Forums » Politics and Healthcare

Medical Marijuana - good or bad, or other. Share your opinion.

    • Moderator
    • 1957 posts
    March 9, 2014 10:49:25 AM PDT

    Another hot topic in the news is Medical Marijuana and this forum is created to generate discussion on the topic. 

    Q1: Some people want marijuana to be legal in every state and claim that their is no harm from it. However, is there any benefit from it?

    Q2: What are potential best and worst case scenarios that might result from all 50 states legalizing medical marijuana? 

    Q3: What are potential best and worst case scenarios that might result from all 50 states legalizing marijuana? 

    Problems with Medicalization of Marijuana

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    This post was edited by DrSocial Admin at April 24, 2015 2:21:56 PM PDT
    • 7 posts
    March 25, 2014 10:06:16 PM PDT

    Q1 I  I see only good for cancer patients. I know there are other groups of patients that would benifit from this too. Anything that helps the truely sick is a good thing. Benifit is that people/patients don't have to resort to street drugs or worry about getting around the rules in the states that allow medical use.   

    Q2 I think there will be a bunch of people who don't understand medicial marijuana doesn't get people high trying to abuse and misuse it. I think there will be some slimmy producers who will make some forms that will indeed be just about getting high and offering no real use to those who are sick. 

    Q3 Best case is that it makes the price come down, insurance being forced to pay for it, may lead to some national guidelines and the general public brcomes more educared. Worst case is more politicians making the rules instead of doctors and patients. 


    This post was edited by DrSocial Admin at April 24, 2015 2:22:19 PM PDT
    • Moderator
    • 1957 posts
    March 25, 2014 10:58:19 PM PDT

    Dear a1b2,

    Thank you kindly for your comments.

    I will respond to your comments as so organized (Q1, Q2, Q3)

    (Q1- reply): I have only seen one patient who was deemed by their care team to have needed marijuana when it was schedule one drug. (FDA regulations determine drug schedules, & schedule one has the most paperwork).

    I can't imagine too many people with cancer finding street drugs such as marijuana, as I would presume usually they are too weak to travel the usual markets. In addition, it is unclear why persons should be given smokeable marijuana instead of the presumably better regulated drug Marinol.

    (Q2-reply): High or not, these people who will benefit from medical marijuana are suffering significantly and I don't think they would take it to get high, but to end their pain and suffering.

    The high or altered mental consciousness from marijuana presumably does not have a threshold dose. Thus, we can anticipate that people who consume medical marijuana will experience all the psychogenic effects of regular marijuana.

    Ideally we would have a medicine that would end suffering without causing det

    erioration of cognition. (Q3-reply): thank you for sharing. It will be interesting it see how this unfolds. Thank you for your comments. I wonder what others anticipate for the future of regulation of this plant-drug.

    Some entrepreneurs are investing in marijuana websites in case the drug becomes less regulated. Personally, I can't fully-understand why someone would want to get high or have altered consciousness, but it makes me sad because it means they are probably not happy. More persons getting high is the anticipated effect from less regulation.

    If someone walks into a bar and drinks a bottle of vodka they will probably be worse off than someone who smokes marijuana. Thus, it seems plausible that at least some people who are opposed to people having altered consciousness is that they enjoy feeling moral superiority to someone who is high. Some persons want to belittle another person so they can feel better about themselves.

    The best aim would be to have a clear mind, pay meticulous attention to detail, and demonstrate excellent patient care.

    Outcomes are what matters, not the treatment method. Physicians who ignore this dogma are probably more concerned with themselves than the patient. To prevent those with selfish agendas from negatively influencing patient care, we must measure outcomes closely and do what is best for the patient.

    Please pardon the typos, I am typing on a mobile device.

    Kind regards


    This post was edited by DrSocial Admin at April 24, 2015 2:26:49 PM PDT
    • 7 posts
    March 26, 2014 5:19:40 AM PDT

    reply

    Q1 It is not the people with cancer that will be buying it. It is family members and friends eho get it and take it to them. I bought some for mom but then I got scared to give it to her. 

    Q2 Medicial Marijuana does not make people high but the perception is that it does. I don't see patients trying to abuse it but there will be a fsir amout people from the general population who will fake illness for the "high". Eventually the word will get out and that should stop or at at least lessen. Althought I don't know how the placebo effect will play out here. 

