AMU Health & Fitness Law Enforcement Public Safety

The History of Marijuana Legalization and Future Challenges

By Mandy Milot, Program Director, Nursing at American Public University

While traveling on spring break to California with my 15-year-old daughter, we happened to stumble across The Green Doctors medical clinic in Venice Beach. The “walk-in medical clinic” was located right next door to a tattoo store and was predominantly painted a bright green color with emblems of marijuana leaves randomly displayed over the exterior walls. Staff members could be seen standing as greeters outside the clinic’s door while other staff members were skate boarding up and down the boardwalk to solicit new “patients.”

All Green Doctor staff members wore the same bright green medical scrubs (with yes, you guessed it), an emblem of the marijuana leaf. The sign outside the clinic door was also bedecked with motifs of marijuana leaves and boldly advertised $40 “medical marijuana evaluations” and “medical card.”

My daughter and I had different yet similar hypotheses about the purpose of the storefront clinic. My daughter proposed that the clinic was selling licenses to individuals so that they could legally smoke pot or legally grow and sell marijuana. I proposed that the clinic was evaluating people and giving them advice on how to get a prescription to legally attain and use medical marijuana. We were both right. Well, sort of.

Marijuana has historically been used for recreational, medicinal and spiritual reasons, and today it remains the most widely used illicit drug in the world. Estimates show that in 2007, 190 million people in the United States consumed cannabis and 14 million used marijuana on a daily basis (Di Forti, Morrison, and Butt).

The Growth of Medical Marijuana
Proposition 215, also known as The Compassionate Use Act, was passed in California in 1996 making it the first state in the United States to allow marijuana to be legally used for medicinal reasons. Despite the federal ban against marijuana, at least 22 other states including Guam and the District of Columbia have passed similar laws and there are more states with legislation pending.

Proposition 215 allows states to legally offer medical marijuana and botanical cannabis programs to treat a variety of symptoms and chronic diseases without federal or state legal ramifications to the prescriber, dispenser, or the end user. Since the inception of Proposition 215 in California in 1996, 15 other states have since passed limited legislation for the use of low tetrahydrocannabinol (THC), high cannabidiol (CBD) products to be used in limited medical situations or as a legal defense for the use of the CBD products.

Since the passing of medical use legislation in 1996, there continues to be questions raised about how medical marijuana should be regulated including policies that address recommendation, dispensing, and the registration of qualified patients. The states that have passed legislation are inconsistent with one another. Policies on marijuana dispensaries range from enforcing stringent rules and guidelines to absolutely no formal policies or guidelines.

In states where marijuana is legal for medical use, the licensing physician determines if medical marijuana will benefit the patient and will issue the patient a marijuana card. Once a patient is issued a marijuana card, they are placed on a list that enables them to buy marijuana through an authorized dealer, also known as a dispensary.

Medical marijuana has a variety of ways in which it can be taken by the patient. The drug may be smoked where the dried leaves are rolled or placed in a pipe; eaten in the appetizingly enticing form of baked cakes, cookies, brownies, gelato, or candy; vaporized where the marijuana is heated until the active ingredients are released but no smoke is formed; or taken as a liquid extract in a tea concoction or bottled cold drinks.

In the past, medical cannabinoid drugs have been predominantly prescribed by doctors to treat or alleviate symptoms from cancer, AIDS, glaucoma, migraine headaches, multiple sclerosis, diabetic neuropathy, chronic fatigue, arthritis. Reported side effects of marijuana include dizziness, drowsiness, euphoria and severe psychosis and anxiety.

Government Oversight of Marijuana Use
Medical marijuana is not monitored like other Federal Drug Agency (FDA)-approved drugs and as a result there is not any substantive data to determine its purity, potency, or side effects. In fact, marijuana is classified by the Drug Enforcement Agency (DEA) as a Schedule I drug which categorizes marijuana and other controlled substances/chemicals such “as heroin, lysergic acid diethylamide (LSD), peyote and ecstasy as the most dangerous chemicals or substances with no currently accepted medical use and a high potential for abuse.”

At the federal level, possession of Schedule I drugs is illegal in the U.S. The DEA considers Schedule I drugs as having the potential to cause severe psychological or physical dependence among users. However, despite limited access to the Schedule I drug to conduct research, medical experts agree that marijuana may be beneficial to treat certain conditions or symptoms.

Legalization of Recreational Marijuana
In November 2012, legislation was passed to legalize recreational use of marijuana in two states: Colorado and Washington. Other states including Oregon and Alaska have since legalized recreational marijuana, which has brought throngs of entrepreneurs scrambling to be among the first to attain a license from state regulators to legally grow marijuana and set up pot shops all over these states.

There is public fear that many of the medicinal dispensaries or recreational pot shops will crop up in close proximity to schools, churches, and hospitals.

Many public officials have expressed concern about the public’s safety and challenges of keeping recreational marijuana out of the hands of minors. By the looks of the ingestible marijuana-laced treats, this may be a daunting task for parents and lawmakers alike.

As you one can see, a leisurely stroll along the boardwalk one afternoon in one of California’s most famous beach towns resulted in a debate between a mother and her teen daughter about medical marijuana. I guess for now it will suffice to say that we were both right about the purpose for the clinic in some way or another. For now, we will have to wait and see how the medical marijuana legislation plays out against the recreational marijuana legislation in the future.

References

Di Forti M, Morrison P.D., Butt A, & Murray R.M. (2007). Cannabis use and psychiatric and cognitive disorders: the chicken or the egg? Current Opinion Psychiatry, 20(3):228-234

Mandy Milot_SMAbout the Author: Prior to joining APU’s School of Nursing as Program Director, Dr. Mandy Milot’s spent more than 35 years in a variety of nursing roles in both the acute care and academic venues. Her experience in the clinical setting includes roles in both private and not for profit acute care settings as staff nurse, charge nurse, and clinical coordinator. For 11 years, Dr. Milot served as the Director of Maternal Child Health at Reston Hospital Center, Virginia with oversight of five departments and 150 staff members. For the past eight years, she has held roles in academia included five years as Assistant Dean for the Accelerated Nursing Programs and three years as the Dean of Nursing both at Northern Virginia Community College (NOVA). Dr. Milot earned her Master’s in Nursing (MSN) in 2006 and my Doctorate in Nursing Practice (DNP) in Nursing Administration and Leadership (2012) at George Mason University in Fairfax, Virginia.

 

 

Leischen Kranick is a Managing Editor at AMU Edge. She has 15 years of experience writing articles and producing podcasts on topics relevant to law enforcement, fire services, emergency management, private security, and national security.

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