COMMENTARY

Readers' Responses to "It Is Time for Marijuana to Be Reclassified as Something Other Than a Schedule I Drug"

Deforest Z. Rathbone, Jr.; Eric A. Voth, MD, FACP; Brian Csermak; Name Withheld Upon Request; Scott Helf, DO; Harriet Peltzman; James C. Garriott; David Nederhood, PharmD, BCPS; Roz Birnbaum, MS; Frank M. Archer, BSP, RPh (ret.); Louis Alvarez; Andrew G. Gordon, MD; Philip A. Gianelli, MD; Arthur W. Anderson, Jr., MD; Dennis J. Verhaagh, PE; Carolen Koleszar, BSN, RN; Diane H. Ranes, PhD, LCSW, MSW, MA; Emmanuel V. Hernani; Ann E. Fonfa

Disclosures

November 04, 2005

To the Editor,

With this nation currently suffering 26,000 overdose deaths a year, nearly all of which started with a shared joint of marijuana from a schoolmate, your proposal to reschedule marijuana is a very dangerous one from a public health standpoint.[1] Marijuana must be kept at the strictest control level despite its widespread illegal use.

Certainly, you would not want to encourage youths to use pot considering the current level of damage that the population is experiencing from its use,[2] yet that is exactly the effect that your proposal would have.

Please reconsider your potentially damaging proposal.

Thanks,

DeForest Z. Rathbone, Jr.
Great Falls, Virginia
dzr@prodigy.net

References

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.

  2. US Centers for Disease Control and Prevention (CDC). Youth risk behavior surveillance -- United States, 2003. MMWR Morb Mortal Wkly Rep. 2004;53:2-29. Available at: http://www.cdc.gov/mmwr/PDF/SS/SS5302.pdf. Accessed October 26, 2005.


To the Editor,

It appears that editor George Lundberg[1] continues his support of medical excuse marijuana. Despite the hue and cry of support from such advocates, the mainstream medical community has largely rejected pot as medicine.

Recent evaluations call into question the utility of marijuana in general with conclusions, such as: "These results should make us think hard about the ethics of clinical trials of cannabinoids when safe and effective alternatives are known to exist and when efficacy of cannabinoids is known to be marginal.[2,3]"

Even the legal literature has voiced concern over the medical excuse marijuana movement. Crites-Leoni[4] stated:

Presentation of marijuana as a medicine that helps people, appears to be an effort by the legalization of marijuana proponents to desensitize the American people to the drug's negative effects. This may cause society to question the illegal status of marijuana. . . . Federal courts have held time and time again that the smoking of marijuana is not a fundamental right. . . . The potential danger of legalizing marijuana for medicinal purposes is clear. Legalization of the drug for medicinal purposes precipitates legalization of the drug on a higher, more reckless scale.

Several large reviews of marijuana have been undertaken. The most prominent of these reviews, which was conducted by the Institute of Medicine, concluded that if there were a future to marijuana as a medicine, it existed in the individual constituents, not in smoked marijuana.[5]

Ballot initiatives financed by wealthy advocates for marijuana legalization have added further confusion to the issue by creating an atmosphere of medicine by popular vote.[6] Such campaigns have enlisted millions of dollars to market to the public and play on well-intentioned sympathy to gain legal status for pot. The intent of such initiatives is to circumvent our usual processes for ensuring safety and efficacy. Can any right-minded physician imagine recommending tobacco as a medicine? If not, then how could marijuana smoking be supported?

Research needs to pursue individual cannabinoids and synthetic derivatives. The voices of reason rather than hysteria and emotion need to prevail against the medical excuse madness.

Eric A. Voth, MD, FACP
Chairman
The Institute on Global Drug Policy
evoth@stormontvail.org

References

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.

  2. Campbell FA, Tramer MR, Carroll D, Reynolds DJ, Moore RA, McQuay HJ. Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review. BMJ. 2001;323:13-16.

  3. Tramer MR, Carroll D, Campbell FA. Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ. 2001;323:16-21.

  4. Crites-Leoni A. Medicinal use of marijuana: is the debate a smoke screen for movement toward legalization? J Leg Med. 1998;19:273-304.

  5. Joy JE, Watson SJ Jr, Benson JA, eds. Marijuana and Medicine: Assessing the Science Base. Washington, DC: Science Division of Neuroscience and Behavioral Health, Institute of Medicine, The National Academies Press; 1999:178. Available at: http://www.nap.edu/. Accessed October 27, 2005.

  6. Voth EA. A peek into Pandora's box: the medical excuse marijuana controversy. J Addict Dis. 2003;22:27-46.


To the Editor,

Your words are not only supported by the recent findings of the Canadian Senate but also common sense.[1] I am a 2-time kidney transplant patient and a hard-working senior engineer for a high-tech company who has been too busy to take a vacation in almost a year -- not your typical "stoner." Although I do use marijuana socially (which, although still technically illegal in Canada, the police here generally don't waste time prosecuting users), my primary use is to help me sleep when I need it to overcome insomnia and night terrors brought on by the prednisone and other sleep disturbances that are associated with my condition.

