Last year, the Compassionate Use of Medical Cannabis Pilot Program Act established the state’s medical marijuana pilot program. About 15 bodies have submitted applications to open a medical marijuana dispensary in Evanston or Niles Township. Medical marijuana has been embroiled in a firestorm of legal, economic and cultural controversy for decades, but what is rarely discussed is the scientific basis for using marijuana as a medical treatment. From the available evidence, two things are clear: First, marijuana, like any other drug, has risks and benefits, but clearly it has at least a limited use in medicine. Secondly, we absolutely need to have more rigorous clinical studies of it.
What are the most reliable uses for medical marijuana? Interestingly, it’s the effects it has on general patient well-being and overall health that are the most consistent. Marijuana can increase appetite and weight, which is a surprisingly important healthcare goal, since there are a variety of medical conditions that have a devastating and persistent wasting component. For example, scientific trials have shown that cannabis can help patients regain a healthy weight while undergoing chemotherapy or even while taking anti-HIV drugs.
There have been other, less conclusive studies. Some have shown that marijuana can cause mild improvements in neurologic symptoms, such as those from multiple sclerosis or Parkinson’s, but this evidence is less compelling. Even in treating nausea, the clinical data of using marijuana has had conflicting results, potentially due to the variety of causes of nausea, as well as varied methods of cannabis administration, either oral or inhaled. Although we currently have drugs that address most of the issues that medical marijuana is intended to treat, its true strength is as a potential alternative. For example, the weight-gain drug megestrol can have unpleasant side-effects, like nausea, vomiting and sexual dysfunction.
For those patients who have such adverse reactions, marijuana may be able to serve as a suitable replacement.
But what are the risks of medical marijuana? Like any medical treatment, there are side-effects, the most common of which are cognitive problems. Interestingly, many clinical trials have shown that smoking marijuana, even chronically, is much less damaging than smoking tobacco cigarettes. There is certainly not enough evidence to say that smoking marijuana is entirely benign, but short-term use in selected patients is clearly reasonable under a physician’s supervision. Ideally, we would be able to purify the active ingredients from marijuana and provide it in pill form like any other drug to control its dosage and pharmacologic effects. But because of its dearth of scientific investigation, and marijuana’s historical medical-legal quagmire, the FDA hasn’t approved marijuana as a treatment. Rather, only drugs similar in activity to THC are available by prescription. Therefore, the legal issues surrounding cannabis have produced a unique and confusing medical system requiring specialized dispensaries.
The most important implication of the legalization of medical marijuana in Illinois is the opportunity for scientific study. Hopefully, definitive clinical trials, with proper controls and comparisons to current first-line treatments, will provide better legitimization and regulation. At this point, based on the evidence, there are clear benefits for some patients with certain conditions, but marijuana’s overall role in medicine remains unknown.
Regardless of the evidence, Northwestern students will not be permitted to use marijuana for medicinal purposes. From the Undergraduate Student Handbook, “medical marijuana on University property or at University-related activities is and shall remain prohibited.” The University recognizes that while it is legal under state law, it is still prohibited by federal regulation, specifically the Drug Free Workplace Act of 1988 and the federal Drug-Free Schools and Communities Act Amendments of 1989.
According to the handbook, if a student is found in possession of medical marijuana, they could lose a year or more of federal financial aid for college. This can be ended by successfully completing a drug rehabilitation program, which would be a curious sanction for a student using marijuana for medical reasons. The use of cannabis as a medical treatment does not fit any honest definition for substance abuse or addiction, and no one is better served at NU by treating it as such.
For students living on campus with medical conditions warranting the use of marijuana, they may be out of luck. But with a dispensary potentially on its way, and the amount of scientific evidence increasing, the University, as well as the federal government, may need to sincerely reconsider its stance.
Ultimately, we must remember to treat medical marijuana as just that: medicine. It will need to be carefully balanced with other medications, and it has the same drawbacks and limitations as any drug. Certainly, we are in the early days of marijuana’s medical application, but the fact remains that we need more scientific investigation to determine the true scope of its potential use.
Sai Folmsbee is a Feinberg graduate student. He can be reached at email@example.com. If you would like to respond publicly to this column, send a letter to the editor to firstname.lastname@example.org.