Weed for What Ails You: Medical Marijuana
The medical marijuana case Gonzales vs. Raich has been remanded by the SCOTUS to the 9th circuit, reports Volkh Conspiracy. Along with Dispatches, I will leave it to the legal experts to comment on the constitutionality of Congress invoking the Commerce Clause to regulate an activity which is neither interstate nor commerce.
While I once agreed with those who asserted there was minimal evidence that marijuana causes lasting biological harm or addiction, there is new evidence not everyone may be aware of. In particular this large study documenting cannabis use associated with development of psychotic disorders (schizophrenia and schizoaffective disorder), this is a metanalysis showing increased risk for schizophrenia with cannabis use, and this review goes over some bench-science data and epidemiological data to the same effect.
I agree it's pretty inconsistant to argue that alcohol should be legal but cannabis illegal, given the overall burden of harm caused by each substance to society. But we shouldn't pretend there are no dangers to cannabis use at all.
However, the potential harms we've found for cannabis, so far, are unlikely to accrue to people with terminal diseases using marijuana to control nausea, for example. There are those who argue that we have not enough evidence that it is efficacious, or that we have other medicines that work. It is too easy though to succumb to the temptation to believe that average effects seen in studies of hundreds of people are directly translatable to every given patient. Just by chance, there will be some cancer patients for whom Anzemet is ineffective, and marijuana is effective. Those people deserve a chance to try marijuana.
The stickier case is the chronic migraineur or irritable bowel patient who wants to try marijuana. In these folks, I think that in general the potential harms--inducing mood disorders in particular--really do outweigh the short-term symptom relief marijuana can provide, especially in younger patients. Cannabinoid analogues like marinol may be a good choice, but smoked marijuana has too quick an onset, thus too much reward circuit activation, to be safe as a long-term treatment.
In the end though, if society trusts doctors to prescribe oxycontin with appropriate regulation (and I think it should), then it ought to trust doctors to prescribe marijuana.