(In response to State Rep. Cohen Will Push Pa. Medical Marijuana Bill)

In Pennsylvania, the Quaker state, where liquor stores are closed on Sundays, a state representative wants to make medicinal marijuana legal.

State Representative Mark Cohen of Philadelphia anticipates the bill will be on the floor of the Pennsylvania legislature soon, and will be similar to a proposal under consideration in New Jersey. Medical marijuana would be available, through a prescription, to those suffering from cancer, multiple sclerosis, or other illnesses. Patients would be able to grow marijuana or buy it from a licensed dealer.

This proposal interests me for a couple reasons. First, my dad, who is an osteopath, works at a drug treatment center in Central Pennsylvania. Secondly, I've known several people who have actively advocated for marijuana legalization. To figure out the pros and cons of the proposal, I spoke to both sides.

First, I called Dad and asked what he thought about the law and about medical marijuana, in general. He said he thinks the law is a bad idea, that it will only spread marijuana use. If you make it accessible to one group of people, he argued, other groups of people will demand access, as well.

Then he pointed out flaws in the medical argument. The active ingredient in marijuana, THC (tetrahydrocannabinol), is already available in medicinal form. For example, I did research and discovered one such medicine, Cesamet, which is used to treat cancer patients suffering from chemotherapy-induced nausea and vomiting. The listed side effects (including dizziness, depression and confusion, dry mouth, headache, trouble concentrating, insomnia) appear similar to those caused by marijuana, as listed by the Wo/Men's Alliance for Medical Marijuana in California.

In addition, Dad pointed out that, since medical marijuana was legalized in California, there has been a rise in testicular cancer amongst marijuana users. According to researchers at the Fred Hutchinson Cancer Research Center in Seattle, researchers found the risk of testicular cancer was 70 percent higher in those using pot (L.A. Times: "Marijuana, Testicular Cancer Link is Found").

Plus, Dad noted that one marijuana cigarette or joint contains as much tar as 8-10 cigarettes. This claim was supported by the National Institute on Drug Abuse (run by the U.S. National Institutes of Health), which quotes Dr. Donald Tashkin of the University of California - Los Angeles: "Because marijuana smokers typically hold their breath four times as long as tobacco smokers after inhaling, marijuana smoking deposits significantly more tar and known carcinogens within the tar, such as polycyclic aromatic hydrocarbons, in the airways" ("Marijuana Smoking is Associated with a Spectrum of Respiratory Disorders").

Effectively, Dad said, the health benefits are canceled out by the negatives.

I should point out that, according to a 2006 study by the David Geffen School of Medicine at the University of California - Los Angeles, however, smoking marijuana did not lead to increased risk of developing lung cancer (Daily News Central; "Smoking Marijuana Does Not Hike Cancer Risk"). So like many other aspects of marijuana use, the medical argument is not clear cut, with good arguments on both sides.

"Well," I asked, "what about the argument that illegal drugs lead to organized crime?" I pointed out that there is an active drug war on the Mexican border, with horrific violence spilling into the United States. Would legalizing marijuana lessen drug-related crime? (CNN; "Official: Mexican Drug Turf Wars Have Led to Surge in Violence").

Dad suggested that a better solution would be to address demand by opening more drug treatment centers, which are far more cost-effective than prisons. He said, "In rehab, most of those people are addicts, and they're selling drugs in order to pay for their habit. I mean, if somebody is using 10 bags of heroin, they've got to pay for that. There's two ways to pay for it: sell drugs or steal."

Not only that, he said, but the amount of money needed to support one person in drug treatment for a year is less than the amount needed to keep them in prison. I found confirmation from the state of Pennsylvania itself: "According to the NADCP [National Association of Drug Court Professionals], incarceration of drug offenders costs taxpayers between $20,000 and $50,000 per person annually compared to an annual cost of between $2,500 and $4,000 per person for comprehensive drug treatment" (Pennsylvania State Web site; "Statewide Symposium Demonstrates Treatment Courts Provide Viable Option to Incarceration"). That's a huge difference, and in this economy, it seems foolish to overlook treatment as a partial solution to drug-related crime.

Plus, if you listen to the talking heads on television, California hasn't exactly been an ideal model for legalization. I know this because I transcribe cable news for a living. Apparently, some people with medical licenses have been dispensing marijuana prescriptions to anyone who asks. To be sure, there have been some high-profile arrests, and there is information available online for people on how to obtain a prescription, which hints at skirting the system. However, I was unable to find any hard statistics on the prevalence of this problem.

I wanted to get the other side of the story, then, so I e-mailed an old friend and fellow Penn State alum, Alan Gordon, a drug policy scholar and former director of the American Drug History Institute (1995-1998). Since he's no longer an active advocate for legalization, I started by asking how he currently feels about legalizing marijuana. He replied that marijuana should be regulated, rather than remaining an underground market.

Far from leading to further drug use, he expected regulation to diminish the problem. He said that drug use rates among youth have been "most effectively corralled amongst the regulated drugs, alcohol and tobacco."

He also pointed to a possible boon from regulating marijuana use. Alan said that making marijuana a taxable industry would bring money to state coffers during a difficult economic period. A similar pattern proved true during the Great Depression, when alcohol prohibition was repealed, and states increasingly benefited from the resulting sales taxes. Sure enough, that argument is being made by Rep. Cohen, who was quoted in the article as saying he thinks medical marijuana can "easily raise $25 million a year in taxes."

