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Opinion: After 20 years, it’s clear that marijuana is not ‘medicine’

It may be too late to reverse legalization, but let’s not kid ourselves: Politics, not medicine, ruled the day

In 2000, Colorado bought a pig in a poke. We truly didn’t know what we were getting. Can we finally admit it?

Dr. Mark B. Johnson

It may have seemed like a good thing in 2000. We voted to legalize the use of marijuana for certain medical conditions that were known to be accompanied by chronic pain, nausea and vomiting, weight loss, muscle spasms and some other physiological symptoms.

The number of patients who were impacted by these conditions was fairly small, we were told. In what was viewed at the time as a humanitarian gesture, we voted to allow them access to “medical” marijuana.

For a while, things seemed to work. Those with medical conditions that were somewhat alleviated by the use of marijuana appeared to benefit.

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But after the law took effect, we soon found that we had tens of thousands of 18- to 25-year-old residents with “severe chronic back pain” and other unquantifiable and untestable conditions who now qualified to grow, purchase and use “medical” marijuana.

By 2012, we had essentially given up on trying to control things, and we opened the floodgates to the use of recreational marijuana as well.

The main reason we did not know what we were doing is that research on the effects of the use of marijuana had been hampered in this country due to federal laws prohibiting it. What research was available at the time, mostly from European countries, indicated that inhaled marijuana may reduce the nausea and vomiting caused by chemotherapy; it may improve appetite, particularly in patients with HIV/AIDS; and there is some reduction in chronic pain and muscle spasms that accompany certain conditions.

With over 20 years of experience now, we have learned that there is a risk of potential adverse effects from the use of marijuana. The most serious of these have to do with cognitive functioning and psychosis.

As I speak with my colleagues in emergency medicine, physicians are seeing what some of them consider to be an epidemic of acute transient psychotic symptoms in their patients who use marijuana, particularly adolescents. Research, too, has shown a dose-related increase in psychosis in adolescents using marijuana — meaning the more they use the worse the effects are — and a two-fold increase in psychosis associated with all cannabis users. 

There is evidence that the earlier the use of marijuana begins, the more serious these cognitive effects and psychosis will be. We are gambling with the health and future of our teens.

Perhaps the horse is out of the barn. Perhaps we cannot live without the taxes the sales of marijuana provide. Perhaps most users will be just fine. Perhaps prohibition is unattainable.

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But can we please stop the charade that “medical” marijuana is medicine? The FDA has not studied and ensured its safety and effectiveness. The dosage is not checked, certified and controlled. Physicians do not prescribe it. Pharmacies do not dispense it.

Politics, not science, has determined it is “safe” to distribute to our kids. Let’s make that clear.


Mark B. Johnson, M.D., M.P.H., of Louisville, is president of the Colorado Medical Society.


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