What about Medical Marijuana?
Recreational marijuana use has been decisively rejected by Christians because of its psychoactive properties and tendency to perpetuate a lethargic and selfish lifestyle. But as cannabis is increasingly being legalized for medical use, a new discussion is emerging within the church about whether or under what conditions its use would be appropriate. This essay presents an overview of the key issues and suggests some practical guidelines for potential cannabis users and leaders who will need to provide a biblical response to them.
The Scientific Dimension
Medical cannabis has been prescribed for AIDS and cancer patients suffering from nausea and poor appetite because of their treatments. This has been viewed largely, though not exclusively, as a palliative care option, or for the duration of chemotherapy, not for ongoing symptom control or treatment. Since long-term use is not in view and few options exist for patients in this sorrowful condition, the benefits seem to some to outweigh the dangers (see Proverb 31:6-7). There is a plausible analogy between opiates and cannabis. Both substances are commonly abused, but could play an appropriate, if limited, medical role.
Though there may be a case for medical cannabis in conditions like terminal cancer or AIDS, marijuana seems to be prescribed (where legal) or advocated for a growing number of real or perceived maladies. In a society with an increasingly permissive view of marijuana, it is likely that almost any justification for its use will be accepted. In a culture ravaged by drug abuse and addiction, this raises obvious problems for the church.
Let’s consider as a case study the debate over medical cannabis and Crohn’s and severe Inflammatory Bowel Disease (IBD). Recent claims have been made about the effective properties of cannabis (THC) in Crohn’s and IBD patients. These claims should be taken seriously both because of the wide range of positive anecdotal testimony and from a sense of compassion that suffering people are experiencing real help.
Two commonly cited studies illustrate the case for medical marijuana. The first is an Israeli study published in the journal Clinical Gastroenterology and Hepatology (Naftali, et. al.: 2012). This study of 21 patients with Crohn’s Disease found that “complete remission” was achieved by 5 out of 11 subjects who smoked cannabis over an eight week period. On this surface of it, this is a significant result. However, there are seriously limiting factors to the study. Eight weeks is not long enough to claim “complete remission,” unless by “remission” is meant cessation of reported bowel flair ups during the time participants smoked cannabis. There were no follow up studies to demonstrate the long-term results of cannabis use. The authors themselves conclude, “[T]he primary end point of the study (induction of remission) was not achieved. ” The crucial point is that short-term relief of symptoms occurred, but not the stronger claim of actual remission of the disease.
A second study by Karen Wright (Wright, K., et al.: 2008) indicates that chemicals found in cannabis could prove an effective treatment for Crohn’s Disease, not just symptom relief. She was able to demonstrate that naturally occurring compounds in the human intestines, endocannabinoids, increase the permeability of the intestinal lining during Crohn’s-related inflammation. These compounds are chemically related to cannabis. In a laboratory experiment, Wright isolated cannabinoids from marijuana which helped epithelial cells from the intestines to form tighter bonds with each other, resulting in a membrane barrier for intestinal tissue. No human subjects were involved. These results correspond to other studies (Izzo, et al: 2012; Capasso et al.: 2008). But significantly, Wright noted, “What is also encouraging is that while THC has psychoactive properties and is responsible for the ‘high’ people experience when using cannabis, cannabidiol, which has also proved effective in restoring membrane integrity, does not possess such properties.” This and related studies could be very promising since it offers a chemical basis for why some compounds in cannabis could help treat Crohn’s Disease. Medications extracted from cannabis would not produce the psychoactive effect that is so central to objections surrounding medical marijuana. However, a safe and effective medication is still a long way off and more studies will be needed to confirm these potentially promising findings.
But the clinical research is by no means uniform in favor of medical marijuana for Crohn’s. A recent study (Storr, et al.: 2014), raises serious questions about the safety of marijuana for Crohn’s patients. This eight month study of 322 patients from the University of Calgary concludes, “Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn’s disease. The study warns, “Cannabis use was associated with higher risk of surgery in patients with Crohn’s disease. Patients using cannabis should be cautioned about potential harm, until clinical trials evaluate efficacy and safety.”
The problem in the mostly self-prescribed world of medical marijuana is that there are no standards for drug safety or clinically established data on its efficacy. The stringent scientific standards applied to FDA approval for new drugs have not been applied to cannabis. However, compounds extracted from cannabis, such as dronabinol (Marinol) have been FDA approved and have a limited but clear medicinal value. Perhaps in the future, cannabis research will lead to the production of medications to reverse the pattern of intestinal degeneration of Crohn’s Disease, but that is yet to be seen. Until then there are many safe and proven medications available on the market today to alleviate the effects of chronic diseases such as Crohn’s. These treatments should all be fully explored before considering something as risky as medical cannabis. It is unfortunate that marijuana is being approved by public vote, not by expert evaluation, in the way all other medications become available.
