COMMENTARY

Medical Marijuana: The State of the Science

Michael E. Schatman, PhD

Disclosures

February 06, 2015

In This Article

Dispensaries and Medical Marijuana

Medical cannabis products are typically sold in dispensaries, which have become ubiquitous in some areas, such as Denver, Colorado.[178] Despite their legality, dispensaries may sell few products that are particularly "medical," because the majority of what is sold is the same quality of marijuana sold on the streets and carries the same health risks.[178]

Questions also have been raised regarding the legitimacy of dispensaries' clientele. A recent study found that most dispensary customers had initiated marijuana use in adolescence, with one half presenting with indications of risky alcohol use and 20% presenting with recent histories of prescription medication or illicit drug abuse.[179]

Emerging data suggest that dispensaries have deleterious societal effects, such as diversion to adolescents who are treated for substance abuse,[180] increased adult treatment admissions for marijuana dependence and alcohol abuse,[181]and increased unintentional pediatric marijuana exposure.[182] The current dispensary system results in unlicensed "pharmacists" dispensing marijuana, who are unlikely to inform customers of the dramatic physical and mental health risks associated with marijuana use and lack expertise on potential drug/drug interactions.[183]

Finally, the THC potency in states with legally protected dispensaries is significantly higher than that in states without dispensaries.[184] Pacula and Lundberg[185] convincingly argue that it is not the medical marijuana laws per se, but rather the dispensary systems, that drive down the price of marijuana and lead to increased use in both established and new users.

Research on the THC/CBD ratio of marijuana sold in dispensaries is sorely needed, although at present, there is no evidence that the overwhelming majority of the cannabis sold in dispensaries is in any way, shape, or form "medical." This supports the argument that the dispensary system, as it exists presently, needs to be dismantled. Legislation such as that being proposed by a group of physicians in Florida stipulating that "medical marijuana" should contain a maximum of 5% THC and a minimum of 10% CBD would go a long way toward legitimizing cannabis as "medicine" and dispensary systems.

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