A friend asked me to watch an interview with Dr Sanjay Gupta on CNN in which Gupta says that he has been wrong about marijuana. He has opposed legalization of marijuana for years and has changed his mind. Now he thinks it would be good to legalize it for medical use. 
 
I know the friend asked me because from a distance he heard conversation that I had with an individual who wanted to know if I thought it would be reasonable to have patients smoke pot who had a medical problem that it seemed to help. At the end of the conversation my friend came over to talk, and said that he wanted me to watch the CNN interview because he did not know who to believe. A rather smart, articulate neurosurgeon has said that medical marijuana is probably a good thing and perhaps it should be legalized. So, I watched.[i] 

Dr Gupta said many things that were interesting. He said that 95% of the research done looked at the adverse effects
of smoking marijuana including the effect it can have on a developing brain. He said that very little of the research looked at what could be the benefits. In his defense, the doctor said that he was NOT advocating the recreational use of marijuana because he has children. He did not offer any studies that showed the benefits of smoking pot. 

When he was pressed by the interviewer as to why he made the change from being against legalization of pot to being for it, Gupta said that his experience talking with patients was the motivating factor. He told the stories of two patients who used marijuana or one of the substances derived from it. One was a child with seizures whose story is heart
rending.  

The reason I don’t find Dr Gupta convincing and I could not agree with the person who wanted me to give my approval to medical marijuana in certain circumstances is the same. Both wanted me to agree based on the stories of patients that they had heard. It is the difference between anecdotal evidence and research. 
 
Anecdotal evidence is the story of one person about the benefits marijuana or any other kind of treatment. Research on the other hand has looks at disease & treatment in large populations. Medical research is supposed to look at a drug, procedure or a question in medicine and answer it by looking at in large populations, thousands if possible. It is also supposed to be objectively measured in a way that is reproducible. A treatment or drug given today should offer the same benefit in 6 months in a different population. All of these studies should have a control group that shows a statistically significant difference between the outcome of being treated and not being treated. 

Remarkably there is at least one person out in cyberspace who has the same reservations I do about “medical marijuana” and the need to legalize pot smoking. In the Huffington Post, Sue Rusche, the CEO of National Families in Action wrote an excellent article which gives a reasonable answer to Gupta’s call for legalization. The article is titled “What Dr. Sanjay Gupta Doesn’t tell Us About Weed”[ii] and in it Rusche presents several things  that we know about marijuana that make using it less inviting. 
 
While there are 400 ingredients in marijuana, Dr Gupta only talked about 2, THC and CBD. Rusche explained that THC
is the “cannabinoid” that the recreational user desires and CBD is the ingredient that seems to hold any medical benefit. The catch is that most marijuana in the US is grown to reduce CBD and increase THC. THC or  tetrahydrocannabinol is the part of marijuana that is credited with the mind altering effects.  
 
The problem with most pot being sold as medical marijuana is that it is grown for it intoxicating effects. THC
concentrations in marijuana in 1970 averaged 3 percent. Today that average is 13% with some samples as high as 36%. Gupta says that marijuana has a relatively low risk of addiction at 9% when compared to cocaine at 25%. Rosche points out that the rate for adolescent user addiction is 17% and for regular daily users it can be from 25% to 50%. That meets or exceeds the rate of cocaine addiction. 
 
Marijuana is not a minimal risk medication like aspirin or Tylenol that we can take with a reasonable expectation of safety and benefit. In an excellent review in this week in the Psychiatric Times, the risk of psychotic episodes is 40% greater for uses than for non users, and the risk for schizophrenia is higher among teens who smoke it than those who do not.[iii] 

So why would we want to legalize a drug that has rather limited medical use without real research? Rosche proposed what I think is the most reasonable response. Instead of a wholesale legalization for medical use that will turn into the circus that now is California and Colorado, why not do real research? The following is a quote from Rosche.

“The government should provide research grade CBD to patients like Charlotte under a compassionate use program while science catches up with and improves the folk-medicine approach(that is generating millions of dollars in profits) we have now. Patients and their families should sign a hold-harmless contract so taxpayers won’t have to shoulder lawsuits from unexpected side effects that might result from being medicated with an experimental, untested drug.” 
 
That makes so much more sense than legalizing a dangerous, addictive, psychosis causing drug because a notable
articulate neurosurgeon has decided that it ought to be on the basis of incomplete science and anecdotal patient stories. Let’s do real research and let the facts decide the best course.   
  
[i][i] You can find Dr Gupta’s comments on CNN under video.  Search Sanjay Gupta and Weed!   
[ii]“What Dr. Sanjay Gupta Doesn’t tell Us  About Weed” Sue Rusche. Huffington Post 08/19/2013.   
[iii] The Cannabis-Psychosis Link June 27, 2012 | Schizophrenia, Alcohol Abuse, Psychotic
Affective Disorders By Marie-josee Lynch, MD, Rachel A. Rabin, MSc, and Tony P.
George, MD, FRCPC - See more at:  http://www.psychiatrictimes.com/schizophrenia/cannabis-psychosis-link-0#sthash.pARp70VE.dpuf




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