But to the person whose life is significantly diminished by chronic IBD/Crohn’s and related diseases, the risks may seem minimal compared to the benefit of symptom relief. For this reason, it is crucial that medical marijuana as a treatment option is viewed from the broader context of the potential dangers THC poses and the presence of alternatives to cannabis for these conditions.
The pervasive assumption seems to be that there is no real down side to smoking marijuana even for purely recreational purposes. But a recent study (Gilman, et. al.: 2014), published in the Journal of Neuroscience, indicates significant brain abnormalities even with casual (weekly) marijuana smoking. The team from Harvard Medical School, Northwestern University, and Massachusetts General Hospital found that cannabis creates disruption of neural organization in the a priori regions of the nucleus of the accumbens, hypothalamus, and amygdala—centers of the brain associated with emotion and motivation. The researchers conclude, “This study raises a strong challenge to the idea that casual marijuana use isn’t associated with bad consequences. People think a little recreational use shouldn’t cause a problem, if someone is doing OK with work or school. Our data directly says that is not the case.” These findings provide more grounds for the National Institute on Drug Abuse warning: “Research shows marijuana may cause problems in daily life or make a person’s existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuana-using peers” (NIDA: 2014).
In addition to the numerous medications available to IBD/Crohn’s disease patients, every expert in gastroenterology is convinced that diet and exercise are critical to keeping symptoms at bay. British Dietetic Association evidence-based guidelines for the dietary management of Crohn’s disease in adults’ states: “Crohn’s disease is a debilitating chronic inflammatory bowel disease. Appropriate use of diet and nutritional therapy is integral to the overall management strategy of Crohn’s disease” (see Lee et. al.: 2013). Self- prescribed and self-monitored marijuana use may actually be a barrier to long-term health by muting symptoms and removing the sense of urgency to develop and sustain a healthy lifestyle.
The Pastoral Dimension
Like many issues facing contemporary society, marijuana use is never mentioned in the Bible. For this reason, medical cannabis needs to be viewed from the perspective of principles relating to substance use and abuse. Four important areas of biblical teaching relate.
First, the Bible calls Christians to sobriety. Since it is impossible to smoke marijuana without getting high, these passages have a direct application. But why does sobriety matter? 1 Thessalonians 5:6-8 contrasts drunkenness and alertness. Paul says, “let us be alert and sober. let us be sober, having put on the breastplate of faith, and love, and as a helmet, the hope of salvation.” Sobriety is essential to exercise faith, love, and hope. Being high dulls us to the moment by moment call to faith. Being high dulls us to the pressing call to love and an awareness of the true needs of others. Being high obscures the tangible reality of hope in the returning Christ. Put simply, drunkenness is a barrier to the Holy Spirit’s filling: “Do not get drunk with wine, for that is dissipation, but be filled with the Holy Spirit” (Ephesians 5:18).
In a related text, Paul says, “but you, be sober in all things, endure hardship. ” (2 Timothy 4:5). Here, sobriety is viewed as a condition for endurance. To be high or intoxicated creates lethargy. To “fulfill your ministry,” demands the willingness to work through pain and discomfort. Self-medicating, whether through alcohol abuse or cannabis, works against developing the kind of toughness required of the effective Christian worker.
A second, and clearly related principle, comes from the context of being in a spiritual battle. Peter warns, “Be sober of spirit, be on the alert. Your adversary the devil prowls around like a roaring lion seeking someone to devour” (1 Peter 5:8). Since marijuana is a psychoactive substance, the mind will be compromised in the spiritual war our enemy wages. Dulled, deceived, and dissipated, without our full faculties, Satan finds an easy target. Perhaps this is why Paul includes pharmakeon, sorcery, as of the flesh (Galatians 5:20). Psychoactive drugs were used in pagan worship and this text directly juxtaposes it to walking by the Spirit.
Third, New Testament teaching on Christians obeying secular government and its laws relates to marijuana: “Every person is to be in subjection to the governing authorities. whoever resists authority has opposed the ordinances of God. it is necessary to be in subjection, not only because of wrath, but also for conscience sake. ” (Romans 13:1,2,5). The scripture calls Christians to live within the law, except when laws directly conflict with the expressed will of God. So, for instance, Peter and John defied the civil authorities in continuing to openly preach the good news (Acts 4:19). Paul frames this obedience as a matter of conscience, a moral issue. Certainly how Christians relate to the secular state is both for the good of social cohesion and for the greater priority of our witness to non-Christians.
