Policymakers, doctors and professors from across New England debated the merits and pitfalls of legalizing medical marijuana at the eighth annual Dartmouth Symposium on Substance Abuse, held on Friday in Collis Common Ground. The conference “Medical Marijuana: Compassionate Care or Oxymoron?” examined the controversial issue of medical marijuana in the context of a current bill facing the New Hampshire legislature.
The symposium aimed to provide an informed, scientific discussion of the topic and sought to eliminate politicized arguments, according to Seddon Savage, director of the Dartmouth Center on Addiction, Recovery and Education and the event organizer.
“I think it’s very important for scientists to be in discussion to bring to light different arguments,” she said. “Often, public debate is based on observations and people’s own personal experiences.”
Organizers chose speakers based on their local and regional involvement in the issue and their ability to engage in balanced dialogue, Savage said.
“I think we heard equally from both sides,” she said. “But it’s very hard to find scientists who will say unequivocally that marijuana is great.”
Where it is legalized, medical marijuana is most often recommended for patients suffering from chronic pain and nausea as a result of cancer treatment, glaucoma and HIV/AIDS, Columbia University psychiatry professor Herbert Kleber said.
Some patients do not respond to treatments for pain or “intractable nausea,” making other approaches necessary, Savage said.
However, a dearth of scientific studies on the efficacy and risks of medical marijuana has made it difficult for organizations to establish clinical policies for recommending the drug to patients.
“People don’t know, patients don’t know and doctors can’t tell them,” Tom Reid, deputy county attorney of Rockingham County, N.H., said.
In places where medical marijuana has been legalized, existing delivery systems such as dispensaries often provide little to no guidance to patients on the type, potency and dosage, Reid said. Doctors who advertise their willingness to write prescriptions may abuse the system, he said.
As the drug becomes more socially acceptable, recreational use becomes more prevalent among youth.
“It’s very hard to craft a system that makes it only available to patients who need it,” Savage said.
“The political context and timing of the conference was wonderful because that bill is before the New Hampshire legislature right now,” Savage said.
New Hampshire may become the 18th state to legalize medical marijuana, according to Savage. Senate Bill 409, sponsored by Sen. Jim Forsythe, R-Strafford, and Rep. Evalyn Merrick, D-Lancaster, would allow the use of medical marijuana by patients with a “debilitating medical condition,” according to the New Hampshire General Court website.
Speakers throughout the day’s events referenced the current deliberations of the state government on the proposed legality of medical marijuana.
Under the proposed law, state-registered patients or caregivers could cultivate up to four mature cannabis plants and 12 seedlings in an enclosed, locked location, and patients would be allowed to possess six ounces of marijuana or less. The bill also prohibits the use of medical marijuana in public, at a workplace or when driving and imposes criminal sanctions on those who violate the proposed law.
The bill passed in the State House of Representatives with a veto-proof majority but only passed in the Senate by a vote of 13 to 11, which is insufficient to override a promised veto by Gov. John Lynch’s, D-N.H., according to Savage. The final vote will take place within the next two weeks, she said.
Friday morning’s programming focused on the medical and botanical aspects of the issue. Harvard Medical School psychobiology professor Bertha Madras opened the conference with a discussion of the history and acceptability of marijuana as medicine.
Edgar Romero-Sandoval, an assistant professor of anesthesiology and toxicology at the Geisel School of Medicine, presented research on the pharmacological impacts of cannabinoids. Gilbert Fanciullo, an anesthesiology professor at the Geisel School, and New York University Medical School professor Nicholas Pace discussed the clinical issues surrounding marijuana used for therapeutic purposes.
The Parliamentary Debate Team also addressed the issue in a debate format at noon in an example of the potential for student contribution, Savage said.
“Psychoactive substances are ubiquitous in our culture,” Savage said in an email to The Dartmouth. “Students need to be informed about their properties not only to make personal decisions about their use, but to intelligently guide others and help shape policies.”
Afternoon speakers tackled the subject from the policy angle, exploring historical trends of marijuana use and the policies of national organizations and the government.
Director of Addiction Services at Dartmouth-Hitchcock Medical Center and psychiatry professor Benjamin Nordstrom Med ’01 presented addictive medications’ trends of recreational use.
The day concluded with a panel discussion and audience question and answer session debating medical marijuana policy in New England. The panel included John Thiele, the director of Maine’s medical marijuana program, and Bobby Sand, county attorney from Windsor, Vt.
The Dartmouth Center on Addiction, Recovery and Education holds two conferences each year, with a fall meeting intended for general practitioners and a spring symposium examining a controversial topic, Savage said. The programming is funded by the center’s operating budget, which is provided by the Provost’s Office and amounts to between $8,000 and $10,000.
The center aims to prevent “substance and addiction problems as personal and public health issues” by facilitating communication, policy implementation and education about substance use in the Dartmouth community, according to its website.