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Is the Acceptance of Marijuana Reaching a Tipping Point?

Polls show a majority of Americans support legalization of marijuana and 29 states now have some form of marijuana legalization.

marijuana

Marijuana is a smoking hot topic in the United States.

A CBS News poll released this month showed that 61 percent of people in the United States think marijuana should be legal. That's an all-time high.

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In addition, 88 percent said they favor legalizing medical marijuana use.

Earlier this month, another poll revealed that 52 percent of Americans over the age of 18 have tried marijuana at least once in their lives.

On Wednesday, the governor of West Virginia signed legislation that allows seriously ill patients to use medical marijuana if their doctors recommend it.

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West Virginia is now the 29th state to approve some form of legal marijuana use, along with Washington, D.C.

In eight states, recreational marijuana use is now legal. Four of those states passed pro-marijuana ballot measures last November.

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In 14 states, post-traumatic stress disorder (PTSD) is an approved condition for treatment with medical marijuana.

According to Arcview Group, which monitors the marijuana industry, recreational and medical sales of marijuana in the United States skyrocketed in 2015 to $5.4 billion, up 17 percent from $4.6 billion in 2014.

An estimate out this week predicts the marijuana industry will be worth $50 billion by 2026.

I don't see any way that anyone is going to stop total legalization in the not-too-distant future.
David Matt Green, marijuana legalization advocate

“I believe we have reached a tipping point when it comes to marijuana,” David Matt Green, a cancer survivor who’s been using medical marijuana for cancer-related pain and anxiety for several years, told Healthline last fall.

Green, an advocate for marijuana legalization for decades, has believed since the 1990s that the federal government would not act until a majority of states changed their laws by either legalizing marijuana or lessening the severity of punishment for possessing or selling it.

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More than half of the states have now done that, he said, “and I don't see any way that anyone is going to stop total legalization in the not-too-distant future. The truth about marijuana as both a medicine and a healthier substitute for alcohol is getting out into the world, and it will set the plant free.”

In September, Dr. Sanjay Gupta, the neurosurgeon and CNN medical correspondent, announced he was wrong for denouncing marijuana legalization for years and said he has changed his mind.

“I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis,” wrote Gupta.

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He said marijuana “doesn't have a high potential for abuse, and there are very legitimate medical applications. In fact, sometimes marijuana is the only thing that works.”

Read more: Does legalization of marijuana increase teen use? »

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Spreading like weeds

A growing number of Americans evidently agree with Green and Gupta.

As the recent polls indicate, attitudes about both medical marijuana and the legalization of small amounts for personal use have changed.

Amid this unprecedented activity on the pro-marijuana side, though, there are still some caveats. The primary one being marijuana remains an illegal drug in the eyes of the federal government.

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Some marijuana critics insist that recreational legalization and the proliferation of medical marijuana will lead to a larger number of young people consuming it.

Marijuana advocates, however, say there is simply no evidence of this.

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Read more: Marijuana and telemedicine, ordering over Skype »

A family’s ordeal

Others have pointed out that in states such as Washington, legalization has led to less accessibility.

There are fewer places to purchase medical marijuana and there are higher prices caused by the corporatization of the plant.

Meagan Holt and her husband, Brandon Holt, from Everett, Wash., are doing all they can to keep their daughter, Maddie Holt, alive.

Maddie, who is 3, has Zellweger syndrome, a rare and terminal genetic disorder that causes seizures.

The family tried everything, including a variety of medications, but in April 2015, doctors told them there was nothing more they could do.

Maddie, who is deaf and blind, entered Hospice care.

Meagan then started looking into medical marijuana. And after giving Maddie the first dose of cannabis oil, she said there was a dramatic change not unlike that in the child in the poignant movie “Lorenzo’s Oil,” about the once-homemade remedy that is now a widely accepted treatment for Adrenoleukodystrophy (ALD).

