As of November 2020, the medical use of cannabis is allowed in 36 US states, as post the presidential election voters in Mississippi and South Dakota approved a measure to regulate cannabis for medical use. 13 additional states have laws that are allowing cannabidiol-products (CBD), the non-psychoactive component of cannabis. However, they are restricting the THC content. There are large variations in the different laws depending on the state, accompanied by the ongoing controversies and divided public opinion.
The Front-Runner Of Legalizing The Medical Cannabis
The differences include everything from production and distribution to medical conditions medical cannabis can be prescribed for, as well as the consumption method. The front-runner in the legalization of medical cannabis has been the state of California that has approved it in 1996.
Although it was voted for by only a slight majority of the voters, with the final voting results in Proposition 215 standing at 56-44, the adoption of medical cannabis in California has been successful.
Dispersion Across The US States
As of July 2020, California remains the US state with the most legal medical marijuana patients in the country, by far. Statista reports on almost 2 million patients. To compare, the state with the second-highest number of legal medical cannabis patients in Florida, followed closely by Michigan with 306 thousand and 261 thousand respectively.
However, even the dispersion between states where the medical use of cannabis is allowed is significant. There were only 435 cases in Louisiana, 404 cases in Alaska, 51 in New Jersey, and 3 in Utah.
Aftermath Of The 1996 California Decision
Having said that, after the initial 1996 California break-through, several states have followed in 1998. In 2000, the state of Hawaii became the first one that legalized medical cannabis through an act of state legislature. Although the majority of states allow the use of medical cannabis or CBD, the conditions under which it is allowed differ greatly.
The Restrictive Nature Of Rules
The Rules In California
To illustrate, in California, treatment with using medical cannabis is allowed in case of AIDS, anorexia, arthritis, cachexia, cancer, chronic pain, glaucoma, migraine, persistent muscle spasms, including spasms associated with multiple sclerosis, seizures, including seizures associated with epilepsy, severe nausea, or other chronic or persistent medical symptoms.
The Rules In Colorado
In Colorado, the rules are even less restrictive and include Cancer, glaucoma, HIV/AIDS positive, cachexia; severe pain; severe nausea; seizures, including those that are characteristic of epilepsy; persistent muscle spasms, including those that are characteristic of multiple sclerosis; PTSD; autism spectrum disorder; and all conditions for which opioids could be prescribed to treat. Other conditions are subject to approval by the Colorado Board of Health.
Nonetheless, many states have rules that are not as broad and open to interpretation (e.g., all conditions for which opioids could be prescribed). To illustrate, the state of Louisiana which is also among the states with the least patients that use medical cannabis for treatment has very specific rules.
The Rules In Louisiana
Medical cannabis is allowed in case of cancer, HIV/AIDS, cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn’s disease, muscular dystrophy, multiple sclerosis, glaucoma, Parkinson’s disease, severe muscle spasms, intractable pain, and post-traumatic disorder (PTSD), and four conditions associated with an autism spectrum disorder.
Medical Cannabis And CBD Still Illegal Under Federal Law
Although 46 out of 50 states have some sort of law regarding medical cannabis, whether it legal medical cannabis or legal CBD, it is still illegal under federal law. The federal government regulates drugs through the Controlled Substances Act (CSA) (21 U.S.C. § 811).
No Difference Between Medical And Recreational Use
The Act does not differentiate between the medical use of cannabis and the recreational use of cannabis. Thus, laws that are applied to highly dangerous controlled substances such as cocaine or amphetamine are, in principle, also applicable to cannabis, whether it is used for medical purposes or not.
Schedule I Drug?
Moreover, the Controlled Substances Act views cannabis as a Schedule I drug, one that is highly addictive and with no medical value. Thus, federal laws are still outdated and do not include any of the research that has been conducted in recent years and shows the advantages of medical cannabis.
Positive Medical Effects Of Cannabis
The most commonly named positive effects of cannabis include lowering blood pressure, stabilizing blood sugar, stabilizing mood, relieving chronic pain, or reducing inflammation. However, the preliminary research has shown that it can also be effective in easing up the symptoms of serious physical conditions such as Alzheimer’s or Parkinson’s disease, as well as mental conditions such as PTSD or schizophrenia.
Can Medical Issues Be A Defense?
Due to how medical cannabis is viewed under the CSA, the punishments can be quite strict. There have been cases where judges have ruled out medical issues as a possible defense. However, the issue that was represented by the gap between state laws and federal laws is somehow less distinct past 2016. In 2016, several federal agencies have issued guidelines concerning legal marijuana enforcement.
The views of American citizens remain split as well. The 2020 survey by Statista showed that 21% of respondents are still completely against the use of medical cannabis among adults, and another 20% would not do it themselves. Only 9% of adults confirmed that they regularly use medical cannabis, with another 7% admitting they do it every now and then.
The Messiness Of The Regulatory Framework
Although it does not come as a surprise that regulations are a few steps behind the innovations, it still has to be developed in an efficient way, within its scope. In the case of technologies, innovations, products, and goods that are not regulated soon enough, a case of a vacuum of regulation is creating.
Unfortunately, in the United States, the regulatory framework dealing with the medical use of cannabis is lacking. A balance between supervision of activities and a highly conservative market must be created. If it is not, we are risking either an illicit market and a possible slippery slope to other substances or medicines that are not thoroughly tested and may not produce desired effects.
Thus, the guidelines and regulations must be in accordance with the latest research and the results from other countries that have more developed regulatory bodies in this field. The irony is that while doctors under federal law can not prescribe cannabis for medical use, they can recommend using it, in accordance with the First Amendment.
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