A Doctorís Take On Pot
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A Doctorís Take On Pot
Posted by CN Staff on August 28, 2016 at 06:07:05 PT
By Nathaniel P. Morris
USA -- Scientific American On August 11th, the Drug Enforcement Administration announced its decision to keep marijuana classified as a Schedule I drug. The federal government has historically referred to this category as the ďmost dangerousĒ group of substances, including drugs like heroin and bath salts.As a resident physician specializing in mental health, I canít make much sense of this.
Every day, I talk to patients about substance abuse. Whether evaluating patients in clinic, in the emergency department or on inpatient units, my colleagues and I screen patients for substance use. Itís a vital component of any clinical interview, particularly in mental health care, and helps us understand patientsí habits and their risks for medical complications.During my medical training, Iíve learned which substances to worry about and which ones matter less.Alcohol is usually the first substance I ask about. Many people have seen drinking go wrong, be it a friend making a bad decision or a family member struggling with alcoholism. But clinicians see the worst of this on the front lines.Intoxicated patients stream into emergency departments after crashing their cars, inhaling their own vomit or falling into a coma. According to the National Institutes of Health, alcohol-related conditions contributed to more than 1.2 million emergency department visits in 2010. The Centers for Disease Control reports excess alcohol consumption causes roughly 88,000 deaths in the United States each year.And alcohol can be just as frightening when patients stop drinking. Heavy drinkers who donít consume as much as they usually do can go into alcohol withdrawal, ranging from mild tremors to terrifying seizures and death. Iíve spent much of my residency training so far learning how to treat and recognize complications from alcohol withdrawal.Itís not only alcohol that clinicians worry about. Cocaine can cause heart attacks, kidney failure and complications during pregnancy like placental abruption. Methamphetamine can trigger an assortment of responses, from hyperthermia to violent agitation to cardiogenic shock. Opioids like morphine can plunge patients into respiratory failure and kill them. Intravenous drug use puts patients at risk for hepatitis, endocarditis or even brain abscesses.But, for most health care providers, marijuana is an afterthought.We donít see cannabis overdoses. We donít order scans for cannabis-related brain abscesses. We donít treat cannabis-induced heart attacks. In medicine, marijuana use is often seen on par with tobacco or caffeine consumption ó something we counsel patients about stopping or limiting, but nothing urgent to treat or immediately life-threatening.The federal governmentís scheduling of marijuana bears little relationship to actual patient care. The notion that marijuana is more dangerous or prone to abuse than alcohol (not scheduled), cocaine (Schedule II), methamphetamine (Schedule II) or prescription opioids (Schedules II, III, and IV) doesnít reflect what we see in clinical medicine.This isnít to say marijuana is harmless.Indeed research suggests it may have deleterious effects on the developing brains of adolescents. Marijuana use has been linked to psychotic symptoms in some individuals. Synthetic marijuana has emerged as a new public health challenge and, in 2012, Congress added many of these toxic compounds as separate entities under the Schedule I category.According to NPR, Chuck Rosenberg, acting head of the DEA, explained the decision to keep marijuana as a Schedule I drug was based more ďon whether marijuana, as determined by the FDA, is a safe and effective medicine.ĒRegulations have prevented U.S. researchers from answering this question over the last several decades. As written in a recent editorial in The New York Times, ďthe government itself has made it impossible to do the kinds of trials and studies that could produce the evidence that would justify changing the drugís classification.ĒYet, according to a 2015 systematic review, studies from around the world suggest cannabis and cannabinoid therapies may help patients in a number of ways. These include treating chronic pain, muscle spasms, debilitating side effects of chemotherapy like nausea and weight loss from HIV infection. Dozens of U.S. states have listened to such findings in recent years and passed legislation approving the use of medical marijuana.Despite keeping marijuana as a Schedule I substance, the Obama administration has promised to expand national research into the drug. This is a welcome change, and weíll hopefully develop deeper insights into the risks and the benefits of cannabis use.In the meantime, our nationís substance policies should be grounded in the realities of clinical practice.In hospitals across the country, patients writhe in agony from alcohol withdrawal, turn violent from crystal meth and struggle to breathe after overdosing on prescription opioids. These are the cases that keep health care providers on edge. These are the patients we follow closely. When our pagers go off, we hurry to the bedside, give medications, alert security or even begin resuscitation.With marijuana? Not so much.This article was originally published by Scientific American.Source: (US Web) Author: Nathaniel P. MorrisPublished: August 28, 2016 Copyright: 2016 Salon Website: Contact: salon salonmagazine.comURL: -- Cannabis Archives 
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Comment #3 posted by observer on August 29, 2016 at 12:03:20 PT
Government Experts should Rule Ignorant Rabble
Similar frame here: the insinuation is that somehow putative health effects should strengthen the case for arrests, prisons, and jail. The "legalization" wording neatly euphemizes away unpleasant thoughts of jail and prison. if some presumed expertise in medical skills should somehow apply to whether or not people should be arrested and jailed. Yet, if enough mainstream media pretend this makes sense, then most won't question it. Which is the situation now.Note also the non-mention of arrest/jail/prison.
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Comment #2 posted by Sam Adams on August 28, 2016 at 11:25:42 PT
thanks observer
Any article that mentions "synthetic marijuana" when discussing the health impact of the actual cannabis plant is a smear piece. Why would a doctor or scientist want to conflate cannabis with poisonous designer drugs from the Chinese underground chemical industry?  Only to slander us further.What is the "relative harm" to "developing brains" of cannabis versus flame retardants? Plasticizers like bpa and many others? Synthetic pesticides? Formaldehyde and other VOC's in housing and building materials?  Mercury air and water pollution? Heavy metal water pollution? Asbestos? Lead paint? Arsenic in water? Fracking chemicals in groundwater? Air pollution from fracking? Antibiotics and synthetic hormones in livestock?All of these are serious, deadly problems that drive a US cancer rate that is literally 10, 20, or even 50 times higher than poor, undeveloped countries for many types of cancer. Is cannabis causing the epidemic of autism and neurological problems in American boys? 
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Comment #1 posted by observer on August 28, 2016 at 10:53:40 PT
A Diversion
The issue about whether or not to arrest jail people for pot is a political decision. When government and mainstream media hold up health reasons as supposed rationale to justify arresting you, jailing you, and slaving you because of pot, you can rest assured: you're being diverted, distracted, and lied to. Scientific American is a publication that seeks to continually justify government, and has continually lied about cannabis, specifically, for almost a century now. 
(see etc.) The narrative of Scientific Americans is this: you're just too stupid to be allowed to rule yourself, because to-day things are so very complicated and scientific that only government-approved and accredited experts can be trusted to understand the complexities of your life. So thus, therefore, and Q.E.D.: You must obey the scientific dictates of government, all the more. Because you're simply too ignorant, stupid and unscientific to know better. So just shut up and obey government. That's "Scientific American".
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