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Dec 6, 2023
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POLICY ANLYSIS PROJECT
The Use of Marijuana for Medical Purposes
Daniel Usman Master of Public Health, Walden University
PUBH 6127: Public Health Policy, Politics, and
Progress
Problem Statement/Identification
What steps can the Indiana Department of Public Health do to encourage marijuana access for secure medicinal use?
Background
In the United States, using whole plants of Cannabis sativa or any of its derivatives is prohibited by federal law for any reason. Cannabis has no recognized medicinal purpose and is categorized as a schedule I drug.
After state legalizing measures were initially implemented in the 1970s, patient medical access rules began to be created in the 1990s. Because state governments are given sovereignty, many US states have decriminalized, allowed its usage for medical purposes, and legalized marijuana for recreational purposes. Thirty-one states have authorized marijuana for medical use, about eleven have allowed it for recreational use, and about thirty states have decriminalized marijuana (Hutchinson & Stickle, 2022).
Currently, 13 states do not have medical marijuana laws or jail time associated with simple cannabis possession, including Indiana. As per the prevailing laws, possessing even one joint might result in a year of imprisonment. Medical marijuana use is prohibited in Indiana, as is adult
marijuana use. A misdemeanor that carries a maximum year in jail and a $5,000 fine is possession of less than 30 grams of marijuana or 5 grams of concentrates. Despite the fact that the U.S. Food and Drug Administration (FDA) has not approved the use of cannabis as a medicine for any ailment. According to DeJesus et al. (2007) and Ware et al. (2008), it has approved synthetic THC for the treatment of chemotherapy-induced nausea and for
boosting appetite in wasting syndrome survivors. According to Elliott et al. (2019), they have also
authorized the prescription use of concentrated cannabidiol (CBD), a non-euphoric cannabis component, for the treatment of rare epileptic disorders. 13 bills pertaining to cannabis that need your support House members in Indiana suggested in 2022 that medical marijuana be made available for usage. For instance, House Bill 1214, authored by Representatives Sue Errington and John Bartlett, and Senate Bill 321, introduced by Senator David Niezgodski, all sought to legalize cannabis for medical use in Indiana but were unable to pass out of committee. Representative Jim Lucas also proposed House Bill 1026. Physician recommendations for medical marijuana will be made possible by the proposed bills for patients with severe medical conditions. Law enforcement will also not be allowed to interfere with medicinal marijuana users or assist the federal government in enforcing federal marijuana laws that outlaw use of the drug by states with permission.
Marijuana regulations impact patients, doctors, marijuana merchants, and the general population, thus it's critical to reduce medical marijuana use and improve access. For Indiana's medically ill patients who depend on marijuana as a kind of medical necessity and will have to travel to states where it is legal to use, this policy analysis is important. Historical records in central Asia, India, and China indicate that cannabis was first used to alleviate rheumatic pain, malaria, beriberi, and gynecological issues (Jiang et al., 2006). An interesting study that was published in the peer-
reviewed journal Molecules offers insights into the treatment of neuropathy, one of the most difficult forms of chronic pain.
The analgesic action of medicinal marijuana is attributed to the binding of opioid, serotonin, and cannabinoid receptors by THC and CBD. At the 2021 American College of Rheumatology
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meeting, researchers presented research showing how beginning a medical marijuana regimen improved sleep quality and reduced pain, anxiety, and depressed symptoms in fibromyalgia patients (Ashare et al., 2022).
The states that border Indiana to the west and north, Illinois and Michigan, have both legalized marijuana for adult use. Its eastern border, Ohio, also boasts a strong medical marijuana program.
Enrolled Act 52, which legalizes low-THC CBD generated from industrial hemp, was passed by Governor Eric Holcomb on March 21. As long as THC level in CBD oil is between and conforms
with specific labeling laws, Less than three percent is legal for anyone to buy, sell, or own. The bill provides a much-needed extension to Indiana's low-THC statute from 2017, which only allowed CBD oil for epileptics without providing a way for them to purchase it. The law was intended for those with seizure disorders. The law still doesn't say whether it's lawful to produce CBD in Indiana.
Political Context of Marijuana
The state of Indiana prohibits the cultivation, possession, and sale of cannabis, with penalties based on the amount sold or carried (Adams et al., 2019). Cannabis products are not easily accessible, even for medical use (Act No. 52). But in recent times, both parties have backed the changes in the state's cannabis law. Proposals include decriminalizing certain acts and legalizing others. having a specific amount of the substance, clearing any cannabis convictions, and waiving unpaid debts for cannabis penalties and charges, as well as the abolition of cannabis's unintended effects.
