Medical marijuana: both sides of the story

There is a rally at the capitol building in Hartford, CT this weekend to show support for a medical marijuana bill.  I will be there to support the bill, but I am not some crazy lady who doesn't fully understand the issues at hand, and it can be beneficial to people, but detrimental as well. In all honesty, marijuana is a lot less detrimental to peoples health than tobacco products and it actually has health benefits, which are not found in tobacco products.  I want to discuss the pros and cons and give some interesting stories from patients who found it helpful and what they have had to go through during their treatments.  You are MORE than welcome to disagree with me and I actually appreciate a good debate!!

It was only in 1972 that marijuana was deemed a Schedule I drug under the Controlled Substances Act by the US government because it was considered to be a drug that had no medicinal use in treatment. Currently marijuana is legal for medical use in 14 of the 50 states (and DC). The debate in a quick synopsis?  The people that are against legalization feel that marijuana is detrimental to peoples health, it has not been FDA approved so it is dangerous to use and you don't know a strength or where it comes from.  As well, they claim it is addictive, it leads to harder drug use, and that it injures lungs, harms immune system and the brain, and sends kids the wrong message.  The pros state that marijuana meets the FDA criteria that the benefit outweighs the harm of a drug (makes you feel good about all FDA approved drugs, right? YIKES), and that it is a safe and effective treatment for multiple sclerosis, glaucoma, cancer, HIV/AIDS, pain, migraines, and epilepsy.

I agree that smoking ANYTHING is horrible for your lungs and I don't encourage smoking of any kind, it does help the patient feel relief faster as the drug reaches the bloodstream within a minute or so, but it does cause damage and the length of time that the drugs stays in the system is much slower than other methods.  But smoking marijuana is the route that most causal users take part in, patients that are legitimately sick, use other methods to gain relief of symptoms from their disease process.   There are methods of vaporizing (like being in a steam room but inhaling cannabinoids along with the vapors instead of eucalyptus on a smaller scale), which is another form of inhalation and can cause burns from high temperature water if done in the wrong way.  AS well, there is making tinctures, by soaking the plant in alcohol and absorbing the THC derivative, allowing patients to absorb the THC directly through the skin (that takes a little longer for them to feel effects and it may not have as strong an effect as smoking or eating, but dulls pain directly at the site) or they can put a few drops sublingually (under the tongue which is great for patients debilitated with pain and caregivers can easily administer without the need for an IV or having to swallow) and is mostly used by pain patients to decrease the pain without all of the psychoactive effects.  And finally, there is cannabutter which is making the cannabis into a butter through simmering over a few hours; the effects of the drugs can be felt for hours for the patients and they can modify the amount they ingest by eating smaller or larger portions, and patients state that this method gives them the best relief of symptoms for the longest amount of time BUT the downside is that they can under/overestimate the potency and eat too much or not enough to relieve symptoms, it can take up to 1 1/2 hours to feel the effects, and eating too much can cause vomiting and loss of consciousness.

As far as long term use of marijuana, there are studies that go back and forth for both sides that solidify and disprove each other, so it is really confusing to read through and sift to get the facts.  One thing I must say, is that one study that was done and is clearly pro legalization of marijuana, stated that long term marijuana smoking doesn't cause lung cancer; as I already stated, smoking isn't good for you, and any constantly inhaled smoke is going to cause damage to the lining of your lungs leading to chronic bronchitis and/or emphysema with the possibility of lung cancer.  Some studies show long term brain damage due to usage of marijuana, but what needs to be studied is the difference between long term marijuana use for pain and long term oxycontin use; this is the real issue here!  Many patients feel better relief from pain with marijuana than standard pain medications that are FDA approved and they have the added benefit of feeling hungry with a decrease in nausea, so with one "medication" they have three treatments, versus taking three or more prescribed drugs that can cause liver/kidney damage and not always feel an effect.

As well, the people who are against the use of marijuana for medical use feel that this gives a poor message to children and that marijuana usage will increase. In states that have legalized marijuana, they have seen no dramatic increase in the use of marijuana by adolescents or adults.  Furthermore, I do think that children already get a confusing view of right and wrong in our society; alcohol and tobacco combined have huge addiction and death rates, but they are both legal, and as stated earlier, tobacco, as distributed currently, has no known health benefits.

I had a patient that was literally wasting away from cancer because of nausea and vomiting from chemotherapy and inability to eat leading to malnutrition, and all drugs that their MD prescribed weren't helping, they literally were dying from the side effects of the medications, while their cancer was actually diminishing. She was on so much oxycontin to diminish her pain that she was constantly dozing off and her life was no longer hers, it was the cancers.   She was staunchly opposed to marijuana because when she grew up in the "Reefer Madness" era, she was told it was a gateway drug and made you crazy, but she finally was so fed up with traditional US medicine that she asked her children to help her find some marijuana and she smoked it one day; her life changed completely.  She was able to eat, and keep the food down!  She felt her depression lift, and she was able to have some pain relief without sleeping her life away.  WIth the help of friends and the Internet, she learned how to ingest the drug by other means, mostly she ate it in her food, and she regained control of her life and her disease.  The problem?  She had to do sketchy drug deals and fear being arrested for buying marijuana, when she was using it as medicine, but just a recreational drug to get high and silly.  How is marijuana any more harmful than oxycontin??  I don't have an answer for you...

I know that this could go on for days and I could write an entire 100 page soliloquy on the topic, and I honestly tried to be neutral, but it clearly didn't come across that way!! There are also governmental monetary issues that i may talk about because the current state of our government economic issues versus the cost of arresting people for marijuana use is ridiculous.   I just wanted to add a chart that shows the death rate of medical marijuana vs standard FDA approved drugs and let you all ponder the true risks of legalizing medical marijuana, and if you support it or not!

DRUG CLASSIFICATION	Specific Drugs per Category	Primary Suspect of the Death	Secondary Suspect (Contributing to death)	Total Deaths Reported 1/1/97 - 6/30/05
A. MARIJUANA also known as: Cannabis sativa L	Marijuana Cannabis Cannabinoids	0	279	279
B. ANTI-EMETICS (used to treat vomiting)	Compazine Reglan Marinol Zofran Anzemet Kytril Tigan	196	429	625
C. ANTI-SPASMODICS (used to treat muscle spasms)	Baclofen Zanaflex	118	56	174
D. ANTI-PSYCHOTICS (used to treat psychosis)	Haldol Lithium Neurontin	1,593	702	2,295
E. OTHER POPULAR DRUGS (used to treat various conditions including ADD, depression, narcolepsy, erectile dysfunction, and pain)	Ritalin Wellbutrin Adderall Viagra Vioxx*	8,101	492	8,593
F. TOTALS of A-E	Number of Drugs in Total	Primary Suspect of the Death	Secondary Suspect (Contributing to death)	Total Deaths Reported 1/1/97 - 6/30/05
TOTAL DEATHS FROM MARIJUANA	1	0	279	279
TOTAL DEATHS FROM 17 FDA-APPROVED DRUGS	17	10,008	1,679	11,687

And check out the website www.medicalmarijuanaprocon.org for more info and all aspects of this debate, and any of you nutmeggers that support a passing of the medical marijuana bill in CT, I hope to see you on Saturday!!

Yours in Good Health!!
B