Many medical marijuana advocates have regularly informed legislators that marijuna is the first line treatment for epilepsy. As a physician who practices evidence based medicine, I peruse the latest literature on the topic and share that with the legislators in Missouri.
I am unaware what the Missouri Legislator decided on Medical Marijuana, but as a physician in primary care, I most certainly follow the standard of care and refer first time seizure patients for a neurological evaluation. For those who think medical marijuna is the treatment for seizures, I refer them to the laudable efforts of JAMA in bringing a quantative analysis to the practice of medicine.
The doses of medications that the FDA selects for patients are often based upon mean pharmacokinetic analysis from clinical studies. Smoking a "marijuana," leaf provides the patient with an unkown level of THC.
As alcohol may be a recreational drug, so have some states decided to make marijuana. However, from a clnical, evidence-based perspective, smoking a leaf is probably less reliable and consistent in therapeutic effect than what we can guarantee to provide a patient with with an FDA-approved pill that is manufactured by a pharmaceutical company that complies with the FDAs manufacturing requirements.
Problems With the Medicalization of Marijuana FREEONLINE FIRST
Samuel T. Wilkinson, MD1; Deepak Cyril D’Souza, MBBS, MD1,2,3
JAMA. Published online May 20, 2014. doi:10.1001/jama.2014.6175
“Medical” marijuana is approved in 21 states and the District of Columbia for numerous conditions, including glaucoma, Crohn disease, posttraumatic stress disorder, epilepsy, Alzheimer disease, and chemotherapy-induced nausea and vomiting.
Both the number of states and the number of approved indications for medical marijuana are expected to increase. Physicians will bear the responsibility of prescribing marijuana and thus have an obligation to understand the issues involved in its “medicalization.”
Medical marijuana differs significantly from other prescription medications. Evidence supporting its efficacy varies substantially and in general falls short of the standards required for approval of other drugs by the US Food and Drug Administration (FDA). Some evidence suggests that marijuana may have efficacy in chemotherapy-induced vomiting, cachexia in HIV/AIDS patients, spasticity associated with multiple sclerosis, and neuropathic pain.
However, the evidence for use in other conditions—including posttraumatic stress disorder, glaucoma, Crohn disease, and Alzheimer disease—relies largely on testimonials instead of adequately powered, double-blind, placebo-controlled randomized clinic
This is incredulous. The laboratory that produces Marinol (dronabinol), a cannabinoid that is FDA approved to treat anorexia/weight loss associated with* AIDS, was cited by the FDA for effectively marketing: Marijuana is a treatment for AIDS!
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