Allen J Frances M.D.

Saving Normal

The Lobby Against Medical Marijuana

Protecting profit against patient welfare

Posted Sep 13, 2016

Our next several blogs will catalogue the various ways drug companies have ruthlessly promoted our nation's deadly opioid epidemic. This first installment on just the latest outrage—political lobbying to block the legalization of medical marijuana. Future blogs will each tell other aspects of this story.

The drug industry is attempting to protect their profits by blocking fair competition from much safer and much cheaper medical marijuana. As usual, the industry displays loyalty to its executives, shareholders, and politicians, but disregard for the lives of its customers and the welfare of our society.

Drug cartels are rightly reviled, but drug companies are now more deadly.

Policymakers should weigh the considerable evidence that legalized medical pot improves pain management and reduces opioid addiction. They should focus less on the few real dangers and be less susceptible to drug industry pressure.

Medical Pot Reduces Opioid Abuse and Deaths

Twenty-five states and the District of Columbia have legalized pot for medical purposes. It turns out that medical marijuana is over-rated for many of the conditions currently treated with it.

However marijuana could have a major role in improving our current management of chronic pain. A review of 79 studies found "30% or greater improvement in pain with cannabinoid compared with placebo."

Studies also show that legalizing medical pot, and making it available in dispensaries, reduces by 15-35% admissions for prescription opioid abuse and opioid overdose deaths.

In states that legalize medical marijuana, doctors also write many fewer prescriptions for medications meant to treat pain, depression, anxiety, seizures, and nausea

The dangerous over-use of prescription opioids has become our national nightmare. Any rational assessment of risks versus benefits would much favor cannabis over addictive pain pills. 

The Fight to Defend Opioid Profits

The drug industry is the most active and powerful opponent of legalized medical pot. Its activities take the usual form: sponsoring friendly anti-pot researchers; funding friendly anti-pot organizations; lobbying government agencies; and mounting public relations campaigns (

The financial stakes are high. On one side, the drug industry is protecting its $10 billion per year revenues. On the other, the costs of opioid addiction to our society include medical and rehab treatments required to deal with prescription opioid abuse and addiction; the lost work productivity; the impact on the legal and correctional systems; and the additional costs occasioned by downstream heroin addiction ( Society needs to learn how to fight back and protect itself.

Several other industries are allied with drug companies in actively opposing the legalization of pot—the beer industry, distillers, tobacco companies, and the prison lobby (

What Needs to Be Done

It makes little sense to make a relatively safe drug illegal, while simultaneously allowing the drug industry to legally push an extremely deadly one.

The epidemic of addiction to, and deaths from, legal prescription opioids is widespread. It will have no simple solution, but clearly the universal legalization of medical pot should be part of the tool kit.

Political opposition is partly based on ideological and puritanical grounds; partly on groundless over-estimation of risk.

The drug industry invests twice as much on marketing and lobbying as it does on research and is much better at buying politicians than producing better products.

Now that 25 states have legalized medical pot and have derived such clear benefit from doing so, can the other 25 states afford to continue suffering the huge human and financial cost of unfettered legal opioids.

Legalizing medical cannabis will not by itself solve the overall opioid mess, but it is an obvious and effective step in the right direction. Other steps will be discussed in later blog entries.

This article was originally published on Recovery Brands' Pro Talk/Pro Corner

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About the Author

Allen Frances, M.D., was the chair of the DSM-IV Task Force and is currently a professor emeritus at Duke.

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