On Election Day, Floridians will vote on an amendment to the Florida Constitution that would allow the “use of marijuana for debilitating medical conditions.” At first glance, the proposed amendment appeals to a sense of empathy and implies safe and limited use by the infirm; however, closer inspection reveals that the framework established by Amendment 2 is problematic in the following ways:
- Potential for fraud and abuse
The definitions and terms in the full text of Amendment 2 are vague. The amendment does not require a doctor’s prescription that specifies dosage and frequency. Instead, the physician issues a “certificate” allowing the purchase of marijuana in any quantity and form. Ambiguities of Amendment 2 create opportunities for abuse and fraud similar to the “pill mill” scenarios experienced in Florida and elsewhere.
- Edible marijuana products present a significant risk
Amendment 2 does not specify the physical form of the marijuana or limit the potency of tetrahydrocannabinol (THC), the euphoric component. Marijuana infused products (cookies, candies, beverages) are made using oils or other extracts that concentrate the THC potency at dangerously high levels of 40-90%. Marijuana edibles (“medibles”) are packaged to look like everyday food products, confections, etc. Accidental ingestion by children, some as young as 2, have resulted in a significant increase in emergency room visits and calls to Poison Control Centers.
- No assurances of quality, consistency in products
There are pharmaceutical grade products that harness therapeutic properties of marijuana, such as Marinol™, used for nausea and loss of appetite for cancer and HIV/AIDS patients. Other products are under development at different stages.
Amendment 2 does not relate to these, but rather to marijuana plants, which pose unique problems for “medical” use. It is not possible to standardize the 66+ active chemical compounds in the stems, leaves and seeds of the marijuana plant, which poses risks for those who use it. Batch-to-batch variations increase the likelihood that no two products derived from the marijuana plant will be the same and have the same effect when inhaled or ingested. Marijuana products provided under Amendment 2 will not be subject to FDA regulations and safeguards that protect the patient and guide the physician; in addition, licensed pharmacies and pharmacists will not dispense them.
- Allows for greater access to marijuana by youth
Increased access to marijuana and its presence in the home has the potential of leading to dangerous experimentation by youth. In states with more lenient marijuana policies, attractive packaging and aggressive marketing campaigns are used to attract younger individuals to become lifelong users.
Compassion compels efforts to care for the sick and to alleviate suffering. However, in this pursuit, society must ensure that those in need are not further endangered by exposing them to even greater harm. While there could be beneficial applications to the proposed use of marijuana, voters must carefully assess the risks and anticipated problems involved in amending the Florida Constitution to garner them.