Drug Watch
International
Position Statement
QUESTIONS GOVERNING THE USE OF
SMOKED MARIJUANA AS A MEDICINE
Drug Watch International and the
International Drug Strategy Institute do not support the smoking of marijuana or
any other substance for medicinal purposes. Marijuana is a dangerous drug, and
its increased potency over the past 15 years has made it a leading cause of
drug-related emergency room episodes. The recent Institute of Medicine (IOM)
report in the United States concluded there is no scientific evidence that
smoked marijuana provides any advantage over currently available medicine,
including synthetic oral THC (tetrahydrocannabinol-dronabinol). The report only
discussed trial use of marijuana for short-term use, less than six months, and
did not support use for glaucoma, multiple sclerosis, or other chronic medical
conditions.
Several U.S. states and various countries have passed laws that allow for the
unproven medicinal use of smoked marijuana for a wide range of alleged medical
ailments. Before implementing medicinal marijuana laws in defiance of federal
and international drug statutes and treaties, Drug Watch International would ask
that the following be considered:
1. Does the proposed law take into account that before prescribing any addictive
medicine, medical ethics require that a determination must be made as to whether
the patient considering smoking marijuana cigarettes as medicine is already a
user of marijuana or other psychoactive and addictive drugs?
2. Does the proposed law allow for periodic drug testing of the patient who has
been prescribed smoked marijuana and the exclusion of any who are found to be
using other illicit drugs? Who will determine who does the drug testing and by
what means? Should the prescribing physician be drug tested for the personal use
of marijuana?
3. Are there any criteria for documenting that the patient has had no success
using conventional medications to treat his or her ailment?
4. If the use of smoked marijuana is part of a study, will the monitoring of
that use be under the supervision of an investigational review board consistent
with guidelines for investigational review boards?
5. Are there any criteria for careful examination and consistent follow-up of
patients who use smoked marijuana as a medical treatment, including pulmonary
function testing, evaluation of immune status, and presence of any
superinfection, and is there periodic random drug testing for illegal drugs?
6. Has any attention been given to the standardization of the THC potency
content of the marijuana to be considered for medicinal use and whether it is
free of microbial contaminants?
7. Since smoked marijuana contains more carcinogens than tobacco, has careful
review been given to which patients should be allowed to use this extremely
dangerous drug? And for what length of time?
8. Since marijuana is a federally controlled substance, has a system been
established to track all patients, their physicians, and their source of
marijuana as with other controlled substances?
9. Will the prescribing physician or caregiver be required to be licensed by the
state or federal government?
10. Will physicians be required to demonstrate knowledge, training, or
certification in addiction medicine and have demonstrable knowledge of the
physiological effects of marijuana, its side effects, and its interaction with
other drugs before being able to prescribe it? Will certification, licensing,
and other attendant requirements, as applied to other therapeutic drugs, be
required?
(July 1999)
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