Despite millions of people now in possession of medical cannabis cards in the U.S., not everyone who wants a card can get one. That’s because states determine the qualifying conditions for which they will approve medical cannabis. Said conditions vary from one state to the next.
Have you ever wondered how states come up with their qualifying conditions lists? I have, so I spent some time researching it. I discovered that there is no clear-cut answer. Whenever state lawmakers are tasked with crafting a brand-new medical cannabis program, they are left grasping at straws in terms of qualifying conditions that should be treated with cannabis.
Limited Scientific Evidence
My research pointed me to a study originally published in 2018, a study that has subsequently been updated several times since. At the time, 33 states and the District of Columbia had active medical cannabis laws. Researchers looked at all the qualifying conditions in the various jurisdictions and how lawmakers may have decided which ones should be on their lists.
Researchers discovered that limited scientific evidence supports the idea of recommending medical cannabis to treat nausea, cancer symptoms, and multiple sclerosis spasticity symptoms. Lawmakers were provided that evidence when considering the three conditions.
On the other hand, there was little to no evidence suggesting that cannabis is an effective treatment for other conditions including PTSD, anxiety, and irritable bowel disease. How lawmakers determined that these other conditions might be eligible for cannabis treatment is unclear.
Anecdotal Evidence Is a Possibility
I suspect a strong possibility that lawmakers looked at plenty of anecdotal evidence. I am guessing they heard plenty of testimony from medical cannabis patients and advocates alike. Knowing how compelling personal testimony can be, I have no problem believing that lawmakers were swayed by what they heard.
For the record, I am not against anecdotal evidence. I believe it is just as important as clinical trial data. But I also believe that making medical decisions based solely on anecdotal evidence is risky. There is a reason pharmaceutical companies need to put new drugs through strenuous clinical trials to gain FDA approval.
Lists Are Made to Be Modified
Just like rules are made to be broken, qualifying condition lists are made to be modified. Indeed, modifications are made every now and again. That is not a bad thing. In 2022, Utah modified its qualifying conditions list by adding acute pain. Chronic pain was on the list from day one.
Salt Lake City’s Beehive Farmacy explains that acute pain expected to last at least two weeks can be treated with medical cannabis if a medical provider believes doing so is the best way to go, and the pain would otherwise be managed with prescription narcotics. That means Utah patients facing major surgery don’t have to take prescription opioids if they don’t want to. With a recommendation from their surgeons, they can use medical cannabis instead.
It Seems a Bit Arbitrary
Despite lawmakers’ best attempts to limit medical cannabis use to a small number of medical conditions, it all seems a bit arbitrary. I can understand cannabis for chronic and acute pain. I’m on board with using it to alleviate the symptoms of cancer and the side effects of cancer treatment. I’m even on board with medical cannabis as a treatment for seizures.
At the same time, there are other qualifying conditions that give me pause. I wonder how lawmakers reached the decision to add them to their lists. Was the testimony that compelling? It must have been, or those conditions would not have made the cut.
