The opinion by Bertha Madras, Ph.D. on medical marijuana, “A Blunt Force to Crush Floridians' Opposition to Marijuana,” (March 2) prior to the Legislature passing HB 307 “The Medical Use of Cannabis,” shows troubling misunderstanding of the subjects where she claims expertise. Her letter was circulated widely as a pro-prohibition manifesto, though the governor has just signed the bill.
Madras seems unaware that nearly 58 percent of Florida voters said YES to medical marijuana in 2014, and polls consistently show 80 percent support for the general concept.
Contrary to Madras’ assertions, cannabis is remarkably safe with well-recognized therapeutic uses. It can be created using best practices for growing food and processed using existing standards for human consumption. High standards should include forbidding dangerous pesticides and implementing serious penalties for their use: exactly opposite what was forced into HB 307.
The bill doesn’t go near far enough, extending the right to try cannabis only to the terminally ill. It codifies a big-investor, pseudo-monopoly system that shuts out small businesses and job-making entrepreneurs, ignoring that free market pressures are the best force to drive quality control and affordability to patients.
Where cannabis is currently allowed by the terminally ill, benefits it affords people in the dying process and the comfort it provides to survivors are palpable. Acknowledging in law the recognized palliative benefit of whole-plant cannabis, not just low-THC varieties, is a minimal step toward a policy based in real understanding of this medicine.
According to the Greek historian Herodotus, cannabis was used in ancient civilizations as a grieving ritual, performed when someone in the community died. This was using cannabis as medicine, not only for those on death’s door but for those trying to move on with life. Today, using cannabis to alleviate stress and anxiety following trauma is well supported by preclinical research, but federal agencies tenaciously stonewall clinical trials that could yield stronger data.
Madras raised numerous false flags to divert Florida voters. Anecdotally, patients who use cannabis have positive clinical outcomes, seemingly better than other patient groups. We see this validated in increasing numbers of scientific studies made possible only as governments repeal prohibition. The same meta-analyses Madras refers to actually found good support for the use of cannabis for pain and spasticity, conditions where high quality clinical trials have been allowed.
While warning of high potency THC, Madras fails to mention an FDA approved synthetic version of 100 percent THC in pill form already exists. A 50 percent THC mixture called nabiximols is also widely used in other countries with an excellent safety profile. Israel is using medicinal cannabis with great success.
She warns of drugged drivers causing accidents but terminally ill people often use more debilitating drugs for symptom control. According to the Insurance Institute for Highway Safety, when researchers controlled for demographic factors (age, gender, ethnicity) and alcohol use, they didn't find an increase in crash risk associated with marijuana use. Experiments to directly test driving impairment find cannabis clearly safer than alcohol.
Most disturbing is Madras’ assertions about cannabis and the brain, an area where drug war luminaries selectively cite poorly controlled studies. Other highly reputable studies that control for things like multi-drug use, alcohol use, socio-economic factors or family genetics have found no difference between users and non-users.
New research published in JAMA Psychiatry finds that although cannabis use has gone up in recent years, problems associated with its use such as addiction have not. While we are sensitive to issues of cannabis dependence, Madras hyperbolizes the risk and severity of withdrawal, conflating findings from heavy, chronic teen users with the issue that is actually at hand: the regulated use of cannabis as a medicine.
We are cannabis reformers fighting for patients, not profits. We urge voters to keep focus on what the majority of Floridians understand quite well: cannabis is real medicine, and reforming cannabis policy is a moral imperative.
Greg Gerdeman, Ph.D. is a a neurophysiologist with expertise in the endocannabinoid system and mechanisms of drug reward and addiction; Josephine Cannella-Krehl is a licensed clinical social worker working in the field of hospice & palliative care; and Jodi James, director of FLCAN.org, is dedicated to developing strategies for the creation of sensible cannabis policies.
