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Medical Marijuana: Please Don't Let Me Be Misunderstood


 

  • Legalization will benefit those with illnesses. Some wrote in with their own anecdotes of how marijuana helped the following: OCD, seizures, Crohn’s disease, migraines, chronic pain such that the user could stop taking narcotics, bone disease, and “saved my marriage, my heart, and my soul.” One commenter asserted that in Oregon, marijuana cures cancer.
  • FDA approval is a catch-22 because cannabis is a Schedule I drug, and this stymies research. In a country where 17 states have legalized medical marijuana, I agree that the FDA should revisit this issue.
  • FDA-approved medications have resulted in many deaths, and FDA-approved medications have been withdrawn for safety reasons. Readers specifically noted Ambien, Xanax, Oxycontin, Vioxx, Avandia, Fen-Phen, and silicone breast implants. They contend that marijuana is safer than these substances.
  • Other legal substances are unsafe, specifically alcohol, tobacco, and the above-mentioned prescription drugs. This is similar to the point made above, and I agree, but I am not sure it’s relevant to the discussion of medical marijuana.
  • Marijuana is safe and effective, and any facts that are presented to the contrary are wrong. There is really no answer to this because this point of view, by definition, is closed to discussion.
  • Marijuana doesn’t kill. If you stay out of a car, don’t lace it with it toxins, and don’t mix it with other drugs, this is probably true.
  • There are inconsistencies in medical practice, and people can get Viagra by calling an 800 number.
  • Marijuana is an herbal product that has been used as medicine for thousands of years and should not treated as a pharmaceutical. Again, this is different issue from those addressed in medical marijuana legislation.
  • Doctors are pawns of the pharmaceutical industry and can’t profit if medical marijuana is legalized. One writer suggested that psychiatrists would be put out of business because marijuana would replace Prozac, and several commenters stated as a fact that my co-author and I are pharmaceutical “shills” who are more interested in dinners and harbor cruises. Neither Dr. Hanson nor I have any financial relationships with pharmaceutical companies, and it’s been years since I’ve gotten so much as a pen, much less a chicken salad sandwich, from a drug rep. I’m not terribly worried that medical marijuana will put me out of business, but I am concerned that it will make my job harder.
  • There were some insults that added nothing to the conversation. "Psychiatrists are the worst kind of quacks because they believe their own nonsense. Their 'successes' are people who are drugged into the equivalent of a chemical lobotomy.”


Personally, I do believe that marijuana should be re-scheduled and that it should be available for use for specific indications where other treatments have been inadequate. But it should be prescribed cautiously, purchased from a pharmacy, with a prescription noting dosage and frequency, and marketed without the propaganda that it lacks adverse effects or the possibility of addiction.

I do not believe that non-psychiatrists should prescribe medical marijuana for psychiatric symptoms, (especially if the patient is also seeing a psychiatrist) and I certainly don’t believe that legislators should propose psychiatric indications for cannabis in opposition to current treatment standards. I believe that if marijuana is used as “medicine,” it should be used because conventional medications, including Marinol, the oral form of synthetic THC, either haven’t worked or have caused unacceptable side effects.

The current mechanism of prescribing medical marijuana is not about cancer, AIDS, MS, or chronic pain patients. Unlike other “medications,” marijuana (medical or otherwise) causes smokers to get high, and legalization requires that we address how this will play out for the work place and our overall productivity as a society.

If the conversation is about increasing access to marijuana for all Americans, one might contend that our current War on Drugs has been a dismal failure, and discussions regarding decriminalization or legalization might best be left to the lawmakers, the constituents, the crime fighters, and the addiction specialists. That’s a conversation that can be had without my input.

If you’d like to read the original article with the comments in the Baltimore Sun, click here.

If you’d like to read an article by a Steve Balt, a California psychiatrist who discusses the issues involved in treating patients who are getting medical marijuana from another prescriber, click here.

And, finally, if you’d like to read an article from Time magazine called "The United States of Amerijuana," click here.

Please note, the ideas expressed here are mine alone and do reflect the views of the co-author of the original article, Dr. Hanson.

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