The Science of Medical Cannabis

The cultural, scientific and legislative divide created by vigorous debates over the legalization of medical marijuana is giving way to a new synergy among community stakeholders across the United States. The goal is to improve access to medical marijuana for patients with refractory debilitating neurological disorders, cancer, and chronic pain as an alternative to ineffective pharmacotherapy and potentially addictive pain medications. The ultimate test of our nations resolve to ensure the welfare of our sickest patients is the enactment and implement of effective public health reform in the area of medical marijuana, also known as medical cannabis.This book evolved out of the present need for a definitive volume on the science and public health aspects of medical cannabis to fuel this national narrative. The ethnographic research presented in the concluding chapter was inspired by Professor Miriam W. Boeri and colleagues, at Bentley University in Waltham, MA. They examined views of community stakeholders including medical marijuana dispensary entrepreneurs, health care professionals, and patients in a state that legalized medical marijuana in 2013, yet there continued to be confusion and misunderstandings in the interpretation and implementation of medical marijuana guidelines during the period of policy shifts. Apparent gaps in policy development and implementation signaled the urgency for a comparison study addressing stakeholder views in New York State, where its medical marijuana program has legally dispensed the drug since 2014. The resulting pilot study was carried out in the Division of Health Policy and Management of the City University of New York School of Public Health. The research model incorporated ethnographic and grounded methodologies to detail the views of physicians, pharmacists, educators, patients, and entrepreneur stakeholders; with triangulation of data and application of dominant themes into a socioecological framework model to identify areas of public health policy reform. The findings of this study detail that New York, like other states that recently legalized the dispensation of medical marijuana, faces challenges beyond policy transparency, communication and education explicitly to improve the implementation process for applying and registering medical cannabis dispensaries, referring physicians, and qualified patient recipients.Ken Langone, Chairman of the Board of New York University Langone Health, and Steven Galetta, Chair of Neurology in the School of Medicine, where the authors is senior staff in neuroepidemiology, motivated him to pursue doctoral training in Health Policy and Management. The author has had the good fortune of interacting with thought-provoking medical students, neurology trainees, public health doctoral students, and professors who reinforce the high ethical standards in medical and public health practice and research. However, his patients still educate him in empathy and humanity. The author is grateful to his family, including his spouse Holly and sons Adam and Seth, who serve as his daily compass, encouraging him to take on projects that promote core values of medicine and humanity.