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Doctors Debate Telling Patients To Smoke Marijuana
Posted by CN Staff on February 20, 2013 at 20:01:25 PT
By Mary MacVean
Source: Los Angeles Times 
USA -- Perhaps you know whether you’d want to use marijuana to relieve severe pain or nausea. But if you were a doctor, what would you tell patients who asked about taking something that’s against federal law? The New England Journal of Medicine poses the question to its readers and on Wednesday presented arguments for and against from doctors. The hypothetical patient is 68-year-old Marilyn, who has cancer and who says the standard medications are not relieving her pain and nausea. She lives in a state that allows medical marijuana use and says her family could grow it. She is asking her primary care doctor for advice.
“I endorse thoughtful prescription of medicinal marijuana for patients in situations similar to Marilyn’s,” writes Dr. J. Michael Bostwick, representing one side. Doctors should turn to marijuana only when “conservative options” fail, he says. “Simply to allow a patient with uncontrolled symptoms of metastatic breast cancer to leave the office with a recommendation to smoke marijuana is to succumb to therapeutic nihilism,” Drs. Gary Reisfield and Robert DuPont write on the other side. Bostwick says that federal policy has not kept pace with scientific advances and that “largely anecdotal but growing literature supports” the efficacy of marijuana for pain and nausea that don’t respond to ordinary treatments. With 18 states making legal medicinal marijuana, “the cannabis horse long ago burst from the federal jurisdictional barn,” Bostwick writes. He notes that the abuse of the state laws by some doctors should not prevent all doctors from being able to prescribe marijuana. He also notes that the federal law has meant that no Food and Drug Administration trials have looked at it in comparison to traditional drugs. If Marilyn had never tried marijuana as a recreational drug, Bostwick writes, she might not like its “psychoactive effects,” but if she feels better with it, “she would channel 5,000 years of medical history.” In the “no pot” camp, Reisfield and DuPont argue that smoking marijuana is “nonmedical, nonspecific and potentially hazardous.” The cannabis plant, they write, has hundreds of pharmacologically active compounds that could lead to unwanted effects. Among the several possible negative results, they write, are effects on Marilyn’s cognitive and psychomotor abilities, such as driving, and effects on her health at a time when her immune system is compromised. While the doctors say the issues surrounding marijuana should be discussed with Marilyn, “there is little scientific basis for recommending that she smoke marijuana for symptom control.” Source: Los Angeles Times (CA)Author: Mary MacVeanPublished: February 20, 2013Copyright: 2013 Los Angeles TimesContact: letters latimes.comWebsite: http://www.latimes.com/URL: http://drugsense.org/url/5QohWg7jCannabisNews  Medical Marijuana Archiveshttp://cannabisnews.com/news/list/medical.shtml 
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Comment #1 posted by Swazi-X on February 24, 2013 at 15:35:13 PT:
You've Got To Be Kidding
"Reisfield and DuPont argue that smoking marijuana is “nonmedical, nonspecific and potentially hazardous."Lies from ignorant doctors. All too common - they not only have forgotten their Hippocratic oath to do no harm (as is evident with each prescription they write for anti-depressants that carry the risk of suicide as a "side effect") but seem to also have forgotten how to read.We expect doctors to have a scientific basis for the treatments they offer, not simply parrot the government position that "drugs are bad, mmmkay?". Unfortunately, most doctors are happy with the status-quo, handing out pills and stacking their cash and not upsetting the apple cart of profit and power.The few doctors and researchers who bother to spend time studying the work on cannabis that's already been done (don't let them lie to you about this either - there are many thousands of peer-reviewed, valid scientific studies on cannabis) almost always change position to become advocates for this little plant.The problem lies in the facts that 
1.Cannabis is non-toxic. 
2.Cannabis has vast health benefits - it's possibly the best tonic ever discovered, especially when used fresh (not dried).
3.Anyone can grow it in their backyard or closet cheaply.
4.There is solid evidence that this plant can actually CURE cancer.These facts scare the pants off anyone who's income depends on feeding an increasing number of people an increasing variety of pills that they're supposed to take for the rest of their lives.It especially scares the pants off Big Pharma - imagine a medicine you can grow that cures cancer, relieves asthma (look it up!), cures diabetes, and that can help keep people from more deadly relaxants like alcohol.Corporations and our own government's fear of reduced income is the only reason this plant is a problem for anyone.
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