An approach to the medical marijuana controversy

The use of smoked marijuana as a therapeutic agent is presently a matter of considerable debate in the United States. Many people suffering from a variety of disorders maintain that it is necessary for their adequate treatment. Yet, the evidence to support claims is insufficient for FDA approval. An interim solution is proposed which would allow patients referred by their physicians to participate in a 6-month program of legal marijuana availability, similar to the 'compassionate IND' program of a number of years ago. A technique similar to that used for post-marketing surveillance is proposed for obtaining quantitative data for a limited number of potential indications. These are: (1) nausea and vomiting associated with cancer chemotherapy or other causes, (2) weight loss associated with debilitating illnesses, (3) spasticity secondary to neurological diseases, and (4) chronic pain syndromes.

The future of medical marijuana

The medical value of marijuana is becoming increasingly clear, as it proves to be a remarkably versatile, safe, and inexpensive drug. Arrangements now being proposed for making cannabis constituents medically available include quasi-legal buyers clubs, restrictive classification as a prescription drug, the isolation of individual cannabinoids, and the manufacture of synthetic analogs. Careful analysis potentially of this inexpensive drug shows that all these proposals are unworkable. Furthermore, cannabis has so many beneficial uses that the strictly medical ones should not be singled out for approval, and its medical potential cannot be fully realized as long as its use for any other purpose is prohibited. Therefore cannabis should be made available under laws similar to those now applied to alcohol.

Youth Alternative Sentencing Program: a description and evaluation of an alcohol and marijuana intervention program

An alternative program was designed for youth who were charged with an alcohol or marijuana offense in San Bernardino County, California. In place of a conviction, the youth could attend an extended educational program that emphasized their ability to change behavior and to understand the consequences of risk-taking behavior. An evaluation was completed by the participants, demonstrating that this population of youth began to experiment with alcohol and marijuana around 12 and 13 years of age. A large number of youths were identified for nontraffic offenses, which offered an opportunity to intervene before members of this population become involved in a motor vehicle crash.

Cannabis policy: issues and options

This paper examines some of the key points relevant to the debate about cannabis policy in New Zealand. It provides a brief overview of cannabis use patterns, the cannabis market and the public health implications of use. It describes the various strategies which comprise our current cannabis policy and the context of and primary concerns relating to it. Several alternative policy options are explained and in each case some evaluative comments are made. These alternatives are: total prohibition with an expediency principle; prohibition with civil penalties, partial prohibition, and regulation of private enterprise producers/distributors. From a public health perspective none of these options is unproblematic but each has the potential to overcome some of the disadvantages of the current policy and each needs to be further evaluated.

[Cannabis consumption in young people living in Brussels: observational conclusions drawn from a preliminary study]

A qualitative study was carried out to explore the adolescents' representations of cannabis and related behaviors. Twenty-two young people aged 13 to 18 years and living in Brussels were interviewed using a half structured interview guideline. The analyse showed that there are three types of behaviors related to cannabis use: the non-users, the experimenters and the users. Parents, the school and peers seem to be specific determinants of cannabis use as well as the main information channels about this product. These preliminary results already lead ways to prevention: training of parents and teachers and school improvement.

Marijuana to prevent nausea and vomiting in cancer patients: a survey of clinical oncologists

Marijuana, if rescheduled by the Drug Enforcement Agency, would be the only Food and Drug Administration (FDA)-approved drug to be administered by smoking. American physicians need timely, factual information about probable usage patterns and potential adverse effects of medical marijuana, and a factual complete review of the literature on the subject. We mailed a survey to 1,500 American clinical oncologists. Of particular interest was whether and how often in the past 24 months these physicians recommended smoked marijuana, synthetic tetrahydrocannabinol, or 5-HT3 (serotonin) antagonists (ondansetron [Zofran], granisetron [Kytril]) for their patients. We also inquired whether and how often the oncologists would prescribe marijuana in the form of cigarettes, were it to be FDA-approved. Completed surveys were received from 1,122 (75%) of the oncologists. The percentages of oncologists who prescribed or recommended selected antiemetics more than five times between 1992 and 1994 were 98% for 5-HT, antagonists, 6% for dronabinol (Marinol), and 1% for smoked marijuana. We also found that 332 (30%) of the oncologist-respondents to this nationwide survey supported rescheduling of marijuana for medical purposes; however, two thirds (67%) of the 332 respondents who were in favor of rescheduling estimated that they would write less than one prescription per month for marijuana cigarettes. A comprehensive literature review failed to provide persuasive evidence to recommend marijuana as a needed antiemetic medicine.

Dutch drug policy: a model for America?

While debates over drug policy in America have focused on choices between demand reduction and supply reduction, the Dutch have pioneered the alternative strategy of harm reduction. The Dutch have built their policy around the principles of separation of markets, low threshold treatment, and normalization of treatment. These policies are worthy of examination as a possible model for drug policy reform in America.

The impact of alcohol consumption and marijuana use on high school graduation

In this study we use data from the National Longitudinal Survey of Youth (NLSY) to estimate the relationship between high school graduation, and alcohol and marijuana use among high school students. We also estimate the demand determinants for each of these substances. Our results show that there are significant adverse effects of alcohol and marijuana use on high school graduation. In particular, increases in the incidence of frequent drinking, liquor and wine consumption, and frequent marijuana use, significantly reduce the probability of high school graduation. Our results also show that beer taxes, liquor prices and marijuana decriminalization have a significant impact on the demand for these substances. These findings have important policy implications. A ten percent increase in beer taxes, reduces alcohol consumption among high school students, which in turn raises the probability of high school graduation by about three percent. A 1 percent increase in liquor prices raises the probability of high school graduation by over 1 percent. Raising the minimum drinking age for liquor also reduces liquor and wine consumption, and thus, improves the probability of high school graduation. Although the relationship between marijuana decriminalization and marijuana use is not significant, decriminalization is found to reduce the probability of becoming a frequent drinker. This result suggests that marijuana use and frequent drinking are substitute activities. Illicit substance abuse reduces the rate of high school completion, reduces expected future earnings and creates potential health problems. Thus, high-school-based preventive programs which discourage alcohol consumption and marijuana use are highly recommended, in order to alleviate these problems.