We rarely worry about marijuana. So why is it still a Schedule I drug?
On August 11th, the Drug Enforcement Administration announced its decision to keep marijuana classified as a Schedule I drug. The federal government has historically referred to this category as the most dangerous group of substances, including drugs like heroin and bath salts.
As a resident physician specializing in mental health, I can't make much sense of this.
Every day, I talk to patients about substance abuse. Whether evaluating patients in clinic, in the emergency department, or on inpatient units, my colleagues and I screen patients for substance use. It's a vital component of any clinical interview, particularly in mental health care, and helps us understand patients' habits and their risks for medical complications.
During my medical training, I've learned which substances to worry about, and which ones matter less.
Alcohol is usually the first substance I ask about. Many people have seen drinking go wrong, be it a friend making a bad decision or a family member struggling with alcoholism. But clinicians see the worst of this on the front lines.
Intoxicated patients stream into emergency departments after crashing their cars, inhaling their own vomit, or falling into a coma. According to the National Institutes of Health, alcohol-related conditions contributed to more than 1.2 million emergency department visits in 2010. The Centers for Disease Control reports excess alcohol consumption causes roughly 88,000 deaths in the US each year.
And alcohol can be just as frightening when patients stop drinking. Heavy drinkers who don't consume as much as they usually do can go into alcohol withdrawal, ranging from mild tremors to terrifying seizures and death. I've spent much of my residency training so far learning how to treat and recognize complications from alcohol withdrawal.
It's not only alcohol that clinicians worry about. Cocaine can cause heart attacks, kidney failure, and complications during pregnancy like placental abruption. Methamphetamine can trigger an assortment of responses, from hyperthermia to violent agitation to cardiogenic shock. Opioids like morphine can plunge patients into respiratory failure and kill them. Intravenous drug use puts patients at risk for hepatitis, endocarditis, or even brain abscesses.
But, for most health care providers, marijuana is an afterthought.
We don't see cannabis overdoses. We don't order scans for cannabis-related brain abscesses. We don't treat cannabis-induced heart attacks. In medicine, marijuana use is often seen on par with tobacco or caffeine consumptionsomething we counsel patients about stopping or limiting, but nothing urgent to treat or immediately life-threatening.
The federal government's scheduling of marijuana bears little relationship to actual patient care. The notion that marijuana is more dangerous or prone to abuse than alcohol (not scheduled), cocaine (Schedule II), methamphetamine (Schedule II), or prescription opioids (Schedules II, III, and IV) doesn't reflect what we see in clinical medicine.
This isn't to say marijuana is harmless.
Indeed research suggests it may have deleterious effects on the developing brains of adolescents. Marijuana use has been linked to psychotic symptoms in some individuals. Synthetic marijuana has emerged as a new public health challenge and, in 2012, Congress added many of these toxic compounds as separate entities under the Schedule I category.
According to NPR, Chuck Rosenberg, acting head of the DEA, explained the decision to keep marijuana as a Schedule I drug was based more on whether marijuana, as determined by the FDA, is a safe and effective medicine."
Regulations have prevented US researchers from answering this question over the last several decades. As written in a recent New York Times editorial, "the government itself has made it impossible to do the kinds of trials and studies that could produce the evidence that would justify changing the drug's classification."
Yet, according to a 2015 systematic review, studies from around the world suggest cannabis and cannabinoid therapies may help patients in a number of ways. These include treating chronic pain, muscle spasms, debilitating side effects of chemotherapy like nausea, and weight loss from HIV infection. Dozens of US states have listened to such findings in recent years and passed legislation approving the use of medical marijuana.
Despite keeping marijuana as a Schedule I substance, the Obama administration has promised to expand national research into the drug. This is a welcome change, and we'll hopefully develop deeper insights into the risks and the benefits of cannabis use.
In the meantime, our nations substance policies should be grounded in the realities of clinical practice.
In hospitals across the country, patients writhe in agony from alcohol withdrawal, turn violent from crystal meth, and struggle to breathe after overdosing on prescription opioids. These are the cases that keep health care providers on edge. These are the patients we follow closely. When our pagers go off, we hurry to the bedside, give medications, alert security or even begin resuscitation.
With marijuana? Not so much.
