COMMENTARY

Marijuana Medical Silliness, Be Gone!

Disclosures

January 31, 2014

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Hello and welcome. I am Dr. George Lundberg and this is At Large at Medscape.

One of the advantages of growing old -- and trust me, there are not many -- is to observe how observations you have made and positions you have taken over the years play out. Now is such a time for me and marijuana.

I am not a user, but I have been a loud proponent for science and justice to supersede ignorance and ideological bias against cannabis since at least September 21, 1970,[1] when I wrote in JAMA that, in contrast to alcohol and tobacco, which kill Americans every day, there appears "...never to have been an authenticated case of marijuana killing anyone..."; and in the journal called California Medicine in May 1971,[2] "...Marijuana is noteworthy for the absence of recognized harmful physical effects...." Needless to say, I have tried to move the issue only incrementally to blunt the effect of the anticipated and realized harsh criticism on my career.

Finally, crowd-sourced science is winning; justice should not be too far behind. Justice Brandeis was right: The states are the laboratories. The people are leading the leaders, who trail badly and now must play catch-up. Because the nonresponsive federal government's repression of research is the main reason we know so little medically about cannabis, the federal coffers (Francis Collins at NIH, Peggy Hamburg at FDA, Nora Volkow at NIDA, and Michele Leonhart at DEA, take note) should now be opened wide to support serious marijuana research in the community as well as in the clinic and laboratory. The people have chosen to become the guinea pigs in real life. Study them clinically, Colorado and Washington. Study them medically, you 20 states (plus the District of Columbia) where medical marijuana is legal.

For the marijuana users: It ain't harmless. Be careful because there is much we do not yet know, largely as a result of the long-term "federal foolishness" that has prevented most serious research from being done.

We do know this:

Developing brains (at least to age 21 or later) are more vulnerable to drug damage.[3] Delay using cannabis as long as possible, if ever.

It is dangerous to drive automobiles (or tractors or motorcycles, or fly airplanes) while stoned. Don't drug and drive.

DO NOT mainline pot potions. Intravenous injection of crude cannabis extracts makes one very sick. We also reported that in JAMA in 1971.[4]

For the criminal justice system: Decriminalize marijuana possession and use. Empty the prisons of nonviolent marijuana offenders, who should never have been there in the first place. Overturn Richard Nixon's Southern strategy of disenfranchising black voters by incarceration. Save tons of public money even while resisting the lobbying of the American for-profit prison system. Reverse 21st century Jim Crow.

For the US Congress: Revise the Controlled Substances Act. Either delete cannabis from any schedule or move it way down from Schedule I. My old friend Roger Egeberg (Assistant Secretary for Health and Scientific Affairs in the Department of Health, Education, and Welfare during the Nixon administration) was seriously wrong in 1970 when he advised you to make cannabis a Schedule I drug.

For journal editors: Invite papers describing reality as recorded by the observant and inquisitive local physician-scientist authors. JAMA: Plan a theme issue on medical and public health/policy aspects of cannabis.

I have included a lot of topics in this brief column, some without building background for the reader. I have the references and will make them available at your request.

That's my opinion. I am Dr. George Lundberg, At Large at Medscape.

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