Health Care and Higher Education

Event examines ethics and policies surrounding medical marijuana

Health experts question initial standards set by pioneering states and what comes next.

March 18, 2016
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DeVos Medical Ethics Colloquy
Dr. Kevin Hill, an expert in substance abuse consultation, discussed the implications and benefits of medical marijuana. Courtesy GVSU University Communications

The ethics and practice of prescribing medical marijuana has been a hot topic for many years across the nation and in the state of Michigan.

That discussion was brought to the forefront in Grand Rapids recently, as the focus point of the first DeVos Medical Ethics Colloquy of 2016.

Featuring presentations from Dr. Yasmin Hurd, director of the Center for Addictive Disorders at Mount Sinai Behavioral Health System in New York, and Dr. Kevin Hill, director of substance abuse consultation services at McLean Hospital in Massachusetts, the conversation covered the implications and benefits of medical marijuana.

Hill opened his presentation by noting that strong arguments could be made on either side of the aisle for and against the use of medical marijuana — and the looming possibility of legalizing the drug entirely — but he noted that in the 23 states with policies legalizing the use of medical marijuana, the implementation has been poor.

“A lot of times, these policies perpetuate major, major issues,” Hill said.

Hill, who is also an assistant professor of psychiatry at Harvard Medical School, noted that the majority of individual states with medical marijuana policies take bits and pieces from policies already put in place by other states.

For instance, he said, a number of states have decriminalized marijuana up to one ounce because that was the standard set early on. The issue, Hill continued, is that one ounce of marijuana contains enough for more than 50 joints — which likely would be far more than someone would use for personal consumption.

“I think that the spirit of this law would be better met with a lower limit,” Hill said. “But, unfortunately, someone got the ball rolling with one ounce, and state after state, city after city, continues to do that. … So that’s the difference between a good idea, perhaps — a lot of people agree with decriminalization — and really poor implementation.”

Hurd, who also works as a professor of psychiatry and neuroscience at the Icahn School of Medicine, discussed her research on the effects of medical marijuana on the brain and its addictive properties.

The research found that in rats whose parents were exposed to tetrahydrocannabinol, or THC, as adolescents, the behavior to seek out and self-administer heroin was more prevalent than in rats whose parents had not been exposed to THC.

Alternately, rats whose parents had been exposed to cannabidiol at a young age actually exhibited a decreased desire to seek out heroin.

Hurd said the concentration of THC in street marijuana has increased in recent years, while the presence of cannabidiol has decreased, leading to more addictive-related disorders in marijuana users.

Still, Hurd noted that if medical marijuana is capable of relieving pain for all the maladies it’s purported to help with — from writer’s cramp to toenail disorders to Parkinson’s disease — then it truly is a miracle drug. But whether that’s the case or not remains unclear.

“We definitely need more research in order to achieve this goal, this hope, of medical marijuana,” Hurd said. “So I’m proposing for more evidence-based research, (and) we definitely need to reduce the federal complications of trying to work with marijuana for research.”

Following their presentations, Hill and Hurd answered questions from the audience, moderated by Corey Waller, medical director of Spectrum Health Medical Group Center for Integrative Medicine.

Both Hill and Hurd agreed that, as it stands, the policies, effects and benefits of marijuana remain hazy, and conversations like the one hosted at the DeVos Medical Ethics Colloquy are vital.

“It’s hard not to imagine that things aren’t going to get worse before they get better unless we really do a better job about talking about this in a productive way,” Hill said.

He added that just by having conversations with their patients about medical marijuana, physicians and other health care professionals can have a positive effect on educating a number of people.

“How we respond as a society to medical marijuana can have a great impact on how this is actually going to be implemented and how effective it can be,” Hill said.

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