Download Myers Samantha Myers Paige French General Medical Conditions 5

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Samantha Myers
Paige French
General Medical Conditions
5 December 2016
Where do We go from Here: Legalization of Marijuana
The most commonly used illegal drug in the United States is marijuana.1 Even though some
states have legalized marijuana, it is still considered an illicit drug because the federal government does
not support its legalization. However, there is controversy whether compounds of marijuana could be
helpful for complex medical cases. This reflection will argue both sides of the debate over the
legalization of marijuana. The discussion of pro-legalization will delve into what medical societies see in
medical marijuana research, the future of medical marijuana and synthetic compounds, and the general
population’s opinion. The con-legalization of marijuana focuses on our understanding of the
neurobiology of addiction, pediatric marijuana use, and economic and environmental factors. By
analyzing both sides, the conclusion may be drawn that medical marijuana should be legalized, while
recreational marijuana should remain illegal.
In order to discuss the pros and cons of the legalization of marijuana, we first need to
understand what marijuana is and how it physiologically affects the body. Marijuana consists of dry
leaves, flowers and seeds from the plant cannabis sativa.1 It is usually consumed through inhalation of a
pipe, cigar, or blunt, and its oils can be used for cooking.1 The key ingredient to marijuana is delta-9tetrahydrocnnabinol, THC, which gives individuals the “high” sensation.1 Potency of marijuana is
determined by the concentration of THC, which has continued to climb since the 1970s, raising concern
about life-long effects of misuse and abuse of marijuana.1 In adolescents, marijuana has been found to
impair coordination, reaction time, memory, balance, and thinking processes.1
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Several medical sources, along with the American Medical Association and the National Institute
of Health recognize that medical marijuana may provide benefits to chronically ill patients; however,
further research is necessary to really understand its benefits. 2-4 The AMA stated, “AMA urges that
marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating
the conduct of clinical research and development of cannabinoid-based medicine, and alternative
delivery methods.”2 This is not saying that the AMA promotes legalization of marijuana, but it realizes
the limitations in research because the drug is an illegal substance. Without legalization of medical
marijuana, it is difficult to conduct research in order to further analyze its effects.2-6 Fortunately, this
August, the DEA has given permission to the University of Mississippi to grow their own marijuana plants
for research purposes, but this still does not account for other researchers having to jump through
various hoops in order to conduct research.5 Moreover, Sativex is a cannabinoid oral spray used in
Canada to reduce neurological pain in patients with multiple sclerosis and has recently been approved
by the FDA for further research in the United States.6 The United States is lacking medical marijuana
research due to the legal restrictions. Therefore, legalization of medical marijuana would lift the
limitations of marijuana research; as a result, our society would have the ability to be further educated
about cannabis.
Potential medical benefits of marijuana include, “Counteract[ing] weight loss in people with
AIDS, nausea among patients who are undergoing chemotherapy, spasticity in those with multiple
sclerosis and spinal cord injuries, and pain among sufferers of nervous system disorders.”3 Studies in
Spain show cannabinoids in mice have reduced axonal nerve fiber damage, which could help reduce the
progression of multiple sclerosis.4,6 A popular case study on Charlotte Figi, a child with epilepsy residing
in Colorado, saw almost complete relief from her chronic seizures from using a marijuana compound,
cannabidiol.6 Charlotte’s story has further sparked curiosity in United States residents who want to seek
synthetic marijuana treatment for chronic seizures.6 Drug companies are beginning to invest in
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developing synthetic compounds of marijuana without causing the side effects of cognitive problems or
the “high sensation.”6 Because these synthetic compounds are developed with “consistent potency” it
would be easier to regulate dosage.6 In addition to MS and epilepsy benefits, THC in marijuana has been
found to increase appetite in AIDS patients, reduce tumor size of breast cancer cells, decrease
inflammation in autoimmune diseases, and even block certain proteins that build up in Alzheimer
brains.6 When considering the vast benefits already found by using medical marijuana for chronic
diseases, legalization for medical use could result in unprecedented relief for many, but legal restrictions
continue to hinder the ability to do so.
On a personal note, my mother, Julie, is a kindergarten teacher and had a student with a serious
case of epilepsy. Julie found herself not being able to teach the rest of her students adequately because
class was frequently interrupted with a medical emergency associated with her epileptic student. The
student began to receive high doses of seizure medications, but the seizures were still out of control.
One of the side effects the student experienced as a result of the seizures and the medication was major
cognitive dysfunction. After one year of battling brutal seizures, the little girl was approved to begin
using a synthetic compound of medical marijuana. Fortunately, this was the only medication that
controlled her seizures. Unfortunately, her life was forever changed because the strong seizure
medications and seizure episodes permanently disabled her. If legalization of medical marijuana is
considered, then further research will provide us with a greater understanding of the benefits it could
have, and could give patients, like this kindergarten student, a better quality of life. NPR published an
article in November 2016 showing that 60% of the general population in the United States supports
legalization of marijuana.7 Alan Brockstein, an investor in the marijuana market said,
“People are still smoking cigarettes. We know there are problems with that…People are drinking
alcohol. We know there are problems with that. Opioids are legal. We know there are problems
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with that. I think that over time research will bear out there are pros and cons to the
consumption of cannabis.” 7
As presented above, there is a strong case supporting legalization of marijuana for medical research,
medical use, and the push for legalization from the general population. On the other hand, there are
many reasons why marijuana is still not legalized by the federal government; some of the main
arguments include our knowledge of addiction, pediatric use, economic and environmental factors.
