Should Christians Smoke Medical Marijuana?

No—It's a bad Witness

Brett McCracken, author of Hipster Christianity: When Church and Cool Collide (Baker), writes about pop culture for Relevant magazine and Christianity Today.

Medical marijuana is certainly helpful for people in great pain, many of whom use the drug in the same way they would use a pain reliever like codeine. The difference between codeine and cannabis is that the latter has a very distinct, largely negative image in culture—an image that carries baggage and connotations Christians must consider if they are thinking of using marijuana, even for medical reasons.

When I was in grad school, several of my colleagues smoked marijuana. I do not doubt that smoking marijuana relieved the aches and pains of my 20-something cohorts. But I wonder if "medical assistance" is the primary reason they were using it. More likely they consumed it in the way Oscar on Arrested Development did—enjoying "primo bud" under the auspices of the legal right to medical marijuana.

In California, the image of marijuana use, even for medical purposes, is mostly a joke. Pot smoking has long been associated with "slackers"—zoned out, disengaged, pleasure-seeking rebels always in search of a high. The image has even given rise to a genre of cinema: the Stoner Film. The image of those who smoke weed in these films is one of laziness, irresponsibility, and mischief.

The image of medical marijuana is not much better. Walk down the Venice or Santa Monica boardwalk in L.A. and you will be bombarded with leaflets for the dozens of medical marijuana dispensaries in town. Affable hippies even call out, "Get your medical marijuana recommendation here!" The dispensaries are more like recreational amusement shops than clinics for the sick, and the overall culture is one of "Here's a sweet loophole!" partying more than anything else.

Given these connotations, Christians should be cautious about using marijuana. Marijuana is associated with vice and unseemly activity. Christians are called to be above reproach, "without blemish in the midst of a crooked and twisted generation," shining "as lights in the world" (Phil. 2:15, ESV). We are told to "not be conformed to this world" (Rom. 12:2) and to "walk properly as in the daytime," avoiding sins of addiction such as drinking and partying (Rom. 13:13). In 1 Peter 2:11-12, Peter urges Christians to "abstain from the passions of the flesh" and to keep their conduct honorable, so unbelievers "may see your good deeds and glorify God on the day of visitation."

The issue is not the relative danger of marijuana itself; it is about witness. If Christians use marijuana as a medical aid, it should be done in a quiet, private manner, without flaunting. Christians must be mindful of pot's controversial and hazardous reputation in culture, and be sensitive to the perspectives of both other Christians and unbelieving observers. Christians should take note of the food offered to idols issue in 1 Corinthians 8-10 and strive to abstain from arguably innocuous activities that are nevertheless contested in culture. It is not worth offending or making someone stumble.

Not unless proven …

Dónal O'Mathúna cowrote Alternative Medicine: The Christian Handbook (Zondervan) and teaches ethics at Dublin City University's School of Nursing.

In most jurisdictions, smoking marijuana, even for medical reasons, is illegal. Christians are called to submit to governing authorities (Rom. 13:1-7). Breaking the law can be justified sometimes, most obviously when we must choose between obeying God or the government (Acts 5:29). This does not apply here; Christians should obey laws that prohibit medical marijuana.

Since God is a healer and comforter, could medical marijuana be approached just like any other medicine? Paul advised Timothy to take a little wine for his stomach and other illnesses (1 Tim. 5:23). Alcohol can be abused and cause harm in many situations. Does Paul's advice provide guidance to Christians on medical marijuana?

The key question is whether medical marijuana has legitimate uses.

Many patients say that smoking marijuana helps control pain, including the side effects of chemotherapy, multiple sclerosis, and other therapies and conditions. But anecdotal reports do not provide the evidence necessary to show if an intervention is beneficial and safe.

The U.S. Institute of Medicine in 1999 and the British Royal College of Physicians in 2005 published in-depth reviews of previous medical marijuana research. Because most of the studies reviewed were not controlled studies, the report concluded that there is little evidence to support the medical use of marijuana. However, products purified from marijuana, most notably a prescription drug called dronabinol, appear to be helpful. These products are legally available and have legitimate uses.

