Examining the debate on the use of medical marijuana

The opium poppy and the coca leaf offer useful perspectives on the current controversies over medical marijuana. In both cases, purified synthetic ana logues of biologically active components of ancient folk remedies have beco me medical mainstays without undermining efforts to reduce nonmedical drug use. A decade ago, a campaign strove to legalize heroin for the compassiona te treatment of pain in terminally ill patients. Like the current campaign to legalize medical marijuana, many well-meaning people supported this effo rt. The campaign for medical heroin was stopped by science when double-blin d studies showed that heroin offered no benefits over the standard opioid a nalgesics in the treatment of severe cancer pain. Scientific medicine requires purified chemicals in carefully controlled dos es without contaminating toxic substances. That a doctor would one day writ e a prescription for leaves to be burned is unimaginable. The Controlled Su bstances Act and international treaties limit the use of abused drugs or me dicines. In contrast to smoked marijuana, specific chemicals in marijuana o r, more likely, synthetic analogues, may prove to be of benefit to some pat ients with specific illnesses. Most opponents of medical use of smoked mari juana are not hostile to the medical use of purified synthetic analogues or even synthetic tetrahydrocannabinol (THC), which has been available in the United States for prescription by any licensed doctor since 1985. In contr ast, most supporters of smoked marijuana are hostile to the use of purified chemicals from marijuana, insisting that only smoked marijuana leaves be u sed as "'medicine," revealing clearly that their motivation is not scientif ic medicine but the back door legalization of marijuana.