1. DrugEpi 5-5 Policy Question: Medical Marijuana Module 5 Overview Context Content Area: Policy Decisions about Drug Use/Abuse Issues Essential Question (Generic): What should be done when preventable causes of disease are found? Essential Question (Drug Abuse Specific): What should be done when preventable causes of drug abuse are found? Enduring Epidemiological Understanding: Policy decisions are based on more than the scientific evidence. Because of competing values - social, economic, ethical, environmental, cultural, and political factors may also be considered. Synopsis: In Module 5, students explore specific drug policy questions and become aware of the factors that influence their own and others' positions on those questions. Lesson 5-1: Individual and Societal Decision Making Lesson 5-2: Drug Policy Question - Should needle exchange programs be implemented? Lesson 5-3: Drug Policy Question - Should high school students be drug tested? Lesson 5-4: Drug Policy Question - Should D.A.R.E. be taught in all schools? Lesson 5-5: Drug Policy Question - Should marijuana be legal for medical purposes?

2. DrugEpi 5-5 Policy Question: Medical Marijuana Module 5 - Policy Decisions about Drug Use/Abuse Lesson 5-5 Drug Policy Question: Should Marijuana be Legal for Medical Purposes ? Content Explanation of how scientific literacy is connected to individual and societal decision-making Definitions and discussion about policy, risk perception and the acceptability or unacceptability of risk Application of Drug Policy question Assignment to question, Should marijuana be legal for medical purposes? Big Ideas In a democratic society, a scientifically literate population is better able to make informed decisions about issues of public health Societal decisions about acceptability versus unacceptability of risk often consider other factors besides the actual magnitude of that risk The issue of whether or not marijuana should be legal for medical purposes is controversial with powerful arguments on both sides This project is supported by a Science Education Drug Abuse Partnership Award, Grant Number 1R24DA016357-01, from the National Institute on Drug Abuse, National Institutes of Health.

3. DrugEpi 5-5 Policy Question: Medical Marijuana Essential QuestionsEnduring Understandings 1.How is this disease distributed? Health-related conditions and behaviors are not distributed uniformly in a population. They have unique distributions that can be described by how they are distributed in terms of person, place, and time. 2.What hypotheses might explain the distribution of disease? Clues for formulating hypotheses can be found by observing the way a health-related condition or behavior is distributed in a population. 3.Is there an association between the hypothesized cause and the disease? Causal hypotheses can be tested by observing exposures and diseases of people as they go about their daily lives. Information from these observational studies can be used to make and compare rates and identify associations. 4.Is the association causal? Causation is only one explanation for an association between an exposure and a disease. Because observational studies are complicated by factors not controlled by the observer, other explanations also must be considered. 5.What should be done when preventable causes of disease are found? Policy decisions are based on more than the scientific evidence. Because of competing values - social, economic, ethical, environmental, cultural, and political factors may also be considered. Where are we?

4. DrugEpi 5-5 Policy Question: Medical Marijuana Drug Policy Question Should marijuana be legal for medical purposes? Individual and Societal Decision Making A. Orientation to the Enduring Understanding Slides B. Drug Policy Question “Hip Pocket” Slides C. Drug Policy Question Summary Slides

5. DrugEpi 5-5 Policy Question: Medical Marijuana Drug Policy Question Should marijuana be legal for medical purposes? Individual and Societal Decision Making A. Orientation to the Enduring Understanding Slides B. Drug Policy Question “Hip Pocket” Slides C. Drug Policy Question Summary Slides

6. DrugEpi 5-5 Policy Question: Medical Marijuana Enduring Understanding Policy decisions are based on more than the scientific evidence. Because of competing values; social, economic, ethical, environmental, cultural, and political factors may also be considered. Individual and Societal Decision Making

7. DrugEpi 5-5 Policy Question: Medical Marijuana Scientific Literacy A scientifically literate person is someone who: National Research Council. (1996) National Science Education Standards, Washington, DC: National Academy Press. … can ask, find, or determine answers to questions derived from curiosity about everyday experiences … has the ability to describe, explain, and predict natural phenomenon … is able to read with understanding articles about science in the popular press and to engage in social conversation about the validity of their conclusions … can identify scientific issues underlying national and local decisions and express positions that are scientifically and technologically informed … (is) able to evaluate the quality of scientific information on the basis of its source and the methods used to generate it … (has) the capacity to pose and evaluate arguments based on evidence and to apply conclusions from such arguments appropriately Individual and Societal Decision Making

8. DrugEpi 5-5 Policy Question: Medical Marijuana Policy A course or principle of action adopted or proposed by a government, party, business, or individual John M. Last, A Dictionary of Public Health Individual and Societal Decision Making

9. DrugEpi 5-5 Policy Question: Medical Marijuana Policy A course or principle of action adopted or proposed by a government, party, business, or individual John M. Last, A Dictionary of Public Health Individual and Societal Decision Making

10. DrugEpi 5-5 Policy Question: Medical Marijuana Drug Policy A course or principle of action adopted or proposed by a government, party, business, or individual that affects drug use Individual and Societal Decision Making

11. DrugEpi 5-5 Policy Question: Medical Marijuana Pre-Drug Policy Question Assignment Survey Summary Individual and Societal Decision Making Should marijuana be legal for medical purposes?

12. DrugEpi 5-5 Policy Question: Medical Marijuana Drug Policy Question Should marijuana be legal for medical purposes? A. Orientation to the Enduring Understanding Slides B. Drug Policy Question “Hip Pocket” Slides C. Drug Policy Question Summary Slides Should marijuana be legal for medical purposes?

13. DrugEpi 5-5 Policy Question: Medical Marijuana Should marijuana be legal for medical purposes? As part of the Investigational New Drug Program, this patient has been allowed to smoke marijuana to relieve the pain from a rare bone disorder.

14. DrugEpi 5-5 Policy Question: Medical Marijuana Should marijuana be legal for medical purposes?

15. DrugEpi 5-5 Policy Question: Medical Marijuana I Should marijuana be legal for medical purposes?

16. DrugEpi 5-5 Policy Question: Medical Marijuana I Should marijuana be legal for medical purposes?

17. DrugEpi 5-5 Policy Question: Medical Marijuana Should marijuana be legal for medical purposes?

18. DrugEpi 5-5 Policy Question: Medical Marijuana Gonzales v. Raich Should marijuana be legal for medical purposes?

19. DrugEpi 5-5 Policy Question: Medical Marijuana This report summarizes and analyzes what is known about the medical use of marijuana; it emphasizes evidence-based medicine, as opposed to belief-based medicine. Should marijuana be legal for medical purposes?

20. DrugEpi 5-5 Policy Question: Medical Marijuana Recommendation Research should continue into the physiological effects of synthetic and plant-derived cannabinoids and the natural function of cannabinoids found in the body. Should marijuana be legal for medical purposes?

21. DrugEpi 5-5 Policy Question: Medical Marijuana Recommendation Psychological effects of cannabinoids such as anxiety reduction and sedation, which can influence medical benefits, should be evaluated in clinical trials. Should marijuana be legal for medical purposes?

22. DrugEpi 5-5 Policy Question: Medical Marijuana Recommendation Clinical trials of short-term marijuana use (less than six months) for medical purposes should be conducted under limited circumstances. Should marijuana be legal for medical purposes?

23. DrugEpi 5-5 Policy Question: Medical Marijuana Recommendation Short-term use of smoked marijuana (less than six months) for patients with debilitating symptoms (such as intractable pain or vomiting) can be permitted under certain conditions. Should marijuana be legal for medical purposes?

24. DrugEpi 5-5 Policy Question: Medical Marijuana Recommendation Clinical trials of cannabinoid drugs for symptom management should be conducted with the goal of developing rapid-onset, reliable, and safe delivery systems. Should marijuana be legal for medical purposes?

25. DrugEpi 5-5 Policy Question: Medical Marijuana How would you determine whether or not Sativex is belief-based or evidence-based medicine? How would you test the effectiveness? Should marijuana be legal for medical purposes?

26. DrugEpi 5-5 Policy Question: Medical Marijuana Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Healthy People - E Random Assignment E DZ Controlled Trial Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Healthy People - E E DZ Cohort Study Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Case-Control Study - DZ E E E E Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Cross-Sectional Study - E E DZ d b c a Should marijuana be legal for medical purposes?

27. DrugEpi 5-5 Policy Question: Medical Marijuana 9010 9010 b d a c or % % Total Sativex No Sativex No Pain Pain Risk of Pain Relative Risk 1 Should marijuana be legal for medical purposes?

28. DrugEpi 5-5 Policy Question: Medical Marijuana 9010 9010 b d a c or % % Total Sativex No Sativex Risk of Pain Relative Risk > 1 Should marijuana be legal for medical purposes? No Pain Pain

29. DrugEpi 5-5 Policy Question: Medical Marijuana 9010 9010 b d a c or % % Total Sativex No Sativex Risk of Pain Relative Risk < 1 Should marijuana be legal for medical purposes? No Pain Pain

30. DrugEpi 5-5 Policy Question: Medical Marijuana Drug Policy Question Should marijuana be legal for medical purposes? A. Orientation to the Enduring Understanding Slides B. Drug Policy Question “Hip Pocket” Slides C. Drug Policy Question Summary Slides Individual and Societal Decision Making

31. DrugEpi 5-5 Policy Question: Medical Marijuana In Favor of Should marijuana be legal for medical purposes? Individual and Societal Decision Making

32. DrugEpi 5-5 Policy Question: Medical Marijuana In Favor ofAgainst Should marijuana be legal for medical purposes? Individual and Societal Decision Making

33. DrugEpi 5-5 Policy Question: Medical Marijuana In Favor ofAgainst Should marijuana be legal for medical purposes? Scientific Social Economic Ethical Environmental Cultural Political Individual and Societal Decision Making

34. DrugEpi 5-5 Policy Question: Medical Marijuana In Favor ofAgainst Should marijuana be legal for medical purposes? Policy decisions are based on more than the scientific evidence. Because of competing values; social, economic, ethical, environmental, cultural, and political factors may also be considered. Individual and Societal Decision Making

35. DrugEpi 5-5 Policy Question: Medical Marijuana Write a Brief Statement Individual and Societal Decision Making Forces that Influenced Your Position

36. DrugEpi 5-5 Policy Question: Medical Marijuana Post-Drug Policy Question Assignment Survey Individual and Societal Decision Making Should marijuana be legal for medical purposes?

37. DrugEpi 5-5 Policy Question: Medical Marijuana Pre-Drug Policy Question Assignment Survey Individual and Societal Decision Making Should marijuana be legal for medical purposes?

38. DrugEpi 5-5 Policy Question: Medical Marijuana Pre-Drug Policy Question Assignment Survey Individual and Societal Decision Making

39. DrugEpi 5-5 Policy Question: Medical Marijuana Pre- and Post Drug Policy Question Assignment Survey Summaries Individual and Societal Decision Making Should marijuana be legal for medical purposes?

40. DrugEpi 5-5 Policy Question: Medical Marijuana Democracy “It is both the glory and the burden of democracy that lay citizens must make the final choice.” Citizen - Kings / Citizen - Queens Individual and Societal Decision Making

41. DrugEpi 5-5 Policy Question: Medical Marijuana Big Ideas in this Lesson (5-5) In a democratic society, a scientifically literate population is better able to make informed decisions about issues of public health Societal decisions about acceptability versus unacceptability of risk often consider other factors besides the actual magnitude of that risk The issue of whether or not marijuana should be legal for medical purposes is controversial with powerful arguments on both sides Re-Cap

42. DrugEpi 5-5 Policy Question: Medical Marijuana End of Module 5 Democracy