Smoked Marijuana Is Medical Marijuana, and Don’t Let Anyone Tell You Otherwise

Smoked Marijuana Is Medical Marijuana, and Don’t Let Anyone Tell You Otherwise

Starting August 1, a “new” product went on sale at medical marijuana dispensaries in Pennsylvania: medical marijuana.

For the first time since sales of medical cannabis began earlier this year, Pennsylvania’s 30,000 (and counting) medical marijuana patients can now legally obtain what PennLive.com referred to as “dry leaf forms of medical marijuana,” or what the rest of us might call cannabis flower, or herb or weed or just plain old cannabis.


Before then, the only cannabis that was legal to be sold in Pennsylvania was processed — in topical oils, in edibles taken orally, in capsules, creams, or other products that had no chance of being used “recreationally.” Thwarting anyone who might want to “abuse” medical-marijuana law in order to simply get high was Pennsylvania lawmakers’ stated motive when they banned cannabis flower. But when sales began in March, dispensaries were so overwhelmed with demand — and so low on processed product, which is more difficult and more expensive to produce than the dried flowers of the female cannabis sativa plant — that regulators reversed themselves and legalized “smokable marijuana.”

This is a good thing for the state’s medical cannabis patients, who now have a better chance of actually accessing cannabis in its cheapest and most effective form.

Which means Pennsylvania is currently getting things half right.

The State(s) of Legalization


Of the 29 states where medical cannabis is legal, only Minnesota bans cannabis flower outright. A handful of states — including New York, Florida, and Pennsylvania — still sell cannabis flower with the understanding that it is not for smoking. That’s right: if you smoke cannabis flower sold in dispensaries in Florida or in Pennsylvania, you are breaking the law. For now, the simplest, cheapest, and most popular form of a drug that has therapeutic value is still not entirely acceptable.

This is a ridiculous state of affairs. It is also untenable, as Pennsylvania’s quick reversal and an ongoing struggle in Florida to give up the charade and legalized smoked cannabis is demonstrating. People are going to smoke weed regardless of the law — might as well pass a law that recognizes this, rather than pretending. And while convincing doctors to embrace smoked cannabis as a healthy practice may be a difficult lift, there is also no honest or scientific medical reason to declare smoked cannabis an unacceptable risk.

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The word “smoking” conjures visions of lung cancer, heart disease, and emphysema. Just so: Smoking tobacco is a terribly unhealthy practice and the leading cause of premature death in the United States, and for as long as anyone alive can remember, to “smoke” or to be a “smoker” was synonymous with tobacco. Thus, it is perhaps understandable that “smoking” marijuana would trigger a similar knee-jerk.

But this is no longer our reality. You can be a cannabis smoker and never touch tobacco. In fact, to do so may be beneficial: The only longitudinal study to examine the effect of marijuana smoking on long-term lung health found no link between cannabis use and lung issues like COPD or lung cancer. Indeed, according to UCLA researcher Donald Taskin’s landmark study, moderate use of cannabis might actually lead to increased lung capacity.

You will hear otherwise, but consider this: Most of the studies cited by health officials and others that do declare cannabis smoking a health hazard come from Europe. This is significant. In Europe, the most common form of cannabis consumption is in concert with tobacco. This is not how we do in the United States.

So that’s the data. Tobacco kills lots of people, cannabis kills nobody — even when smoked. It’s past time to admit this, yet old conditioning dies hard. (Not long ago, I was hanging out with a friend, a medical doctor. I offered him a hit of a joint, but he declined. “I want to healthier,” he explained, as he lit a cigarette. Yes, people like this exist. This really happened.)

About the best you can hope for from a medical professional was the honesty displayed by Harvard Medical School’s Peter Grinspoon. “It is not recommended (at least by doctors) that people smoke it,” he wrote on HMS’s medical-marijuana explainer page.

“Though, interestingly,” he noted, “it hasn’t been linked to lung cancer in the studies I’ve seen.”

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This is not to say that vaporizing is not a healthier option (though it absolutely depends on what you are vaporizing; any benefit to not inhaling butane and burnt plant material may be lost if you’re sucking on a PCB stick laden with accelerants), or that someone with preexisting lung issues should find an alternative method of using cannabis. This is to say that cannabis and tobacco do not belong in the same bucket.


To pretend that smoking one is like smoking the other is dishonest. It is not unlike eating a toxic mushroom versus a chanterelle bought at Whole Foods. Yes, they are both “mushrooms,” and they are both “eaten.” But it is there that the similarities end. A child could grasp this concept, yet there are lawmakers and medical professionals who continue to fail to make the same distinction with cannabis.

No Weed, No Laughing Matter

In sum: People smoke weed. They always have, and they always will. There is no real reason to pretend otherwise. It does not benefit public health to prohibit people with medical cannabis recommendations from smoking their medicine. Indeed, to do so only creates financial and logistical barriers — it makes obtaining and using medicine more difficult. Get it right: It makes medicine and ergo healing less accessible. In this way, banning smoked marijuana not only violates common sense, it also does real avoidable harm.

This is slowly permeating the public knowledge. In Florida, patients and patient advocates will see a challenge to that state’s ban on smoking marijuana head to the state Supreme Court. Despite losing in a lower court, the state and the state’s health department are currently continuing to argue that the 71 percent of state voters who approved medical marijuana in November 2016 didn’t knowingly legalize marijuana in its most common and most recognizable form. It would be a joke if real patients weren’t suffering in the meantime.