There are traps that medical marijuana smokers risk falling into. For instance, most employers require a drug test as a condition of employment. Cannabis smokers will fail that test. So there could easily be significant financial loss associated with medical marijuana. Further, because of the way THC stays in the body, it is possible to be arrested for the equivalent of drunk driving even a week after smoking. Ohio law states that it is illegal to drive a vehicle while under the influence of marijuana. A level of 2 nanograms per milliliter of the driver’s blood is sufficient to establish impaired driving. Prosecutors will not need to present proof of impairment in the driver’s faculties. This is very serious for anyone using medical marijuana because the average blood THC level for them is 10-20 nanograms. The reality is that medical marijuana users, legally, should not even be driving (see Ohio code 4511.19 Operating vehicle under the influence of alcohol or drugs—OVI). These are very serious risks indeed. People thinking about using marijuana should talk to a lawyer about potential legal dangers.
Fourth, drunkenness is serious enough to call for church discipline (1 Corinthians 5:11). That’s pretty sobering! Users of medical marijuana seek primarily the symptom relief THC brings, but as a psychoactive substance, the dissipating effect is also present. A way of living that includes getting high seems clearly, on the surface, to be sufficient to remove someone from fellowship. Particularly in a church context where people are trying to make a break from drug addiction, cannabis users who could be treated with other medications present an unedifying, compromising example that can easily undermine the walk of their weaker brothers and sisters.
Drawing Some Conclusions
Addressing medical marijuana use in the home church is complex and often laden with deep emotion. Each situation will bring its own complexities. Being sensitive to people who are in pain pulls us toward compassion. Reading the scripture with honesty and integrity pulls us toward concern for obedience to God’s revealed will and the life-giving principles expressed by it. Consider the following areas in the process of counseling medical cannabis users and the home church.
What is being treated? Is it a physician-diagnosed condition? If so, what are the treatment options? Medical marijuana would have to be the last resort for all the reasons explored in this paper. That means home church leaders will need to do some research. But the onus falls to the cannabis user to explain why this is the only effective option available to them. Getting the opinion of a Christian physician specializing in the relevant area would be valuable and should be pursued.
Get the advice of other Christians with the same diagnosis. It’s easy to argue that those not afflicted with a medical problem can’t relate. On a certain level this is true. But there are many people at Xenos who have learned how to deal with chronic disease victoriously without smoking marijuana. Home church leaders should insist that prospective medical cannabis users meet with these people and seek practical counsel on how to deal with their problem in a godly way. Would-be medical marijuana smokers should be called on to diligently follow the example of mature Christians in this area. There is legitimate concern that with the attitudes toward marijuana in our culture, and people will seek relief in something that is dangerous and works against their long-term health and spiritual life.
Study the available research and biblical texts together. Are you and the person considering medical cannabis clear on all of the related issues? Do you agree on the appropriate course of action? Since this is an area of potential church discipline, make sure to draw the leadership team of the home church and the sphere into the process early on. If the person decides to pursue smoking marijuana, you will need to make it clear what that choice involves in terms of their standing in the home church.
References to Related Publications
Capasso, R. et al.: Cannabidiol, extracted from Cannabis sativa, selectively inhibits inflammatory hypermotility in mice (2008: British Journal of Pharmacology)
Criminal Defense Lawyer.com. Outline of definitions for impaired driving and penalties.
Gilman, J.M, et al.: Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users (2014: J. Neurosci.)
Izzo, A. et al.: Central and peripheral cannabinoid modulation of gastrointestinal transit in physiological states during the diarrhea induced by croton oil (2000: British Journal of Pharmacology)
Lee, J. et al., British Dietetic Association evidence-based guidelines for the dietary management of Crohn’s disease (2013: J Hum Nutr Diet.)
Lomer, M.c. et al.: Current practice in relation to nutritional assessment and dietary management of enteral nutrition in adults with Crohn’s disease (2013: The British Dietetic Association)
Naftali, T., et al.: Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study (2012: Clinical Gastroenterology and Hepatology)
Storr, M, et al., Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn’s Disease (2014: Crohn’s and Colitis Foundation of America)
O’Mathuna, D. et al.: Should Christians Smoke Medical Marijuana? (2011: Christianity Today)
O’Mathuna, D., Ethics of Marijuana Use (2014: Family Research Council)
Ravikoff. A. et al.: Marijuana use patterns among patients with inflammatory disease (2013: National Center for Biotechnology Information)
Wright KL (2008) Cannabinoid (CB)-2 receptors in the gastrointestinal tract: a regulatory system in states of inflammation. Br. J. Pharmacol. 153(2), 263-7
What about Medical Marijuana? Introduction Recreational marijuana use has been decisively rejected by Christians because of its psychoactive properties and tendency to perpetuate a lethargic
The Christian Case for Marijuana
If we are concerned about justice and the mitigation of pain, we must get beyond the just-say-no mentality.
