George D. Lundberg, MD, Editor-at-Large

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GEORGE LUNDBERG: Hello, and welcome. I'm Doctor George Lundberg. And this is At Large at Medscape.

One of the advantages of growing old-- and, trust me, there are not very many-- is to observe how observations you have made and positions you've taken over the years play out.

Now is such a time for me and marijuana.

I'm not a user, but I have been a loud proponent for science and justice to supersede ignorance and ideologic bias with cannabis since at least 1970 when I published in JAMA on September 21 that, in contrast to alcohol and tobacco-- which kill Americans every day-- there appears never to have been an authenticated case of marijuana killing anyone and, in the Journal called California Medicine in May 1971, marijuana is noteworthy for the absence of recognized harmful physical effects.

Needless to say, I've tried to move the issue only incrementally to blunt the effect of the anticipated and realized harsh criticism on my career.

Finally, crowdsourced science is winning. Justice should not be too far behind. Justice Brandeis was right. The states are the laboratories. The people are leading the leaders who trail badly and now must play catch up.

Since the non-responsive federal government's repression of research is a main reason we know so little medically about cannabis, the federal coffers-- Francis Collins at NIH, Peggy Hamburg at FDA, Nora Volkow at NIDA, and Michele Leonhart at DEA take note-- should now be opened wide to support serious marijuana research in the community as well as the clinic and laboratory.

The people have chosen to become the Guinea pigs in real life. Study them clinically, Colorado and Washington. Study them medically, you 20 states plus DC with legal medical marijuana. For the marijuana users, it ain't harmless.

Be careful because there's much we do not yet know, largely as a result of the long-term federal foolishness as it prevented most serious research from being done. We do know this.

One, developing brains at least age 21 or later are more vulnerable to drug damage. Delay beginning cannabis use as long as possible if ever. Two, it is dangerous to drive automobiles or tractors or motorcycles or fly airplanes while stoned. Don't drug and drive. Three, do not mainline pot potions.

IV injection of crude cannabis extract makes one very sick. We also reported that in JAMA in 1971. For the criminal justice system, decriminalize marijuana possession and use.

Empty the prisons of nonviolent marijuana offenders who should never have been there in the first place. Overturn Richard Nixon's southern strategy of disenfranchising black voters by incarceration.

Save tons of public money even while resisting the lobbying of the American for-profit prison system. Reverse 20th century Jim Crow. When the United States Congress revives the Controlled Substances Act, either delete cannabis from any schedule or move it down from Schedule 1.

My old friend Roger Egeberg was seriously wrong in 1970 when he advised you to schedule cannabis one. For general editors, invite papers describing reality as recorded by observant and inquisitive local physician scientists authors.

JAMA, plan a theme issue on medical and public health policy aspects of campus. I have included a lot of topics here, some without building background for the reader in this brief column.

I have references and will make them available to your request to [email protected] That's my opinion. I'm Doctor George Lundberg, At Large for Medscape.