Chronic Relief: A look into the risks, rewards and laws of medicinal cannabis

By Kyle Rich

By Kyle Rich and Nader Ihmoud, Assistant Sports & Health Editors

After being bedridden for 1,000 days, Mike Graham’s nurse gave him a choice: Use medical cannabis or continue taking the same medication and eventually die from those drugs—if his disease didn’t kill him first.

“I didn’t want to be a criminal, but I didn’t want to die either,” Graham said.

Graham, an Illinois resident who uses marijuana as medicine, has lumbar radiculopathy, a degenerate spinal disc disease. He said he did not begin using cannabis until after approximately 14 different pharmaceuticals failed to work and almost killed him, causing depression, three heart attacks, a stroke and severe weight loss.

“I was down to 130 pounds—about half my body weight,” he said. “I couldn’t keep food down. It was a fight every day. There was no quality of life.”

Now, Graham uses less than two grams of medical marijuana daily and can complete tasks that were once impossible. Despite his family’s background in law enforcement, Graham said his desperation outweighed his concerns about the legality of medical marijuana.

While Graham’s marijuana use is a crime under federal and Illinois regulations, laws legalizing the use of weed for numerous purposes have been enacted around

the country.

Illinois lawmakers are currently considering a bill that would provide medical marijuana only to patients with debilitating medical conditions, according to Eric Berlin, a partner at Jones Day, a global law firm.

The conditions outlined in State House Bill 30 would provide limited access to cannabis for those suffering from HIV and AIDS, multiple sclerosis or cancer, as reported by The Chronicle Dec. 3.

Berlin has been involved with proposing an Illinois bill for almost three years, acting as a representative of medical marijuana patients with debilitating medical conditions. Berlin said he has personally used marijuana in the past to alleviate symptoms of Crohn’s disease and recognizes its

medicinal qualities.

“The first part is trying to convince … our legislators to look at the science over their preconceived notions or ideological beliefs,” Berlin said. “I feel like I was invited to help progress the bill.”

Berlin was not able to comment on what was said during the closed-door meeting between representatives and members of the Senate on a date when they discussed HB30 but said the bill was just a few votes shy of being passed. He said he was optimistic it could pass while satisfying the needs of patients and the concerns of legislators.

However, some decriminalization advocates say action at the federal level is necessary, too. Under the Controlled Substances Act—a primary federal statute—possession, distribution and cultivation of a Schedule 1 drug such as marijuana is illegal in all 50 states. Schedule 1 drugs have been deemed to have no medicinal value, according to Ann Toney, a private practice lawyer in Colorado and author of “Colorado Medical

Marijuana Law.”

“Part of the struggle is to get marijuana reclassified on a federal level,” Toney said. “It can’t be seen helpful if it [remains] a Schedule 1 drug.”

Marla Levi, an Illinois resident who uses marijuana to help alleviate her multiple sclerosis, swears by the drug. She was initially turned on to marijuana by a friend who continues to supply her with it.

“Of all the stuff I have taken, [marijuana] has helped my symptoms tremendously,” Levi said. “Before I was a nightmare. I couldn’t [attend] physical therapy.”

Levi explained that the most excruciating effects of her condition were stiff legs and muscle spasms that she described as having “a mind of their own.” Her preferred method of using marijuana is not smoking  but ingesting it in the form of cookies, oil

and lollipops.

“I was just at the neurologist, and he told me as soon as a bill passes, he will write a script for me,” Levi said.

While state legislation remains up in the air, patients like Levi are left breaking the law. Although cases are being made for medical cannabis, new studies have emerged on the negative side effects of the drug, giving opponents more reasons to question its safety.

Marta Di Forti, a clinical lecturer at the Institute of Psychiatry at King’s College in London, led research that explored the psychological impact of daily marijuana use. The study, published in the British Journal of Psychiatry in 2009, found that the daily use of high-potency cannabis is associated

with psychosis.

The researchers collected information on cannabis use from 280 people who sought psychiatric services after having an episode of psychosis and 174 mentally stable subjects. The study analyzed two strains of marijuana that are used throughout the U.K.: Hash, which contains 2 to 4 percent Tetrahydrocannabinol, the active ingredient in marijuana, and Sinsemilla the more popular of the two that contains 12 to 18 percent THC, according to the study. The amount of THC in medicinal marijuana reflects Sinsemilla but varies

between strain.

Researchers found that both groups had approximately the same number of users, though the strain of weed and how frequently it was used varied. Those who had psychotic episodes were more likely to be current users. Among those, 78 percent used Sinsemilla, compared to 37 percent of the control group. Among those experiencing psychosis, 59 percent had used marijuana for more than 5 years, compared to 38 percent of the control.

“If you use cannabis daily and you are genetically susceptible to the effects of cannabis, your chances to develop psychosis [from] using cannabis are even greater,” Di Forti said.