In 2007, the first randomized controlled trial of marijuana smoking was published. Patients with painful HIV-related neuropathy smoked either marijuana or placebo cigarettes daily. Patients' pain scores decreased an average of about one-third with marijuana. Since then, a few other controlled studies have produced beneficial findings for medical marijuana. However, these studies also showed that medical marijuana does not work well for everyone and has side effects. The prevalence and seriousness of the side effects is still debated.

Christians should approach the smoking of medical marijuana as they would other medical decisions. If there are good reasons to legalize marijuana, we can work to do so. Decisions about the legal status of medications should be based on sound research. Christians could act for the greater good by participating in research aimed at providing clearer evidence about smoking medical marijuana. If high-quality studies continue to show evidence of benefit, regulators should consider changing the legal status of medical marijuana.

When legal, medical marijuana should be weighed against other treatments that may be more effective. If these do not work or cause side effects, smoking medical marijuana may be an option. Meanwhile, Christians should obey the law as it stands.

Yes, with care

Ed Welch is a counselor with the Christian Counseling and Educational Foundation and author of several books on addiction and mental illness, including When People Are Big and God Is Small.

Ah, those Californians—a bunch of grown-up hippies single-handedly keeping medical marijuana in the national consciousness. But wait. My wife and most of her family are from California, and they all seem surprisingly normal. Maybe medical marijuana is worth a careful biblical look. Scripture raises important questions.

First, is it moral? This is the most important question. Does Scripture prohibit or command using marijuana for medical purposes? If something is illegal, unless Scripture commands us to do it, we do not. Where medical marijuana is legal, this is no longer an issue.

Second, are mind-altering drugs sinful? This one is a bit more slippery. Many prescription drugs—like psychiatric drugs—can be mind-altering, and so are legal drugs such as tobacco and alcohol. Christians have reasonable arguments on both sides. But I think we can agree that one's motivation is relevant. If someone puts their hope in mind-altering drugs, and these drugs become a way to turn away from the Lord, they are idolatrous and wrong. Even then, that does not mean that the person must stop taking the drugs. It means they must learn how to turn to the Lord in their troubles.

Third, is it wise to smoke medical marijuana? This overlaps with the morality question. There are times when something is morally permissible, yet unwise. If you struggle with a desire for alcohol, it is permissible but unwise to work in a place where alcohol is served. With medical marijuana, that question could be reframed as, "Is it helpful or dangerous?" Are there deleterious consequences to this treatment? The brief answer, and I suspect there would be many heads nodding at this, is that every medical treatment has possible harmful side effects. In an era of full disclosure, many prescription warnings end, "Oh, and you might die too." When you line up modern pain relievers, marijuana looks quite tame. It is riskier than Tylenol but safer than Vicodin. The dangers ebb when the marijuana user is terminally ill, and Scripture supports palliative care for the dying (Prov. 31:6-7).

Finally, is your conscience clear? Is it okay that people know you are taking medical marijuana? You do not have to announce it in front of the assembly, but you should not be ashamed if other people know. If your conscience bothers you, do not do it. For some people, the stumbling block might be that you smoke it. Put it in a pill form and use its technical name, and many consciences would probably be soothed.

Many innovations have unwanted side effects. For example, the Internet is a purveyor of pornography. Yes, more people will use marijuana for non-medical reasons. People who would not cross the barrier between legal and illegal might be more prone to try something that is legal though restricted.

How would I vote? Be wise and do not violate your conscience.

Related Elsewhere:

Previous Christianity Today coverage of drug ethics and addiction includes:

Rehab Revival | Evangelism among addicts seeing success, efforts bear a mixed public blessing. (April 11, 2011)

Can't Get No Satisfaction | Addiction is the spiritual disease of our time. (December 9, 2010)

Talking Honestly about Alcohol | Wise pastoral care for today's insidious disease. (October 18, 2010)

Court Rules Against Student in 'Bong Hits 4 Jesus' Case | The ruling supports school's right to ban promotion of drug use, not speech on political or social issues. (June 7, 2007)