Please continue to use your respected voice afforded you by your position to change the US government's stance on this issue before they strong-arm the Canadian government away from its current path of decriminalizing marijuana and making medicinal marijuana broadly available to those who would benefit from it.

Brian Csermak
Hamilton, Ontario, Canada

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

As an HIV patient who benefits from some of the properties of marijuana, I couldn't agree with you more.[1] I have seen many of my HIV-positive friends benefit from its use, even when synthetic THC [tetrahydrocannabinol] in the form of dronabinol (Marinol) had not helped them. One friend's elderly disabled mother actually, without his knowledge, had her husband purchase some marijuana from "some guy he worked with" just so her critically ill son might gain enough of an appetite to stay alive for a while longer.

As someone who worked in the legal profession prior to becoming disabled, I can tell you that federal policy regarding marijuana makes no more sense from a legal perspective than it does from a medical one. Our court system and our jails are clogged with those being prosecuted from offenses related to marijuana use, crippling our justice system's ability to more effectively deal with more serious crimes. This country can no longer afford to lock up people who are not a threat to society. Although (legal) alcohol produces erratic and sometimes even violent behavior, most people who smoke too much marijuana either just go to sleep or lose all motivation, neither of which is much of a threat to the well-being of others!

Name Withheld Upon Request

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

Great stuff, again![1]

Although I don't endorse the use of marijuana for nonmedical purposes, this civil libertarian applauds any measures that allow science, and the art of medical practice, to act unfettered by "moralist agendas" imposed upon the public by the "man." Let governments collect taxes and protect us from foreign threats and guard our civil rights; let the clergy morally guide us (and by our own choice); let doctors practice medicine; and let patients choose their doctors and treatments.

In such a world, I believe, George Orwell would be proud.

Scott Helf, DO

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

As a retired pharmacist, I couldn't agree with you more![1] I have campaigned for just this legislation for more years than I care to admit, but I don't see movement in that direction at all. In fact, with this paranoid and uptight administration in Washington, DC, I can't see it happening at any time in the foreseeable future. More's the shame. There are countless thousands of patients who could benefit from the availability of medicinal marijuana, and they must wait for this relief or else break the law to obtain it. What a travesty!

Please continue campaigning for this legislation. It is sorely needed.

Harriet Peltzman

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

I am most gratified that you are still contributing good sense and scientifically based opinions about these matters.[1] Having done basic research on marijuana in the 1960s, when much science was still to be done, I had always thought that the growing body of scientific information would eventually sway the country to be realistic and to alter our absurd laws accordingly. I was wrong, as it seems to have now gone even further toward the dark ages.

Maybe you will wake somebody up.

Thanks for speaking out.

Best regards,

Jim Garriott
San Antonio, Texas
jcqarriott@satx.rr.com

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

I agree with your opinion wholeheartedly.[1] If the decision of how drugs are scheduled was one based on data and not emotion, we would not be having this discussion regarding marijuana. No question that ethyl alcohol has resulted in more morbidity and mortality than marijuana, but does not engender the type of hysteria when discussed socially. As you point out, the current Republican administration has the cover of populist opinion, which could facilitate a change in schedule to permit medicinal use of this physiologically active substance, to the betterment of thousands of patients throughout our country. And is that not why we are healthcare professionals, to improve the health and lives of our patients? Simultaneously, remove the social stigma and hurdles that patients currently must endure. I would even advocate for federal legislation patterned after a few of our more progressive states (eg, Alaska, California), which permit growing limited amounts of this plant for personal consumption, but for fear of this step undermining the move toward medicinal availability.

Thank you for your well-reasoned opinion and attention.

David Nederhood, PharmD, BCPS
Guilford, Connecticut

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

I agree with Dr. Lundberg.[1] I am a drug and alcohol therapist, and I see no correlation between marijuana use and other drugs. In fact, what I see is that marijuana is not the "gateway" drug at all; alcohol is usually the culprit for other drug use. It is legal and "loosens" the inhibitions that lead the way to further drug experimentation. For addicts, alcohol is the first thing that they will use, which usually leads them to their drug of choice -- not marijuana.

