An Open Letter to Users, Prescribers, and Proponents of the “Medical” Use of Marijuana

by Paula D. Gordon, Ph.D.

February 13, 2014

There are many unaddressed or partially addressed issues concerning the “medical” use of marijuana.  These include the following:

What is the nature and quality of the marijuana that is being use for ostensibly medical purposes?

How much of the active principle, THC, is in it?   The amount of THC would appear to vary extremely widely with no titration of dose levels.

Is it possible that some medical marijuana is "laced" with other things?

Are those being "prescribed" the medical marijuana aware of the multiple effects that marijuana use has?  Are they aware of the wide range of effects that marijuana with differing quantities of THC can have?

  • Are they aware of the effects of marijuana use on the functioning of the brain?  Are they aware that permanent damage and lowering of the IQ can occur in those 25 years or younger whose brains are still in the process of development?  Are they aware that marijuana use affects cognitive skills, memory, reasoning, judgment, and perception?
  • What has the efficacy of the "treatment" been for any of a wide range of conditions and ailments?
  • Has marijuana been “prescribed” when there are other equally or more effective agents that could be used in treatment that would not have the risks to mental, psychological, and physical health that marijuana has been shown to have?
  • Have those involved in the experiment been informed prior to their involvement, during their involvement, and now?
  • Has the person who has been prescribed medical marijuana been made aware of the risks and weighed the risks against the possible benefits?
  • Has there been any follow up with those partaking in the "experimental" use of marijuana for “medical purposes”?   If not, why not?
  • Who is responsible for any harm done to those involved in the "experimental" use of marijuana for “medical purposes?
  • What provision is there to help those who have been using marijuana for “medical” purposes who realize that they have become psychologically and/or physically habituated to the use of the drug?   When a person engaged in the "experimental" use of marijuana for “medical” purposes recognizes they are habituated, to whom can they turn for help in “withdrawing” from the use of marijuana?
  • Can the use of medical marijuana that is now technically sanctioned in many states be characterized in essence as a large scale unregulated experiment?  Is this relatively unregulated experiment unlike other carefully crafted scientific experiments or clinical trials designed to test the efficacy of a treatment regimen in that there are few qualifications for those involved in the experiment, few qualifications for those in officially authorized roles to initiate (and prescribe) to those in the experiment, and no provision for tracking the effects of the use of the agent on those involved in the experiment?

It is interesting and concerning to contrast the medical marijuana "experiment" with the Tuskegee Airmen experiment.  That experiment involved unethically infecting the group with syphilis and then using an experimental approach to treat the group that had been infected, unbeknownst to the Airmen and without their consent or knowledge.

With the medical marijuana experiment, those involved in the experiment have some knowledge of the fact that they are involved in an experiment of sorts.

  • To what extent have those sanctioning the experiment and those in a position of overseeing the experimental use of medical marijuana actually monitored the effects of the experimental use of marijuana on those involved in the experiment?
  • To what extent have those sanctioning the medical use of marijuana and those in a position of overseeing the experiment been involved in following up and tracking the results of the "treatment".

There are of course major ethical questions involving the Tuskegee experiments.  There would also appear to be a very wide range of ethical questions raised regarding the medical marijuana experiments that are going on today.

It may be informative to ask some additional questions concerning the motives of the key stakeholders and decision makers in this unprecedented experiment with "medical marijuana".

  • Are some organizations that have been advocating the spread of medical marijuana use and experimentation trying to create public acceptance of the recreational use of marijuana?
  • Are there monetary incentives for those "prescribing" and "supplying” the marijuana for “medical” purposes?
  • What are the motives and the incentives of those engaged in promoting the use of medical marijuana?  How do they differ from the motives and incentives of those engaged in promoting the recreational marijuana?
  • What is the range of ethical considerations or unethical considerations that might be found amongst the key “players” and stakeholders of those engaged in any or all aspects of this vast experiment?

There are certainly many unaddressed and unanswered questions concerning the medical use of marijuana.  Indeed there would appear to be many potential law suits concerning such an ill - conceived and poorly controlled experiment.

The medical use of marijuana is highly risky. Marijuana should only be used for extremely serious medical conditions that have not been aided by other treatment regimen.  The treatment of serious medical conditions should be closely followed by medical practitioners who are administering titrated dose levels of THC and who are knowledgeable concerning the wide range of harmful effects of marijuana.  It should not be smoked. As it can be harmful to unborn fetuses and as its use can result in miscarriages and stillbirths, it should not be used by those expecting or by those wishing to conceive. It should not be used by those with a history of depression, anxiety, sleep disorders, or a predisposition to mental illness.

A February 13, 2014 Open Letter