Volkow et al. wrote an article on the neurobiology of addiction; they are a group of doctors that
work for the National Institute of Drug Abuse and the National Institute of Alcohol Abuse and
Alcoholism.8 Their goal is to improve medical professionals’ and public understanding of the biological
process and voluntary behavioral control of addiction.8 They concluded that the process of addiction
follows three steps: binge and intoxication, withdrawal and negative affect, and preoccupation and
craving.8 During the binge and intoxication stage, we know that consumption of a drug increases
dopamine levels in the brain and initiates a Pavolvian learning effect.8 Individuals begin to anticipate the
drug before consumption because of associated environmental cues, otherwise known as the rewardsystem theory.8 This theory is also supported in Raymond Anton’s article.9 During the withdrawal and
negative affect stage of addiction, individuals realize that the drug is not pleasurable anymore and climb
into a dysphoric phase but resort to using the drug again through an anti-reward system in order to feel
“normal”.8 The last stage of addiction is preoccupation and craving. By altering the dopamine-receptor
system, the brain’s prefrontal cortex lapses and people are unable to make appropriate decisions and
resist cravings, resulting in the individual’s continued dependence the substance.8-9 Through the
physiology of addiction, we learn that addiction and dependence is a disease that needs proper
treatment. Some argue that marijuana is not addictive; however, if someone is using marijuana for over
12 months and it is resulting in withdrawal, tolerance, and social and occupational impairment, then
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they are dependent on it.10 In 2011, The American Psychiatric Association studied marijuana abuse
criteria from the DSM-IV and found a higher prevalence in marijuana abuse than those dependent on
pain relievers, cocaine, tranquilizers, hallucinogens, and heroin combined.11 If dependence on marijuana
is already higher than multiple drugs combined, why is there an argument that marijuana is not
addictive? If we continue to pursue legalization of marijuana, we will be enabling the current problem
that exists in our society.
The biggest fear of legalization of marijuana in youth is that its abuse will increase in rate.12 We
know that those who begin to use marijuana in adolescence are “2 to 4 times more likely to become
dependent after 2 years of their first use.”1 Availability of marijuana would increase with the
legalization, and thus its access to adolescents would increase. Research has shown that youth’s general
perceived risk of marijuana has decreased from 2002 to 2011, and lower perceived risk is associated
with a higher prevalence rate.11 If we are already seeing a drop in perceived risk in adolescents, then
legalizing marijuana would further lower perceived risk. We also know that adolescents’ vulnerability to
the key ingredient in THC is higher than an adult because the brain does not fully develop until about 21
years of age.1 Moreover, studies have shown an increase in high school dropout rates and lower grades
in those who smoke marijuana compared to non-smoking peers.1 Alcohol and tobacco are the most
highly abused drugs consumed by adolescents, and by legalizing marijuana we are potentially adding a
third drug to that substance abuse list.12
My childhood best friend smoked marijuana for the first time in our freshmen year of high
school. She had an older brother at our high school who was a junior, and she said she felt safe while
using marijuana since she was with her older brother. She did not experience a “high” the first time of
consumption, so that influenced her to smoke again. After that, our friendship was never the same. She
claimed it was a way for her and her older brother to “connect in a way that they have never connected
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before.” Her older brother would drive us to school every morning; watching them smoke a blunt before
school on the drive there was not uncommon. She became unenthused by things we used to enjoy
together. She quit varsity and club cheerleading as a sophomore in high school; she had been good
enough to cheer at the Division I level. Even after her brother graduated, she continued to smoke
marijuana more and more because she felt like she was not getting the same effect (otherwise known as
tolerance).10 In my own experience, I lost a best friend because of her dependence on marijuana. Today,
she is not in college, works part time at a fast-food restaurant, and now engages in harder drugs.
Addiction is a brain disease, and can significantly impair adolescents. I defy the stigma that marijuana is
“not addictive” because I saw her lose everything that she had going for her.
