Medical Marijuana and Halacha

15

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mm[By Rabbi Yair Hoffman]

As of this writing there are twenty states in the U.S. that have now legalized “medical marijuana,” and a number of others on the way as well. The change in legal status has been both fast and furious. Proponents claim that it has so many beneficial medical effects. Opponents of the legalization of marijuana claim that the legalization thus far has been anything but truly “medical.”

The question is how does halacha weigh in on this topic?

Few in either the halachic world or l’havdil the medical world would argue that if the chemical components of marijuana (THC) were used in medicines that followed the normal way in which medicines are approved, then its use might be recommended and thus halachically permitted when warranted medically. The push toward legalization, however, has come from grassroots support (no pun intended), rather than from the medical world. As a consequence, it is not like medicine.

THE VIEW OF THE MEDICAL WORLD

Why is most of the medical world not backing it up thus far? According to an article in Arthritis Care and research by Mary-Ann Fitzcharles, MD, of McGill University in Montreal, and colleagues, at the current state of affairs, there are a number of issues including acute and chronic risks, a lack of evidence for efficacy, the absence of data on appropriate dosing.

Sharon Levy, an assistant professor of pediatrics at Harvard Medical School and chair of the American Academy of Pediatrics committee on substance abuse, recently told the Washington Post that she is a strong proponent of studying and developing medications from the active ingredients in marijuana. But she does not support the idea of patients or parents making their own oral preparations and guessing at proper dosage without knowing long-term side effects. “It is a bad idea. When I look at the accumulation of studies about marijuana and children, I am very concerned,” she said. The authors of the study have written that “Simply acceding to patient demands for a treatment on the basis of popular advocacy, without comprehensive knowledge of an agent, does not adhere to the ethical standards of medical practice,”

One major obstacle to the acceptance of medical use is the wide variation of active compounds in the plant, with THC concentration ranging from 1% to 30% of the plant and blood levels among individuals who inhale it that range from an estimated 7 ng/mL to 100 ng/mL.

It is also interesting to note that of all the tens of thousands of recommendations for medical marijuana in the state of Colorado, almost half of these recommendations had been made by only 15 physicians. This is a clear indication that the medical world has not embraced medical marijuana as the panacea in which the media has marketed it. The authors of the study point out that the motives for this medical behavior should be questioned and raises ethical concerns.

RAV MOSHE FEINSTEIN’S VIEW

Back when it was illegal in all fifty states, Rav Moshe Feinstein zt”l addressed the question in his Igros Moshe Yoreh Deah Vol. III #35. Rav Moshe pointed to no less than nine very serious issues in which marijuana affects a person. 1] It affects a person physically and 2] mentally. It further 3] prevents him from studying Torah properly and from 4] davening properly. It further 5] affects the proper performance of Mitzvos, eliciting a zombie-like element in their performance. Rav Moshe also presents the idea that 6] elicits within the user a stronger desire for things, and explains that this is one of the problems associated with a Ben Sorer U Moreh, the rebellious son discussed in Dvarim 21:18. Rav Moshe further explains that it is an 7] abnegation of the Mitzvah of Kivud Av v’Aim, as well as 8] a violation of the Ramban’s understanding of Kedosim ti’hiyu, the commandment to be holy. 9] Finally, Rav Moshe writes that such activity induces the user to violate other Mitzvos in the Torah, thus increasing impurity in Israel.

ANOTHER ISSUE, AND THREE MORE VERSES

In consonance with many experts on medical marijuana, two Poskim have voiced to this author their opinion that Marijuana still most certainly constitutes a “gateway drug” leading the user to begin experimenting with other drugs that are illegal and dangerous. The researchers have said that even in areas where medical marijuana is legal, most users obtain marijuana illegally. This obligation appears to be a biblical one predicated upon the verse, “venishmartem me’od bnafshosaichem – And you shall be very careful regarding yourselves (Dvarim 4:9).” not just limited to “veNishmartem” (Dvarim 4:9). The verse later on (Dvarim 4:15), “Rak hishamer lecha” is understood by most Poskim to actually comprise a second Mitzvah (See Rav Chaim Kanievsky Shlita Shaar HaTeshuvos #25). There is also a third Mitzvah, “V’Chai Bahem – And you shall live by them” (VaYikra 18:5).

SO DO RAV MOSHE’S POINTS APPLY TO MEDICAL MARIJUANA?

We will start with the physical and mental effects. According to a long term study of Swedish youth cited by the study, the odds on getting lung cancer if one regularly uses marijuana increase 200%. Yet another concern is for driving. The authors of the study have noted that impairments can last up to a full day after a single ingestion.

What about the mental effects? The study cites the possible effects on mood, and particularly depression, and the possibility of dependence. Marijuana use has been linked to higher rates of mental illness, including thought disorders, depression and anxiety, as well as — according to one prominent study published last year — diminished IQ over time.

