In response to Wyatt Emmerich’s opinion, “Case good for medical pot,” while I fully understand this was an opinion piece, a topic of this importance and impact to public health needs the respective rebuttal of a physician, an expert in medicine. It is prudent to present facts as this will affect the health of Mississippians.
First, medical marijuana is Cannabis. It contains both CBD and THC. CBD is a Cannabidiol and does not contain THC (Delta-9-tetrahydrocannabinol) nor is it psychoactive. It has been extensively researched and found to be effective for a multitude of illnesses such as seizures, migraines, decreased appetite and nausea. In fact, it is FDA approved. The FDA has approved the medication, Epidiolex, which contains a purified form of CBD for the treatment of seizures related to Lennox-Gestaut syndrome or Dravet syndrome. Being FDA approved means that it has been rigorously studied and found to be safe. The side effects are mild.
THC however, which is in medical marijuana in addition to CBD, is a psychoactive compound that produces a “high.” THC is addictive and long-term use can cause negative psychiatric effects amongst others. The known adverse effects of THC are many including low birth rates, chronic bronchitis, increase motor vehicle crashes and in teens, increased risk of developing schizophrenia. Neither medical marijuana nor THC have any scientific evidence that they are beneficial for any illness. In fact, it cannot even be studied by the FDA because it is a Schedule 1 drug. Being a Schedule 1 means that it has no medical use and a high potential for abuse. Substances that are Schedule 1 cannot even be studied in humans. Thus, there is no scientific evidence that medical marijuana is effective for any condition or safe.
Now to speak to the flaws of the Medical Marijuana 2020 ballot initiative. It gives an extensive list of illnesses that medical marijuana can be used to treat. It is important that I again emphasize that there is NO scientific evidence that marijuana treats any of the conditions listed. As a psychiatrist, I am especially bothered that PTSD and anxiety are amongst the illnesses. There are studies that have proven that there is NO psychiatric illness in which marijuana treats and in long term use can increase the risk of psychiatric illnesses. Also, there is no way to measure or objectively test for either PTSD or anxiety. There are no labs or imaging to prove its presence in the patient. It will be very easy for people to malinger symptoms in order to secure marijuana certification.
Once patients obtain the certification, they can go to a dispensary and get up to 2.5 oz of marijuana (that’s no small amount). Because marijuana is not FDA-studied, there is no data or guidance for physicians to know which amount to “prescribe.” And once the marijuana is obtained, it is “user’s choice” how the marijuana will be administered meaning that smoking/inhaling is an option thus increasing healthcare costs even more.
I know one of the biggest arguments for the passage of the initiative is that it will reduce opioid-related deaths and help treat chronic pain. This is untrue. As far as chronic pain, the studies are poor but show insufficient evidence that Cannabis is effective for chronic pain. In fact, studies point to the fact that Cannabis was associated with more subsequent pain, less self-efficacy for managing pain and no reduction in opioid use. Instead of it decreasing the use of opioids, Cannabis was positively associated with greater use and misuse of prescription opioids.
Sarah Katherine Gantz Pannel, DO.