    Q3 I hope that doctors educate themselves. There are many different kinds of medicial marjiuana designed to do different things. I had a friend who used it. He smoked one kind for head aches, another kind for nausa and a third kind to help him sleep.   I can not imagine what the last few years of his life woild have been like if he didn't have it.  


    This post was edited by DrSocial Admin at April 24, 2015 2:27:45 PM PDT
    • Moderator
    • 1957 posts
    March 26, 2014 6:03:16 AM PDT
    Dear a1b2,

    Thank you for your reply. You are absolutely on the right track about physician education. I can only speak for myself, but I need to review the medical literature, guidelines, and discuss the best practices for this. Personally, if marijuana becomes legal in my state I intend to refer the patient to a consultant for such evaluation.

    Medical marijuana is not yet legal in my state, but I will certainly get updated on this evolving area of healthcare before it does. I apologize for the brevity. - mobile Kind tegards.

    -Brett
    • 5 posts
    May 28, 2014 9:23:12 PM PDT

    Great discussion.  It's interesting to read everyone's opinions here.  I can't say I know much about the pros and cons of medical marijuana, but perhaps this is a legal issue that should be decided by each state -- and then is between each patient and their doctor.

    • Moderator
    • 1957 posts
    May 29, 2014 3:44:57 AM PDT

    Thanks for your comment AnnieMP

    I have a friend who bought a MedicalMarijuana website in St.Louis. They recently approved marijuana for medical use. Interesting when advocates were motivating the legislature, they mentioned that it was a first-line therapy, for epilepsy. However, pandering fear often trumps evidence and good decision making, even among physicians. 

    I am interested to hear more about why we SHOULD NOT legalize marijuana for everyone. What is the downfall. IMHO, I am afraid it would be sold to children by adults who purchase it legally. 

     


    This post was edited by DrSocial Admin at June 12, 2014 7:44:21 AM PDT
    • 1 posts
    August 28, 2014 11:26:13 PM PDT

    Well, voters in Washington state and Colorado recently approved measures that lead to cannabis decriminalization, while a similar law was defeated in Oregon. Some feel it was the wrong move, but decriminalizing it is set to yield some severe economic advantages. Semantics aside, those states are poised to reap financial benefits of doing so, not least of which being million in tax revenue. Look no further, all of the facts you need is at MatchFinacial.com.

    • Moderator
    • 1957 posts
    August 28, 2014 11:48:37 PM PDT
    Thank you K,

    I was unaware that a similar vote failed in Oregon.

    Kind regards
    • Moderator
    • 1957 posts
    September 21, 2014 4:45:28 PM PDT

    http://www.nejm.org/doi/full/10.1056/NEJMp1408965#t=comments

    Data by Profession and Location
    RICHARD KENNEDY | Other | Disclosure: None
    LORTON VA
    September 14, 2014

    Marijuana is medicine

    Thanks to the NEJM for continuing its effort to correct a horribly misguided federal policy on medical marijuana, and what a tragedy that Dr. Kassirer's 1997 editorial advice was not followed. To see how research on medical marijuana is exploding, do a PubMed search for "cannab* or marijuana". The annual number of hits was usually in single digits before 1964, when THC was first isolated. It then soared above 400 in the early 1970s, before falling back, presumably because of marijuana being placed in Schedule 1 of the Controlled Substances Act in 1970. It was 200-plus in the 1980s, before the CB1 and CB2 receptors, and the chemicals that plug into them, were identified. After that it soared again, passing 400 in 1997, 1000 in 2004, 2000 in 2012, and is already above 2000 this year with almost four months to go. Skeptics should visit The AnswerPage.com--accredited by the Massachusetts Medical Society--where they can earn CME credits for learning about medical marijuana.

    stuart gitlow | Physician - Psychiatry | Disclosure: None
     
    September 11, 2014

    Why is State Law Important?

