The Marijuana Movement and the Normalizing of Self-Medicating

This statement may not be terribly shocking, but I have some issues with medical marijuana.  I could go on and on about the reports that come out on a regular basis proving that medical marijuana has been based on anything but reputable science.  (It’s interesting that when this is pointed out that the reaction of some in the industry is simply to scrap the entire system of using science and evidence to approve medicines.)   I could also point out the statements from the pro-pot advocates that expose the truth that this has always been about softening up the public to get them to approve recreational marijuana.  But today, I want to focus on a side effect of medical marijuana and the marijuana legalization movement that I don’t think anyone is thinking about, but that has long term ramifications for current and future generations.

The side effect I am speaking of is the normalization of self-medicating with recreational drugs.  I’ve been focused on marijuana policy for the past few years.  I’ve watched the arguments unfolding in public, the bills that have been introduced in the Maine Legislature, the testimony and statements supporting the further loosening of medical marijuana policy in Maine.  One subtext that has been inescapable is a recurring theme of self-medication.  That is, that laws and regulations around marijuana should be loosened in Maine so people can use it to treat just about anything under the sun.  In fact, we had that specific bill this past year as LD 23 would have essentially done away with the list of allowable conditions for which medical marijuana could be certified.  Thankfully the bill was defeated, but if it had passed, there would have been essentially no barriers to getting certified to use medical marijuana for anything, even with an absence of science supporting the treatment.

The marijuana industry is not the only guilty party in promoting patients to self-diagnose and self-medicate.  Big Pharma has played a significant role.  You can’t watch television, pick up a magazine, or browse the web without being inundated with a variety of ads instructing you to instruct your doctor to write you a script for Pill X to fix the condition that you may or may not have.  This barrage of Direct to Consumer Advertising was unleashed in 1997 when the FDA issued new guidance that essentially relaxed regulations that kept these DTCA ads off of our televisions.  The pharmaceutical industry saw that daylight and before you knew it, you couldn’t watch the Price is Right without the barrage of advertisements telling you to get the purple pill for your heartburn.

Before the onslaught of DTCA, you would go to see the doctor, tell him or her what was wrong with you, and you had a conversation about what kinds of treatments will help.  This may or may not have involved different kinds of medications, or perhaps even options that didn’t involve drugs, but the doctor was really driving this part of the conversation.  What emerged was a new narrative where the patient self-diagnoses, with the consult of the friendly actor-playing-a-doctor on the television, and goes to the real doctor demanding the pills that were advertised.  The emergence of DTCA basically flipped the script.

As detrimental as that has been, the medical marijuana industry has upped that game substantially.  Enter the walk-in medical marijuana card mills.  Several of these operations have opened up in Maine.  The sole purpose of these “clinics” is to issue you a medical marijuana certification to allow you to buy products from a dispensary or medical marijuana caregiver.  You aren’t going to walk in with headaches and be given a prescription for ibuprofen or get a recommendation for non-chemical therapies.  In fact, it is clear they assume that they will be issuing you a certification as the medical history paperwork you download from their website asks: “When did you discover that cannabis helped with your symptoms?”  (No, I am not going to link to their website.)  It seems obvious then that there will be no discussion of, IF, medical marijuana would be right for the condition, much less if there is any actual medical evidence to support it as a treatment for the given symptoms.  This is a business model purely based on churning out medical marijuana certifications and premised on self-diagnosis and self-medication.  These are not science-based medical practices.

My biggest concern with this is the impact it has on our youth.  In previous articles I’ve written about the risks posed to youth from marijuana legalization in terms of normalizing the drug.  But what I think everyone is missing, or ignoring, is that our youth are also hearing that you don’t need a doctor to help you treat your medical conditions, you can self-diagnose and treat them with recreational drugs.  Instead of seeing a psychiatrist, who can create a science-based treatment plan to help treat your depression, just smoke marijuana.  The science is pretty clear that as an adult, marijuana is a really bad drug to be using to “treat” your depression.  For teens, not only is self-medicating with marijuana not doing to treat the depression, it is going to create even more health problems, up to and including developing a drug addiction.

But if our youth see and learn from adults that self-medication with marijuana is a good idea, will they stop at marijuana?  What other licit and illicit recreational drugs will youth turn to in order to self-medicate to treat symptoms?  Of course we know that this is the very reason many youth experiment with drugs.  To self-medicate and to escape.  But now, we have an element of our culture and society that is saying that is okay.  Not only is it okay, it is celebrated.  I fear that what we will find is more youth eschewing science and medicine for instant gratification and hollow quick-fixes.  This has potential long term negative consequences for both substance abuse trends, and the overall health and wellness of future generations.

Our veterans deserve access to the best medicine science can create, instead of settling for snake-oil promises from a greedy marijuana industry.  Our young people deserve the care and attention from our best and brightest medical professionals, instead of being sold on easy button “treatments” that are proven to be barriers to wellness.  It’s time to turn away from the sexy slogans and empty talking points.  It’s time for society to once again hold up and champion science over rhetoric.  It’s time to flip the script again.


Scott M. Gagnon, MPP, PS-C

About Scott M. Gagnon, MPP, PS-C

Scott M. Gagnon, MPP, PS-C is a Certified Prevention Specialist and is the Director of Operations at AdCare Educational Institute of Maine, Inc. He currently serves on the Maine Substance Abuse Services Commission as well as the U.S. Substance Abuse and Mental Health Services, Center for Substance Abuse Prevention National Advisory Council. Scott volunteers as the Chair of the marijuana policy education and advocacy group, Smart Approaches to Marijuana Maine and is the current Board President of the Maine Council on Problem Gambling. Scott also serves as a Co-chair of the Prevention & Harm Reduction task force of the Maine Opiate Collaborative, the effort convened by U.S. Attorney Thomas E Delahanty, II to address Maine's growing opiate and addiction crisis. Scott is the recipient of the 2015 Maine Public Health Association's Ruth S. Shaper Memorial Award and 2015 Healthy Androscoggin Will Bartlett Award and is also the 2013 recipient of the Maine Alliance to Prevent Substance Abuse Prevention Award.