As far as the other effects mentioned by Rav Moshe are concerned, someone has pointed out that they apply even more so nowadays, because the concentration of THC has clearly increased. Thus the issues of Bitul Torah, effect upon Davening and Mitzvah performance clearly apply even more. The same is true with Rav Moshe’s latter points.

In short, the rise of the legalization of medical marijuana is fraught with danger in its current form. It is sad, because for epilepsy and for other uses, had it been approached through the medical world, it could have been useful and halachically permitted. At this point, it remains a huge stumbling block and would constitute a biblical prohibition.

The author can be reached at [email protected]

ARTICLE PUBLISHED BY 5TJT


15 COMMENTS

  1. The biggest fraud out there is “medical cannabis.” If AIDS/immunosuppressed people can take the “drug” and handle it properly, how is it that a perfectly healthy person can not?

    The CHOICE to use Cannabis should be legal for all.

  2. Once again an interesting article by Rav Hoffman. Now all the nay-Sayers can come with their split tongues… or perhaps I can do it for them.

    1) What an outrage to bring up this topic?! Is this all this Rabbi thinks about?!
    2) This Rabbi is Biased! I can quote dozens of sources why there is nothing Halachicly wrong with Marijuana!
    3) All these research firms that he quotes are biased and making up things!
    4) There’s nothing wrong with Marijuana! GET A LIFE!!!
    5) I take pot all the time and I am the top in my class! I am also a safe driver!
    6) Who’s this Rabbi Hoffman anyways?!

    Did I get them all? No?!
    🙁

    In short, just to add. The reality is that more than anything else, Marijuana is an emotional addiction. I have yet to meet someone that smokes Marijuana who I would say is “not” reliant on it for his emotional balance. I have also yet to meet someone who admits that he is emotionally reliant on it. In every case I have seen I can show you their weaknesses and how they turn to Marijuana to fill the gap.

    To anybody curious about Marijuana, my advise is the same as for any other addiction. If you don’t need it why start?!

  3. Mr softwords,
    First, what a well written, soft spoken list.
    For those who smoke it often (daily, usually all day!) , you are right, the addiction is not physical (like tobacco) but emotional.
    There are those however who do smoke it on occasion, and those people do not fall into the addiction category.
    I will also state that short of heroin, marijuana is the most powerful *natural* pain reliever that I know of.
    לא עלינו

  4. I agree with R’ Hoffman that no one should use marijuana.

    However, many people have found that as a last resort it is the only effective medicine for their conditions.

    In addition, I doubt there’s any possible Torah justification for throwing people in prison for years for owning a certain plant. The US has the world’s highest incarceration rate, and African-Americans are arrested and charged at many times the rates of whites, even though the overall rates of drug use between blacks and whites is basically the same.

    For these reasons it makes sense to legalize marijuana for both recreational and medical reasons. The cost of prohibition is just too high, in higher taxes, people influenced negatively by other prisoners, ruined lives from a criminal record, etc.

    However, at the same time we should redouble efforts to make sure that we and our children stay as far away from the drug as we can, except in those rare cases in which a grave medical conditions will respond to no other known treatment.

  5. Why doesn’t Rabbi Hoffman write about its’ use by those suffering from cancer R”L? It is clearly useful in reducing the nausea that is associated with chemotherapy as well as reducing some of the pain of the cancer itself.

    Would Rabbi Hoffman deny medical marijuana to a dying person?

    The issues that he quotes from R’ Moshe seemingly only deal with one who uses it recreationally. Would R’ Moshe deny its’ use for a dying person? I highly doubt it.

    Two Poskim stated that it is a gateway drug? What about dozens of articles written by scientists who state that it is not?

    I am not advocating for legalization of marijuana for recreational use. But there is plenty of evidence that it is very useful for many medical issues, including glaucoma AND depression.

    This article oversimplifies this complex issue.

  6. no less than nine very serious issues in which Vicodin/codeine/percecet/oxycodine/xanax affects a person. 1] It affects a person physically and 2] mentally. It further 3] prevents him from studying Torah properly and from 4] davening properly. It further 5] affects the proper performance of Mitzvos, eliciting a zombie-like element in their performance. Rav Moshe also presents the idea that 6] elicits within the user a stronger desire for things, and explains that this is one of the problems associated with a Ben Sorer U Moreh, the rebellious son discussed in Dvarim 21:18. Rav Moshe further explains that it is an 7] abnegation of the Mitzvah of Kivud Av v’Aim, as well as 8] a violation of the Ramban’s understanding of Kedosim ti’hiyu, the commandment to be holy. 9] Finally, Rav Moshe writes that such activity induces the user to violate other Mitzvos in the Torah, thus increasing impurity in Israel.

  7. there is a big difference between medical marijuana and ‘recreational’ marijuana.

    Using marijuana for enjoyment is probably one of the worst things a person can do with his life. I have personally seen people who as youths light up and later drop out of society preferring a basically hedonistic lifestyle. It ruins family values not to mention Torah values.

