In stark contrast to our current widespread use and accessibility of alcohol, the Prohibition era in the United States implemented a ban on the sale, production, importation, and transportation of alcoholic beverages. The only way to legally obtain alcohol was with a prescription from an authorized physician. The ratification of the 21st amendment was brought about in response to a vast majority of the public, brewers, and doctors claiming that beer was a vital medicine. A similar scenario can be seen over the debate over the legalization of marijuana and its potential medicinal properties. Since 1996, 24 U.S. states have passed laws allowing specific forms of marijuana to be used for a variety of medical conditions. Under this new legislation, the highly anticipated medical marijuana dispensaries in New York finally opened their doors to the public in January, 2016. With increasing ease of access to the drug, advocates believe more effective therapies can be provided in order to treat conditions like cancer, glaucoma, nerve pain, muscle spasms, nausea, and seizure disorder. Opponents argue that these benefits are disproportionate to the damage this drug can cause. However, marijuana pharmacies throughout New York aim to safely provide medical marijuana therapies to deserving and qualified patients.

Strict eligibility guidelines for marijuana therapy negate much of the proposed damaging consequences of widespread marijuana usage. To be eligible, a patient must be approved by a registered physician that is certified by the New York Department of Health. The physician has to successfully complete the online Medical Marijuana certification course and pass the exam as part of the registration process Upon approval, the department will provide the patient with a registry identification card, which is required to pick-up the prescription. According to Dr. Tricia Reed, a pharmacist at Columbia Care Marijuana Dispensary, “once a patient is registered, their first appointment involves discussing the details as to why they are prescribed this therapy, and to decide on which type and constitution of marijuana will work best for them.” It is important to note that the registered physician monitors the patient’s cannabis use. The mandatory course allows the physician to have a sufficient understanding of the endocannabinoid system, possible drug interactions, and adverse side effects that may occur to patients. That is why a medical marijuana certification expires after a year, and the physician must re-register with the state by passing the exam again. Tetrahydrocannabinol, or THC, is one of the active ingredients of medical marijuana, along with cannabinoids. The exact level of THC sensitivity is decided after evaluating the patient’s history with marijuana. This evaluation also determines the composition of the drug, which can be 20:1, 1:1, or 1:2, depending on the ratio of THCs to cannabinoids. Most dispensaries, “depending on the need of the patient, ...start from 1:2 for someone who has never been exposed to cannabinoids.” When combined, cannabinoids and THC work to help provide the patient with increased comfort and satisfaction. Cannabinoids are beneficial in treating effects of anxiety, seizures, inflammation, and are known to carry out cytotoxic activities against cancer cells. Meanwhile, “THCs provide an opioid type pain relief for severe pain, and it’s also used to aid with sleep disorders, treat nausea, and to relax muscles,” says Reed.

Despite its outpouring popularity, jury is still unsure whether marijuana is truly the panacea its supporters claim it to be. Due to the lack of evidence-based randomized controlled studies on medical marijuana, the stance on legalizing marijuana is still uncertain. Listed as schedule 1 drug, marijuana is still in the same category as heroin and LSD. However, advocates have been working to reassign it to a lower tier, claiming that marijuana has less harmful consequences and more foreseeable benefits than alcohol. Reed affirms that “addiction rates for marijuana don't match up to even alcohol. It’s [on the schedule 1 list] due to misconceived measures by the DEA.” 

The duration of marijuana therapy can vary from months to lifelong, based on the symptoms being treated. However, when asked about the number of patients at Columbia Care that were successfully treated by marijuana therapy and subsequently weaned off the drug, Reed responded “none.” Her answer propagates the perplexity regarding how smooth the process of discontinuing this drug is. Reed also spoke in favor of marijuana therapy, stating that it has the potential to help patients cease their use of opioids, which have far greater known side effects.

According to the Journal of American Medical Association, cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. In a systematic review published in June of 2015, a total of 6,462 participants were included, to test for the efficiency of cannabinoids. Even though some trials showed improvements in symptoms, the data collected showed little statistical significance. Out of all the other conditions, cannabinoids show eloquent effects on nausea and vomiting due to chemotherapy on 47% of the group using it, as compared to 20% of the controlled group. The results also showed moderate improvements on pain, and muscle spasms. 

Although recent statistics show scant support in favor of marijuana therapy, Reed argues that it is “a little too soon” for numbers. The field of medicine is constantly changing, and the statistics used for analysis may be outdated. Even Columbia Care, New York’s first marijuana dispensary, has only been open for under a year. With greater usage comes greater, newer data, allowing for improvement and modifications upon therapeutic techniques. It is evident that marijuana therapy has its medical benefits, and with further research and greater patient numbers it may prove to be one of this decade’s most important medical advancements. Whether we are merely repeating history or living in our own time, most change is for the better, especially in the medical community. And, personally, I look forward to it.