Psychosis is not the only concern researchers have about cannabis usage. Like many pain medications, researchers found that withdrawal symptoms may occur when users

quit using.

David Allsop, a lecturer at the National Cannabis Prevention and Information Centre at the University of New South Wales in Australia, led a study quantifying the significance of cannabis withdrawal. Researchers asked users to stop using the drug for two weeks to study

the effects.

The volunteer-based study used 49 subjects from Sydney who admitted to using weed recreationally five or more days per week, were dependent on it and described at least one or more withdrawal symptom.

As outlined in the study there are currently seven diagnostic markers that indicate drug dependence, according to the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. Three of the seven markers are needed to classify drug dependence, the seventh being the presence of characteristic physical or mental withdrawal symptoms or use of a substance to alleviate withdrawal. Cannabis, unlike other drugs, doesn’t currently include this seventh marker to classify a disorder in the DSM, although researchers have found withdrawal symptoms in the observed cases.

“You have symptoms shown similar to nicotine withdrawal, like irritability, outbursts and anxiety,” Allsop said. “All of these symptoms seemed to show within 24 hours of the last smoke and peaked within four to five days, of abstinence.”

According to the study, the more dependent users showed  more functional impairment than the less dependent. However, all subjects shared similar symptoms when they stopped usage.

“People’s inability to sleep was most [common],” Allsop said. “Sleep really affects their day and could also lead to this anger and short temper that was also seen across these withdrawal symptoms.”

But those with debilitating conditions can be dependent on the drug to be able to function.

“It allows me to eat,” Graham said. “I haven’t found any negatives. I’m able to function and be involved with my family. I feel better.”

Victoria Cortessis, an assistant professor of research at the University of Southern California, conducted a study in Los Angeles that found a relationship between marijuana use and testicular cancer. She said the study was the third of its kind to indicate that recreational marijuana use can increase the chance of developing testicular cancer.

Cortessis explained that her study explored what young men were doing differently, as the risk of testicular cancer has continued to increase during the past 100 years. Cortessis and her team concluded that a look into the use of drugs might hold the answer.

“It really seems plausible that it is the marijuana exposure to young men that’s leading to the increased risk [of testicular cancer],” she said. “What has happened in California is that when medical marijuana became available, marijuana actually became the drug choice [for] young people.”

Despite the study’s results, the importance of how frequently users ingest marijuana can be disputed, as those who reported using marijuana less than once per week were more than twice as likely to develop testicular cancer than those who reported  more frequent use. But Cortessis said this was not the most significant finding.

“We found a three-fold increase in a type of testis cancer, nonseminoma, which occurs earlier, and it’s a more aggressive type of cancer,” she said.

Cortessis said her study’s conclusion does not deem marijuana as positive or negative and explained there should be concern about male teenagers using cannabis. But she added that the drug could still have realistic benefits for people with specific ailments.

“When you think about cannabis use, you can’t conclude in absolute terms that cannabis is good or cannabis is bad,” she said.

These risks are just a few concerns of those opposed to medical marijuana. In some states, like California, the current law allows patients to obtain medical marijuana for less serious ailments. Patients can come in with a laundry list of complaints and are almost never denied, according to Alec Banks, a writer based in LA. Banks conducted a loose social experiment for an article he was writing for in which he tried to get himself denied a medical marijuana card by Los Angeles County.

“On paper, I thought it was funny,” Banks said. “The doctors all guided me and helped me find an ailment [for medical marijuana use]. You could have no ailment, and they will find one. Smoking pot out here is seen as taking an Advil.”

For his article, Banks told doctors he had ailments such as “a bad case of the Mondays” and an “intense phobia of kite flying.” He even told a doctor he wanted medical marijuana because he was too paranoid when he smoked pot. He said all of these reasons were enough to get him a card, and the information was processed in less than five minutes.

Although his experience is comical, Banks reflected that medical marijuana for those with debilitating illnesses is no laughing matter.

“I had guilt during my experience taking a doctor’s time when they could have been using it to treat somebody who was actually sick,” Banks said. “I hope the misuse of medicinal marijuana wouldn’t affect somebody who actually needs it.”

Cannabis supporters in Illinois have worked toward making medical marijuana available only to those with chronic health conditions. According to Graham, the current bill waiting to be voted on would not allow patients who only describe chronic pain or nausea to obtain cannabis cards. He said those two conditions account for almost 80 percent of the abuse in the 14 states with functioning medical marijuana programs.

“In the legislation, it provides for specific conditions that have research–based proof that patients benefit medicinally from using cannabis for that condition,” Graham said.

Berlin is positive that an agreement can be reached that will satisfy proponents and opponents of the drug’s

medical purposes.

“We need to satisfy the opponents with a law tight enough that it won’t lead to diversion from the program or go to the youth, [which] folks are so concerned about,” Berlin said. “I have a feeling we can get a bill drafted in a way that would provide patients with safe, legal and affordable access [while] still getting enough votes to take care of people’s concerns.”