Prescription for Pot: A Debate on the Merits of Medical Marijuana
The use of marijuana for medicinal purpose has been a hotly debated topic in the United States. While cannabis is still listed as an illegal narcotic under federal law, 15 states and the District of Columbia have statutes decriminalizing medicinal marijuana as therapy for specific ailments. Recently, the American Medical Association released a report urging review of marijuana as a schedule one controlled substance, noting that physicians should be protected from prosecution for recommending marijuana and that further studies should be conducted into marijuana’s use as medicine.
To provide further insight on this controversy, MD Magazine Peers & Perspectives convened two leading experts in the field to debate the merits or lack thereof of medical marijuana. The panel was moderated by Peter Salgo, MD, professor of anesthesiology and internal medicine at Columbia University. The panelists were Joel W. Hay, PhD, a professor of clinical pharmacology and pharmaceutical economics and policy at the Shafer Center for Health Policy and Economics in the school of pharmacy at the University of Southern California, and Joseph I. Sirven, MD, professor and chairman of the department of neurology at the Mayo Clinic in Arizona.
The panelists discussed the potential of medical marijuana for treating a variety of different conditions and their symptoms, including analgesia, problems with appetite, and spasticity. But they agreed that there are many unanswered questions regarding the use of medical marijuana.
Hay said one of his issues with the use of medical marijuana is that fact that it is unpredictable because it has not gone through the FDA’s approval process in which the active ingredient is isolated and purified, then used to develop a pharmacologic standard product.
Sirven said that despite the clinical research proponents point to as underscoring the efficacy of medical marijuana, most physicians still seem to be uncomfortable with it. “There’s that very distinct stigma that’s still attached to the discussion of the drug, for wrong or right,” Sirven said.
To read the entire article based on the roundtable discussion, click here.
We want to know what you think:
Do you believe that marijuana is a legitimate tool for the treatment of certain conditions?
Do you believe there is enough clinical research to support its use?
Although medical marijuana has been approved by a number of states, it is still a Federal crime for physicians to prescribe marijuana for medical reasons. Do you believe the Federal government should change these laws?
To provide further insight on this controversy, MD Magazine Peers & Perspectives convened two leading experts in the field to debate the merits or lack thereof of medical marijuana. The panel was moderated by Peter Salgo, MD, professor of anesthesiology and internal medicine at Columbia University. The panelists were Joel W. Hay, PhD, a professor of clinical pharmacology and pharmaceutical economics and policy at the Shafer Center for Health Policy and Economics in the school of pharmacy at the University of Southern California, and Joseph I. Sirven, MD, professor and chairman of the department of neurology at the Mayo Clinic in Arizona.The panelists discussed the potential of medical marijuana for treating a variety of different conditions and their symptoms, including analgesia, problems with appetite, and spasticity. But they agreed that there are many unanswered questions regarding the use of medical marijuana.
Hay said one of his issues with the use of medical marijuana is that fact that it is unpredictable because it has not gone through the FDA’s approval process in which the active ingredient is isolated and purified, then used to develop a pharmacologic standard product.
Sirven said that despite the clinical research proponents point to as underscoring the efficacy of medical marijuana, most physicians still seem to be uncomfortable with it. “There’s that very distinct stigma that’s still attached to the discussion of the drug, for wrong or right,” Sirven said.
To read the entire article based on the roundtable discussion, click here.
We want to know what you think:
Do you believe that marijuana is a legitimate tool for the treatment of certain conditions?
Do you believe there is enough clinical research to support its use?
Although medical marijuana has been approved by a number of states, it is still a Federal crime for physicians to prescribe marijuana for medical reasons. Do you believe the Federal government should change these laws?
Comment(s)
Your comments are valuable to us. Thank you.
Gary Alan Mohr MD
September 22nd, 2011 - 06:13:38 PM
There is, or has been, a medically pure form of THC in pill form. One of my patients who was going through chemo & radiation for Hodgkin's got it from his oncologist.
I have concerns about the long term safety of "medical marijuana". Pulmonary and psychic effects can be considerable. I would probably never use it myself.
On the other hand, I am a libertarian. I think people should be allowed to do stupid things, as long as they assume the responsiblity for the consequences. I think it should be legalized, but not "medicalized".
I have concerns about the long term safety of "medical marijuana". Pulmonary and psychic effects can be considerable. I would probably never use it myself.
On the other hand, I am a libertarian. I think people should be allowed to do stupid things, as long as they assume the responsiblity for the consequences. I think it should be legalized, but not "medicalized".