One example of a cannabis-related legislative initiative is House Bill 1311, which was introduced by Republican Cindy Ziemke of District 55 in the Indiana General Assembly. It creates a legalization process for cannabis and amends current laws pertaining to the plant. Democrats and one Republican, Representative Steve Bartels (District 74); Democrat Justin Moed (District 97); and Democrat Vanessa Summers (District 99) are coauthors of the bill. Senate Bill 414, sponsored by Democrats David Niezgodski of District 10 and Eddie Melton of District 3, is a comparable political endeavor.
Even though Republicans and Democrats have worked to change the state's cannabis laws, some state legislators are opposed to any changes to the legislation. On July 1, 2021, for instance, Senate Bill 201 was signed into law by a group of senators, the majority of whom are Republicans. Driving after using any cannabis product, even if one was not impaired or involved in a collision, is punishable under the bill as a class C misdemeanor. Cannabis users who use it for medical purposes are subject to the law. Even though Republicans and Democrats have worked to change the state's cannabis laws, some state legislators are opposed to any changes to the legislation. On July 1, 2021, for instance, Senate Bill 201 was signed into law by a group of senators, the majority of whom are Republicans. Driving after using any cannabis product, even if
one was not impaired or involved in a collision, is punishable under the bill as a class C misdemeanor. Cannabis users who use it for medical purposes are subject to the law. Interestingly, Indiana Republican governor Eric Holcomb does not think that changing the state's cannabis laws should be a top priority.
Economic Issues
A number of stakeholders have suggested that legalizing cannabis could result in more tax income for the state as well as jobs for state residents. For instance, Indiana recently employed personnel for its hemp pilot programs, despite the fact that state law opposes the majority of uses of cannabis products (Mark et al. 2020). People who purchase, import, or transport cannabis products pay a stamp tax to the states, which they are required to pay because it is unlawful to possess cannabis. However, many choose not to pay this tax. As a result, the state loses money from the stamp tax (Gillespie 2022). According to a 2020 report, Indiana's cannabis prohibition costs $71 million USD (Miron 2020), or 45.2% of the state's potential marijuana tax revenue (Bieber 2022). These facts clearly imply that the state is losing a significant amount of money as a result of the cannabis ban.
Legal Factors
However, Indiana lawmakers are currently engaged in a political and moral debate regarding the legalization of marijuana for medical use. Concerning the health of people who can benefit from using marijuana to treat a medical condition, Indiana's existing legislation makes no allowances. One reason for public health concerns is marijuana's addictive properties. A study found that 10%
of cannabis users will become addicted, and that 3 out of 10 users have a marijuana use problem (Hasin et al., 2015; Lopez-Quintero et al., 2011). According to Winters and Lee (2008), there is a
higher chance of developing marijuana use disorder in those who start using marijuana in their youth or adolescent and use it more sometimes.
Public health issues are addressed in the medical marijuana measures that are being presented. For instance, Senate Majority Leader J.D. Ford's proposed legislation 175. States that have legalized medical cannabis had much reduced incidence of fatal opiate overdoses. According to
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Bachhube et al. (2014), in areas where medicinal marijuana is legal, the average number of overdose deaths from opioids—including morphine, oxycodone, and heroin—reduced by 20% after a year, 25% after two years, and up to 33% by years five and six.
Practical factors
Where and how medical marijuana is used are governed by state laws. Limitations on individual consumption seem to be driven more by appearance than by content, as medical marijuana laws are morality laws (Hollander and Patapan 2016) and the law has recently changed regarding marijuana usage. and ethical status (Akins and Mosher, 2019).
Those who oppose legalization contend that, unlike alcohol, marijuana does not have a lethal overdose risk or a physiological addiction. It is unlikely for a marijuana overdose to be lethal, according to the Centers for Disease Control and Prevention (CDC, 2021). Nevertheless, marijuana may also have other unfavorable consequences, particularly when taken in high dosages. Numerous academic works have acknowledged the usage of marijuana for medical purposes (Camilleri, 2018).
Prohibition has been shown to be an ineffective policy. According to federal studies, legalization hasn't resulted in a rise in teen use (O'Connell et al., 2022). The rate of consumption has increased since the 1930s, when prohibition was instituted, and it peaked during the strict drug enforcement years of the 1970s and 1990s (Martins et al., 2022). Quite the opposite—those who had previously needed to traverse state lines to obtain cannabis are now able to use it within their own communities because of its legalization for medical purposes.