Cannabis saved [my daughter’s] life. She has gone several days, even weeks, completely seizure-free.
Meagan Holt, Washington mother

Maddie’s seizures are not completely gone, Meagan said, but she breathes through them and no longer has hour-long events where she requires CPR, Meagan said.

“Cannabis saved her life.” Meagan said. “She has gone several days, even weeks, completely seizure-free.”

But as a result of the legalization of marijuana for recreational use in Washington, the state's 1,500-plus marijuana dispensaries will reportedly no longer exist.

In their place will be a couple hundred new retail stores licensed by the state.

Meagan is concerned that this will make medical marijuana much less accessible for Maddie and others who need it most.

She said the retail stores will not be able to maintain the supply of special cannabis-based oils — both CBD oil and THC oil — to treat Maddie.

“Maddie is off hospice and on palliative care, and continues to make improvements despite having a disease that is only known for being progressive,” Meagan said.

The bottom line, Meagan added, is that natural treatments should not only be available to all but should be first-line options.

“I am on a mission to educate others on the healing properties of cannabis, but to also empower every American to stand up for themselves and understand that healthcare is a business, and you are the customer,” she said. “It is time the government stops telling us what is best for us.”

Read more: If marijuana is medicine, why can’t we buy it in pharmacies? »

The DEA’s heavy hand

Despite growing support for cannabis, the Drug Enforcement Administration (DEA) still refuses to reschedule marijuana from its current prohibitive Schedule 1 status.

Federal officials still see marijuana as having no medical benefits and have kept it in the same forbidden class of drugs as heroin and LSD.

While technically this means that possessing or selling the ancient herb can still land you in jail, it is increasingly rare that first-time offenders are locked up, say law enforcement officials.

However, drug laws are not retroactive and are generally not reversible, except for a few programs scattered across the country that release nonviolent drug offenders early.

Multiple sources interviewed for this story were quick to point out that there are still people doing hard time in American prisons for selling small amounts of marijuana.

In addition, federal law still prohibits doctors from prescribing marijuana. Doctors can only write a recommendation for medical marijuana, which is not the same as a prescription.

Read more: Vietnam veterans still have PTSD 40 years after the war »

Veterans denied marijuana

The U.S Department of Veterans Affairs (VA) continues to deny disabled and other former soldiers access to marijuana through the VA system.

The agency forbids VA doctors to even discuss it with patients.

Veterans nationwide are urging the VA to allow its doctors to write prescriptions and talk about medical marijuana with patients.

Even the historically staid American Legion, among the largest and oldest of America’s veteran service organizations with 2.4 million members, has joined this battle cry.

Earlier this month, Legion members passed a resolution to promote research on marijuana’s potential use for treating PTSD and traumatic brain injury (TBI).

The resolution noted that with the DEA’s recent approval of a study on the effectiveness of cannabis for PTSD, Congress should remove marijuana from its Schedule 1 designation.

“Amend legislation to remove marijuana from Schedule 1 and reclassify it in a category that, at a minimum, will recognize cannabis as a drug with potential medical value,” the Legion wrote.

Two weeks ago, New Jersey Gov. Chris Christie signed a measure allowing people to use marijuana if their PTSD isn’t treatable with conventional therapy. While the measure makes New Jersey the 18th state to allow medical marijuana to be used to treat the condition, there isn't exactly an abundance of studies on cannabis and PTSD.  

But there is anecdotal evidence from thousands of veterans across the country that scientists and researchers are now acknowledging.

In Germany, studies on mice showed evidence that marijuana can help with PTSD. And a study published two years ago by George Greer in the Journal of Psychoactive Drugs concluded that “marijuana is associated with reductions in PTSD symptoms in some patients.” 

But there have been no randomized, controlled studies in the United States for PTSD using the plant instead of synthesized marijuana or oils.

That's about to change.

Stars and Stripes reported in April that the DEA has approved the first randomized, controlled clinical study that will assess the safety and efficacy of four types of smoked marijuana to manage chronic, treatment-resistant PTSD symptoms.