#1: misterwhite To: Deckard (#0)
Here we f**king go again. Set up that "dangerous" -- no, "most dangerous" -- strawman and knock him down!
misterwhite posted on 2016-08-24 11:30:23 Reply Private Reply
#2: misterwhite To: Deckard (#0)
Benefits, my ass. There isn't one thing that cannabis does that 10 other FDA- approved drugs do better.
And when researchers isolate, purify and concentrate one cannabinoid chemical compound found in marijuana and state that it may be helpful in treating "X" disease, suddenly a million dopers declare they have "X" disease and interpret that as a green light to smoke weed.
misterwhite posted on 2016-08-24 11:39:12 Reply Private Reply
#3: rlk To: misterwhite (#2)
bingo!
rlk posted on 2016-08-24 11:51:24 Reply Private Reply
#4: Deckard To: misterwhite (#1)
Good grief - you are a fucking idiot.
Deckard posted on 2016-08-24 11:53:00 Reply Private Reply
#5: Deckard To: misterwhite (#2)
Which Big-pharma company do you work for shill?
Deckard posted on 2016-08-24 11:54:08 Reply Private Reply
#6: ConservingFreedom To: misterwhite (#1)
Back to that lie? "Schedule I drugs are considered the most dangerous class of drugs" - https://www.dea.gov/druginfo/ds.shtml
ConservingFreedom posted on 2016-08-24 12:06:18 Reply Private Reply
#7: ConservingFreedom To: misterwhite (#2)
For every single patient?
ConservingFreedom posted on 2016-08-24 12:07:43 Reply Private Reply
#8: Deckard To: ConservingFreedom (#6)
He can't help himself.
"Schedule I drugs are considered the most dangerous class of drugs"
That fact is even linked in the first paragraph of the article, and whitey still can't admit it.
Deckard posted on 2016-08-24 12:41:28 Reply Private Reply
#9: Pinguinite To: misterwhite (#2)
Do you mean to say that one must take 10 different FDA approved drugs to achieve what Cannabis can do alone? It's often the case where a cocktail of FDA drugs is prescribed for a single condition.
Many people, namely AIDS and cancer patients, would disagree. FDA approved drugs that would substitute for Cannabis often come with very unpleasant side effects.
There was an author named Peter McWilliams, who was a strong advocate for medical marijuana. He had, I think, cancer and took cannabis as part of his treatment. He was arrested and charged. Denied any permission by the court to mention his medical condition to the jury, he took a plea to stay out of jail. Forced to live with his mother, his mother's house was on bond, forfeited if he ever tested positive for Cannabis. So he stayed away from it.
He died soon after, choking one night after becoming nauseous, which is one thing Cannabis would have prevented.
Yes, it's only one person and one example. Feel free to call him scum that should never have lived in the first place.
Pinguinite posted on 2016-08-24 12:47:34 Reply Private Reply
#10: ConservingFreedom To: Deckard (#8)
I notice that link is to a web.archive.org page - turns out that between the 18th and the 19th of this month the DEA removed that statement from their page. Hilarious!
ConservingFreedom posted on 2016-08-24 13:06:20 Reply Private Reply
#11: Deckard To: ConservingFreedom (#10)
Gee - now why would they go and do that?
No wonder whitey is confused.
Deckard posted on 2016-08-24 13:45:31 Reply Private Reply
#12: misterwhite To: Pinguinite (#9)
Nope. Pick one.
"Yes, it's only one person and one example."
Uh- huh. Which is why I ignore anecdotal stories.
misterwhite posted on 2016-08-24 13:56:53 Reply Private Reply
#13: misterwhite To: Deckard (#11)
Probably for the same reason they no longer promote the movie Reefer Madness. Doesn't stop you though.
misterwhite posted on 2016-08-24 14:20:40 Reply Private Reply
#14: misterwhite To: ConservingFreedom (#6)
Hmmmm. Nothing on your link about "most dangerous".
misterwhite posted on 2016-08-24 16:47:21 Reply Private Reply
#15: nolu chan To: Deckard (#0)
What DEA really announce: HHS, not DEA, evaluates for medical use. An international treaty requires maintaining marijuana as a scheduled drug. Congress established only one schedule, schedule I, for drugs of abuse with no currently accepted medical use in treatment in the United States and lack of accepted safety for use under medical supervision. 21 U.S.C. 812(b).
nolu chan posted on 2016-08-24 16:56:33 Reply Private Reply
#16: Gatlin To: Pinguinite, misterwhite, nolu chan (#9)
You make it sound like Peter McWilliams was arrested and charged for taking cannabis as part of his treatment.