Tracey Standring
September 22nd, 2011 - 06:19:18 PM
We need to pull together and VOTE! I am a pharmacy technician, and have done a lor of reaearch on medicinal marajuana. I don't understand why cocaine is a control 2 substance, but marajuana, which no one has ever died from, is a control schedule 1! Makes no sense to me!
David Van Gorp
September 22nd, 2011 - 07:49:57 PM
I have practiced for 30 years and do not have any reason to prescribe marijuana to my patients. There are many other safe, legal options. If this were a new drug developed by a rich pharmaceutical company, the company would be sued for side effects and ill effects not related to the intended use. WE DON'T NEED IT.
Jack L. Underwood, M.D.
September 22nd, 2011 - 09:44:24 PM
Of course it should be legal. It's safer than alcohol. Since its not going to be made legal, it should be medically available for pain where it is very useful. However, it should be done like liquor in Vermont, not as it is done in California.
Helen Montague Foster, MD
September 23rd, 2011 - 07:46:14 AM
I do not think the cost/benefit ratio of smoking marijuana makes it appropriate for any medical condition. Marinol, the purified form of marijuana, is available for some uses. There are other alternatives, and the risks of marijuana include precipitating psychosis in vulnerable individuals, as well as a number of other adverse psychiatric side effects. Some studies show that, like benzodiazepines which treat anxiety but when used alone may lead to worsening depression, marijuana also may lead to depression. I do not think there is enough clinical research that supports its use.I oppose changing the Federal laws that restrict marijuana use.
Theodore Carl Houk, M.D.
September 23rd, 2011 - 10:32:27 AM
I had a patient who smoked only marijuana daily and presented with rectal cancer metastatic to his groin lymph node. I am sure all smoke is carcinogenic, from my grill and fire place and yours. Vaporizers may help, but this must be studied prospectively with hundred of completers before we can recommend it at all. Calcium, vitamin D and multivitamins have all fallen down in prospective RCTs. Pot causes paranoia and schizophrenia - how can we expect it survive an RCT? Does anyone recall the CAST trial? fancy drugs suppressing PVCs were killing people. There is a big profit motive in CA. So far it is proven valuable to the seller only
WBCSPORTS ARNP
September 23rd, 2011 - 11:37:22 AM
The reason that MJ has not been evaluated by legit drug companies is as big a mystery as AREA 51. I suspect there are hidden DEA motives for not promoting access to research what would very likely be the source of several new drugs to develop and make people's lives better. The FEDS should change their name to Lola, as in whatever Lola wants,Lola gets.
Bruce W. Young, MD
September 23rd, 2011 - 12:20:52 PM
Cannagbis is NOT legit !
JACOB GOLDBERG, D.O.
September 23rd, 2011 - 09:25:52 PM
NO ONE SEEMS TO HAVE THE ANSWER TO THIS QUESTION, LARGELY BECAUSE SO MUCH IS UNKOWN ABOUT MARIJUANA AND SO MUCH PREJUDICE ABOUNDS. FOR WHATEVER REASON THERE IS LITTLE BEING DONE REGARDING CONTROLLED RESEARCH TO FIND ANSWERS TO THE UNANSWERED QUESTIONS. THOSE REPORTS THAT WE DO HAVE OFTEN ARE BIASED PRO OR CON AND SHED LITTLE LIGHT ON THE ISSUE. WE DO KNOW THAT MARIJUANA IS COMPOSED OF MANY CHEMICALS. UNTIL EACH COMPONENT IS ADEQUATELY EVALUATED IT IS ILLOGICAL TO CONCLUDE THAT MARIJUANA HAS NO MEDICAL VALUE. I DON'T KNOW WHAT DR. HOUK'S SPECIALITY IS, BUT HE SEEMS TO HAVE DISCOVERED A CAUSE FOR SCHIZOPHRENIA - POT. THERE ARE NO STUDIES TO SUPPORT HIS CLAIM, YET IT IS CLEAR THAT SOME INDIVIDUALS SEEM TO DEVELOP PARANOIA FROM MARIJAUNA. SINCE MARIJUANA IS ILLEGAL, ANYONE USING IT "OFF THE STREET" CAN'T BE SURE WHAT THEY ARE USING AND I HAVE HEARD REPORTS FROM PATIENTS THAT DRUG DEALERS ADD SUBSTANCES TO THE MARIJUANA THEY SELL TO GET REPEAT BUSINESS. WHILE I DON'T CONDEM THE USE OF MARIJUANA I DO WARN MY PATIENTS OF THE INHERENT RISKS, LEGAL, PSYCHOSOCIAL AND PSYCHIATRIC. THE BOTTOM LINE IS THAT WE NEED MORE GOOD SCIENTIFIC DATA BEFORE ARRIVING AT CONCLUSIONS ABOUT THE POTENTIAL MEDICAL BENEFITS OF MARIJAUNA OR ANY OF ITS COMPONENTS.
