
One of the largest topics of debate in health to date, is the use and study of medical marijuana. Marijuana is consumed for two of its properties, tetrahydrocannabinol (THC), which gives users a psychoactive effect and cannabinol (CBD) which holds much of the plants health properties. Currently, marijuana is considered a schedule-I narcotic by the FDA, which puts it in the same category as heroin and LSD. Is marijuana the same legitimate risk as some of the other narcotics in it’s class? No, however, there is a legitimate lack of knowledge holding back the advancement of medical marijuana that correlates with the current legal status of the drug.  In order for the United States to make legitimate strides, there needs to be a major emphasis on research. The recent elections, Florida, North Dakota, and Arkansas joined the rapidly growing group of states that have legalized marijuana for medical use. In result of these structural changes, states such as Colorado have been pulling in more tax money than almost ever before. Colorado brought in more than 1 billion dollars in tax revenue from marijuana sales. This research could legitimately be funded by itself. This is a change that will continue to happen in coming years, therefore we must find a way to properly regulate and manage the narcotic. In the observation of current research and the status of medical marijuana, it is apparent that the benefits of medical marijuana far out weigh the risks or health factors previously held with the substance; however, these benefits can not be fully understood without more comprehensive research and less limited access to recreational marijuana for the field to continue to advance. The legality of marijuana use is still very much in debate, however the use of medical marijuana is currently legal in 28 states and Washington D.C.. This from medical marijuana being legalized on solely a state level due to the lack of FDA approval keeping its legality questioned on a federal level.Currently the Food and Drug Administration requires evidence from at least two randomized clinical trials before gaining it’s approval for a drug. Some argue that the current lack of conclusive evidence is result of government regulation making the clinical study difficult. Marijuana is currently a schedule-I drug, putting it in the same category of heroin and LSD. In order for the FDA to loosen its restrictions and push marijuana to a schedule-II substance, this is because there is a lack of supported evidence in the evaluation of the safety and effectiveness of marijuana. The legality of medical marijuana is suppressed by a lack of conclusive research on the substance. The FDA has recently approved more and more research studies, which has given way to breakthroughs such as cannabidoil (CBD) in the treatment of epilepsy. It is not a matter of if the field of medical cannabis will grow, but when. It’s growth depends on more extensive research, that is sure to come in the years ahead. As we take steps forward in medical use of cannabis, there must be a further emphasis on government regulation. The standards for qualification must be set firm, and the drug must be monitored and used as any other medically prescribed substance.

Medical marijuana has an extensive list of uses for treatment, usually presented as a safer alternative to the current standard of treatment. One of the the most common uses of medical marijuana currently, is for patients suffering from the adverse effects of chemo therapy (American Cancer Society). Specifically, aiding these patients with their pain, nausea, and vomiting. AIDS patients have also found use of medical marijuana for an appetite stimulant. There is also limited evidence supporting medical marijuana use for other specific pain syndromes and spasticity from multiple sclerosis. Marijuana has also been prescribed highly for use as a nonspecific subjective relief. It may not treat an ailment, but further give relief to a patient. Patients suffering with PTSD, Crohn disease, sickle cell disease, psoriasis, and epilepsy. Marijuana could replace or lower the required dosage of opioids or benzodiazepines, helping patients avoid substance abuse. In short, medical marijuana can find uses in aiding pain, muscle spasticity, and neurological disorders. Further evaluation and study of the use of medical marijuana will continue to give way to more benefits of marijuana and its properties. 

Though there is an extensive list of alternative treatments associated with medical marijuana, there are adverse effects said to be associated with the use of marijuana. One of the most highly contested adverse effects, is that chronic use of marijuana can cause cognitive impairment and damages, “particularly white matter, where cannabinoid 1 receptors abound (Evidence Reviewed, Abstract)”. The brain is at risk of impairment with chronic use and the abuse of the substance, but this goes back to a necessity for proper regulation of the drug. Medical marijuana is very easy to build a tolerance to, and at its current status, there is not much guidance on dosages for patients with continual use. Other than the unapparent health effects of medical marijuana, marijuana use is associated with laziness, memory loss, and a lack of motivation(Is the Cart Before the Horse: Jama). This would be highly avoidable with proper use of the narcotic for its benefits, and a patient not relying on or abusing it’s use. Patients wishing to use medical marijuana as a medical alternative, must be aware of these claims. A patient should take proper steps to educate themselves on the product before trial use. This will help ensure there is less room for user error and abuse when using cannabis. 