    You write: "Since federal drug laws are unlikely to change any time soon, changes in state law become more important — and signal, I think, a tipping point: a majority of states will soon permit medical uses of marijuana." Let's say that state law were to permit medical use of candy wrappers. There is, in fact, no medical use of candy wrappers. If 26 or even 50 states had such legislation, that would not make candy wrappers any more medically useful. Here, we have a situation where the AMA, ASAM, and APA have all said, essentially, that there is no currently acceptable use of the plant marijuana in a medical setting. There are appropriate uses of components of marijuana, as in the FDA-approved drug Marinol. There is certainly a potential use of other components of marijuana, and all these groups recommend further study and research. But in terms of the actual plant, there is no such thing as a medical application. Given that, marijuana is in the same position as candy wrappers. What the majority of legislatures do to make believe that it has a medical application is not germane to the issue and is therefore unimportant.

    BRETT SNODGRASS, MD | Other | Disclosure: None
    FLORISSANT MO
    September 10, 2014

    Assertion of Motives may be misguided.

    Dear Reader, I have met federal agents of the FBI before and I have the utmost respect for their thoroughness and high-level of professionalism. Although the DEA is a separate federal agency, I am highly skeptical that a federal agency would engage in plain-language bullying. They federal government engages in numerous sting operations. If these doctors reacted as very alarmed, then they would be suspicious. This is likely an investigative effort to understand the physician's intent. If the doctor had a panic attack when approached by the DEA then the DEA would know which doctors were uncertain of the reasons of their conduct. Please consider giving more credit to our Federal Agencies. I highly doubt that the DEA officers would take it upon themselves to bully doctors for the effect of bullying. Intelligence agencies are brilliant. Consider the myriad of ways that doctors interview patients. Sometimes it isn't the question itself that is of interest, but how the patient responds to the question. I blog at http://drsocial.org/ on marijuana quite frequently and I have encountered no intimidation or bullying. I would love to hear a reply to my skepticism . Kind regards

    FREDERIC AUERBACH, MD | Physician - EMERGENCY MEDICINE | Disclosure: None
     
    September 10, 2014

    Oxymoron

    Medical Marijuana is nothing but another societal oxymoron, an ever-increasing creeping issue of permissiveness in what former NY Senator Patrick Moynihan labeled as "defining deviancy down". We, as a collective, will pay heavily for such stupidity in future years. Liberals win in the short term and most everybody eventually loses...even them!

    Page


    This post was edited by DrSocial Admin at April 24, 2015 2:20:16 PM PDT
    • Moderator
    • 1957 posts
    September 24, 2014 12:22:29 PM PDT

    New study: Cannabis Use

    "Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorder

    Cannabis is known to be associated with neuropsychiatric problems, but less is known about complications affecting other specified body systems. We report and analyze 35 recent remarkable cardiovascular complications following cannabis use.

    Methods and Results In France, serious cases of "abuse" and "dependence" in response to the use of

    psychoactive substances must be reported to the national system of the French Addictovigilance Network. We identified all spontaneous reports of cardiovascular complications related to cannabis use collected by the French Addictovigilance Network from 2006 to 2010.

    We described the clinical characteristics of these cases and their evolution: 1.8% of all cannabis‐related reports (35/1979) were cardiovascular complications, with patients being mostly men (85.7%) and of an average age of 34.3 years. There were 22 cardiac complications (20 acute coronary syndromes), 10 peripheral complications (lower limb or juvenile arteriopathies and Buerger‐like diseases), and 3 cerebral complications (acute cerebral angiopathy, transient cortical blindness, and spasm of cerebral artery). In 9 cases, the event led to patient death.

    Conclusions Increased reporting of cardiovascular complications related tocannabis and their extreme seriousness (with a death rate of 25.6%) indicate cannabis as a possible risk factor for cardiovascular disease in young adults, in line with previous findings. Given that cannabis is perceived to be harmless by the general public and that legalization of its use is debated, data concerning its danger must be widely disseminated. Practitioners should be aware that cannabis may be a potential triggering factor for cardiovascular complications in young people."

    ---

    BrettMD's commentary: 

    This is a nice observational study that may be affected by reporting bias secondary to mandatory reporting if Cannabis is involved. It is hypothesis generating and worthy of further consideration. Future studies might analyze whether it was smoked marijuana that created an inflammatory mileu, or whether it is a component of cannabis itself that adversely affects the vasculature, and thus causes "heart attacks," aka. acute coronary syndromes.


    This post was edited by DrSocial Admin at April 24, 2015 2:17:22 PM PDT
    • 445 posts
    April 24, 2015 3:18:56 PM PDT

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