By FEDERICO MARIONA, MD
Last Nov. 6, in lieu of a legislative decision that never took place, the Michigan voters approved the legalization of marijuana for recreational use by adults. That made our state the first in the Midwest to have such policy, complementing the previous implementation of the medical marijuana use. The statute included the proviso that recreational marijuana was to be allowed on persons of 21 years old and above, and that certain rules and regulations were to be developed via legislation to organize the cultivation, process, distribution and sales of the approved substance by a state certified system.
As of May 6, six months after the approval, a rather confusing environment is in front of us. And we have only six more months to be up and running. First, if medical marijuana is a substance that treats certain medical conditions, we must know that indeed the results of its use shows an improvement on those conditions as part of the public health effort to improve population health and practice evidence-based medical care.
The Michigan public, the state Department of Health and the practicing physicians are entitled to see those results to justify supporting the medical use of cannabis in the improvement of the debilitating conditions determined by the state.
The FDA approves and evaluates for safety and effectiveness any medication prescribed and sold to the public. Marijuana should be the subject of the same rigorous process or the public, technically, is buying at its own risk. Conversely, the use of cannabis for leisure, described as recreational, presents a somewhat different picture. It has no state-specific list of indications. Like tobacco and alcohol, marijuana is legal and for recreation. With tobacco and alcohol it is widely known, understood and accepted that there are variable individual responses to the same substance.
Moreover, there is an unsubstantiated increasing perception of decreased risks with the use of cannabis. Evidence-based information describes along with certain beneficial effects of cannabis described through centuries, some adverse results such as psycho-social cannabis use disorder, effects on the developing human during early pregnancy and changes in sperm that may alter fertility. Some of these effects relate to the age at use, the amount and type of cannabis used and the frequency of use.
Indeed Michigan elected and appointed officials have the unique opportunity put a system in place that eases the stigma of cannabis use, considers social justice and erases racial disparities in law enforcement, innovates to reduce public harm and analyzes the benefits of tax revenue.
Michigan can set an example of civil responsibility and put in place a system that will serve as a template for the nation. Let us not waste the opportunity.