The largest issue in the development of medical marijuana and it’s uses, are the current limitations of research keeping much of the drugs uses, benefits, and properties in the dark. The legality of marijuana on a state level but not a federal level, has limited research. The federal government must show support and a desire to regulate cannabis study, which would allow there to be a national standard for medical marijuana use. This does not mean they must make legal change on the federal level, but begin to fund and formulate a societal standard from the top down. This is an extension of the major federal regulation on the clinical studies of medical marijuana. Every state that has legalized the use of marijuana for medical conditions, has made the standard for medical marijuana in their state. This has lead to it consistencies in the qualifications and standards for medical marijuana use (Cart Before the Horse, Jama). The inconsistency of treatment by state, has made it hard for advocates to constantly argue on behalf of medical marijuana. In contrast, the study of marijuana is difficult to pinpoint. Unlike other FDA drugs, with one or two active constituents, “marijuana is a complex of more than 400 compounds including flavonoids and terpenoids and approximately 70 cannabinoids other than tetrahydrocannabinol (Cart Before the Horse, Jama)”. The extent of marijuana's properties makes it a difficult process for researchers to study individual cannabinoids. Unlike other FDA drugs that have a uniform composition, the composition of cannabis preparations vary based on CBD and THC content. The last major hurdle for the medical marijuana industry is pinpointing dosages. The proper dosage for marijuana is currently difficult for physicians to identify for their patient. There are now so many different ways and forms of cannabis for a patient to ingest, and each one has a different effect and dosage. Currently, medical cannabis products, such as edibles and oils, have detailed instructions on how a patient can start by slowly taking the substance and take more as need be. However, these directions still leave room for error, as a 90 pound woman can not ingest the same minimal dosage as a 190 pound man. What happens when the product is catered to the larger man as opposed to the small woman? Potentially, the woman would end up ingesting beyond her recommended dose. There must be a more specifically designed system for patient dosages and for how doctors distribute the medication. The current room for error, when using medical marijuana, is from a lack of scientific information. This lack of information, is a direct product of government regulation, the best way for the US government to control and monitor medical cannabis is to take over the medical study of cannabis and set the standard for treatment at a national level. 

Though research in the field is limited, there have been some major breakthroughs with medical cannabis in recent years. The greatest success of these breakthroughs was the development of CBD and the treatment of Dravet Syndrome in a child from Colorado, named Charlotte. This girl found life changing success in treatments from a special strain of cannabis called “Charlotte’s Web”. This strain was designed to be high in CBD (cannabidoil) and low in THC (tetrahydrocannabinol), which is the property that gives users a “high”.  This made it possible to take the majority of negatives effects, such as the “high” associated with smoking cannabis, out of the consumption. The general idea of the strain, was to minimize as much of the plant as possible with the emphasis of the product being health related. As for Charlotte, she was suffering from up to 300 grand mal seizures a week, after hundreds of failed treatments over the first five years of her life. She began taking CBD oil in her food twice a day, and this has kept her seizures down to two or three a month, usually in her sleep. She was the first of now 41 patients who have been able to find benefits from using this specific strain to treat epilepsy and cancer. This is a simple breakthrough, and is not seen as conclusive evidence, but it shows genuine evidence that the health properties of marijuana can benefit the medical field. 

Medical Marijuana is very much limited in this day and age for a number of reasons. The marijuana dispensaries and the field itself is at war with one of the highest paid industries in the United States, and that is the pharmaceutical industry. Cannabis would significantly cut into these companies wallets and potentially build to be a competitor. The pharmaceutical industry is very intertwined and involved with the US government, which could be playing a roll in its current schedule-I status. In relation to this, the federal government must back the medical marijuana industry for it to have success. This would call recreational marijuana use needs to be thrown out and treated as a schedule-II drug. Just as someone should not use abuse prescription opiates, they should not abuse cannabis. When marijuana use is held to a higher standard, the window for advancement in the field of research will open up, and potentially gain more public and federal support. The most common counter argument to medical cannabis, is the effect of long term use. The proper regulation of the drug would help prohibit this by allowing thought who strictly qualify and need it to gain access. This would statistically lower the amount of chronic marijuana users. The limitations set on the advancement of medical marijuana research set by the government shows a necessity for change.

Medical marijuana has risks presented with it, but many of these risks are from a lack of knowledge or improper use, however these risks do not come close to the amount of life saving potential presented with alternative treatments using marijuana. Recreational use of marijuana is medical marijuana’s worst enemy. The growing standard of recreational marijuana is allowing potential for abuse by it’s users. Those who abuse any drug will suffer from doing so, and this will only set back the advancements of the drug, by making the national view marijuana as an abused substance. If the proper steps are taken in the development of alternative treatments using medical marijuana, there genuinely can be major changes for the betterment of society at large. 
