Pubdate: Sun, 03 Aug 2014 Source: Baltimore Sun (MD) Copyright: 2014 The Baltimore Sun Company Contact: http://www.baltimoresun.com/ Details: http://www.mapinc.org/media/37 Page: 24 MARIJUANA PARADOX Advocates' Concerns About Some Aspects of Maryland's Proposed Medical Marijuana Regulations Reflect the Lunacy of Federal Treatment of the Drug Advocates are generally praising Maryland's proposed new medical marijuana regulations as a step in the right direction after an initial effort failed to make the drug available to patients with chronic pain, nausea and other conditions thought to be alleviated by it. But they have raised concerns about some details that essentially boil down to this paradox: They object that the regulations would treat marijuana like any other medicine and that they would not. When a doctor prescribes a statin to control cholesterol, for example, we would expect him or her to specify exactly what type, the dosage, the frequency of use and so on. In the same vein, the proposed marijuana regulations call for doctors to specify the quantity and possibly the strain of marijuana they recommend for their patients. But acvocates say that amounts to the same thing as a "prescription," even though the law and regulations call it a "recommendation," and there's well established case law making clear that doctors can't prescribe marijuana, for fear of losing their medical licenses or worse. In this regard, advocates want marijuana treated differently from other drugs. Another part of the regulations calls for physicians who recommend marijuana for their patients to undergo training. Advocates object to that, too, saying in this instance that marijuana should be treated like all other drugs. Physicians do not need to take courses or continuing education credits to prescribe new drugs other contexts. They are expected to do their own research on a drug's uses and dangers and to prescribe it appropriately. But the trouble with marijuana is that it has not been approved by the Food and Drug Administration or subjected to controlled clinical trials, as any other drug would be. We sympathize with both sides in this controversy. Advocates are right to be concerned that we do not again create a medical marijuana program - something that an overwhelming majority of Maryland voters support - that fails to provide access to marijuana for people who could potentially be helped by it. And the commission is right to frame the program in a medical and scientific context rather than as legalization-light, as medical marijuana has turned out to be in some other states. Maryland can surely find a way to work around the contradictions produced by these two points of view. Dr. Paul Davies, the chairman of the commission, said last week that the commission intended the specifications for the strain, dosage and so on to be an option for doctors, not a requirement. And MedChi, the state medical society, is already working on marijuana courses for physicians, which will most likely be available online or in person and which will focus on the specifics of Maryland's law. But the real issue is a federal marijuana policy that is increasingly out of touch with reality. Marijuana is classified as a Schedule I controlled substance, putting it on par with drugs like heroin and LSD for which there is no accepted medical use. At a time when 23 states and the District of Columbia have medical marijuana programs, some of them in place since the 1990s, that's laughable. The U.S. Department of Justice has announced a policy that it will not prioritize the prosecution of those involved in legitimate medical use of marijuana. But that's not good enough. Not only does it leave the matter to the whim of whatever administration is in the White House but it also leaves in place restrictions that have effectively quashed research into marijuana's medical properties and risks and prevented doctors from managing its use as they would other drugs. Separate from the broader questions about national marijuana policy - whether it should be treated like alcohol, as is the case in Colorado and Washington, or whether it should be effectively decriminalized, as is the case in Maryland and several other states - it is clear that it should be removed from Schedule I so that its pharmacological use can be properly studied and regulated. - --- MAP posted-by: Jay Bergstrom