Oh, the poor baby .that is not so!
McWilliams was a gay man who contracted HIV which developed into the associated non-Hodgkins lymphoma. He contacted Aids in 1996, the same year California voters approved Prop 215.
McWilliams got written verifiable recommendations from two California board licensed physicians and he was entitled to legally purchase marijuana from any dispensary in California and he could legally grow, consume and possess marijuana under California State Law Prop 215.
With state law authorizing the treatment that he found most effective and with the wherewithal to grow it at home, Peter McWilliams might have been home free. But he wanted, as was his wont, to do more.
He made an arrangement with another patient, Tod McCormick for McCormick to grow marijuana. McWilliams financed the rental of a large, old and almost gutted house in Bel Air as a greenhouse. McCormick was arrested and charged with cultivation for sale as the Bel Air Mansion Pot Grower. McWilliams finance the growing operation and was also arrested.
At his death, McWilliams was waiting to be sentenced in federal court after being convicted of having conspired to possess, manufacture and sell marijuana after he and McCormick were charged with growing more than 4,000 marijuana plants.
Gatlin posted on 2016-08-24 17:31:39 Reply Private Reply
#17: ConservingFreedom To: misterwhite (#14)
Not any more - they pulled that text a few days ago: web.archive.org/web/20160...dea.gov/druginfo/ds.shtml
ConservingFreedom posted on 2016-08-24 17:45:33 Reply Private Reply
#18: misterwhite To: ConservingFreedom (#17)
Probably because it was an outdated position they no longer have. NOW what are you going to do?
misterwhite posted on 2016-08-24 19:20:30 Reply Private Reply
#19: misterwhite To: Gatlin (#16)
misterwhite posted on 2016-08-24 19:24:17 Reply Private Reply
#20: Gatlin To: misterwhite (#19)
I give no sympathy or agreement until I have learned the other side of the story or the rest of the story.
Gatlin posted on 2016-08-24 19:38:15 Reply Private Reply
#21: ConservingFreedom To: misterwhite (#18)
If by that you mean they realized that continuing to claim that marijuana was one of the "most dangerous" drugs had become so laughable as to do them more harm than good.
ConservingFreedom posted on 2016-08-25 17:34:29 Reply Private Reply
#22: nolu chan To: ConservingFreedom, misterwhite (#21)
It appears they became sensitive to the fact that their phrasing did not comport with the Schedule I definition at 84 Stat. 1247 (1970).
84 Stat. 1236, 1247 (1970). It is codified at 21 U.S.C. § 812 without textual change.
nolu chan posted on 2016-08-25 18:58:53 Reply Private Reply
#23: ConservingFreedom To: nolu chan (#22)
Yes, "became sensitive" after at least 45 months of having that text on that page, just at the time when their decision to not reschedule was drawing attention to that page.
ConservingFreedom posted on 2016-08-25 19:14:35 Reply Private Reply
#24: A K A Stone To: ConservingFreedom (#23)
A K A Stone posted on 2016-08-25 19:41:35 Reply Private Reply
#25: ConservingFreedom To: A K A Stone (#24)
Was it commies who ended the Prohibition of the stupid-making drug alcohol?
ConservingFreedom posted on 2016-08-25 20:21:31 Reply Private Reply
#26: A K A Stone To: ConservingFreedom (#25)
A K A Stone posted on 2016-08-25 20:25:58 Reply Private Reply
#27: ConservingFreedom To: A K A Stone (#26)
Nope - the subject was drugs and their unbanning.
ConservingFreedom posted on 2016-08-25 20:27:37 Reply Private Reply
#28: A K A Stone To: ConservingFreedom (#27)
A K A Stone posted on 2016-08-25 21:32:30 Reply Private Reply
#29: buckeroo To: A K A Stone (#28)
Glad you cleared that distinction all up, Stone. For the longest tyme, I was afraid you were confused.
buckeroo posted on 2016-08-25 21:35:49 Reply Private Reply
#30: nolu chan To: ConservingFreedom, A K A Stone (#27)
Marijuana has not passed the tests that every drug must pass. Anecdotal evidence from the illegal use of marijuana does not suffice.
