Willie Nelson may be America’s most famous marijuana user. In a recent interview in Rolling Stone, he said: “It’s nice to watch [marijuana] being accepted — knowing you were right all the time about it: that it was not a killer drug. It’s a medicine.” Nelson’s description of marijuana as “medicine” reflects wider confusion in our culture regarding the morality of marijuana use, a confusion sometimes reflected within the church. As states rush to legalize medical marijuana, how should Christians think about it?
To begin, we should note just a bit about the pharmacology of marijuana. Its two active chemicals are Tetrahydrocannabinol (THC) and Cannabidiol (CBD). THC is the main psychoactive (mind-altering) chemical responsible for making people intoxicated, while CBD does not have this effect. Medical marijuana comes in various forms, some which include THC and are intoxicating, and other forms which only use CBD and do not make you high.
When discussing medical marijuana, the first obstacle one faces is getting good data to use in forming opinions. Anecdotal claims about purported curative properties of marijuana abound, almost as widespread as the testimonials related to diet pills and weight-loss fads. Peer reviewed data based on controlled experiments is rarer, but data based on controlled experiments is what Christians need to form a moral opinion. Christians should use discernment in weighing the various claims about medical marijuana because many of them are exaggerated.
To date, the FDA has only approved three drugs derived from marijuana. Two of these drugs contain THC – dronabinol and nabilone – and are prescribed to treat nausea caused by chemotherapy and to increase appetite in patients with extreme weight loss caused by AIDS. Currently, only one drug derived from CBD is approved by the FDA: Epidiolex is prescribed for the treatment of seizures associated with two rare and severe forms of epilepsy.
Of the many over-stated claims about medical marijuana’s benefits, one of the most often repeated is that it relieves intraocular pressure associated with glaucoma. Smoking marijuana does relieve intraocular pressure, but only for 3 – 4 hours at a time. The problem is that glaucoma needs to be treated 24 hours a day. Thus, for marijuana to be effective, it would have to be smoked 6 – 8 times day, meaning a person would be perpetually stoned. The American Glaucoma Society says, “Although marijuana can lower the [intraocular pressure], its side effects and short duration of action, coupled with a lack of evidence that its use alters the course of glaucoma, preclude recommending this drug in any form for the treatment of glaucoma at the present time.”
Marijuana is also touted as a cure for far more vague issues such as chronic pain, stopping muscle spasms, treatment for depression or anxiety, alleviating PTSD, plus a whole host of other medical conditions. These ill-defined categories present a major problem with medical marijuana: People without a clear diagnosis may find a friendly physician to fill out the paperwork for a medical marijuana card, which in many cases is nothing more than a way to purchase pot for recreational use. Furthermore, when some people say they smoke marijuana to get relief from pain, what they have in mind is relational or emotional pain, but getting high on marijuana is a terrible coping mechanism for psychological distress and grief.
The appropriate use of medications is morally permissible for Christians. Yet, at this stage, it is still unclear exactly how marijuana or products derived from it can be appropriately used. The Bible gives us two principles which should guide our reflection. First, we are admonished to get wisdom and understanding (Proverbs 4:7) and we also commanded, “Do not participate in the unfruitful deeds of darkness, but instead even expose them.” (Ephesians 5:11) Wisdom dictates Christians wait for the best research and only use medication derived from marijuana under guidance of a physician and pharmacist so that dosage and timing can be controlled for the most efficacious result. At the same time, the recreational use of marijuana has no place in a Christian’s life, but is associated with the “unfruitful deeds of darkness.” In this light, carelessly smoking marijuana as a cure-all is not only foolish, but sinful.
In the 1800s, a flood of patent medicines were sold over the counter, some containing dangerous drugs such as opium. Unknowingly, many people with minor ailments became addicted to these drugs, with devastating consequences. Yet in each case, the patent medicine claimed to provide miraculous relief from the pains of life. In a strange turn of events, the legalization of medical marijuana has brought a new wave of cannabis-based patent medicines into the market, many of which make ridiculous and unproven claims, but have the potential to lead the unwise Christian into a life of drug use. When listening to claims about medical marijuana, remember Proverbs 14:15, “The naïve believes everything, but the sensible man considers his steps.”
 James Minchin, “The High Life,” Rolling Stone April 29, 2019, https://www.rollingstone.com/music/music-features/willie-nelson-weed-issue-826290/.
 National Institutes of Health, National Institute on Drug Abuse, “What is Medical Marijuana?,” July 2019, https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine#references.
 U.S. Food and Drug Administration, “FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy,” June 25, 2018, https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms.
 Henry Jampel, “American Glaucoma Society Position Statement: Marijuana and the Treatment of Glaucoma,” Journal of Glaucoma 19.2 (February 2010): 76.
 John Hudak, The Medical Marijuana Mess: A Prescription for Fixing a Broken Policy (Washington, DC: The Brookings Institution, 2016), 18.