A few of the groups that have worked to alter the narrative are those addressing opioid abuse, parents of children with seizure disorders (Cha 2014), and veterans (Jonsson 2018). With these In
order to increase the scope of conflict and present evidence in favor of providing the groups with medical marijuana's benefits, advocates are using positively constructed groups, such as those with high power (veterans), low power (parents and children), and even a negatively constructed group with low power (opioid drug users) (Schneider and Ingram 1993).
References
Adams, M. Indiana Has Its Work Cut Out For It Trying To Stop Interstate Marijuana Trafficking. 2019;
Available from: https://www.forbes.com/sites/mikeadams/2019/06/21/indiana-has-its-work-cut-
out-for-ittrying-to-stopinterstate-marijuana-trafficking/#63ee90d17475
Ashare, R. L., Kelly, E., Hajjar, E. R., Pant, S., Meghani, S. H., & Worster, B. (2022). Characterizing
anxiety, pain, sleep, and quality of life among patients in a state Medical Marijuana
Program. Complementary Therapies in Clinical Practice, 101612.
Bachhuber, M. A., Saloner, B., Cunningham, C. O., & Barry, C. L. (2014). Medical cannabis laws and
opioid analgesic overdose mortality in the United States, 1999-2010. JAMA internal medicine, 174(10),
1668-1673.
Bieber, C. (2022). Marijuana Tax Revenue: A State-by-State Breakdown: Marijuana can bring in big
bucks for state governments. The Motley Fool. url: https://www.fool.com/research/marijuana-
taxrevenue-by-state/
Camilleri, M. (2018). Cannabinoids and gastrointestinal motility: pharmacology, clinical effects, and
potential therapeutics in humans. Neurogastroenterology & Motility, 30(9), e13370.
Centers for Disease Control and Prevention (CDC. (2021). Marijuana and Public Health
DeJesus, E., Rodwick, B. M., Bowers, D., Cohen, C. J., & Pearce, D. (2007). Use of dronabinol improves
appetite and reverses weight loss in HIV/AIDS-infected patients. Journal of the International Association
of Physicians in AIDS Care, 6(2), 95-100.
Elliott, J., DeJean, D., Clifford, T., Coyle, D., Potter, B. K., Skidmore, B., ... & Wells, G. A. (2019).
Cannabis based products for pediatric epilepsy: a systematic review. Epilepsia, 60(1), 6-19.
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Gillespie, J. (2022). Indiana Marijuana Laws. Nolo. url:
https://www.criminaldefenselawyer.com/marijuana-laws-and-penalties/indiana.htm
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Hasin, D. S., Saha, T. D., Kerridge, B. T., Goldstein, R. B., Chou, S. P., Zhang, H., ... & Grant, B.
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(2015). Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-
2013. JAMA psychiatry, 72(12), 1235-1242.
Hollander, R., & Patapan, H. (2017). Morality policy and federalism: Innovation, diffusion and
limits. Publius: The Journal of Federalism, 47(1), 1-26.
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Hutchinson, Z., & Stickle, B. (2022). Recreational Marijuana Laws. Marijuana in America: Cultural,
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Jiang, H. E., Li, X., Zhao, Y. X., Ferguson, D. K., Hueber, F., Bera, S., ... & Li, C. S. (2006). A new
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Jonsson Patrik.2018. As War Vets Enter the Fray, Stigma Lessens Around Cannabis. Christian Science
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Jones Christopher.2019. Is Medical Marijuana the Solution to the Veteran Opioid Crisis? Pacific Standard
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Mark, T., Shepherd, J., Olson, D., Snell, W., Proper, S., & Thornsbury, S. (2020). Economic viability of
industrial hemp in the United States: a review of state pilot programs.
Martins, S. S., Levy, N. S., Bruzelius, E., & Segura, L. E. (2022). Cannabis legalization in the US. Where
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Miron, J. A. (2005). The budgetary implications of marijuana prohibition. Marijuana Policy Project.
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Mosher, C. J., & Atkins, S. (2019). In the weeds: Demonization, legalization, and the evolution of US
marijuana policy. Temple University Press.
O’Connell, M., Levy, S., Shrier, L. A., & Harris, S. K. (2022). Trends in cannabis-related attitudes and
behaviors among cannabis-using adolescent and young adult outpatients following medical cannabis
legalization in Massachusetts. Substance Abuse, 43(1), 328-335
Schneider, A., & Ingram, H. (1993). Social construction of target populations: Implications for politics
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Ware, M. A., Daeninck, P., & Maida, V. (2008). A review of nabilone in the treatment of chemotherapyinduced nausea and vomiting. Therapeutics and clinical risk management, 4(1), 99.
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