As a physician with more than 20 years of experience dealing with patients who are addicted to drugs, I am often asked my professional opinion about a contentious public health question: What is the medical basis for smoking marijuana? The answer needs some context.
Americans today have the world's safest, most effective system of medical practice, built on a process of scientific research, testing and oversight that is unequaled.
Before the passage of the Pure Food and Drug Act in 1907, Americans were exposed to a host of patent medicine "cure-alls," everything from vegetable "folk remedies" to dangerous mixtures with morphine. The major component of most "cures" was alcohol, which probably explained why people reported that they "felt better."
Needless to say, claimed benefits were erratic and irreproducible.
Marijuana, whatever its value, is intoxicating, and it's not surprising that sincere people will report relief of their symptoms when they smoke it. The important point is that there is a difference between feeling better and actually getting better. It is the job of modern medicine to establish this distinction.
The debate over drug use generates a great deal of media attention -- including the focus on the administration's appeal this month to the U.S. Supreme Court against medical marijuana -- and frequent misinformation. Some will have read, for instance, that the medicinal value of smoking marijuana represents "mainstream medical opinion." It is time to set the record straight.
Simply put, there is no scientific evidence that qualifies smoked marijuana to be called medicine. Further, there is no support in the medical literature that marijuana, or indeed any medicine, should be smoked as the preferred form of administration. The harms to health are simply too great.
Marijuana advocates often cite the 1999 National Academy of Science's Institute of Medicine report as justifying the drug's medical use. But, in fact, the verdict of that report was "marijuana is not a modern medicine." The institute was particularly troubled by the notion that crude marijuana might be smoked by patients, which it termed "a harmful drug-delivery system."
These concerns are echoed by the Food and Drug Administration, the agency charged with approving all medicines. As the FDA recently noted: "While there are no proven benefits to [smoked] marijuana use, there are many short- and long-term risks associated with marijuana use."
