Few opponents of a ballot question that would legalize the use and distribution of marijuana for medical use stake their argument on whether the drug benefits people who are suffering from pain, nausea, or other effects of long-term medical problems. Many are focused on how medical marijuana programs can go awry.

I wrote in today’s G section about concern among substance abuse doctors and researchers that medical marijuana will lead to increased use of the drug among teens and adolescents whose developing brains are particularly vulnerable to its effects. Recent studies have found that the drug can have long-term effects on cognition and mental health, particularly for those who begin using it when they are young and continue over time.

Others point to drug trafficking issues. The Oregonian published a series of stories this weekend outlining how marijuana ostensibly grown for medical use has been shipped to dealers across the country. Oregon voters passed a ballot measure in 1998 legalizing production and use of marijuana by patients with certain medical conditions and a doctor recommendation.

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Reporter Noelle Crombie detailed a story of a woman licensed to grow medical marijuana who was caught attempting to ship 74 pounds of marijuana in a cargo container bound for Boston. Crombie writes:

Authorities found 350 pounds of medical marijuana in packages moving through the U.S. mail facility in Portland from October 2011 through May of this year. They also discovered a half-million dollars in cash—proceeds from the sale of medical marijuana—in packages mailed to Oregon addresses.

The incentive to move Oregon medical marijuana out of state boils down to simple economics. It goes for $1,000 to $3,000 a pound in Oregon, law enforcement officials say. Once it reaches the Midwest and East Coast, Oregon pot can net up to $5,200 a pound.

In separate stories, Crombie outlined how some growers participate in “card stacking,” becoming caregiver to multiple patients in order to increase the amount of pot they are able to grow legally. And she wrote about how convicted felons, including some with a drug history, are eligible to become cardholders.

Some say health concerns and even the changing black market support the case for widespread legalization of marijuana for medical use, because such laws provide a path to better regulation.

Dr. Eric Ruby, a pediatrician in private practice in Taunton, e-mailed me this morning after reading about the drug’s effects on teens. Ruby, who also has advocated for the ballot question that would allow doctors to prescribe life-ending drugs to people who are terminally ill, said his patients’ families want access to medical marijuana.

He wrote:

We know tobacco causes lung disease, worsens heart ailments, and is the leading cause of death from disease in the United States. We regulate it, we tax it and we allow for individual choice and its consequences.

We know that liquor causes cirrhosis. We regulate it, we tax it, and we allow for individual choice and its consequences.

We are involved in the legalization of gambling in Massachusetts even today. The Commonwealth benefits from it financially knowing full well what public health consequences may result.

I won’t even talk about guns.

In so far as medical marijuana is concerned, if revenue is an issue, here is a solution.

If crime is an issue, here is a solution. If clinical trials are an issue, have the FDA reclassify THC. There are already more significantly more expensive, toxic and addictive pharmaceuticals approved. If quality control is an issue, this is the way to protect our population.

What’s your take on medical marijuana, readers? Is its prohibition in Massachusetts an inadequate substitute for better regulation or necessary to protect public health?