Bryant Draper MD
September 24th, 2011 - 06:59:55 PM
I do believe that California's stance on the medicinal use of THC is ahead of the times. Personally, many of my patient's report self medicating. In fact, about 50 percent of my patients, from all walks of life, use the substance. I am not to judge, I am only to help people. That is the Oath I took. From my 18 years of ER and Primary Care experience, I have never seen an overdose. Ever. I have never seen a single marijuana addict lose everything in their life over the drug. I have seen emphysema as a result of chronic use. I have looked at and read the many studies out there on the topic. There are not many studies out there. What I do extrapolate from the studies I have read is that there is medicinal value. That there is a change in mood from its use. The substance helps with everything from rheumatoid arthritis (I have a 77 year old woman who uses it regualarly instead of take narcotics) to cancer ( I prescribe Marinol regularly for Cancer patients with cachexia from chemo) --and you know something--the stuff works. So, it is in this practitioners experience with patients, that it is MEDICINE. Used as medicine, in the hands of physicians, I think it is a great thing for those who feel it will help them. On the other hand, the negative aspects-abuse, dependence, addiction--I really have not seen it to the extent of other prescription or illicit drugs. Like I stated before, I have never seen a reported death from an overdose on THC. I have worked in inner city ER's, Rural ER's, and Suburban ER's. I have never seen a police report in the ER warning of us of a dangerous new type of THC on the street. In fact, the newer synthetic cannabinoids the kids are smoking (K2) is quite dangerous. The kids are using it to beat a drug test for THC. Now what is wrong with that picture. Shame on you all --America. Did you all not learn from the 1960's? Human beings have used substances to alter their consciousness since the dawn of time whether it is legal or not. And, guess what, they will continue too. Ok, so the newer designer drugs are made to beat the dreaded piss test, and the clandestine chemists and drug culture will continue to stay one step ahead of regulatory agencies to produce a product that will alter mood and bring in cash. Why not just decriminalize all drug use like Portugal or other more cerebral countries in this world. I have watched the drug war fail. Crusading against any medicine that makes people better is archaic. We are in the 21st Century folks. THC is a medicine like it or not. The studies prove it.
It is safer than most b blockers. Have you ever treated a B Blocker overdose?
It is my opinion that it is not the THC but the politics of it that intrigue most. If the US was to legalize it would crumble the foundation of the Federal Sentencing Guidlelines which are based on Marijuana equivalents. Funny, how this simple substance could change the entire sentencing structure of the Department of Justice it is was made legal. This is just one of the many reasons why the governement will never legalize. Now, I do believe that medicines should be left to doctors. Right now, THC is a schedule 3 in Marinol form. MJ itself is a schedule 1 right up there with heroin and cocaine. WOW It needs to be schedule 3. Give the person the choice of using medicine to help whatever ails them. I see far many more people today Addicted to something the Primary Care Doc prescribed than the all of the illicits combined. My opinion lies with that of the Doctor's of California. Please read the California Medical Professional's stance on the subject. I agree with the doctors that have been using this medicine with great success. Follow California, they are always ahead of the times.
It is safer than most b blockers. Have you ever treated a B Blocker overdose?
It is my opinion that it is not the THC but the politics of it that intrigue most. If the US was to legalize it would crumble the foundation of the Federal Sentencing Guidlelines which are based on Marijuana equivalents. Funny, how this simple substance could change the entire sentencing structure of the Department of Justice it is was made legal. This is just one of the many reasons why the governement will never legalize. Now, I do believe that medicines should be left to doctors. Right now, THC is a schedule 3 in Marinol form. MJ itself is a schedule 1 right up there with heroin and cocaine. WOW It needs to be schedule 3. Give the person the choice of using medicine to help whatever ails them. I see far many more people today Addicted to something the Primary Care Doc prescribed than the all of the illicits combined. My opinion lies with that of the Doctor's of California. Please read the California Medical Professional's stance on the subject. I agree with the doctors that have been using this medicine with great success. Follow California, they are always ahead of the times.
Jeremy Mesches, MD
October 5th, 2011 - 12:30:21 AM
I think marijuana is a legitimate treatment option for some conditions, such as pain, wasting, nausea, and insomnia. However, I do not believe there is enough clinical research to support it's use. I think the federal government should decriminalize marijuana.
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P: 609-716-7777
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Copyright HCPLive 2006-2011
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