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.
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MAP posted-by: Jay Bergstrom