Friday, February 19, 2010

Medical Marijuana on KevinMD

Lockup doc gave us the head's up that KevinMD is also talking about the legalization of marijuana for medical uses. He has good discussion of the issues up, do check it out: Medical Marijuana has Doctors Asking Questions. How'd he know I was asking about this?

The summary comes from HCPLive:

In January, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses. Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington; around a dozen more states are weighing pending bills.

Medical marijuana has doctors asking questions The New Jersey law is the most restrictive in the nation and authorizes prescribed marijuana for only a handful of chronic illnesses, such as multiple sclerosis, cancer, glaucoma, epilepsy, Crohn’s disease, AIDS, muscular dystrophy and Lou Gehrig’s disease. Unlike other states, physicians in New Jersey will not be able to prescribe medical marijuana for anxiety, headaches, or chronic pain.

It goes on to discuss the lack of evidence to support uses for medical marijuana, and the obstacles to research:

Despite the Obama administration’s relaxation on prosecutions, many researchers are still having difficulty getting approval to conduct studies that involve smoking marijuana. Requests to conduct the studies must go through the National Institute on Drug Abuse (NIDA), which controls supply from a plantation at the University of Mississippi, the only federally approved source of marijuana. NIDA routinely turns down study requests unless they are designed to evaluate the potential harm from smoking marijuana. The Drug Enforcement Agency has also declined petitions from researchers requesting permission to grow their own marijuana for use in studies.

The article notes that there are some continued issues:

Most states with medical marijuana laws allow employers to refuse employment to individuals who use medical marijuana. In some states, like Colorado, the laws are ambiguous and employers are unclear as to whether they can forbid employees to use medical marijuana outside of work. Schools are also grappling with the issue, as well, with more high school students—particularly in areas with less restrictive medical marijuana laws—receiving prescriptions for marijuana, increasingly to treat ADHD. In addition, some facilities that perform organ transplants acknowledge denying transplants to patients who use medical marijuana.

In the absence of any proven benefits from smoking marijuana, physicians in the 14 states where it is legal may want to discuss some of the pros and cons with their patients prior to issuing a prescription. Patients need to be aware of the potential impact of medical marijuana on all facets of life and should be wary of letting the anecdotal hype surrounding medical marijuana use dissuade them from first trying a proven treatment option.

View the discussion on


On another note, Rach asked us to post the following:

Stan Kutcher at Dalhousie University (Halifax, NS) is asking Canadians for feedback on how to improve infant, child and youth mental health services via an anonymous survey.


Anonymous said...

I live in a state where it's not legal(NC). I have MS, and there have been many times when I was desperate enough to want to move to a state where it is legal. I totally understand the conundrum MDs would face (esp psychiatrists), and I don't know if pot would help me or not..but it sure would be nice to at least have the option. I challenge anyone to spend a week in my body, dealing with the pain of muscle spasticity, and THEN say that we shouldn't at least be offered some additional hope. So many of us with MS are already taking interferons, baclofen, klonopin etc.. and these drugs have MAJOR short and long term side effects as well. I'm certainly not looking for a "high", I'm simply wanting to get through the day and be able to participate in my kid's lives. said...

If someone gave you seeds, that could be made into paper, fiber, fuel, clothing, be used as a medicine, and intoxicant, would you keep the seeds, or toss them away? - National Geographic

Considering Marijuana is one of the oldest organic substances used by Man, it is also important to fully-realize - it is the most complex and undervalued organic materials too. Marijuana needs to be legalized and fully researched — so more its potential can be discovered.
Join us in making this difference!

Dinah said...

I am fully in favor of more and better research on the uses of marijuana. It seems ridiculous that we'd legalize the use of a substance for mediccal purposes when the FDA has approved no medical uses, and when research has been limited.
If studies show that it helps with symptoms and the good is not outweighed by the bad, then I'm all for it.
It's hard to even think about legalizing pot smoking in school to treat ADHD-- even if it helps with attention (?) there's really no way to get around the fact that the kids get high and that's not conducive to an atmosphere of learning.
Research. And I'm not sure I understand the concept of cannabis dispensaries: if it's got a medical use, why doesn't it just get filled in a drug store? You can get morphine, xanax, and ritalin, why not marijuana?

Anonymous said...


With all due respect, I vehemently disagree with your position on marijuana. Just so people know, I have never taken it and have no plans to do so unless something drastic changes that would necessitate its use. But I see alot of hypocrisy in your position even it is unintentional.

You keep harping on studies but there certainly aren't strong ones in prescribing psych meds. There certainly isn't a study that show the effectiveness of antidepressants for 5 years.

You're depending on FDA studies of meds that are a joke. Studying the effectiveness of a med for 8 weeks proves nothing.

