On Wednesday with little fanfare Gov. John Kasich ( R) signed into law Ohio’s medical marijuana bill, in part to head off a medical marijuana ballot initiative campaign in the state. The new law will allow patients with certain conditions to get a doctor’s recommendation to use medical marijuana, which they will be able to acquire from state licensed dispensaries. This makes Ohio the 25th state (plus the District of Columbia) to adopt a real medical marijuana law. This is not simply a big psychological victory for the reform movement but a very significant political milestone because of the unique design of Congress.
Representation in the House is based on population, and a majority of Americans already live in states with medical marijuana thanks to the passage of medical marijuana in Pennsylvania early this year. But the Senate gives equal representation to the states regardless of population; every state gets two senators. Now thanks to this new Ohio law, half of the members of both houses of Congress represent areas with local medical marijuana. This has a powerful impact on the federal debate over marijuana.
The issue of marijuana has stopped being theoretical for a majority of members of Congress and will soon be very tangible as these new states set up their medical marijuana programs. The fact that half of the senators and the majority of House members will now be representing districts with medical marijuana does not necessarily mean they will support federal marijuana reform, but it will exert a significant pressure on them going forward. They will have numerous patients, doctors, medical marijuana growers, testing labs, and dispensary owners in their districts that would be both physically and financially hurt by any federal crackdown or helped by any positive federal reforms.
Politically, it is dramatically easier to oppose something in concept than it is to actively take something away from your constituents they currently have. This why defense contractors spread projects over as many states as possible, like the flawed F-35, which has suppliers in 45 states and the M1 Abrams tank that the Army no longer even wants but keeps buiding since its parts are made in numerous states. Having the programs employ people in so many states makes them hard for politicians to oppose even when they are clearly flawed.
The important political question in Congress is no longer how most members feel about marijuana reform in the abstract. The question is now whether a majority of members are willing to directly take something away from their constituents.
A long term study in New Zealand followed 1,000 people from birth to age 38, allowing researchers to examine what negative impact marijuana use may have on physical health, and they found the impact is pretty minor. The study looked at an incredibly broad spectrum of health indicators such as lung function, systemic inflammation, body mass index, waist size, cholesterol, glucose control, etc… The only physical health problem that correlated with marijuana use was an increased level of gum disease. Otherwise, marijuana smokers’ physical health indicators were basically on par with everyone else in their age group.
From purely a physical health perspective (mental health was examined separately), this indicates that smoking marijuana might fall on the spectrum of bad behavior somewhere between sloppy toothbrushing and not visiting the dentist regularly. By comparison, the same data showed that tobacco smoking was not only associated with increased gum disease but also numerous more serious health issues including reduced lung function and bad metabolic health indicators. This study is inline with several other studies which have found significant health problems from tobacco or alcohol use but relatively few physical problems from marijuana use.
The study didn’t set out to examine why marijuana use was correlated with worse gum health, but the most likely explanations fall into three broad categories. First, it is possible that it is the act of smoking which is bad for the gums. The fact that smoking tobacco is also associated with gum issues gives some weight to this hypothesis. If the cause is smoking itself, it might be possible for individuals to reduce or eliminate this potential physical health issue by using alternative methods of ingesting marijuana, such as vaporizing or edibles.
Second, it could be something unique to marijuana, such as THC or some other cannabinoid, that is causing issues for the gums. For example, many people do complain of “cottonmouth” from marijuana use, so maybe this mouth dryness is causing problems for gum health.
Finally, there is the small possibility this is simply a correlation without causation. The statistical analysis used tried to account for likely confounding variables, but they still could have missed something unexpected. For example, maybe people who enjoy marijuana also are more likely to enjoy a particular acidic food.
More research will be needed to verify if there is a connection and what the cause might be, but in light of this new study it would be advisable for anyone who smokes marijuana to try to be diligent about brushing, flossing, and visiting a dentist regularly — good advice for anyone, whether they enjoy marijuana or not.
The House of Representatives on Thursday took a major step for marijuana reform. In a vote of 233 to 189, the House approved an amendment to the FY2017 Military Construction and Veterans Affairs Appropriations bill allowing doctors at the Veterans Administration to recommend medical marijuana to their parents if they live in states where medical marijuana is currently legal. The Senate already approved similar language in the past, so it is expected this language will remain in the final appropriations bill when it is eventually adopted into law. This means that barring some unforeseen problem, veterans will soon have an easier time accessing medical marijuana.
“We are pleased that both the House and Senate have made it clear that the Veterans Administration should not punish doctors for recommending medical cannabis to their veteran patients,” said Michael Liszewski, Americans for Safer Access Government Affairs Director. “We anticipate this amendment will reach the President, and once signed, it will give VA physicians another tool in their toolbox to treat the healthcare needs of America’s veterans.”
Currently, veterans using the VA system for their health care needs have to go to outside physicians to get the necessary recommendation to take part in state medical marijuana programs. Depending on the state this can be a needlessly costly, difficult, and/or time consuming endeavor for veterans with serious medical conditions.
These needless hurdles for veterans are simply cruel — research shows that medical marijuana can potentially help reduce the use of opioid pain medications, and there is a serious chronic pain and opioid abuse problem among veterans at the moment. In addition, a study is about to be conducted that will look into whether medical marijuana can be an effective treatment for PTSD since some data suggests it might be.
