Certainly, the creation of novel molecular compounds is risky, and you can only mitigate the risks you know about. But that's not the comparison we're talking about here. We're not talking about smoking marijuana plant-matter vs. taking new GSK LessCancerPainIum™️. We're talking about smoking marijuana plant-matter vs. taking a pill that was created by processing grown marijuana plant-matter, or with an active ingredient synthesized to be identical to the ingredient-under-test of marijuana plant-matter.
Personally, I've never heard of a case where Big Pharma has ever created a delivery vehicle for a well-known, Generally-Recognized-As-Safe active ingredient (like e.g. aspirin) that then kills, or even harms, people.
Like, the Tylenol murders? Those were big news. It'd be even bigger news if the manufacturer themselves were responsible instead of some random MITM. But there has never been that kind of big news. They don't screw up when making pills. Pills are pills. Novel active ingredients can kill you. But—presuming the active ingredient is safe—the pills themselves killing you? When has that ever happened?
> Unfortunately, I have lost track of how many people I have seen die that were the direct result of alcohol ingestion.
Well, yeah; people are consuming arbitrary amounts of alcohol. That's what's bad about recreational alcohol use.
Same goes for opioids, in a different sense; addiction drives you to consume arbitrary amounts of opioids. That's what's bad about drugs of abuse.
And yet, as an EMT, you still stick car-crash victims with fentanyl, no? Even though it's an opioid, and potentially a vector for chemical dependence. But you're not likely to kill them with it. Why? Because it's a measured dose.
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Note that I'm not arguing that the active ingredients in medical cannabis could kill anyone. It's been pretty well shown that they don't really have an LD50.
It's not the active ingredients I'm worried about. It's the rest. It's the reason that hospitals don't get food for patients catered from arbitrary restaurants. You want to control all the variables you can. A CBD+THC tincture is going to have strictly fewer non-controlled variables than smoking the raw plant. A crystallized distillate suspended in a PEG gel pill is going to have fewer non-controlled variables still.
It's not about not-killing people. It's about treating people, successfully, with the highest ROI per treatment-hour possible and the least time spent flailing around trying to diagnose unknown brokenness while the patient continues to suffer.