What about the potential for abuse of the medicinal marijuana system? Alan pointed out that, while medical marijuana laws are frequently used to mask recreational use in California and other states, "no anti-drug effort has yet been able to effectively control underground or 'street' pot sales anyway, and so perhaps taxing and regulating is better."

But he was quick to add that medicinal marijuana is not the cause of drug use among youth: "Any teen who wants marijuana in California can buy it without utilizing a medical pot shop… the trick is to keep children from wanting to use it in the first place." He said that can be done through education, treatment, and providing a range of other activities for youth. In addition, he thought it was important to de-glamorize pot "so it doesn't seem like a Robin Hood industry struggling against the oppressive forces of heavy-handed government." In other words, the current system only feeds the teenage desire to rebel.

With all these arguments in favor of legalization, why is it still such a thorny issue? Alan has done research into the drug's permeation throughout different cultures, and he said that it has always been controversial. "Its oldest known written depiction, from the 5,000-year-old pharmacopia of China's Emperor Shen Nung, shows the controversy existed even then, and similar controversies seem evident in Judeo-Christian scriptural depictions, as well."

He said that the current legalization debate is not new either: "Over the history of human civilization, humanity's love-hate relationship with the drug has led entrepreneurs to zero in on the trade, governments to crack down harshly, and, inevitably, for entrepreneurs to pay governments to crack down, for the sake of driving up prices and centralizing supply lines."

I told him about my Dad's proposal that, instead of legalizing marijuana, we should open more drug treatment centers. He said that we should do both: regulate drug sales and provide treatment and prevention centers. Furthermore, he suggested that "we should impose a special surtax on cannabis earmarked solely for drug treatment and prevention efforts (including for drugs other than cannabis)." This would be similar to the tobacco settlement which requires money from tobacco sales go towards education and smoking cessation efforts.

He pointed out that, in many states, drug forfeiture property is already used to pay for prevention and treatment.

Regarding medicinal marijuana, Alan has some personal knowledge: "I observed the creation of Philadelphia's first underground medical buyer's clubs for AIDS patients around 1990, and the topic has evolved rapidly since those people were fighting for their very lives in utter secrecy, and were not targeted by police because they weren't really competing against the drug dealers the police were paid to protect."

He expected arguments to arise over how to implement a medical marijuana law: "Now some of those advocacy groups will begin to push for the most expansive rights for medical marijuana users, while anti-drug groups will push for the tightest possible restrictions. The final decision will not satisfy anyone, but will hopefully take a form that all parties can live with."

He hopes that solution would include the ability of patients to grow the plant themselves, and he explained why. Since marijuana is a perishable produce, he said that it "doesn't readily lend itself to the uniformity required of other pharmaceuticals." There are hundreds of phenotypical variants, according to him, "each with their own distinct, flavor, potency, and blend of medicinal components, each yielding different effects." As with any other plant-based pharmaceutical, he feels that "a patient should be able to choose the strain that's right for her/him, and then be able to obtain that strain without suffering the degradation that occurs in processing, packaging, shipping and storage."

All of this discussion would be moot, however, if such a law could not be passed. On the one hand, Alan pointed to Pennsylvania's history of harsh enforcement. He said, "While Pennsylvania's neighbors, New York, New Jersey, Ohio and Maryland have all in recent years moved towards lessening of drug penalties (either with medical marijuana, marijuana overall, or drugs overall), Pennsylvania has not budged an inch on drug policy at the state level for thirty-five years, when a young Philadelphia D.A. named Arlen Specter in the early 1970's implemented one of the nation's first first-offender programs, which has since become a national and even global model law."

On the other hand, because of New Jersey's cultural and economic proximity to Pennsylvania, particularly to Philadelphia, Alan felt there was a chance the state's power brokers would "realize that medical marijuana is no longer a 'West Coast' phenomenon, and may be appropriate for more sober-seeming Northeastern states, as well."

He added that the western half of the state, from Pittsburgh to Erie, "behaves more akin to a Rust Belt state, politically, and borders on Ohio, which has enjoyed slap-on-the-wrist marijuana laws for decades, without any resulting marijuana epidemic." Perhaps voters in those regions would be less worried about legal consequences of regulation.

Likewise in the southwestern tier counties, and in the Appalachian mountain counties, he said, where the "culture is more akin to West Virginia's sucked-dry mining and logging sectors, and so they have long been dependent on marijuana as a regional cash-infuser." The biggest opposition, he suggested, may come from Erie legislators, "who for years have unwittingly received Canadian smugglers' drug money for strong anti-drug attitudes, for the sake of keeping prices high."

While polls (Gallup; "Who Supports Marijuana Legalization?" and "Medical Marijuana: Is It What the Doctor Ordered?") show overwhelming support by the populace for medical marijuana, Alan conceded that "history shows many legislators' unwillingness to even vote on such measures." Give all these factors, though, he predicted that Pennsylvania will pass the proposed legislation within the next two years.

After listening to both sides, I can understand the arguments both for and against medical marijuana, but I have doubts this law could pass as quickly as Alan believes. Rep. Cohen is from the more liberal Philadelphia metro area, so perhaps he doesn't realize how much of an uphill battle this proposal might face in rural areas. Lawmakers would need to weigh the possible benefits of the plan versus the likelihood that voting for the proposal will cost them reelection. Even if an evaluation of the arguments leans in favor of legalizing medicinal marijuana, I'm not sure Randy the farmer will support the plan. Ultimately, regardless of the arguments, if the lawmakers are afraid to support it, Cohen's proposal will go up in smoke.

 

Further information: Medical Marijuana Pro/Con