Blog | Friday, August 26, 2016

Who decides if medical marijuana is safe and effective?


Medical marijuana is a smokin’ hot issue in Ohio. Marijuana enthusiasts targeted our state constitution again this year with another amendment attempt, which failed. Instead, our legislature passed House Bill 523, which will legalize medical marijuana use.

As a physician, with some training and experience in prescribing medicines to patients, these marijuana machinations are medical madness. Is this how we want to bring new medicines to market?

I think it is absurd that a specific medical treatment—or any medical treatment—should become a constitutional issue. Do we want to establish a constitutional right to a specific medicine? Why stop at marijuana? Why not start circulating petitions for constitutional amendments for screening colonoscopies, mammographies, and MRIs for back pain? Patients with chronic lumbar disk issues have rights too!

The Ohio bill specifies an array of medical conditions that could be treated with marijuana, including AIDS, hepatitis C, inflammatory bowel disease, Parkinson's disease, post-traumatic stress disorder, and many other illnesses. Is it the legislature's responsibility to decide that a medicine should be approved for a medical illness? Do legislators have medical expertise? Do we want the state's Senate or House weighing in on approving a new chemotherapy agent or artificial hip?

Might I suggest with just a tincture of cynicism that medical marijuana mania has become a mite politicized? Do we want folks who stand to make money or enhance their political power from a new medicine and who have no medical expertise to be the ones with a major role in approving its use? Are cannabis con artists using a political pathway because they fear that the medical avenue will less hospitable to their objective?

Once marijuana becomes a legal product, an inevitable outcome, will enthusiasts for its medical use support vigorous testing of its therapeutic value?

I am deeply skeptical that the medical claims of medical marijuana adherents are supported by persuasive medical evidence. I remain open, however, to submitting marijuana to the same Food and Drug Administration (FDA) testing that all new medicines are subjected to. Let the scientific method with appropriate clinical studies and peer review judge the product for safety and efficacy. If approved, then the public and the medical profession can be confident that the approval was on the basis of science and not smoke. Shouldn't those who champion medical marijuana use demand this level of independent scrutiny? If not, then why not?

Yes, I have heard powerful individual vignettes describing great benefits of medical marijuana. Every physician has similar anecdotes of patients who have achieved significant benefits from unconventional and unapproved medical treatments. But, anecdotes are not science. If medical marijuana is the healing elixir its proponents promise, then prove it.

Let our politicians do what they do well, whatever that is, and leave medicine to the professionals.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.