1. a skeptical attitude; doubt as to the truth of something.
“these claims were treated with skepticism”
synonyms: doubt, doubtfulness, a pinch of salt…
— Google.com Retrieved 2016-12-15
We’re pretty firmly in the “skeptics camp” here at Twelve High Chicks. We research, reserve judgement when necessary, and doubt anything that sounds too good to be true. But since we’re also pro-medical marijuana, the continued insistence by government organizations that cannabis is a dangerous drug with no medical value is an assertion that we’re … skeptical about. When contesting governmental control it’s important to be skeptical of skepticism.
Accepted Medical Use
The FDA and Health Canada are skeptical about medical marijuana, but agree that cannabinoids themselves are medically useful. While Health Canada no longer actively fights the Supreme Court of Canada’s insistence on medical access, they’re still not assisting or educating doctors on its use. And the FDA recently decided to keep marijuana listed under Schedule I.
Synthesized THC is approved to treat various medical conditions, as is synthetic CBD. These chemicals went through the kind of research that science, the FDA, and Health Canada prefer: controlled studies of single cannabinoids. And from that research, everyone agrees that Cesamet and Sativex are useful, proven medications.
But how can that mean marijuana itself isn’t medicinal?
If something with medical value comes directly from something else, how can that direct source not have medical value at all? There are more constituents to marijuana than THC, CBD, and other cannabinoids, but that doesn’t mean synthetic THC and CBD are medically useful while the THC and CBD in marijuana aren’t. It means the FDA, etc, don’t want to consider a plant a medicine … and they’re willing to cherry-pick and weight evidence to prevent it.
“Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse.”
— DEA.gov Retrieved 2016-12-15
In its letter to the DEA (shared by VICE News through a Freedom of Information Act request) advising that cannabis remain in Schedule I, the Department of Health and Human Services (HHS) asserts that “the available evidence is not sufficient to determine that marijuana has an accepted medical use” (Page 5). They recognize that there is research, but find issue with methodologies — dosage and form of consumption, mainly — and discount evidence that isn’t from a controlled study.
If an organization tasked with overseeing drugs wants to stick to the scientific method to make its determinations, more power to them. But the FDA, NIDA, and HHS only insist on that for analyzing “medical use” not for any of their other considerations.
The Secretary of the HHS is required to consider a variety of factors to make recommendations on scheduling. For this decision, the information used wasn’t from controlled human studies but from surveys, observation, and inference. There was more weight put on the “known” (but not scientifically proven) negative effects in the decision than on the “insufficient” but available evidence of medical value.
The recommendations fail to live up to their own standards in a variety of ways, though not all factors were problematic.
Factor 1. Potential for Abuse
Straight off the bat a big problem is that negative effects aren’t necessarily even defined. The Controlled Substances Act doesn’t even have a scientific definition for the term “drug abuse” (Page 7). Throughout the recommendation marijuana use is referred to as abuse. Since it’s not legally available, the only use is abuse, right?
In this section, self-reported use of marijuana is considered evidence of abuse and of a hazard to the community. People sent to treatment facilities — not for physical dependence but because others believe that any use is abuse — is considered evidence of abuse.
That it can be used recreationally is considered evidence that it is only used recreationally. Pot makes people feel better, regardless of why they use it. So the FDA would prefer no one use it at all.
Factor 2. Pharmacological Effects
The FDA report uses self-administration of THC by animals to determine “abuse potential” in humans. Rhesus monkeys seem to self-administer drugs that humans would take and potentially abuse. But when it came time to teach animals to self-administer cannabinoids, rhesus monkeys weren’t used.
Once researchers taught squirrel monkeys to give themselves THC, they unsurprisingly started giving themselves THC (page 14). Rats also take cannabinoids. That squirrel monkeys, rats, or other animals in an artificial environment will take drugs instead of placebos can’t be directly inferred to mean that humans will definitely abuse that drug, though. If you were stuck in a lonely, small cage, you’d want to get out of your head too. Put animals in a natural environment and use patterns change.
Additionally, studies testing other effects of cannabinoids on humans and other animals show that they affect us differently (Page 24). So we should be skeptical that what squirrel monkeys take is what humans will abuse.
Factor 3. Scientific Evidence
This section is the one that lays out the catch-22: marijuana hasn’t been studied “sufficiently” to be considered medicinal because it’s a Schedule I drug. And it will remain a Schedule I drug because it hasn’t been studied sufficiently.
The FDA wants a standardized chemical profile, a reproducible marketable product, not a variable plant with hundreds of “constituents.” But trying to isolate specific cannabinoids for use isn’t necessarily the way to go, either, as whole-plant therapies are proving to be more effective.
There are lots of actual studies that could have been considered, but the HHS dismisses their findings due to study design limitations. Information on “abuse” however, doesn’t seem to need to be held to the same standard.
Factor 4. Historical and Current Abuse
There are a lot of statistics given here, but none of it proves marijuana abuse. Self-reported experimentation by children isn’t evidence of abuse by adults.
Neither are emergency room visits where someone has been using marijuana. Surveys and reports aren’t held to the standard of studies. As well, more than half of treated patients were referred by the judicial system, not self-referred for medical support (Page 38). Basically, use is still considered abuse even if there are no negative effects that would cause someone to seek medical help.
Factor 5. Scope, Duration, and Significance of Abuse
Again, self-reporting and admission for therapy (while also using other drugs) were the focus. No definition for abuse disregarding normalized recreational use were established. There were no controls or expert diagnoses. These reports should be taken with a level of healthy skepticism.
So in order to claim sufficient medical value, many more double-blind, placebo-controlled studies — not self-reported studies or general consensus — must be done on specific cannabinoids for specific treatments. But in order to claim danger enough to keep marijuana in Schedule I, taking all available uncontrolled sources and self-reports is enough.
I’m skeptical of skepticism that is not a fair and balanced way to analyze medical marijuana.