Good Medicine

Q. Should marijuana be legalized for medical use?

A. “Marijuana as a medicine needs to be approached as many other medicines are approached: with thoughtfully-designed, randomized, controlled trials to determine safety and effectiveness. It is somewhat difficult to give a blanket, affirmative answer to the issue of legalization. The reason is that for several conditions that we have an important role in treating, there is evidence that marijuana constitutes a major risk factor for the illness. I’m actually just starting to do a study on this. It constitutes a risk factor, not necessarily for everyone, but for people who have a genetic or other vulnerability to the development of schizophrenic illness.”

— Theo Manschreck, M.D., president, Massachusetts Psychiatric Society

A. “If Massachusetts enacts legislation that requires a physician’s recommendation or prescription before an individual may legally possess or use marijuana, doctors will appear to incur the risks of civil liability for patient injuries, adverse interactions and contraindications. They stand exposed not only to civil liability and administrative investigations, but also to potential federal prosecution for distributing or recommending distribution of an illegal substance under federal law. What, if any, effective protections might be put into place by the Commonwealth if legalization is pursued is an open question.”

— Anthony E. Abeln, associate, Morrison Mahoney LLP, Boston

“I do not support approving marijuana for medical purposes. In 2006, the FDA reiterated that smoked marijuana does not meet existing standards of safety and efficacy for modern medicine. Chronic smoked marijuana is detrimental to health – it is teratogenic; increases the risk of pulmonary, cardiac and bone diseases; compromises cognitive function; is addictive and is implicated in psychiatric conditions. Approval will send a wrong message that cigarettes and marijuana are safe, and the process of ballot initiatives for drug approval sets a dangerous precedent by circumventing FDA standards. Also, The Institute of Medicine has declared that smoking marijuana is not modern medicine and should not be recommended generally for medical use. ”

— Bertha Madras, Ph.D., professor of psychobiology, Harvard Medical School

“I have no first-hand knowledge of the benefits of medical marijuana. I am aware that in other states and countries, it has been used to reduce suffering and as palliative treatment for various neurologic conditions such as multiple sclerosis, severe chronic pain, neuromuscular disorders and seizures. Instead of relying on anecdotal evidence, I would support funding for studies and clinical trials to evaluate its potential uses and benefits, as well as its risks and adverse effects. If it is legalized for medical use in this state, I would need to increase my knowledge base to be able to make informed decisions about the use of the drug/plant in cases of appropriate neurologic care.”

— Alan Kurland, M.D., president, Massachusetts Neurologic Association