MARIJUANA LEGALIZATION: ETHICAL CHALLENGES

Nowadays, there is a global debate on recreational and medical marijuana legalization, but the facts show us that we know too little about its long term effects on human health. Thus far, there have not been enough large-scale clinical trials showing the benefits of the marijuana plant and its risks as potential medication. Many studies have reported about the detrimental effects of marijuana. Safety concerns, include cognitive impairment, increased risk of motor-vehicle accidents, increased risk of unsafe sexual behaviors, mood swings, severe anxiety, paranoia, psychosis, addiction, altered brain development, respiratory problems, vascular and heart damage. Unfortunately, these effects are not properly addressed by mass media. Conversely, the two main cannabinoids (THC and cannabidiol), found in varying ratios in the marijuana plant are of therapeutic interest. To date, many countries have approved pharmaceutical formulations of these extracts for several medical conditions and a growing body of literature supports their usefulness in many others. The actual restricting laws which consider marijuana an illegal substance and the pressure of marijuana legalization supporters makes it difficult to evaluate objectively the pros and cons of medical marijuana and of its active molecules. Considering, the responsibility physicians have in assuring public health, government funded research and more time are needed before making any claim. It is imperative to emphasize the importance of communication among all parties due to the possible side effects of treatment with marijuana and its potential to interact with other medications the patient may be taking. However, if physicians believe a law or the public information provided is unfair it’s an ethical and professional responsibility to work and actively change things. Psychiatrists may have a role in these challenges.