Roz Birnbaum, MS
Drug and Alcohol Counselor
Allentown, Pennsylvania

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

No doubt that you have reviewed the sorry history of marijuana prohibition.[1] It's too bad that most people haven't; however, this hasn't stopped the majority from reaching the correct conclusion either from personal experience or just plain common sense. As a Canadian, I watch our federal government attempting to decriminalize the simple possession of small amounts of this substance, only to see it beaten up by various US law enforcement agencies, the US ambassador, and the Executive, all of which seem to have a vested interest in continuing the "war on drugs." Most police forces across the country have reached the conclusion that this war is unbeatable, and have lately embraced the concept of harm reduction. Unfortunately, "most" does not include the national police force (that some call the domestic military) nor the Royal Canadian Mounted Police, who long ago gave up their horses, except for the Musical Ride, for the comfort of police cars, who have great relations with the FBI [Federal Bureau of Investigation], the DEA [Drug Enforcement Administration], and who knows how many other US agencies engaged in the war on drugs. As such, they tend to share the opinions of these agencies. Although even simple possession of a small amount of marijuana could theoretically result in a life sentence, even people caught in extensive urban grow-ops are routinely given conditional sentences or small fines from judges who understand the societal impact of marijuana. In Vancouver, British Columbia, near to where I live, there are marijuana cafes, similar to those in Amsterdam, The Netherlands, and the attitude of the police (except for some publicity busts) is that they only act on complaint. No complaints, no action. Still, we have marijuana refugees from the United States, sick with every variety of chronic condition, trying to obtain sanctuary in Canada. Thankfully, most pharmacy regulatory bodies have adopted the sensible attitude that marijuana is a drug like every other drug -- it has its benefits and its risks -- and support the dispensing of medical marijuana from community pharmacies. This is a far cry from when heroin was reintroduced in Canada, and some pharmacy officials predicted that criminal gangs would be roaming through hospitals searching for this drug. I once served on a provincial government task force set up to recommend actions to be taking with the problems associated with illicit drug use. An emergency ward physician on the panel startled everyone when he said that Canada faced major problems from only 2 drugs -- alcohol and tobacco. Despite sensational reports in the media about marijuana intoxication and bad trips on LSD, ecstasy, cocaine, crystal methamphetamine, etc, these could be conveniently categorized as "Other" as the reasons for admittance.

Frank M. Archer, BSP, RPh (ret.)
Delta, British Columbia, Canada

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

I have to agree with your assessment with the current state of affairs concerning the so-called marijuana laws. I have posttraumatic stress disorder (PTSD). Doctors have me on a variety of drugs, especially one that I am so addicted to that several are at odds on how to deal with it. The drug is clonazepam. I have been taking this drug since 1987, partly because it took 25 years to finally figure out that I have agoraphobia (amongst other disorders) secondary to PTSD. (I was not diagnosed with PTSD until 1995.) Sometimes, I feel better if I have a half a "joint" (marijuana cigarette) to calm me down rather than take a tranquilizer. I am also a former law enforcement officer and have personally seen the effects of other drugs when making arrests or when a crime was committed as opposed to drugs, such as crack cocaine, methamphetamine, cocaine, heroin, and other "lab" chemicals (such as ecstasy). If a person became difficult when "on" marijuana, there were mitigating circumstances that contributed to this behavior. Normally, alcohol was the problem. If anyone was just smoking marijuana, they were compliant at least 90% of the time. Strangely, the other 10% of the subjects had another unknown problem, such as a psychiatric disorder or "unknown" substance, in their system.

I have a personal statement to be made concerning the economic and social implications of legalization regardless of reclassification or even being sold over-the-counter. The jails would not be overcrowded with nonviolent criminals who have been arrested for possession and/or use of marijuana. Taxation of the plant would create economic growth in this country (as well as the savings made by the government by changing the focus of drug enforcement, prosecution, and jailing of subjects who traffic "harder" narcotics). Doctor-monitored use will enhance the lives of the terminally ill, those with eating disorders, some psychiatric disorders, and many other uses that it does have that have not been identified here or in science. There are many more benefits that cannot be described in this venue. I am not saying that this is a wonder drug or that there is not some consequence to using marijuana in medicine or otherwise. I am just saying that it is time for the government to take another look at the issue and see some of the benefits of legalization. Thank you for your time.

Louis Alvarez
solesource@direcway.com


To the Editor,

As a practicing internist for almost 20 years, and with prior experience before going to medical school as a counseling therapist for hardcore addicts, I've always been troubled by the harsh hand of the law when it came down to the laws governing the use of illicit substances. I've always believed that if the profit motive were taken out of the equation and those people who were addicted had to receive medical assistance for either efforts at detox or clean drugs and needles, then the cachet, the violence, and especially the profit that surround the drug culture would disappear. Could one even imagine what we could do with all the monies that are put into interdiction? Marijuana is just the tip of the iceberg, but as good a place as any to start. Our young people are spending their lives in prisons for psychological addictions -- generations wasted.