This vote is a big step for veterans that should help numerous individuals all over the country. But that’s not the only reason it’s significant: this is one of the most direct measures yet acknowledging marijuana’s medical value approved by the House. It also shows that the politics surrounding marijuana in this country are changing rapidly. Two years ago, a similar amendment was defeated easily in the House. Last year the House only narrowly rejected the amendment by three votes, and just 13 months later it easily won approval with a strong bipartisan vote in the House.
One of the most popular arguments against marijuana legalization can basically be summed up with the famous Simpsons scene where Helen Lovejoy yells, “Won’t somebody please think of the children?” Opponents of marijuana legalization have frequently tried to scare voters by claiming legalization would result in a significant increase in the use or availability of cannabis among teenagers.
For example, an official argument against I-502 published in Washington State’s 2012 voter guide began by stating, “Legalizing marijuana will greatly increase its availability and lead to more use, abuse, and addiction among adults and youth. Most 12th graders currently report not using marijuana because it is illegal.” Similarly, just two months ago, the first argument used by Massachusetts Governor Charlie Baker in an op-ed against a legalization initiative in his state was that, “Kids in states that have legalized marijuana have easier access to the drug.” Yet new research undermines these claims.
A study to be presented at the Pediatric Academic Societies 2016 Meeting found that in Washington State there was effectively no change in how easy teenagers felt it was to acquire marijuana after the state legalized it. The research looked at data from the Washington State Healthy Youth Survey. Back in 2010 when marijuana was still illegal under state law, it found 55 percent of teens in Washington reported that it was “easy” to access marijuana. By comparison in 2014, the year the state implemented legalization, 54 percent of teens said marijuana was easy to access.
Since marijuana legalization is a relatively new and limited phenomenon, the study looked at only one state for a rather limited window of time. While more studies should be done on this issue, this is still very reassuring news for legalization supporters. It should make the public more skeptical about many of the arguments made against legalization.
In addition to this real-world data, there is also a very logical reason to doubt opponents’ claims that legalization will increase teen access. Currently, the black market has zero incentive to not sell to people underage or check IDs. On the other hand, legal licensed businesses risk big fees or closure if caught selling to minors. Colorado’s Marijuana Enforcement Division in their first underage stings found 100 percent compliance while Washington had a compliance rate of 81 percent in their first round of marijuana age check stings.
The news bodes well for cannabis advocates across the country, and we hope to see more research into this issue soon.
The DEA recently told lawmakers that they will likely reconsider marijuana’s current legal classification in the first half of 2016, but that doesn’t necessarily mean there will be good news this summer. Over the past few decades, the federal government has examined marijuana scheduling many times and each time decided to keep it Schedule I, which legally defines marijuana has having “a high potential for abuse” and “no currently accepted medical use.”
If the DEA does act, though, it is most likely only to move marijuana to Schedule II, since there is a growing political push for that change. Several senators and presidential candidate Hillary Clinton have called for moving marijuana to Schedule II, which would legally define it as having a high potential for abuse but with an accepted medical use in treatment. That’s the same Schedule as cocaine and morphine.
To fully understand what this potential change would mean, you need to separate the rather modest legal implications from the important political signal it would send.
The legal implications
In the short term, if marijuana were moved to Schedule II but nothing else changed, the impact would be fairly minor, as Mark Kleiman argued in 2014. State-approved medical marijuana would still be illegal in the eyes of the federal government, just like any use of cocaine is illegal except in an FDA-approved form or setting. Theoretically, as a Schedule II drug, marijuana could be prescribed but only if a specific preparation of marijuana goes through the process to become an FDA-approved medication — an expensive process that could take years and might never happen. At most, the FDA would likely only approve particular extracts of cannabis and not the raw flower.
Schedule II would legally make research on federally-approved marijuana somewhat easier. The licensing and reporting requirements to be able to conduct clinical trials with any Schedule I substance are more stringent than drugs in lower classifications. Yet one of the biggest hurdles to research is actually the DEA-mandated National Institute on Drug Abuse (NIDA) monopoly over production of approved marijuana. Even if marijuana is moved to Schedule II, the DEA could still use this monopoly or its ability to set production quotas to continue to hinder research.
The important political impact of rescheduling
The impact of moving marijuana to Schedule II would be much greater than what a mere examination of the legal technicalities would imply. To understand why, you need to look at other Schedule II substances. Cocaine is still a highly controlled Schedule II medication, so logically the source of cocaine – coca leaves – is classified as Schedule II as well. Similarly, morphine is used for medical treatment so its source, opium poppy, shares its Schedule II status.
Yet synthetic THC is Schedule III, while marijuana – the natural source of THC – remains Schedule I. The DEA is effectively claiming that even though marijuana naturally produces a proven medicine, it also magically has no medical value. The federal government is clearly signaling that their disdain for marijuana is so strong that they are willing to not only ignore the current science but also basic logic to hinder it.
As a result, by keeping marijuana Schedule I, the federal government is sending a powerful message to researchers, drug companies, hospitals, and similar institutions: that they should not waste their time and money on marijuana’s medical uses. They are going to face unnecessary hurdles at every turn and their results will likely be ignored by regulators.
So, if the DEA were to move marijuana to Schedule II this summer, it could signal a profound paradigm shift. It would likely indicate that the federal government is finally willing to start moving beyond its irrational disdain of marijuana. We would likely see a significant increase in interest from researchers and companies once it seemed like their work wouldn’t be actively hindered and dismissed by officials. To fully see the medical potential of marijuana explored and utilized would still take further steps at the federal level, but nothing is going to happen until the federal government is willing to at least legally acknowledge that marijuana has medical value. Rescheduling marijuana is the first step.