The lead investigator of the study, which is expected to get under way in a matter of days, is Sue Sisley, a psychiatrist with the Scottsdale Research Institute in Arizona, who's treated patients with PTSD for more than 20 years.

Sisley told Newsweek in 2015 that “a mountain of anecdotal evidence was piling up over the last decade” from veterans and others who have used marijuana for their PTSD. 

Sisley told Stars and Stripes that she is “determined to find new treatments for PTSD — besides the only two [FDA] approved medicines on the market, Zoloft and Paxil, which are both highly disappointing.”

Sisley added that while she is not expecting the study to find that cannabis is a cure for PTSD, “What we are hoping is that cannabis is alleviating the suffering of PTSD patients and not just masking it. This is a distinction that can only be evaluated through a randomized controlled trial.”

Read more: Children’s accidental exposure to marijuana »

Saved by marijuana

Erik Knowles served more than five years in the Marines.

That included a rugged six-month deployment during the Iraq War in Jalibah, a combat zone in southern Iraq about 90 miles west of Basra.

After returning to civilian life, he suffered from deep depression and considered suicide multiple times. He was given antidepressants, but nothing worked for him until he tried medical marijuana.

“I never smoked pot in high school. I was a straight arrow, a jock who used to tell on dope smokers,” Knowles said.

But marijuana changed his life. It enabled him to get off antidepressants, stop drinking, and pursue a long-held dream of becoming a stand-up comedian.

I know veterans who try pot and then they sleep for the first time in days, even months. Cannabis can save these guys’ lives.
Erik Knowles, former Marine

A few weeks ago, that vision reached its apex when Knowles won the World Series of Comedy competition in Las Vegas.

It’s quite an impressive accomplishment for the Marine corporal, now a fast-rising comedian whose first album comes out next March on Uproar Records.

Knowles’ life in the Marines is the basis for an upcoming situation comedy, “High and Tight,” about a Marine who gets by with the help of medical marijuana.

“I’ve seen how many of my friends who’ve served have been helped by marijuana,” said Knowles, a married father of four, who’s dedicated his life and career to lowering the high suicide rate among America’s veterans.

Currently, 20 veterans commit suicide every day.

“I know veterans who try pot and then they sleep for the first time in days, even months,” he said. “Cannabis can save these guys’ lives. But the VA leaves veterans’ hands tied. The VA has a real opportunity to become more open-minded and get veterans off the addicting opioid painkillers and psychotropic drugs.”

Read more: Gulf War veterans are still fighting serious health issues »

How the VA views it

Officials at the VA have consistently said that they recommend their physicians use “evidence-based” practices — therapies proved by scientific research to be effective — to treat mental and physical health conditions such as PTSD, depression, and pain.

But Knowles and many other critics of this policy point to the damage being done by current psychotropic drugs as well as painkilling opioids.

They also point to a growing number of studies that show marijuana can treat pain and PTSD.

As marijuana use is still a federal offense [the] VA will not provide for use or conduct research with illegal substances regardless of state laws.
Veterans Administration statement

In a statement sent to Healthline, a VA spokesperson said that the agency’s policy “does not administratively prohibit veterans who participate in state marijuana programs from also participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals.”

The statement continued, “As marijuana use is still a federal offense [the] VA will not provide for use or conduct research with illegal substances regardless of state laws. However, patients who participate in a non-VA marijuana program will not be denied access to care for VA clinical programs, but should be assessed for misuse, adverse effects, and withdrawal.”

The statement concluded, “While patients participating in state marijuana programs must not be denied Veterans Health Administration services, the decisions to modify treatment plans in those situations need to be made by individual providers in partnership with their patients.”

Read more: Painful headaches plaguing many war veterans »

Congress fails to do it

Critics also blame Congress.

