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One of these things ...



Think of dangerous drugs, and you'll likely think of heroin, cocaine or methamphetamine. You might even consider ecstasy or LSD. However, under the Controlled Substances Act (CSA), marijuana is listed as more dangerous than either cocaine or meth, and just as dangerous as the other three.

Something's wrong there, according to the Coalition for Rescheduling Cannabis. So in 2002, the national nonprofit petitioned to reclassify cannabis from a Schedule I substance to a less restrictive class. Eight years later, it was still waiting for a response from the Drug Enforcement Administration and U.S. Attorney General.

So the group filed a lawsuit in May, asking for a court order "to issue a full and final determination on petitioners' Petition to reschedule marijuana, or, alternatively, state whether it will initiate rulemaking proceedings, within 60 days." And in a June 21 letter, the DEA indeed responded. With a denial.

The issue, of course, is not going away. In fact, just last month, Reps. Barney Frank, D-Mass., and Ron Paul, R-Texas, introduced the "Ending Federal Marijuana Prohibition Act of 2011." Their bill proposes to completely take marijuana off the schedule, leaving it up to the individual states if they want to criminalize marijuana, allow its use for medical purposes, or legalize it for personal use with taxation and regulation, such as with for alcohol.

Frank's also sponsored the "States' Medical Marijuana Patient Protection Act," which would list marijuana as other than a Schedule I or Schedule II substance. For now, both bills are up in the air.

Heavy hitters

The Schedule of Controlled Substances has five classifications, all of which have very clear definitions and guidelines.

Substances in Schedule I "have a high potential for abuse, have no currently accepted medical use in treatment in the United States, and there is a lack of accepted safety for use of the drug or other substance under medical supervision." These include heroin, LSD, marijuana, peyote, methaqualone (Quaaludes) and MDMA (ecstasy).

Looking at heroin, for instance, the National Institute on Drug Abuse notes possible effects including slowed cardiac function and death from overdose and addiction. Moving down the ladder to cocaine — a Schedule II substance, like meth, opium and morphine, that "may lead to severe psychological or physical dependence" — you get heart attack; addiction; stroke; and acute cardiovascular or cerebrovascular emergencies and seizures, all of which can result in sudden death.

The worst effects of marijuana, according to the NIDA, include euphoria, distorted perceptions, memory impairment, and difficulty thinking and solving problems.

When the CSA was enacted in 1970, marijuana was "temporarily" categorized as Schedule I, pending further investigation into its effects. Upon completion of that investigation, President Nixon's Commission on Marihuana and Drug Abuse recommended that it be decriminalized for medical use. The request was denied.

In response, the National Organization for the Reform of Marijuana Laws filed a petition to reschedule in 1972; that request went without a decision for 22 years. No surprise, since early in the proceedings the administrator of the DEA reportedly said, "no matter the weight of the scientific or medical evidence which petitioners might adduce, the Attorney General could not remove marihuana from Schedule I."

This was reinforced by a one-page letter from the acting secretary of the Department of Health and Human Services stating there "is currently no accepted medical use of marihuana in the United States."

Times, however, have changed. The American Medical Association and the American College of Physicians have both urged the federal government to re-examine cannabis as a Schedule I substance.

Doctor's orders

The DEA's continued opposition is based, in part, on a 1999 study from the Institute of Medicine, the health arm of the National Academy of Sciences. It concluded "that smoking marijuana is not recommended for the treatment of any disease condition."

While true, the Institute's research spoke more to the delivery of cannabinoids than their actual healing potential. To wit: "Scientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation; smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances. ... That risk could be overcome by the development of a nonsmoked rapid-onset delivery system for cannabinoid drugs."

Many doctors who recommend MMJ today use just such delivery systems.

"I do counsel patients to medicate completely without smoking," says Dr. Margaret Gedde of Littleton-based Gedde Whole Health, which offers clinics around the state. For a time-released delivery system, Gedde recommends edibles. For a rapid-onset delivery, she recommends vaporizers, which deliver the medication to the lungs without smoke; tinctures, which are placed under the tongue and absorbed through mucus membranes; suppositories, which are also absorbed through mucus membranes; and topical ointments that do not produce psychoactive side effects.

"Marijuana offers better benefits with less toxicity than commonly used medications," says Gedde, adding that "the physical dependence is very mild. So you can quit cold turkey."

According to Dr. Charles Stephens, medical director and co-founder of Peak Addiction Recovery Center, marijuana used regularly can take six weeks to exit the system. "Because of that gradual withdrawal," he says, "other than some irritability, it may be difficult to actually pinpoint symptoms of withdrawal."

So in terms of dependence, then, marijuana falls short of even Schedule II severity. And as for overdose?

"You can die from taking a bottle of aspirin," Gedde says. "There has never been a death from overdose of cannabis in recorded history."


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