Psych meds are prescribed for kids that have very dangerous side effects off label and have no studies to back them up.

Funny you mention ADHD because I just saw this article about stimulants not being effective.

I do wish the article had provided a direct link to the study but I think it is quite interesting. I had seen a previous study that stimulants ceased to be effective after 3 years.

So if you're going to go by studies, why aren't your colleagues paying attention to this?

Sorry for the rant but I am just so tired of the hypocrisy. Maybe if Caroline Riley had given her kid, Rebecca, marijuana, instead of the 4 drug cocktail she was on, she might stil be alive?

Please don't misunderstand me, I am not advocating giving a 2 year old marijuana. I am just trying to put things in context and give you some perspective about the meds that you prescribe that have horrific side effects that sound worse than marijuana.

And speaking of stoned, one reason I decided to taper from my psych meds because I felt stoned on them. It isn't just marijuana that does that.


Sunny CA said...

In agreement with the last Anonymous:
My short term memory on psych meds was pitiful and my emotions seemed to be non-existent. I felt like a robot with a poor memory. I have smoked marijuana and never had anywhere near as bad effects or side effects as on psych meds. (I have been off psych meds since May, 2006 and not smoked MJ since the early 70's so this is historical perspective.)
In agreement with Dinah:
I had a student who I thought was ADHD (based on behavior in the classroom) who got into smoking pot before and during school who was largely incapacitated by the MJ in terms of learning ability. At least in his ADHD state his brain was still functional. I have had teacher testimonials about current meds for ADHD working miracles though I have not seen it myself. I do have this one really impactful personal experience to have me not want any student of mine to be smoking pot. That being said, I know that inner city kids smoke pot rather than drink because it is easier to buy due to its illegality.

mem said...

I will let these links speak for themselves.

I am not anti-legalization and tend to agree with British psychiatrists that education is the way to go.

What I am very much against is the naivete' that believes that because it's green and grows in the ground and is "natural" and is an "herb" and other people can do lots of it, that *all* people can without significant risk of the develpment of *serious* effects.

Anonymous said...

I find it highly significant that we never hear people who dislike and don't use mj talking on its behalf. Proponents mostly seem to be users talking about how useful/safe it is and "it's the only thing that works for my [fill in the blank]." If I heard people saying they quit because they hated the "high" despite significant benefits in other areas I might have a bit more belief in mj as a useful drug. Usually what I hear, as a crisis worker, are claims that the mj is treating Sx of what actually sound like mj withdrawal (anxiety, depression, poor sleep). MJ dependency seems to be overlooked as a major cause of the disorders that mj supposedly treats. From what I've read about anandamide (the neurotransmitter mj releases) and how it works, this would seem to be the case with most of the psych issues people are treating with mj.

Anonymous said...

Dinah, I don't understand how you can have a problem with marijuana because there are no studies, despite the fact that there are no studies because it's illegal. Isn't that completely circular?

Dinah said...

I think there should be studies.
What's circular about that? It wasn't my idea to make it illegal to do studies.

Anonymous said...

So now all you have to do is find a politician with enough common sense to realize that it would be a good idea to legalize it for research before jumping to any conclusions about what it may or may not be useful in treating. (A politician with common sense.. okay, that kills it right there.) At the same time, though, given the lack of studies, isn't it premature to turn it into an addiction issue? Especially given the fact that you're dealing with a population that by definition has mental problems. Just because someone prone to depression and anxiety gets hooked on it doesn't mean that the chemical itself is necessarily particularly addictive. (I'm sure it is somewhat, for some people, but if you consider the number of things people can develop addictions to-- shopping, internet, sex, gambling, bungee jumping.. simply to say that something can be habit forming and that some people have problems stopping is rather meaningless. That's true of almost anything on the planet.) Most people without problems don't see psychiatrists, clinical contact with the population of people who do use it but don't have major problems in functioning? You don't have a representative sample.
Also, anybody who has done some "research" in Amsterdam will tell you that different strains have different effects. Some will produce more of a "high" while others will decrease anxiety and others will cause paranoia, just to name a few. Which is another reason why regulation would be a very good idea.
Without research, it's also nearly impossible to differentiate the "high" from other effects. I would expect there would be a great many people who would love to discover a strain that would decrease anxiety without clouding their thinking. Or anything at all that might do that without requiring thousands of hours of meditation.
I agree that it's absurd to use it to treat ADD. However, it seems possible that it could help with attention problems caused by anxiety.

rach said...

Long time no visit.
Thanks for posting that link for me... ~R

Lockup Doc said...

Check this out--from CNN: Medical MJ Users Risk Job Loss--legal medical MJ users may get fired for positive drug tests: