• Mississippi’s medical cannabis program, which began in 2022, is still in its infancy. Stigmas and confusion about the benefits and harms remain in many parts of the state.

Elizabeth Feder-Hosey with Mississippi Patient Voices recently spoke on the stigmas that linger with the use of medical cannabis, often preventing those who could benefit from joining the program from doing so.

She told the Medical Cannabis Advisory Committee that some “still feel like they are doing something wrong, they’re afraid to talk to their doctors.”

“They’re afraid to talk to people about it in general and the information on the internet isn’t super clear and it can be an overwhelming process,” Feder-Hosey said. 

For decades, the use of cannabis has been denigrated. One notable instance is the 1936 movie “Reefer Madness,” a film that scared a generation into thinking they would lose their minds if they consumed the substance, Felder-Hosey described.

“It’s not like meth, which ‘Reefer Madness’ makes it look like,” Felder-Hosey told committee members. “So, a lot of people grew up thinking it was a very dangerous drug.” 

Even current medical cannabis cardholders fear the stigma of the general public finding out they use the drug to treat long standing conditions.

“I was embarrassed for people in my church to know,” cardholder Lizz told Magnolia Tribune, who asked that only her first name be published for privacy.

Jay Mason, a 59-year-old business owner in Mississippi, said he was raised to think cannabis would result in his life taking a downward spiral if he used the product. However, a prostate cancer diagnosis changed his way of thinking about five years ago.

“So, I was raised to believe that if I used marijuana today, that tomorrow I would probably have a heroin needle in my arm and probably be under a bridge somewhere,” Mason said. “And that’s how I raised my three kids, and I was wrong.”

Then there is the stigma that comes from medical providers who do not support the use of cannabis to treat conditions.

“People are worried they’re going to get flagged and put on some list or that their doctor will say, ‘I won’t treat you anymore,’” Felder-Hosey said.

The number one piece of misinformation that concerns Felder-Hosey with the medical cannabis program is that cardholders can no longer possess, much less carry, a firearm. 

“People believe that if they get their medical card, they will not be able to carry a gun, or their concealed carry gun,” Feder-Hosey said. “So, I think in this state we really need to let the public know that getting your card will not impact your Second Amendment right.”

While Mississippi’s statute on medical cannabis protects a cardholder’s Second Amendment rights, federal law still poses a conflict. Since federal law supersedes state laws, the Gun Control Act of 1968, which states the unlawful use of a controlled substance makes gun ownership illegal, does raise concerns for medical cannabis users. As the Reason Foundation reports, courts are divided on the issue.

State Rep. Lee Yancey (R), a member of the Drug Policy Committee in the Mississippi House of Representatives, said that so long as cardholders are not smoking medical cannabis in areas outside of their home, such as in a vehicle, there should not be an issue with law enforcement, even if they are in possession of approved medical cannabis and have a firearm.

“Assuming there’s not, you know, smoke all over the car, they should have presumed that the person is part of the program, and they’re headed home,” Yancey told Magnolia Tribune.

The status of medical cannabis as a relatively new legal substance means established protocols for enforcing DUI Other arrests are still being tweaked in Mississippi. 

Cardholder Lizz told Magnolia Tribune she was arrested in December 2023 for DUI Other during a minor traffic stop. The incident occurred while she was driving through Hattiesburg for an MRI appointment to address a longstanding neurological condition for which she has been treated for more than year.

Lizz said the stop began after she tried to use the emergency lane to get to the exit with traffic backed up. The stop by a State Trooper with the Mississippi Highway Patrol resulted in the discovery of medical cannabis.

Lizz’s uneasy gait while exiting the vehicle presumably led the trooper to place her under arrest for DUI Other, she said. She explained to the trooper that she suffers from balance issues due to her condition and is a medical cannabis cardholder. Lizz told Magnolia Tribune she was not under the influence of cannabis at the time of the stop.

The resulting Justice Court hearing found Lizz guilty, and she said her photo and arrest information was published in a local newspaper. As a result of the court’s ruling, her attorney Nicholas Sakalarios said he submitted an appeal to the County Court. Lizz said she has been waiting on an appeal date since July.

There are established protocols for determining alcohol intoxication, but Sakalarios believes more specific protocols on establishing medical cannabis intoxication need to be established. He said the cues indicative of cannabis use, red eyes and the smell of marijuana, are not indicative of impairment.

“I don’t think everyone in law enforcement is necessarily on the same page about the change in the law,” Sakalarios told Magnolia Tribune. “Because now, I think you need proof of impairment because it’s a prescription medication. But instead, they’re just finding people, they find out they’re a cardholder and they say, ‘Hey, have you smoked today?’ And if they say ‘Yeah.’ They take them to jail. That’s not what I think the Legislature intended to happen.”

His advice for cardholders who become involved in a traffic stop is to obey the officer’s commands and refrain from answering questions.

“It’s pretty simple, you obey the commands of the law officer and you don’t make any unnecessary statements of any kind, because you don’t have to,” Sakalarios continued. “You know you have a right to remain silent, you have a right to counsel and people tend to just want to answer questions.”

Dr. Brent Boyett, Addiction Medicine Specialist at the Neuroscience Institute of North Mississippi Medical Center, believes more research is needed to better understand the human body’s endocannabinoid system, the parts of the body that react to the chemicals in cannabis.

Boyett said when he went to medical school in the 1990s, the endocannabinoid system was not included in any curriculum, as most of the scientific understanding known of the substance was conducted overseas in Israel. That research identified the CB1 and CB2 receptors, the aspects of the body that react to cannabis.

Today, science has noted that those receptors are some of the most numerous in the human body.

“And we had a blind spot to them until recently,” Boyett said. “There’s a lot we don’t know, and there’s a lot of research that needs to be done. As you know this substance has been locked away in a vault of prohibition for the last 50 or 60 years, and research is now being done. But there are some things that we do know, and we can actually apply that in clinical practice.”

Boyett, who specializes in researching how opioids react with the human body, said he was a skeptic when medical cannabis became legal.

“I thought medical cannabis was a mistake, but after working with it for the last two years I have come to view it as a valuable tool in the tool kit,” he said.

Dr. Boyett now says that while medical cannabis is considered safer than full agonist opioids (i.e. morphine, heroin, fentanyl, oxycodone, hydrocodone), there are some harms associated with medical cannabis that need to be acknowledged. 

“You don’t have to do a lot of research to know that smoking, inhaling smoke and chemicals in your lungs, to be harmful to your body in a lot of different ways, your lungs, your cardiovascular system,” Boyett described.

There is also the potential for addiction, especially for young people. He said that while medical cannabis is safer in certain patient populations, Boyett noted age matters because younger individuals, especially adolescents and those in early adulthood, are more inclined to become addicted. 

When he operated a drug and alcohol rehab in Huntsville, Alabama, Dr. Boyett noticed that within the adolescent unit, the number one diagnosis for an adolescent to enter rehab was due to cannabis use disorder.

“I’ll tell you this, it’s a greater risk in younger brains than it is more mature (brains),” Boyett elaborated.

Even though the possibility of addiction is there, Dr. Boyett said it is less severe with medical cannabis than full agonist opioids. 

With a full agonist opioid, people suffer from a process called opioid induced hyperalgesia, a condition where long-term full agonist opioid use makes a patient more sensitive to pain. Dr. Boyett said that adaptation in the brain makes it harder for the patient to stop using full agonist opioids the longer they use them. 

“It’s a catch-22 really when you take it,” Boyett said about opioids. “Over time, you get caught up in this cause-and-effect loop that says, ‘Do I take full agonist opioids because I am in excruciating pain, or am I in excruciating pain because I take opioids?’ And the answer to both is, ‘Yes.’”

Dr. Boyett noted that the United States makes up only a small portion of the world’s population, but its people are prescribed opioids at the highest rate. 

“The U.S. makes up 4.5 percent of the world population, but according to the World Health Organization in 2011, American doctors prescribed over 80 percent of the global supply of prescription opioids,” Boyett described.

The states that have the most opioid prescriptions include those in the southeast, with Alabama ranking first, according to the report Dr. Boyett referenced.

Another harm comes when the patient engages in overconsumption of medical cannabis, which could lead to an unpleasant experience in the form of anxiety and other mental side effects, Boyett added.

While there are risks, Dr. Boyett said he is not aware of any case where a patient died from an overdose of medical cannabis. A 2022 study published by The National Library of Medicine concurs that the risk of death due to cannabis toxicity is negligible. 

“However, cannabis can prove fatal in circumstances with risk of traumatic physical injury, or in individuals with cardiac pathophysiologies. These indirect harms need careful consideration and further study to better elucidate the role cannabis plays in drug-related mortality. Furthermore, the relevance of cannabinoid quantifications in determining cause of death in coronial investigations is limited,” the study noted.