By Jonathan Merritt
Mr. Merritt writes about the intersection of religion, culture and politics.
June 20, 2019
I grew up in an evangelical Christian minister’s home during America’s “Just Say No” era, which means I spent most of my life believing that marijuana was just one more sinful tool that the devil used to shred America’s moral fabric. But that was before I developed a mysterious and debilitating chronic pain disorder against which most traditional medicines proved worthless. Pain, like time, has a way of transforming us.
On a gray morning in December four years ago, I awoke in my cramped Brooklyn apartment and could not feel my hands. Over the following weeks, the numbness morphed into burning, tingling, stabbing pain that spread all over my body. The pain was soon accompanied by panic attacks, crippling depression and something bordering on suicidal thoughts.
Desperate for answers and relief, I plowed through health care professionals — six neurologists, three primary care physicians, two chiropractors, two physical therapists, an orthopedist, a cardiologist, a rheumatologist, a physiatrist and one especially earnest Hasidic Jewish healer. They offered me no answers, but instead gave me a cabinet full of nerve pills, painkillers and anti-inflammatory drugs that clouded my mind and were accompanied by side effects that were often worse than the symptoms themselves.
In the depths of my despair, I visited a so-called green doctor in Venice Beach, Calif., and did something that the pious childhood version of me would have considered unthinkable: I asked for a medical marijuana prescription. That evening, I sampled a small dose and experienced what some might call a miracle. The excruciating pain receded and the cloud encircling my head lifted for the first time in months. I laid in bed and wept for more than an hour.
I used my prescription dozens of times in subsequent weeks, each time with similar effect. The reduced level of pain cleared a path for me to research and experiment with non-substance solutions for my illness including yoga, mindfulness meditation and dietary changes. Even still, the experience forced me to consider that perhaps marijuana should be legalized and regulated like alcohol and tobacco rather than banned like heroin and meth.
Ever since the newly formed religious right enlisted in the Reagan revolution, conservative Christians have been reliable supporters of the “war on drugs,” and by extension, stalwart opponents of legalizing marijuana. But many prominent Christian pastors and leaders I’ve spoken with told me that they are quietly changing their minds on the matter. Others who remain skeptical admit that much has changed since the 1980s and they no longer are sure of what they believe. The faithful need to have an up-to-date discussion on the morality of marijuana.
For starters, Christians should easily affirm the use of cannabis for medical purposes. Though recent research has revealed marijuana can have “a deleterious impact on cognitive development in adolescents,” numerous studies have also showcased its remarkable healing potential for adults. This has led more than 30 states to legalize it for therapeutic uses. As a doctor friend of mine in New York recently commented, if medical marijuana was a synthetic pill produced by Pfizer and not a historically villainized substance, it would be fast-tracked by the Food and Drug Administration and celebrated as a “miracle drug” by every respectable health practitioner in America. In clinical trials, medical marijuana has been shown to be safe and effective in relieving pain, decreasing inflammation, controlling seizures, reducing anxiety and depression, and easing the nausea related to chemotherapy.
America is sick, and the Christian call to compassion obligates the faithful to act. Chronic pain and illness now affect tens of millions of Americans, and in many cases the cause eludes the brightest medical minds. To fight these ailments, Americans have been prescribed mind-altering anti-depressants, highly addictive pain relievers and opioids, and all manner of legal substances with a list of side effects so long that drug commercials feel like “Saturday Night Live” shorts.
Christian ethics has long taught that the faithful must take an active role in caring for the ailing among us. The New Testament repeatedly commands the people of God to engage in “healing the sick,” an act that plays a central role in Jesus’s ministry in all four Gospels. In fact, one of Jesus’s most famous parables, in Matthew 25, lists humans’ willingness or failure to care for sick people as one of the chief criteria upon which they will be judged by God in the afterlife. And in at least one instance, the Apostle Paul, who wrote more of the New Testament than anyone else, encourages his protégé Timothy to use a potentially harmful substance for the sake of health and healing. “No longer drink water exclusively,” Paul writes in 1 Timothy 5:23, “but use a little wine for the sake of your stomach and your frequent ailments.”