The House and Senate failed recently to move a bill forward that would allow VA doctors to discuss medical marijuana to patients and prescribe it.

The provision was in an amendment to a VA funding bill the House passed earlier this year.

It would have allowed doctors to send VA patients to medical marijuana facilities in states where it is legal.

The Senate also approved a similar measure.

But during negotiations on the 2017 Military Construction, Veterans Affairs, and Related Agencies Act, the marijuana provision was reportedly cut by Republicans over an unrelated Zika virus funding issue.

During the debate over the issue, Rep. Earl Blumenauer, D-Oregon, stated, “The death rate from opioids among VA healthcare is nearly double the national average … What I hear from veterans is that medical marijuana has helped them deal with pain and PTSD, particularly as an alternative to opioids.”

But Rep. Charlie Dent, R-Pennsylvania, was one of several House members who opposed the idea.

“I’m uncomfortable in trying to dictate policy on medical marijuana without input from the FDA and National Institutes of Health,” he said.

Read more: New guidelines to help prevent opioid addiction »

Pot, pain, and opioids

One of the biggest problems for veterans, and the country in general, is the opioid epidemic and the related heroin crisis.

Of the 21 million Americans 12 or older that had a substance abuse issue in 2014, 1.9 million had an issue with prescription painkillers. Another 586,000 had a substance abuse issue involving heroin, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

From 1999 to 2014, more than 165,000 people in the United States died from overdoses related to prescription opioids, according to the Centers for Disease Control and Prevention (CDC).

Many medical marijuana advocates insist that the American medical establishment is still way behind in terms of recognizing cannabis as a viable painkilling alternative to dangerous opioids such as oxycodone, Vicodin, and Percocet.

Cannabis has been used for thousands of years across cultures. There is no reason to exclude it from treatment options.
Amanda Reiman, University of California, Berkeley

HelloMD, a digital healthcare platform for the cannabis industry, and the University of California, Berkeley, have just announced the launch of the largest-ever patient survey conducted on pain and opioid use.

The study will ask 100,000 of HelloMD’s registered participants questions regarding cannabis and how it has affected their use of opioids.

This is a follow-up to the company’s Comprehensive Medical Marijuana Patient Study of 17,000 patients conducted in January.

One of the study leaders, Amanda Reiman, Ph.D., M.S.W., lecturer in the School of Social Welfare at U.C. Berkeley, and manager of Marijuana Law and Policy for the Drug Policy Alliance, said in a statement, “It is imperative that we investigate alternatives to opiates for the treatment of pain. Cannabis has been used for thousands of years across cultures. There is no reason to exclude it from treatment options, and even less of a reason to discriminate against those who choose it as the best treatment for themselves.”

Read more: Why some drugs cost so much and others don’t »

People over profits

Neal Miller, an acupuncturist and Eastern medicine practitioner in Los Angeles for 30 years, treats patients suffering from pain, autoimmune conditions, cancer, and viruses.

He told Healthline that while California law does not allow acupuncturists to prescribe marijuana for medical use, he refers many patients interested in exploring the alternative to respected physicians to discuss whether it’s a viable option.

Miller said patients seeking pain relief are increasingly choosing medical marijuana rather than pain relievers and anti-inflammatory medications.

There needs to be more integrated, quality, objective research into the medicinal properties of medical marijuana.
Neal Miller, acupuncturist

“Patients are also seeking medical marijuana for insomnia rather than the over-the-counter and prescription sleep medications,” he said. “The quality of the relief and minimal unwanted side effects are the reasons most cited. My clinical observations of patients’ subjective history of helpful benefits from medical marijuana with minimal side effects and improved quality of life is clear.”

Going forward, Miller concluded, “There needs to be more integrated, quality, objective research into the medicinal properties of medical marijuana. We all need to put patients’ health, pain relief, and quality of life first, rather than looking at profits and taxes as the motivating factors.”

This story was originally published on Sept. 29, 2016. It was updated on April 20, 2017.

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