Andrew G. Gordon, MD


To the Editor,

Your position on medical marijuana brings to the surface a more profound and fundamental issue regarding the regulation of drugs of abuse in the United States.[1]

We have lost the "war on drugs" in a miserable fashion, and dollar-for-dollar treatment works about a hundred times more efficiently than interdiction. The problem? It's OK to suck down a pack or 2 of Marlboros at the corner bar, spending my paycheck on State-sanctioned Power Ball (gambling) while swilling oneself into an afternoon, evening, night -- life of oblivion and lung cancer. Substances that "free us" from a world of incredible stress will always be abused by those who, for reasons of genetic predisposition and environmental bad luck, develop a pattern of coping through their use of chemicals. Is this a conscious, informed choice? Let's see. I think I'll do 20 bags of heroin a day for the next 20 years. When I'm 40, I really want to be HIV-positive and hepatitis C-infected, living in a shelter in New York, NY. It is really time to take our heads out of the sand (or other dark places) and start addressing addiction as the neurologic disorder (quote -- C. Evertt Koop, MD) that it is. Oh, and by the way, while we're at it, let's talk about parity -- the equating of mental illness and addiction on the same level (especially as far as reimbursement) as "real" medical illness.

Sincerely,
Philip A. Gianelli, MD
Addiction Psychiatry
New York

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

Thank you for that extremely lucid and convincing article about the need for taking marijuana off the schedule I list.[1] It becomes an entry drug largely because the kids discover it as so harmless, and then they believe that other proscribed drugs must be equally safe.

A good friend, Jerry Uelmen, professor at Santa Clara University School of Law [Santa Clara, California], has been active in the state battle to permit medical marijuana use in California. You are likely acquainted with Lester Grinspoon's position on the subject. If not, ask Google about him. Grinspoon was a real heavyweight in psychiatry even before he took on this campaign promoting responsible marijuana use as an enhancing drug.

As a psychiatrist for 50 years, I have been puzzled about the abhorrence that many people feel about THC [tetrahydrocannabinol] and the extreme overreaction of the Feds. It appears to me that its association with the anarchistic elements of the hippie movement is the primary reason.

Thanks again.

Art Anderson
Saratoga, California
xcaliburx@comcast.net

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

I agree with your editorial in today's Medscape regarding declassifying marijuana to something less than a class I drug.[1] Marijuana got a bad rap as the drug of choice among the antiwar generation during the 1960s and has suffered from the more conservative generation's backlash ever since. Glaucoma runs in my family, and my sister was recently diagnosed with early signs of that disease. She asked her doctor about its use for treatment, and he dismissed it as unavailable because of the politics of the time. Thanks again for pushing the envelope.

Dennis J. Verhaagh, PE
Green Bay, Wisconsin

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

I agree with your opinions about marijuana[1] What can we do to stop the madness? I have worked as a nurse in the prison system -- so many people are incarcerated for marijuana; it's absurd.

Carolen Koleszar, BSN, RN
Columbus, Ohio
CarolenK@aol.com

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

Hurrah for Medscape and the medical community for finally getting to this position.[1] I see this every day in my practice of psychotherapy and agree entirely! I not only work with children but with those on serious pain medications for whom the use medically may really help out with pain and appetite.

Thanks,

Diane H. Ranes, PhD, LCSW, MSW, MA
Chapel Hill, North Carolina
doncranes@earthlink.net

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

Your article is so interesting,[1] and I find it factual since it is also happening in our country, the Philippines. Lawmakers in my country seem to act brazenly without studying further the issues on marijuana, and I believe that our government's medical and health consultants are not doing their jobs of providing factual information regarding marijuana. Many people have been prosecuted with the same law regardless of the substance. I would say that they classify marijuana like methamphetamine in terms of its psycholegal effects.

Once it was made an issue by one of our congressmen whom I presumed to understand the facts about marijuana, but his thesis "was killed to the drain" by older lawmakers who seem to know only the so-called "bad implication." It seems that marijuana has been held responsible for people and not the other way around. As a substance dependency counselor, I have known people who have used marijuana and experienced its benefits -- and these are psychological and medical benefits that I am talking about. I am agreeable to your position because I perceive that it's time for us people who know the issue to present both sides and study further for our benefit.

I thank you for listening me.

Yours respectfully,
Emmanuel V. Hernani
Cebu, Philippines
healinghome@yahoo.com

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.


To the Editor,

Once again a marvelous editorial,[1] and much needed. We have beer commercials that make fools of young men at the same time as marijuana persecution continues.

Cancer patients whisper to each other of their desire to "try" it to relieve unbearable nausea while studies show that it may have many other medical uses.

Thank you for speaking up.

Ann E. Fonfa
President
The Annie Appleseed Project
Delray Beach, Florida
www.annieappleseedproject.org
annfonfa@aol.com

Reference

  1. Lundberg GD. It is time for marijuana to be reclassified as something other than a schedule I drug. MedGenMed. 2005;7(3). Available at: http://www.medscape.com/viewarticle/510902. Accessed August 24, 2005.

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