Standardizing and Regulating Medical Marijuana — Who Are We Doing It For?

My husband told me something that I thought was a joke, but he convinced me it was serious.

During “drive-time” he heard an advertisement for a medical marijuana dispensary on the radio.  Among the many conditions it promoted marijuana as helping was eating disorders.

My thoughts went immediately to stoners with the midnight munchies making an emergency run to 7-11 for Cheetos or the late-night drive through at Burger King.

If you’ve read many of my ramblings, you will know that I have no problem with recreational use of marijuana (or at least, I believe that people should have the freedom to choose how they wish to kill their brain cells) and think it should be legalized or decriminialized or whatever the legal procedure is.

However, I take my medicine very seriously and have a strong opinion that marijuana is not a good treatment for anything.

That is why I am happy about what is going on in Colorado – they are trying to standardize medical marijuana.

I am concerned that people who are somehow trying to do good — physicians who are trying to be ethical — careen up against brick walls. People who believe in marijuana (users and sellers) believe in it like a religion.  It is a divine gift, it has lovely cords and fibers and other wonderful things. Patients have sometimes shown me zip-lock bags full of leaves and stems and seeds that look like they were dug up from somebody’s garden.

The THC pill is rarely prescribed because anyone who works with this stuff at all knows the best way to get it into someone’s system is by aspiration – meaning inhale-and-hold. The experience of taking the drug and the social interaction of ingesting it with others is at least as important as the effects of the drug. In the pill form at least, there seems to be no real thrill to swallowing it like an aspirin. Regulatory agencies are supposed to protect consumers.  They get tied up in the government bureaucracy — which frankly I would rather not enlarge.  Still I remember vividly the first time I heard about the FDA, in a science class in prep school, from a favored science teacher. He said it covered cosmetics, too, which was a brilliant thing to say because my classmates and myself were just at the place in life where one starts experimenting with cosmetics  (it was an all-girls school). He said if there were no FDA, and not even the shadow of a “Big Brother” regulating such things, people could manufacture and sell face powder, for instance, that had ground glass in it. Charming, innocent young things such as myself and my preppie girlfriends might — in the name of glamour — apply something to our cheeks that would make them bleed. We all decided then and there we loved the FDA. Now today, I understand this agency for the toothless monster it seems to be, and know that my benign science teacher did not. There is just plainly little or no scientific research about most of the conditions that marijuana is supposed to help, let alone how “wacky weed” is supposed to help them. This kind of research is hard to do.  One might want to find people who have a given condition and are trying to use marijuana to help it.  One might want to give measured doses, maybe compare ideally against a placebo. Okay, so designing the experiment may not be the most difficult part, but who is going to fund it?

Plenty of pharmaceutical companies already have FDA approved treatments on the market to handle the exact ailments the pot smokers are self-treating for.  They invested huge amounts in testing and approval for their medicines and certainly don’t want competition from something that grows wild or is easily cultivated by anybody with a flower pot.

The government?  There is still a lot of moral outrage against drug usage among the majority of tax-payers and funding marijuana research would never get approved.

It seems unlikely that the consumers of medical marijuana really care very much – especially if they’ve been partaking of the herbal cigarettes for some time. One of the problems I see with patients who use pot regularly remains the classic amotivational syndrome.  These folks seem to end up saying in their homes, and at the rare times they venture outside to see me, they tell me that they are going to do things – but they never seem to get around to them. As consumers, maybe they care about how much bang they get for their buck.  It is true that any time somebody walks into a drug store, that person knows just how much “active principle” of a drug they are buying.  It is certainly spelled out clearly on a prescription, but it is also there on every single over the counter pill, printed plainly on the label. My husband will attest to the amount of time I have spent in drugstores reading the back of boxes of over-the-counter drugs. The real question here is how hard someone has to work to protect a consumer who does not seem to give a damn. Removing pollutants, verifying the dose of active principle — these are good ideas.  If they were made public, the consumer would actually be able to tell something about if they are getting something strong enough to be worth their money. I suppose marijuana will always be, at least in part, an “underground” sort of thing.  The people who want it — at least the patients I know who want it — are going by their own experience and that of their friends, by idealism and sometimes nihilism and certainly not by pharmacology, which would be served by honesty, truth in labeling, and well, just a little plain old truth. I do not think truth is what most people want. I think they want accessibility to something that delivers a short-term feel-good without the risk of legal hassles or the bother of wandering around town looking for a supplier who is probably paranoid about dealing with strangers. I made a special study of psychopharmacology – served a fellowship and did FDA clinical trials research on a lot of the major drugs out there on the market today.  Yet there is nothing else for which a prescription can be written about which I know so little.  I have never used marijuana, and most of my information comes from what patients tell me or what I read (and choose to believe) in the mass media. At least with alcohol, they have to put how many proof or what percentage alcohol content it is on the bottle. Maybe the answer to marijuana is something similar. I don’t think we have any reasonable data to become marijuana regulators right now  Until now, this has been a problem of politics. I applaud at least the effort to move it into pharmacology, and medicine.