Medical associations have concerns about all three of the "medical marijuana" initiatives approved for Missouri's November ballot.
Numerous studies have identified negative health effects associated with use of marijuana on a "large number of diagnoses," Missouri State Medical Association Director of Governmental Relations Jeff Howell said in a statement released Friday.
"These are schedule one narcotics that have to go through testing," Howell said. "Without that scientific testing, we don't think (legalization is) proper."
He expanded, saying the term "medical marijuana" is a misnomer. THC (the active ingredient in marijuana) may ease some types of nausea, but it doesn't cure anything, Howell said.
Two of the initiatives set for the Nov. 6 ballot would amend the Missouri Constitution to allow use of medical marijuana. They would create regulation and licensing for the product, set a tax and designate what the tax is to be used for. The third would make use of medical marijuana a state law; remove prohibitions on growth, possession and production and sale of marijuana; and designate how a tax on the product would be used.
The newspaper reached out to sponsors of the bills but did not receive responses Monday.
Ron Fitzwater, chief executive officer of the Missouri Pharmacy Association, said if any of the bills passed, they would "pose a dangerous risk to the public."
Fitzwater said he's sat in on meetings and discussions about marijuana.
"It's just not a regulated product," he said. "When it's approved by the FDA, that means it meets the guidelines and goes through strenuous testing - and continues to be tested. That's the way we think it ought to be done."
He said the FDA recently approved its first marijuana-derived drug to treat rare, severe forms of epilepsy.
On June 25, the FDA approved Epidiolex oral solution for the treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome, in patients 2 and older.
"This is the first FDA-approved drug that contains a purified drug substance derived from marijuana," according to an FDA news release. "It is also the first FDA approval of a drug for the treatment of patients with Dravet syndrome."
Dravet is a condition that appears during the first year of life and includes frequent fever-related seizures. Other types of seizures associated with the syndrome typically arise later.
People with Lennox-Gastaut generally begin having frequent seizures between 3 and 5 years old. Most patients have tonic seizures, which cause the muscles to contract uncontrollably.
Epidiolex (cannabidiol) is a chemical component of marijuana; however, it does not cause intoxication or euphoria that comes from tetrahydrocannabinol (THC).
Because cannabidiol comes from marijuana, it is still considered a Schedule 1 narcotic (has high abuse potential, no medical use and severe safety concerns).
However, members of the Missouri Board of Narcotics and Dangerous Drugs believe it will be classified as a Schedule 3 drug (which has a lower potential for abuse, has a medical use and has lower addiction potential), Fitzwater said.
"As a pharmacy association, we support the same conclusion. If the drug has undergone the testing, meets the guidelines and is approved by the FDA, we would distribute it," Fitzwater said.
When it comes to medical marijuana, Missouri has the benefit of hindsight, Howell said.
States that have approved medical marijuana have incidents of people getting the prescriptions and giving them to someone else, he said.
It's a slippery slope, and once a state moves down a marijuana legalization path, it doesn't stop, he said.
In states that have legalized marijuana for recreational use, public safety officials have encountered large numbers of underage users and people using marijuana while operating vehicles, he added.
"Some of the states that have done this - at least in Colorado, which is full-on recreational - there have been detriments to public health with recreational use," Howell said. "It's not the path Missouri physicians want to see."