While a majority of Christians now favor permitting medical marijuana, they are far more resistant to legalizing it completely. But the faithful must consider that America’s drug war has been a catastrophic failure and has perpetuated social injustices against communities of color.
Justice is one of the main themes in both the Jewish scriptures and the Christian New Testament. This includes the famed teaching from the Jewish prophet Micah that “to do justice” is one of only three actions that God “requires” from God’s people and Jesus’s repeated teachings on justice (often translated in English as “righteousness”). The more than 2,000 verses about justice in the Bible have grounded Christians in every major political justice movement in modern American history — from abolition to women’s suffrage to the civil rights movement — and provide solid ground for Christians seeking to rethink this matter as well.
The Christian rapper Jason Petty, known as Propaganda, has witnessed the injustices of this disparity firsthand as a black man. He told me that his cousin spent 25 years in prison for a nonviolent drug offense, and a close friend of his served a five-year jail sentence just for riding in a car with another person in possession of drugs. As he put it, “American Christians have to stop being the last ones to the table to have discussions like these. Given the proven racist intent of the war on drugs and the criminalization of marijuana, it’s time for Christians to think critically about this issue and not just default to abstinence.”
Indeed, people of color are far more likely to be searched or harassed, and black Americans are imprisoned for nonviolent drug offenses at a rate 10 times higher than white Americans despite the fact that white Americans use drugs far more frequently.
Even if arguments like these are persuasive to Christians, there is the matter of finding respected leaders to take them to the masses. Enter the California pastor and author Craig Gross, who has just started Christian Cannabis, a national effort to educate and engage the faithful on this issue. The organization’s flashy website, which includes a logo of a dove with a marijuana leaf in its mouth, includes a blog and a podcast. It also features a number of cannabis-infused vaporizer pens with names like Praise, Peace and Persevere, which will be for sale on the site in the future.
Mr. Gross is no stranger to sparking difficult conversations among believers. In 2002, after the explosion of the internet, he started a national organization called XXX Church with the mission of starting a conversation about the negative effects of pornography. Most Christian leaders felt uncomfortable discussing the topic so openly at the time, but Mr. Gross persisted and soon the issue went mainstream. More than 15 years later, XXX Church facilitates online Bible study groups and has created porn-blocking software. What Mr. Gross did with pornography he hopes to replicate with pot.
Mr. Gross, who is 42, admits to being personally invested in the issue. After years of struggling with a health condition that resulted in him being hospitalized and on the hook for expensive medical bills, he tried medical marijuana and found both relief from his symptoms and clarity about a new calling. He told me, “Through my experience, the Lord met me in ways more powerful than I’ve ever known. It convinced me that I am supposed to lead this new conversation.”
He is not the only one who is rethinking his views. While I was working on this story, I corresponded with numerous Christian leaders — prominent pastors, radio hosts, authors, organizational leaders. They admitted to me that they believe this issue needs to be reconsidered, and several said that they had used marijuana in recent days. But few were willing to speak on the record for fear of backlash from more politically conservative believers.
A pastor at one of America’s largest and most respected evangelical megachurches spoke to me on the condition of anonymity for fear of jeopardizing his job. He has quietly battled unbearable mental illness for more than two decades. To survive the “gruesome ride,” as he described it, he tried counseling, reading therapeutic books and a lot of prayer. Years ago, he was forced to begin taking prescription drugs with a host of negative side effects just to function at home and at work. But in recent years, he secretly added medical marijuana to his therapy regimen. Today he feels “invigorated” instead of “debilitated,” and he is no longer taking the prescription drugs on which he once depended. He said that the experience has changed both his political and his theological views.
“I have lived my whole life thinking that using marijuana was wrong and sinful, but now I cannot deny that God has used this for my good,” he told me. “It’s made me a better husband, a better human and a better recipient of God’s love.”
For the 70 percent of Americans who claim to be Christian to rethink and re-engage with this issue, believers will need to hear more stories like his, recounted by voices they trust. Right now, most Christian leaders are unwilling to step up and speak about such a stigmatized topic.
American Christians are as divided as ever over all manner of cultural issues, and it remains to be seen whether the mass of the faithful will have the energy and interest to address this issue on the level it deserves. Historically, conservative Christians have been Johnny-come-latelys to leading-edge cultural conversations. That needs to change, and not just when it comes to cannabis.
Jonathan Merritt (@JonathanMerritt) is a contributing writer for The Atlantic and the author, most recently, of “Learning to Speak God From Scratch: Why Sacred Words Are Vanishing — And How We Can Revive Them.”
If we are concerned about justice and the mitigation of pain, we must get beyond the just-say-no mentality.