Letter
July 9, 2015

Reasons to oppose medical marijuana laws

By Ed Gogek, M.D.

State legislatures across the country are legalizing medical marijuana, but the nation’s physicians aren’t demanding these laws. The American Medical Association (AMA) doesn’t support them, and the American Academy of Pediatrics and the American Society of Addiction Medicine both oppose these laws. The American Cancer Society hasn’t demanded medical marijuana, and the Glaucoma Foundation even warns patients against using the drug.

Instead, demand comes from the Drug Policy Alliance and Marijuana Policy Project, lobbying groups supported by pro-marijuana billionaires. These are not medical organizations, and state legislators who listen to them are ignoring some very serious problems.

The biggest problem is that medical marijuana laws are responsible for most of the growth in adolescent use. According to the University of Michigan’s Monitoring the Future survey, teen use in the United States surged between 2005 and 2011. But it didn’t surge equally in all states. In 2005, only about 20 percent of the U.S. population lived in medical marijuana states, yet those states accounted for more than two-thirds of the increase in adolescent use.

Data from the National Survey on Drug Use and Health (NSDUH) shows that the number of teens who smoked pot over the previous month increased by 33 percent in medical marijuana states, but only by 6 percent in the rest of the country. If it weren’t for states with medical marijuana laws, teen use would barely have increased at all.

There’s also evidence that nearly all the “medical” marijuana goes to drug abuse. The largest survey of medical marijuana patients, published in 2014 in The Journal of Global Drug Policy and Practice, found that only 6 percent reported cancer, AIDS, glaucoma, Alzheimer’s, Crohn’s disease, or Hepatitis C. The vast majority—91 percent—got their marijuana for pain.

Research shows that most chronic pain patients are women. In 2001, the journal Pain published a study by researchers who interviewed over 17,000 people and found that 54 percent of those with chronic pain were female. On the other hand, five years of data from the NSDUH showed that adult marijuana abusers were 69 percent male. So if the pain patients using medical marijuana are genuine, they should be mostly female. If they’re substance abusers faking or exaggerating pain just to get high, they should be about 69 percent male.

Between 2011 and 2013, I contacted all the state medical marijuana programs and got data from seven. In all but one of the states, between 64 – 74 percent of the pain patients were male. In Vermont, it was 67 percent.

That’s what we’d expect if the patients were all substance abusers rather than legitimate pain patients. So while not every medical marijuana patient is misusing the law just to get high, the great majority probably are.

A study from the 2011 Journal of Drug Policy Analysis found similar results. The researchers surveyed 1,655 consecutive patients from nine medical marijuana clinics in California, and found the average patient was a 32-year-old male who started smoking pot as a teenager.

Increased teenage use and substance abuse might be understandable if these laws served a purpose, but they don’t. While some seriously ill patients are helped by marijuana, there are four prescription cannabinoid medications that are just as helpful. So there’s no reason to use marijuana itself as medicine.

Two of these medicines, Marinol and Cesamet, are available by prescription in the United States. A third, Epidiolex or pure cannabidiol, is available for children with seizures through a special FDA program. The fourth, Sativex, is in the last stages of approval.

Some of these medicines have fewer side effects than marijuana and are more long-acting, which means they’re better for genuine patients who don’t want to be stoned all the time. However, the biggest advantage of prescription cannabinoids is that they’re much less likely to be abused or diverted to teenage use than medical marijuana is.

State legislators who want what’s best for the country should ignore the pro-marijuana lobbyists and instead listen to the AMA, the Academy of Pediatrics and the Society for Addiction Medicine. If we want to rein in teenage marijuana use and prevent widespread abuse of the drug, instead of passing new state medical marijuana laws, we should get rid of the ones we already have.

Ed Gogek, M.D. is an addiction psychiatrist and author of the book Marijuana Debunked: A handbook for parents, pundits and politicians who want to know the case against legalization, to be released this summer by Chiron Publications. This article originally appeared on www.philly.com/thinktank, a section of the Philadelphia Inquirer.

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