Lastly, people think marijuana should not be legalized because it does not provide the United
States with any economic or environmental benefit. Research has found that, contrary to popular belief,
legalization of marijuana will not create revenue from taxes.11 Healthcare consequences associated with
marijuana would exceed the potential revenue consumed from legalization.11 Current projections of tax
revenue from legalization of marijuana are not considering social consequences, such as incarceration,
motor vehicle accidents or hospital visits.11 We already know that it costs our country $700 billion
annually related to crime, healthcare, and work compensation as a result of legal and illegal drug abuse.8
If it is already costing our society that much as a result of alcohol, tobacco and illicit drugs, logic would
say that $700 billion would increase as a result of the legalization of marijuana. In addition to economic
reasons why legalization is not beneficial, the environment is also significantly affected by the cultivation
of marijuana because of the immense amount of chemicals used during the growing process.11 The
chemicals used to protect the plants during the growing process runoff to natural water resources and
affect native vegetation and water sources for wild animals.11 Wildfires are also a large concern
associated with the cooking process of marijuana.11 An illegal drug-trafficking organization caused a
large wildfire in Southern California in 2011 associated with marijuana cooking, destroying about 89,000
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acres of national forest.11 Wildlife experts predict it would cost roughly $16,000 per acre to clean up
contaminated land.11 It does not make sense to pollute our already polluted world for a drug that causes
addiction, lasting side effects and will not provide any income for our country. Based on the economic
and environmental burdens that legalization of marijuana would present us with, it does not seem
logical for the federal government to legalize marijuana.
Based on the material that was presented above, I think it is time for our federal government to
reschedule marijuana from a Schedule I illegal substance to a lower schedule in order for medical
marijuana to be further researched and accessible for chronically ill patients. However, the reality of the
neurobiology of addiction, risk for pediatric use, and economic and environmental consequences cannot
be ignored, which is why recreational use of marijuana should continue to be illegal. If marijuana’s class
schedule was changed, then not only could medical marijuana research occur, but other research
associated with addiction, motor vehicle accidents, and developing a screening tool for law enforcement
could develop for driving under the influence of marijuana. 2016’s presidential election was a
monumental election for many reasons, but also in the realm of marijuana legalization. As our
President-Elect continues to hire his cabinet for the upcoming four years, drastic changes associated
with the legalization of marijuana are likely to occur. In a Washington Post article, nominee for head of
the Department of Homeland Security, Marine General John F. Kelly, has said that he does not support
recreational use of marijuana for the fear of it being a “gateway” drug.13 However, he also stated, “But
I'm told it has a medical use. So whether it's veterans or anyone else, if it helps those people, then fine.
Medicine is medicine.”13 It is clear that there is a dividing line between both sides of the argument on
the legalization of marijuana that our society needs to ponder about. Bridgewater College’s question of
the year is “where do we go from here?” Through evaluating the evidence, it seems clear to legalize
medical marijuana and continue to restrict recreational use.
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Works Cited
1. Zhao S. Marijuana cessation screening and counseling for young adults in the primary care
office. Consultant. 2015: 172-178. http://www.consultant360.com. Accessed December 3, 2016.
2. Wells B. Marijuana legalization: implications for property/casualty insurance. Journal of
Insurance Issues. 2014: 77-92. http://www.insuranceissues.org/PDFs/371W.pdf . Accessed
November 17, 2016.
3. Henry S, Lehrman S, Motte P. Medical marijuana gets the high sign. Health (Time Inc. Health).
November 1997;11(8):23. Accessed December 1, 2016.
4. Durand M, Holland N. Considering cannabis. Inside MS. June 2007;25(3):56-57.
http://www.nationalmssociety.org/InsideMS. Accessed December 1, 2016.
5. Hart C. Our senseless pot laws. Scientific American. October 2016;315(4):13. Accessed
December 1, 2016.
6. Noonan D. Marijuana's medical future. Scientific American. February 2015;312(2):32-34.
Accessed November 17, 2016.
7. Berliner U. As more states legalize marijuana, investors and marketers line up. NPR Web site.
http://www.npr.org/2016/11/20/502577270/investors-marketers-line-up-to-tap-legalmarijuana-around-u-s. Published November 2016. Accessed December 6, 2016.
8. Volkow ND, Koob GF, McLellan AT. Neurobiologic advances from the brain disease model of
addiction. New Engl J of Medicine. 2016; 374:363-371.
9. Anton R. Substance abuse is a disease of the human brain: focus on alcohol. Journal of Law,
Medicine and Ethics. 2010: 735-744.
10. Cuppett M, Walsh K. General Medical Conditions in the Athlete. St. Louis, MO: Mosby Inc. an
affiliate of Elsevier Inc.; 2012: 436-437.
11. Answers to Frequently Asked Questions about Marijuana. Office of National Drug Control Policy
Web site. https://www.whitehouse.gov/ondcp/state-laws-related-to-marijuana. Published n.d.
Updated n.d. Accessed November 12, 2016.
12. Joffe A, Yancy W. S. Legalization of marijuana: potential impact on youth. Pediatrics. 2004; 113:
e632-e638. Accessed November 17,2016.
13. Ingraham C. Trump’s DHS pick is cool with medical marijuana. Washington Post. December 7,
2016. https://www.washingtonpost.com/news/wonk/wp/2016/12/07/trumps-dhs-pick-is-coolwith-medical-marijuana/?utm_term=.6012522674f1. Accessed December 8, 2016.