Page 35 - Spring 2019 Journal

however, dosing instructions and warnings are absent.
Advocates of medical marijuana often uncritically credit all forms of marijuana and all methods of consuming marijuana as having therapeutic benefits, whether smoking a joint, downing a THC-infused soda, eating a mari- juana brownie or vaping or “dabbing” highly concentrated THC resin. The average marijuana dispensary lumps all of these together under the mantle of “medicine.”68 The online cannabis marketplace also lacks standardization and quality control, with a high rate of mislabeling CBD and THC content.69
Contamination represents another serious concern. Recent laboratory tests of retail can- nabis products in California found that 80 to 90 percent of the products contained pesticides, fungus and mold—potentially dangerous toxins, especially if inhaled.70 Voters in the state ush- ered in licensed medical marijuana dispensaries two decades ago, yet these recent tests prove that the state is incapable of protecting consum- ers from contaminated products. In fact, even after media reports of the lab tests, California allowed dispensaries to continue selling the con- taminated products for six months rather than forcing a recall. Even if CBD does turn out to hold promise as a medicine for those with rare seizure disorders, users should have access to purified preparations that do not contain harm- ful contaminants.
Because the side effects of CBD can poten- tially be serious, parents should not strike out on their own on this new medical frontier. It is important to work under a doctor’s supervi- sion so that treatment with CBD can be altered or terminated if necessary. As new informa- tion emerges about the patient characteristics (whether genetic or physiological) that may increase the risk of adverse events, the respon- sibility for evaluating the research and advising physicians regarding cannabis use for medical purposes should remain at the federal level rather than playing out in piecemeal manner state by state.
William Bennett, MD, wrote the follow- ing to the FDA: “In 1986, we lost a 22-year-old son at the University of Oregon due to a dose of cocaine taken in a fraternity. We hope that
SPRING 2019
the Food and Drug Administration will use the same criteria with crude marijuana as medicine that they use for any other therapeutic substance. We need scientific proof of efficacy and safety in well-controlled clinical trials. Further, insistence on exact dosing, standardization of preparation, avoidance of contaminants, and evaluation of the smoking method of drug delivery needs to be done. Clearly crude cannabis contains many ingre- dients, and this will be almost impossible to standardize for clinical use.”
THE PUSH FOR LEGALIZATION
Groups like the Drug Policy Alliance and Marijuana Policy Project
continue to lobby state officials to legalize cannabis. However, policy- makers, voters and health-conscious consumers would be well-advised to become better informed about the personal, economic and social costs related to cannabis legalization and thoroughly analyze the medium-range and long-term consequences. Moreover, many of the assertions put forth by pro-pot organizations (such as “it is not addictive” and “it never killed anyone”) are so patently false that they should call into question the orga- nizations’ sweeping medical claims. It’s true that laws against marijuana use have unnecessarily targeted minorities and the poor, often resulting in unjustly harsh prison sentences. But legislators and citizens need to consider carefully the possible effects of removing all laws against the sale and use of marijuana.
Colorado is a revealing test case that may help legislators evaluate the wisdom of allowing similar policies to spread throughout North America. Commercialization of medical marijuana exploded in Colorado beginning in 2009, with favorable health board and legislative rulings allowing the emergence of over five hundred approved dispensaries by 2012 (and hun- dreds of unlicensed dispensaries) as well as over one hundred and eight thousand registered medical marijuana “cardholders” as of that year.71 A report from the Rocky Mountain High Intensity Drug Trafficking Area (RMHIDTA) extensively describes the downside of Colorado’s rush to embrace commercial cannabis, covering many adverse impacts. These include statistics on impaired driving, traffic fatalities, youth and adult use, emergency department and hospital admissions and diversion of Colorado marijuana to other states.71 Health care providers interviewed for the report describe “debilitating” symptoms, lives that have been “completely disrupted” and well-documented cases of psychosis. There has also been a 65 percent increase in first-time marijuana use among Colorado youth since legalization.72
In California, the “Silent Poison”73 website describes a neglected aspect of the state’s booming marijuana cultivation, outlining widespread devastation of the state’s ecology. Environmental hazards include heavy use of agricultural chemicals and pesticides and massive pollution of waterways. Other problems described on the website include grower ties to transnational criminal organizations and increased risks of violent robberies and other crimes.
One advocacy group, Smart Approaches to Marijuana (SAM), en- courages medical research into cannabis but discourages outright legaliza- tion. Concerned with the potential for negative public health outcomes, SAM has lobbied for caution in embracing cannabis as a “wonder drug”
Wise Traditions 33