    However, I have seen people in late stages of illnesses that are killers and generate much pain. One of my close friends was in such an advanced state of an illness that the pain was more than he could endure. The doctors gave him medical morphine so that he could cope with his last days.

    There is a place for medical drugs (they are called drugs since many are just that: drugs). It is for relieving pain. Medical marijuana is the same; if used to help a person who has a physical illness that can not be cured, well, then it is in the service of man.

    But if the person just wants a ‘pickup’ from something minor or a personality problem that can be solved otherwise, etc, marijuana can be the worst thing possible.

    Like all things, cool intelligent minds must decide if this particular case or that case requires medical marijuana or not and not the prospective user.

    I do not believe there is a case to forbid medical marijuana anymore than medical morphine and I do not believe there is a case to permit recreation marijuana anymore than there is any reason to permit recreational morphine, heroin, etc.

  8. sim_cha – like I said, If you don’t need it, why start?! You don’t need cigarettes, right? Why marijuana? You don’t need it. Also, let’s face it. We can’t imaging Rav Chaim or Rav Steinman, shlita puffing a reefer. There’s a reason for that. It’s simply not something a Ben Torah would do. If you are smoking pot, you can’t be considered a TRUE Ben Torah. It’s as simple as that. You may feel yourself to be, but NO Chochom will consider you one.

    Yanky55 – I can’t really speak for R’ Hoffman, but I’m going to guess from his statements that he wouldn’t object for someone with cancer. Of course, that would be something that an individual would have to ask his posek and is not something that is a psak for the general public.

    yytz – your comment is akin to someone saying, “I object to premarital relationship, but I feel that we should hand out contraceptives”. That’s just ignorant thinking.

  9. I am personally acquainted with a Rabbi here in Israel who’s son is undergoing cancer treatment and the medical marijuana is the ONLY thing that has been able to help control his nausea and let him lead a less painful and more normal life. I am also familiar with another person, also a rabbi, who is paralyzed from the waist down and suffers from debilitating spinal pain, and after many years he found that the medical marijuana was the only thing that could help him.

    Also the marijuana does not have to be smoked, it can be baked into foods. In fact I have seen medical marijuana foods here in Israel with a hechsher on them.

  10. You forget one important component there are actually studies that show marijuana actually combats the risks of lung cancer..these are medical studies so I am not sure where he sees that it raises the risks. Maybe smoking cigarettes raises the risks oflung cancer by 200% but not marijauna. Feel free to Google this info but I am 99% this is true.

  11. whatever doubts we have now about the dangers of marijuana will be proved medically in the coming years,r moshe is not wrong.im gonna rely on him until its proved in labs(thats fun)

  12. Softwords: It’s ignorant to question putting millions of people in jail, exposing them to brutality and forced sodomy and at great taxpayer cost, even though 1) the Torah does not specify imprisonment as a punishment, 2) the Torah never bans any plants, 3) criminalization does little to decrease use? In fact, in countries with legal marijuana, such as Netherlands, the overall rate of pot use is lower than in the US.

  13. #13 yytz – My comment was not concerning your first two paragraphs, but rather the later two. I agree that the legal actions taken are ridiculous! The addict shouldn’t be punished! It’s the pushers that should pay the price! Medical marijuana should be legalize, but with stricter conditions such as only for cancer patients as a pain reliever, etc. Right now, everybody knows that the medical legalization is being abused.

    What’s ridiculous is to legalize it for recreational purposes and then expect people to stay away from it (especially children). That’s like giving a teenager a computer with non-filtered access and expecting him not to surf porn sites! Only an absolute idiot expects that his kids won’t look merely from his request to refrain!

  14. Softwords, I agree that there is a risk that complete legalization would lead to an increase in use. However, use is already so high (nearly 40% of adults in the country have tried the drug) that I do not think use would rise much. If we say we are legalizing it because of the harms of prohibition, not because it is a safe drug without any dangers, then this should help stop use from increasing significantly.

    Just as we realized the the prohibition of alcohol in the early 20th century was a failure, and had to undo it, we should do the same today. To be sure, some people may have been concerned that repealing prohibition sent a message that drinking alcohol habitually or in large amounts was OK. But that is a risk we had to take. If we speak to our children honestly and tell them about the dangers of marijuana — panic attacks, mental health problems, anxiety, accidents, making bad decisions — and supervise them appropriately, then b’ezras Hashem we can keep them from using the drugs.

    In practice, the government will continue to lock tons of people up for using marijuana as long as it is illegal. Decriminalization would be an improvement but would retain all the violence and public health problems associated with a black market. That is why I support complete legalization.

    It is possible there are some real “pushers” who deserve to be punished harshly, but most drug dealers are not in the business of cajoling people into using the drug — they’re just providing people with a product they want, and if they didn’t do it somebody else would. If that’s all they’re doing then I think it’s a poor life choice, but not something worth a prison sentence.