vomiting; especially cased by chemotherapy used
to treat cancer
Marijuana can relieve spasticity of the muscles that is sometimes associated with MS and
paralysis
Marijuana can help treat appetite loss associated with HIV-AIDS and certain types of cancers
Marijuana can relieve certain types of pain
Marijuana is safe, safer in fact than many other prescribed medications to treat the same
symptoms
Studies do show that smoking marijuana alone (without the concurrent use of tobacco) does not
increase the risk of lung disease
Marijuana has been used for centuries as a medicinal agent with good effect
Cons
Frequent marijuana use can seriously affect your short-term memory
Frequent use can impair your cognitive ability
Smoking anything can seriously damage your lung tissue, however, marijuana smoke contains
50-70% more carcinogenic ingredients than cigarette smoke
Not enough evidence supports marijuana as a n effective pain relieving agent
Marijuana carries a risk of abuse and addiction
Smoked marijuana contains cancer-causing compounds
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Smoked marijuana has been implicated in a high percentage of automobile accidents and
workplace accidents
Other States Response:
14 states and Washington D.C. have now adopted medical marijuana laws since 1996, those states are:
Alaska
California
Colorado
Hawaii
Maine
Michigan
Montana
New Jersey
New Mexico
Nevada
Oregon
Rhode Island
Vermont
Washington
Washington D.C.
These states have laws which allow patients to use and possess small quantities of marijuana for
medical purposes without being subject to state criminal penalties. They also allow a patient’s
caregiver, which is an adult who agrees to assist with a patient’s medical use of marijuana to possess but
not use marijuana.
Most state laws protect “qualifying patients” who have received a diagnosis of a debilitating medical
condition and have written documentation from their physician indicating that they might or would
benefit from the medical use of marijuana or that the benefits outweigh the risks involved. Definitions
of debilitating conditions vary by state, but typically include: HIV-AIDS, cachexia, cancer, glaucoma,
epilepsy and other seizure disorders, severe nausea, severe and chronic pain, muscle spasms from MS or
Crohn’s disease and some other conditions also.
State laws do not regulate quality or potency and most don’t address how to obtain the drug. Most all
states allow patients to cultivate the drug, but do limit the amount they can cultivate.
Missing from many state laws is a requirement that physicians recommending use of marijuana to adult
patients provide the rudimentary disclosure of risks and benefits necessary for informed consent. This
disclosure is required for minors.
Wisconsin’s Legislative Response:
Jackie Rickert, a state activist and a long-time Mondovi patient has been leading the cause to get
legislation introduced regarding use of marijuana in the state of Wisconsin. This past legislative year
2009-2010, Assembly Bill 554 and Senate Bill 368 were introduced into Wisconsin legislature under the
support of Representative Mark Pocan (D- Madison) and Senator Jon Erpenbach (D- Waunakee). The
legislation was very similar to what the other states have in place. However, the session ended prior to
these bills getting passed. Governor Doyle supported this legislation. In December of 2009 there was a
public hearing on this bill and there was a combination of 104 patients and physicians testifying or
registering their support of this legislation and only 6 against it.
This legislation will now have to be re-introduced and depending on how elections go in the fall, it is
uncertain what kind of support this legislation will get. In the meantime, this activist group is working
within counties to place local advisory referendums in support of this legislation on their November
ballots, Dane County voted in July to do this in November.
Organizations in Support:
- Wisconsin Nurses Association (Oct. 1999)
- American Nurses Association (March 2004)
- American Civil Liberties Union(2005)
- Wisconsin Public Health Association (1999)
- American Bar Association(1998)
- American Public Health Association (Jan. ,1995)
- American Academy of HIV Medicine (2003)
- American Academy of Family Physicians( 2001)
- Lymphoma Foundation of America (Jan. 1997)
- Institute of Medicine (1999)
Organizations in Opposition:
American Medical Association (No. 2008)
- The Wisconsin Medical Society does not feel that marijuana is any more helpful than other
current drugs on the market for pain control (2009)
The U.S. Drug Enforcement Administration is not in favor of legalizing the use of marijuana
- Crohn’s and Colitis Foundation of America (Oct. 2009)
- National Eye Institute (May 2009)
- National Multiple Sclerosis Society (Mar. 2009)
- US Food and Drug Administration (Sept. 2009)
Organizations neither in support or opposition:
The American Medical Association has recently called for changing the status of marijuana
from a Schedule 1 to a Schedule II drug in order to enable more research on medical marijuana
No information was able to be found on this topic from the American Organization of Nurse
Executives
Conclusion:
Obviously, there are opposing views on this subject matter. One question is who should be deciding
what is best for patients; individuals and their physicians or federal bureaucrats? Supporters of medical
marijuana want to protect medical privacy and the physician/patient relationship. Opponents are
looking to put some control by government on these decisions.
Although some states have enacted laws, we need to remember that Federal law still treats the use of
marijuana as a criminal offense even if the use is for medical reasons. The DEA has actually increased
enforcement efforts against Americans who use or grow marijuana for medicinal use, even in states
where such use is legal under state law. Thus, the battle continues and it does not seem that the fight
will be over soon.
Prepared by: Joyce Schaefer, Adm. Pt. Care Services
Amery Regional Medical Center
and
Legislative Committee of the W-ONE
Bibliography
Articles:
1. Degenhardt, Louisa and Wayne D. Hall. “The adverse effects of cannabinoids:
implications for use of medical marijuana.” Canadian Medical Association Journal,
17 June 2008: 1685-1686.
2. Hoffmann, Diane E. and Ellen Weber. “Medical Marijuana and the Law.” The New
England Journal of Medicine Vol. 362; 16, 22 April 2010: 1453-1457.
3. Sanchez, Eva Martin, Toshiaki A. Furukawa, Julian Taylor and Jose Luis R. Martin.
“Systematic Review and Meta-analysis of Cannabis Treatment for Chronic Pain.”
American Academy of Pain Medicine Vol. 10, Number 8, 2009: 1353-1368.
4.
Seamon, Matthew J., Jennifer A. Fass, Maria Maniscalco-Feichti, and Nada A. AbuShraie. “Medical marijuana and the developing role of the pharmacist.” American
Journal Health System Pharmacists Vol.64, 15 May 2007: 1037-1044.
5.
Wallace, Mark, et al. “Dose dependent Effects of Smoked Cannabis on CapsaicinInduced Pain and Hyperalgesia in Healthy Volunteers.” Anesthesiology Vol. 107, No.
5, November 2007: 785-795.
Websites:
1. “Medical Marijuana.” ProCon.org. 8 May 2008. 23 August 2010.
http://www.medicalmarijuana.procon.org/view.source.php?sourceID=001402
2. “Medical Marijuana Fact Sheet.” DrugPolicy.org. 9 June 2004. 21 August 2010.
http://www.drugpolicy.org/library/factsheets/06_09_04mmjfactsheet.cfm
3. “Speaking out against Drug Legalization.” U.S. Drug Enforcement Administration.
May 2003. 25 August 2010.
http://www.justice.gov/dea/demand/speakout/index.html
4. “What are the Pros and Cons of Medical Marijuana?” About.com. 26 April 2009.
5 August 2010.
http://dying.about.com/od/symptommanagement/f/med_mj_procon.htm