Higher Ground: The control group 

Those who say that medical marijuana is a steppingstone to recreational marijuana are correct — although generally for the wrong reasons. However, in the rush to recreational here in Michigan and elsewhere, it would be a huge mistake to discount medical use and the needs of patients.

People outside of the marijuana movement tend to see the pro-marijuana crowd as a bunch of stoners wanting to get high — even the medical users. There are some people who are using medical marijuana with a wink and a nod as cover to get high. But I've also talked to numerous folks who would either be dead or have a significantly lower quality of life without it. People tell me they are successfully treating cancer and managing the symptoms of epilepsy with marijuana extracts. Others are using it to control pain and to kick addictions to painkillers that no longer work for them. People with multiple sclerosis and diabetes are finding that it enhances their quality of life.

Many of these folks have been using marijuana medications they make themselves or get it from friends who might not be the most adept when it comes to cooking up a batch of medicine. There are huge variances in the way people are putting stuff together. To a certain extent, that's OK because different people have different needs and tolerances, but the guidance of rigorous science would be helpful — except rigorous science is mostly blocked by federal government policy. So if you want to be mad at somebody because they're cooking up a batch of something in the basement, maybe you should be mad at the government about that. If above-ground medical labs were working on this, most folks wouldn't be trying to figure it out for themselves.

Medical marijuana is a steppingstone to recreational marijuana because it belies most of the anti-marijuana propaganda that has been official policy for decades. Once marijuana comes out of the shadows, people figure out that it's not as bad as they've been told. From there the prospect of recreational use is not so intimidating.

Marijuana has led to the discovery of the human endocannabinoid system and its receptors throughout our bodies. They work to maintain a stable internal environment — for instance the life and death cycle of cells. Our bodies make cannabinoids naturally — they're in breast milk.

It's the cannabinoids that make marijuana medical, and there are dozens of them in the plant. Scientists and a lot of other people are slowly finding that many of them have an effect on health and have nothing to do with getting high. One of the most popular at the moment is cannabidiol, or CBD.

There's been a rush to the CBD-only uses of marijuana among those unfamiliar with it because, unlike THC, CBD doesn't get you high. But I've talked to plenty of people who say their CBD is more effective with a dash of THC in it. And there's an emerging sense in research that CBD, THC, and other cannabinoid compounds in cannabis work together in an entourage effect that works better than any of them alone.

GW Pharmaceuticals, the British pharmaceutical company, is working from that premise. The company first produced Marinol, a synthetic THC that was prescribed to cancer patients to control nausea. Many patients reported that real marijuana worked better than Marinol. GW has since come out with Sativex, made from actual marijuana, which reportedly works much better than Marinol.

Sativex is used in many parts of the world, but not in the United States because it's actually made from marijuana — making it illegal. The less effective and synthetic Marinol is used in the United States because it's not made from the dreaded marijuana plant.

The concern here is that as marijuana is more generally accepted as an intoxicant (but much healthier than alcohol and tobacco), the needs of patients will get lost. Corporate interest in marijuana is about maximizing profits, and the biggest market is for recreational marijuana, not refining a medical product for some esoteric ailment that a small percent of the population suffers from.

Others have the attitude that legal recreational marijuana can also be used medically, which is partially true. However, when it comes to the concentrates, infusions, tinctures, oils, salves, and more that are being used for medication, there need to be standards for how much is in there so patients know what they're taking. And there needs to be discovery about just how effective they are.

Marijuana cancer treatments are notoriously subject to the variances in quality of marijuana. Patients need such large amounts to create the oils they use, it's hard to get a steady supply of the exact same stuff. When the marijuana you get changes, then the amount of what you take changes, but it's a trial-and-error process. That's especially concerning with people who make small batches. It would be nice to go out and get five pounds of the stuff to make your oil, but that's an expensive and legal-line-crossing proposition. Saying that the medical-marijuana world needs more development is an understatement. Not to mention the part where doctors learn about the stuff and start prescribing the stuff.

Polls say that most Americans expect there to be legal recreational marijuana in the near future. That's fine. Just don't leave the patients behind. It was the discovery that so many people who are suffering can be helped by marijuana that opened the door for more widespread use.

And that's worth remembering.

Larry Gabriel writes the Stir It Up and Higher Ground columns for the Detroit Metro Times and is editor of The American Cultivator.

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