opinion

'Medical' marijuana is already available

As a physician, I am amazed by the miracle of healing when I see people recover from injury and illness. I am also touched by the sadness and misery of pain that illness brings.

Medical use of marijuana plant as an appetite stimulant, muscle relaxant, anti-convulsant, and for relief of pain and vomiting was first discovered in 1839 by William O'Shaughnessy, an Irish physician working in India.

It is, however, a mind-altering substance with major psychotropic effects, especially on the developing and teenage brain.

It is also a gateway drug, leading to advanced drug use and addiction. Driving under its influence is hazardous.

Societal consequences of marijuana prevalence are being discovered in states that have legalized it. Policy Statement of American Academy of Pediatrics “opposes legalization of marijuana because of potential harms to children and adolescents.”

Studies of the medical uses of marijuana are not fully reliable because the accepted (and the gold standard) scientific method of a double-blind controlled trial cannot be applied to this research.

The distinctive smell and the intoxicating effects of marijuana do not allow for a control or placebo group that can be compared to the therapy group. Anecdotal healing effects of marijuana have been claimed for many conditions.

Recent reviews published in the Journal of the American Medical Association have shed light on this matter. Evidence shows that medical marijuana may be useful in treatment of epilepsy, glaucoma, nausea and vomiting due to cancer chemotherapy, anorexia resulting from HIV/AIDS, chronic pain, neuropathic pain, and spasticity due to multiple sclerosis.

Effectiveness of marijuana is poor in treatment of anxiety, sleep disorders, terminal cancer, diabetes, Tourette’s, Huntington’s chorea, Crohn’s disease, PTSD, Hepatitis and others. Risk of adverse events is significant.

Pharmaceutical companies now offer the chemical components of marijuana plant in the form of pills. