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The Great Debate: Medical Marijuana or Not?

Will New Jersey legislators pass a law in 2009?

Monday January 26, 2009
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Encouraged by recent passage of a medical marijuana law in Michigan, supporters of a similar effort in New Jersey hope that 2009 will be their year. Opponents are equally determined to make sure it won't be.

On Election Day 2008, Michigan became the 13th state to legalize medical marijuana. The law lets patients with "debilitating medical conditions" use marijuana when approved by a physician. But the federal government still classifies marijuana as an illegal Schedule I substance, defined as having a high potential for abuse and no medicinal value. Because physicians can't prescribe Schedule I substances and licensed pharmacies carry only prescribed drugs, pharmacies cannot dispense marijuana even in the states that have passed the laws.

The State Debates

The New Jersey Compassionate Use Medical Marijuana Act, was introduced in 2005 by state Senator Nicholas Scutari, and has since attracted several cosponsors in the Senate and Assembly. There have been two hearings but no votes.

Proponents say marijuana is the only drug that works quickly to relieve debilitating pain, nausea, dizziness, and headaches caused by many conditions, and say it's safe, in part, because there is no known lethal dose.

"We estimate that 30,000 to 50,000 people in New Jersey are suffering needlessly or are risking arrest or imprisonment because they can't get safe or easy access to medical marijuana," said Ken Wolski, RN, MPA, executive director of the Coalition for Medical Marijuana in New Jersey.

Opponents say there is no evidence that the drug is safe, that it may, in fact, harm patients, and that the advocates are trying to push legalizing all marijuana. They say there are synthetic drugs with some of the same properties as marijuana, such as Marinol, that already have FDA approval.

"We're not against anything being used as medicine, as long as it goes through our normal drug approval process, which is the FDA drug approval process," said David Evans, spokesman for the Drug-Free Schools Coalition, which has been lobbying against medical marijuana in several states. "We only want to use a medicine if it's safe and effective. Marijuana has not met that test."

"And there is a hidden agenda," Evans says. "They are using sick people to promote their political agenda, which is to legalize marijuana."

Two Sides to Every Issue

Several health organizations, including the NJSNA, the ANA, and the American College of Physicians, have come out with statements favorable to medical marijuana.

The American Medical Association, the National Multiple Sclerosis Society, and the American Cancer Society, are among those that have rejected smoking marijuana as medicine.

Sharon Rainer, MSN, APN, deputy executive director of the NJSNA, says the association easily passed the 2002 resolution in support of medical marijuana. She says two sticking points were the smoking aspect, both for the patient and those who would be exposed to secondhand smoke, and nurse practitioners' fear that they would be criminally liable for prescribing the drug.

Regarding the smoking issue, she says, "At that point, it was risk versus benefit, and we felt that if people have tried other things and all else has failed, then the benefit would outweigh the risk." Language written into the bill would protect those prescribing marijuana.

Both sides cite scientific evidence in their arguments.

On April 20, 2006, the FDA issued a statement saying, "There is sound evidence that smoking marijuana is harmful. A past evaluation by several Department of Health and Human Services agencies, including the FDA, Substance Abuse and Mental Health Services Administration, and National Institute for Drug Abuse, concluded that no sound scientific studies supported medical use of marijuana for treatment in the U.S., and no animal or human data supported the safety or efficacy of marijuana for general medical use."

The National Institute of Medicine noted in a 1999 report: "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."

Tough Fight Ahead

In Michigan, the campaign to pass a similar law took a year and a half, says Dianne Byrum, a former Michigan legislator and head of the Michigan Coalition for Compassionate Care Campaign. It passed with 63% of the vote. She says it was the chance to put it before the people that made the difference.

"You cannot get a legitimate public policy debate around marijuana in its medical use," she says. "You might have a hearing, but you're not going to get a vote — at least not in Michigan. There aren't enough people who will come forward to have a scientific and medical discussion rather than a political discussion."

"But this overwhelmingly favorable vote means we are now going to have a medical discussion in Michigan. Ultimately, this will force the federal government to engage in a scientific and medical discussion."

Wolski knows that the effort in New Jersey — where passage is up to the legislature and not a ballot initiative — will be a tough fight. He says that New Jersey tends to be conservative on such issues. But he is encouraged by the fact that New Jersey's law is by some measures more conservative than Michigan's.

"I'd like to think we could get this done in 2009," Wolski said. "We have 25% of the country living under a medical marijuana state, and if New York and Wisconsin agree that medical marijuana would be a good idea, that would put more pressure on New Jersey legislators."


Marcia Frellick is a freelance writer. To comment, e-mail editorPA@NursingSpectrum.com.
Patient Speaks Out

Scott Ward, 25, who lives outside Trenton and has multiple sclerosis, says marijuana is the only drug that keeps his nausea, dizziness, weakness, and headaches at bay. He was diagnosed in November 2006, and, he says, because of his age, physicians aggressively prescribed more than two dozen drugs over time.

He has stopped taking them and relies now on the only thing that he says works — about an ounce of marijuana a day. Without legalization, Ward says, he will continue to risk arrest every day.

Ward, who testified before the N.J. Assembly Health and Senior Services Committee in May 2008, said about the prescribed drugs, "They had no benefit that I could tell. This is what works for me. Maybe it doesn't work for other people. But they should have the chance to find out."

Ward testified in favor of a bill proposing that the state would establish a list of eligible patients, mostly those with terminal or chronic conditions, such as MS, AIDS, or cancer. Each would receive an ID card that would allow him or her to grow no more than six plants and possess one ounce of usable marijuana.

The oversight of such a law and control over access are of particular concern to the opposition.