i.

Quotes from the IOM report Marijuana and Medicine

ii. Quotes from other sources
I. Quotes from the IOM report Marijuana and Medicine: Assessing the Science Base
Pro medical marijuana

Con medical marijuana

"Marijuana is not a completely benign

substance. It is a powerful drug with a variety
of effects. However, except for the harm
associated with smoking, the adverse effects of
marijuana use are within the range tolerated for
other medications. Thus, the safety issues
associated with marijuana do not preclude
some
medical
uses."
Mar. 1999 IOM (pages 126-127)

"[S]moked marijuana, however, is a crude THC

delivery system that also delivers harmful
substances."
Mar. 1999 IOM
(page 4)

"Until the development of rapid-onset

antiemetic drug delivery systems, there will
likely remain a subpopulation of patients for
whom standard antiemetic therapy is
ineffective and who suffer from debilitating
emesis.
It is possible that the harmful effects of
smoking marijuana for a limited period of time
might be outweighed by the antiemetic benefits
of marijuana, at least for patients for whom
standard antiemetic therapy is ineffective and
who suffer from debilitating emesis.
Such patients should be evaluated on a caseby-case basis and treated under close medical
supervision."
Mar. 1999 IOM
(page 154)

Numerous studies suggest that marijuana

smoke is an important risk factor in the
development
of
respiratory
disease."
Mar. 1999 IOM
(page 6)

"The profile of cannabinoid drug effects

suggests that they are promising for treating
wasting syndrome in AIDS patients. Nausea,
appetite loss, pain, and anxiety are all
afflictions of wasting, and all can be mitigated
by marijuana. Although some medications are
more effective than marijuana for these
problems, they are not equally effective in all
patients.
A rapid-onset (that is, acting within minutes)
delivery system should be developed and
tested in such patients. Smoking marijuana is
not recommended. The long-term harm caused
by smoking marijuana makes it a poor drug
delivery system, particularly for patients with
chronic illnesses.
Terminal cancer patients pose different issues.
For those patients the medical harm

"Chronic marijuana smoking might lead to

acute and chronic bronchitis and extensive
microscopic abnormalities in the cell lining the
bronchial passageways, some of which may be
premalignant.
These respiratory symptoms are similar to
those of tobacco smokers, and the combination
of marijuana and tobacco smoking augments
these
effects."
Mar. 1999 IOM
(page 115)

associated with smoking is of little

consequence. For terminal patients suffering
debilitating pain or nausea and for whom all
indicated medications have failed to provide
relief, the medical benefits of smoked
marijuana might outweigh the harm."Mar.
1999 IOM
(page 159)

"Until a non-smoked rapid-onset cannabinoid

drug delivery system becomes available, we
acknowledge that there is no clear alternative
for people suffering from chronic conditions
that might be relieved by smoking marijuana,
such as pain or AIDS wasting..."*["in those
patients who have not responded to
standard approved therapy"].
* [The above bracketed and bolded words were
suggested to ProCon.org on Feb. 26, 2002
byJohn A. Benson, Jr., MD, Co-Principal
Investigator of the 1999 IOM report.]
Mar. 1999 IOM
(page 179)

"The most compelling concerns regarding

marijuana smoking in HIV/AIDS patients are
the possible effects of marijuana on immunity.

"RECOMMENDATION: Short-term
use
of
smoked marijuana (less than six months) for
patients with debilitating symptoms (such as
intractable pain or vomiting) must meet the
following conditions:

"[C]ellular, genetic, and human studies all

suggest that marijuana smoke is an important
risk factor for the development of respiratory
cancer."
Mar. 1999 IOM
(page 119)

failure of all approved medications to

provide relief has been documented,

the symptoms can reasonably be

expected to be relieved by rapid-onset
cannabinoid drugs,

such treatment is administered under

Reports of opportunistic fungal and bacterial

pneumonia in AIDS patients who used
marijuana suggest that marijuana smoking
either suppresses the immune system or
exposes patients to an added burden of
pathogens.
In summary, patients with preexisting immune
deficits due to AIDS should be expected to be
vulnerable to serious harm caused by smoking
marijuana."
Mar. 1999 IOM
(page 117)

medical supervision in a manner that

allows for assessment of treatment
effectiveness, and

involves
an
oversight
strategy
comparable to an institutional review
board process that could provide
guidance within 24 hours of a
submission by a physician to provide
marijuana to a patient for a specified
use.

Mar. 1999 IOM

(page 179)

"The different cannabinoid receptor types

found in the body appear to play different roles
in normal physiology. In addition, some effects
of cannabinoids appear to be independent of
those receptors. The variety of mechanisms
through which cannabinoids can influence
human physiology underlies the variety of
potential therapeutic uses for drugs that might
act selectively on different cannabinoid
systems.
RECOMMENDATION: Research
should
continue into the physiological effects of
synthetic and plant-derived cannabinoids and
the natural function of cannabinoids found in
the body. Because different cannbinoids
appear to have different effects, cannabinoid
research should include, but not be restricted
to, effects attributable to THC alone.
Mar. 1999 IOM
(pages 70-71)

"High intraocular pressure (IOP) is a known

risk factor for glaucoma and can, indeed, be
reduced by cannabinoids and marijuana.
However, the effect is too short-lived and
requires too high doses, and there are too
many side effects to recommend lifelong use in
the treatment of glaucoma.
The potential harmful effects of chronic
marijuana smoking outweigh its modest
benefits in the treatment of glaucoma."
Mar. 1999 IOM
(pages 177)

II. Quotes from other sources

Pro medical marijuana

Con medical marijuana

The Honorable Alex Kozinski, US Ninth Circuit

Court Judge, in his Oct. 29, 2002 concurring
opinion in Conant v. Walters [309 F. 3d 629 (9th
Cir. 2002)]:

Voth, MD, an internist in Topeka, KS, noted in a

Apr. 1, 1999 editorial posted to the website of
the Institute of Global Drug Policy:

"The IOM Report found that marijuana can

provide superior relief to patients who suffer
these symptoms as a result of certain illnesses
and disabilities, in particular metastic cancer,
HIV/AIDS, multiple sclerosis (MS), spinal cord

"As one of the final reviewers of the Institute of

Medicine evaluation of marijuana, and as a
physician who has studied this issue for over
twenty years, I am aggravated by the
inaccurate portrayal of marijuana that the
media has generally set forth.

injuries and epilepsy, and those who suffer the

same symptoms as side effects from the
aggressive treatments for such conditions.
As a consequence, the IOM Report cautiously
endorsed the medical use of marijuana."
Oct. 29, 2002 Alex Kozinski

The IOM summary should be seen as a victory

for opponents of smoked marijuana. It
supported research into naturally occurring or
synthetic cannabinoids, but it also stated that
any research using any form of THC should
culminate in the development of non-smoked
forms of THC....
Furthermore, the study should serve as a death
knell for the ballot initiatives and state laws
allowing the prescribing of marijuana to virtually
any patient....
The IOM findings are consistent with previous
evaluations by the American Medical
Association and the National Institutes of
Health. They are a long way from wide support
for the use of marijuana. If anything, the
headlines should say, 'Smoked marijuana as a
medicine
is
dead.'"

Apr. 1, 1999 Eric Voth

Andrew Weil, MD, stated in a June 6, 2002

article published in the San Francisco
Chronicle:
"The Institute of Medicine, in a report
commissioned by the White House "drug czar,"
concluded in 1999 that there is convincing
evidence of marijuana's value in relieving
nausea, weight loss, and other symptoms
caused by diseases such as AIDS, cancer and
multiple sclerosis, as well as the harsh drugs
often used to treat these conditions.
The institute concluded that for some patients
the potential benefits clearly outweigh the risks,
and that ways should be found to make
marijuana
available
to
them."
June 2, 2002 Andrew

Weil

Ethan

MD,

Russo,

clinical

neurologist,

The National Multiple Sclerosis Society had

this to say about the IOM Report:
"A report issued March 17, 1999 by the
National Academy of Sciences/Institute of
Medicine on the medical uses of marijuana,
which was commissioned by the White House,
concluded that smoked cannabis does not
have a role in the treatment of MS.
However, there is the possibility that specific
compounds derived from marijuana may
possibly reduce some MS symptoms,
particularly
MS-related
spasticity."
May 2001 National Multiple Sclerosis Society

The US DEA stated in its Apr. 25, 2005 press

researcher and author, wrote ProCon.org on

Dec. 31, 2002:
"Even the Institute of Medicine recognized the
rationale behind smoked cannabis in terminal
patients. Suitable alternative delivery systems
are
now
available.
Smoking is a rapid and easily titrated form of
cannabis delivery, but modern techniques such
as vaporization, sublingual and nebulized
cannabis-based medicine extracts offer other
choices to the clinical cannabis patient without
the
risks
of
smoking."
Dec. 31, 2002 Ethan Russo

release "Marijuana: The Myths Are Killing Us":

"In 1999 the Institute of Medicine (IOM)
undertook a landmark study reviewing the
alleged medical properties of marijuana.
Advocates of so-called medical marijuana
frequently tout this study, but the study's
findings decisively undercut their arguments.
In truth, the IOM explicitly found that marijuana
is not medicine and expressed concern about
patients' smoking it because smoking is a
harmful drug-delivery system.
The IOM further found that there was no
scientific evidence that smoked marijuana had
medical value, even for the chronically ill, and
concluded that 'there is little future in smoked
marijuana
as
a
medically
approved
medication.'
In fact, the researchers who conducted the
study could find no medical value to marijuana
for virtually any ailment they examined,
including the treatment of wasting syndrome in
AIDS patients, movement disorders such as
Parkinson's disease and epilepsy, or glaucoma.
The IOM found that THC (the primary
psychoactive ingredient in marijuana) in
smoked marijuana provides only temporary
relief from intraocular pressure (IOP)
associated with glaucoma and would have to
be smoked eight to 10 times a day to achieve
consistent results. And there exists another
treatment for IOP, as the availability of
medically approved once- or twice-a-day eye
drops makes IOP control a reality for many
patients and provides round-the-clock IOP
reduction.
For two other conditions, nausea and pain, the
report recommended against marijuana use,
while suggesting further research in limited
circumstances for THC but not smoked
marijuana."
Apr. 25, 2005 DEA

Why Marijuana Should Not Be Legalized?

Don't know why marijuana is illegal? Here are 10 reasons that will make all your
confusion disappear.

1. Damage Your Health

Smoking any substance will have a negative and

potentially life-threatening effect on your respiratory health. Marijuana use can affect a
person's memory, IQ, judgment, and problem-solving skills. There are many cases,
linking the use of marijuana to the increased chance of forming a mental illness, although
there is little scientific evidence to prove this. For example, some people who have
smoked marijuana have later been diagnosed with psychosis or schizophrenia. Another
notable point is that the strains of cannabis in circulation now are much stronger than
they once were.

2. Endanger Public Safety

Marijuana use, like the use of alcohol, can cause impairment in the user. This means if a
person is driving whilst under the influence, they may be more prone to having a collision
and potentially harming a pedestrian or fellow road user. There is also a chance that
marijuana use during work will reduce your ability to perform your job efficiently, which
can be potentially dangerous for certain professions, such as pilots, doctors, care
providers, etc.

3. Lack of Support for "Medical Marijuana" Claim

There is clear evidence that smoking marijuana is harmful. The FDA, which has the right
to approve all prescription medicine, stated on marijuana that "there is currently sound
evidence that smoked marijuana is harmful". And there is just no or not enough medical
support for using marijuana medically.

4. Jeopardize Young People

Why marijuana should not be legalized? It's because it can harm the young people who
are the hope and future of human kind. Marijuana may affect the development of the
brain if smoked at a young age. This is not only harming the future of young people, but
also the future of our country and the world. If marijuana was legalized, then it would
become more easily accessed by younger generations, with fewer stigma attached to its
consumption. Like alcohol, the responsibility must lie with the dispensaries and the
parents.

5. Marijuana Legalization Will Become the New "Big Tobacco"

Like everything in a corporate world, the legalization of marijuana is bound to be
controlled by big, for-profit corporations (similar to the pharmaceutical industry). Much
like the claims that big tobacco companies once had, there are fears that these big
conglomerates are trying to market their product to younger generations to increase sales
and profit and create lifetime cliental, a devious tactic indeed.

6. Use of Marijuana Will Increase After Legalization

Another reason "Why marijuana should not be legalized?" is that legalization may
increase its abuse. The most widely used drugs in society are legal ones. Alcohol is
perhaps the most common, with cigarettes being a close second, marijuana being the
third most widely used recreational drug. The legalization of cannabis will lead to a rise in
its use and consumption because it is more accessible. Besides, the price of marijuana is
dropping.

7. Marijuana Can Affect Your Sex Life

Smoking can lead to impotence in males, which means those who smoke marijuana have
an increased chance of becoming impotent and infertile. Smoking marijuana will also
make your breath smell really bad, which will definitely affect your sex life. What's more,
there are even studies that link marijuana use with the occurrence of testicular cancer in
young men.

8. It Has Been Linked With Dangerous Narcotics

Due to drug laws in America, marijuana, the naturally grown leaves and flowers of the
hemp plant, has been listed as a narcotic along with heroin, cocaine, meth and other
dangerous substances. Marijuana is often described to be a gateway drug, meaning
users who take cannabis are more likely to take harder, more dangerous drugs. This
plays a big part in "Why marijuana should not be legalized?".

9. Lower Your Quality of Life

Marijuana affects users differently: Some smokers of marijuana find themselves unable to
look for work due to lack of motivation; and some fail to carry out normal tasks, such as
cleaning the house. This means that they cant support themselves or their families
properly.

10. Cost, Not Yield, Tax Dollars

The last reason "Why marijuana should not be legalized" is about the cost. The
consumption of drugs always poses the risk of adding burdens to the public funds.
Alcohol alone is believed to cost society fifteen times more than the revenue gained by its
taxation. This is due to the increased chance of road accidents whilst intoxicated, as well
as treating the physical damage that alcohol does to your body. If cannabis was
legalized, it is theorized that the same could be true.
http://www.newhealthadvisor.com/Why-Marijuana-Should-Not-Be-Legalized.html