Scientific review of marijuana supports regulation, not criminalization

The National Academy of Sciences, Engineering, and Medicine released a comprehensive report on Thursday acknowledging that “conclusive or substantial evidence” exists for the efficacy of whole-plant cannabis and its derivatives in patients suffering from chronic pain, multiple sclerosis, and other disorders.

Authors reviewed over 10,000 scientific abstracts when compiling their findings. The report marks the agency’s first comprehensive review since 1999 specific to the science surrounding marijuana and health.

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“In adults with chronic pain, patients who were treated with cannabis or cannabinoids (constituents found organically in the marijuana plant) are more likely to experience a clinically significant reduction of pain symptoms,” experts concluded. They also affirmed that marijuana-derived medicines are effective anti-emetics and that they improve symptoms of spasticity.

The findings have intriguing political implications for the federal classification of the cannabis plant. Presently, the US Controlled Substances Act defines marijuana as a schedule I prohibited substance with “no currently accepted medical use in treatment in the United States.”

In August, the US Drug Enforcement Administration rejected a pair of petitions that sought to reclassify the substance, claiming, “There are no adequate or well-controlled studies that determine marijuana’s efficacy.”

The National Academy of Sciences’ conclusions are clearly at odds with the DEA’s position.

Authors of the report also addressed marijuana’s effects on overall health and safety. Not surprisingly, they acknowledging that the substance may pose some potential risks for certain groups of people, such as adolescents, pregnant women, those with a family history of mental illness, and those who engage in driving shortly after ingesting cannabis.

However, in each of these cases, marijuana’s risk potential may be mitigated by better regulations and public education, and by the imposition of age restrictions in the marketplace.

By contrast, researchers found little or insufficient evidence to support claims that cannabis exposure is linked to lung cancer, chronic obstructive pulmonary disorder (COPD), heart attack, stroke, occupational accidents or injury, or overall mortality, or that its use serves as a so-called ‘gateway’ to the eventual use of other illicit substances – results that are commonly associated with the consumption of other licit substances such as alcohol, tobacco, or opioids.

Taken in their totality, the Academies’ conclusions that cannabis possesses established therapeutic utility for certain patients and that it possesses an acceptable safety profile when compared to those of other medications or recreational intoxicants are not surprising.

Scientific evidence with regard to marijuana’s health and safety has been mounting for decades. Yet nonetheless marijuana policy in this country has largely been driven by rhetoric and emotion, not science and evidence.

A search on PubMed, the repository for all peer-reviewed scientific papers, using the term ‘marijuana’ yields over 24,000 studies referencing the plant or its biologically active constituents — a far greater body of literature than exists for commonly consumed conventional drugs like Tylenol, ibuprofen, or hydrocodone.

Further, unlike modern pharmaceuticals, cannabis possesses an extensive history of human use dating back thousands of years, thus providing society with ample empirical evidence as to its relative safety and efficacy.

Moreover, today, 29 states and Washington, DC permit physicians to recommend marijuana therapy. Some of these state-sanctioned programs have now been in place for nearly two decades.

Eight states also permit the regulated use and sale of cannabis by adults. To date, these regulatory schemes are working largely as intended, and the regulation of cannabis has not adversely impacted workplace safety, teen use rates or access, or motor vehicle accidents.

At a minimum, we as a society know enough about cannabis, as well as the failures of cannabis prohibition, to regulate its consumption by adults, end its longstanding criminalization, and to remove it from its undeserved Schedule I prohibitive status under federal law.

Paul Armentano is the deputy director of NORML (the National Organization for the Reform of Marijuana Laws) and an adviser for Freedom Leaf. He is the co-author of the book "Marijuana Is Safer: So Why Are We Driving People to Drink?" (Chelsea Green, 2013) and author of the book "The Citizen's Guide to State-By-State Marijuana Laws" (Whitman Press, 2015).


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