For medical use, Medical marijuana requires that the product be of a known strength and purity.
Even grandpappy making perfectly good shine, if he wants to go legal and get licensed, probably would have to do some things that he does not do when making his shine.
And to get a schedule change, there nothing like reading who does it according to federal law.
The Attorney General requests from the Secretary (not DEA but DHHS) a scientific and medical evaluation, and recommendations. The Attorney General considers and acts upon schedule changes. DEA is an enforcement agency, not a medical or scientific department. It is part of the Department of Justice.
In the case of an applicable treaty, and there is one, removing a drug from the schedule would require a change in the treaty or federal law.
http://law.justia.com/codes/us/2014/title-21/chapter-13/subchapter-i/part-b/sec.-811/
nolu chan posted on 2016-08-26 00:01:34 Reply Private Reply
#31: buckeroo To: nolu chan (#30)
Or are you really understanding and knowing the goddamned concept that: GOVERNMENT CAN NOT ENFORCE MARIJUANA LAWS?
buckeroo posted on 2016-08-26 00:33:29 Reply Private Reply
#32: misterwhite To: ConservingFreedom (#21)
They never claimed that. Geez Louise. Why do you repeat the lie? They were referring to Schedule I.
So I'm guessing they dropped that descriptor because ignorant people like you insisted on applying it to marijuana. Now it's gone. As is your argument.
misterwhite posted on 2016-08-26 09:18:09 Reply Private Reply
#33: misterwhite To: buckeroo (#31)
Correction. Marijuana is an illegal backyard weed.
misterwhite posted on 2016-08-26 09:20:00 Reply Private Reply
#34: misterwhite To: nolu chan, ConservingFreedom (#22)
Good point. The Controlled Substances Act passed by Congress almost 50 years ago never used the phrase "most dangerous". Adding it was inflammatory, disingenuous and incorrect.
misterwhite posted on 2016-08-26 09:27:17 Reply Private Reply
#35: ConservingFreedom To: misterwhite (#32)
Which Schedule has marijuana been on for the entire history of Schedules, dissembling fuckwit?
ConservingFreedom posted on 2016-08-26 10:49:19 Reply Private Reply
#36: ConservingFreedom To: misterwhite (#34)
That's the War on Drugs for you.
ConservingFreedom posted on 2016-08-26 10:50:03 Reply Private Reply
#37: ConservingFreedom To: A K A Stone (#28)
Nobody said nor implied they were the same - the issue is, what reason there is to think that legalization of the latter but not of the former would make "America drugged and stupid so that we fall as a nation."
ConservingFreedom posted on 2016-08-26 10:56:28 Reply Private Reply
#38: Roscoe To: misterwhite (#33)
Roscoe posted on 2016-08-26 10:58:05 Reply Private Reply
#39: nolu chan To: buckeroo (#31)
It is a backyard weed that can send you to prison in all 52 federal jurisdictions. Possession, cultivation or distribution of any amount of marijuana, for medical use or otherwise, is a Federal crime, regardless of any state blatherings.
If they go after two or more potheads, they can charge conspiracy and need only prove that at least one of the co-conspirators took an overt act in furtherance of the conspiracy. All your personal property used in furtherance of the conspiracy can be forfeited to the government. And you can get a long stretch in prison.
Gonzales v. Raich arose in California via the 9th Circuit Court and was decided in the U.S. Supreme Court. It remains good law and slaps down all state laws inconsistent with federal law. The Supreme Court clearly stated, "The Supremacy Clause unambiguously provides that if there is any conflict between federal and state law, federal law shall prevail."
Gonzales v. Raich, 545 U.S. 1, 27-29 (2005)
nolu chan posted on 2016-08-26 18:31:13 Reply Private Reply
#40: nolu chan To: buckeroo (#31)
Have you considered ministering to the prison population?
nolu chan posted on 2016-08-26 18:32:49 Reply Private Reply
#41: ConservingFreedom To: nolu chan (#39)
Interesting!
ConservingFreedom posted on 2016-08-26 20:05:54 Reply Private Reply
#42: nolu chan To: ConservingFreedom (#41)
Problematic.
Nobody that matters is performing the requisite tests. Whoever controls whether testing gets done could get rich just arranging for donations from alcohol industry lobbyists to his trust fund.
nolu chan posted on 2016-08-26 23:14:29 Reply Private Reply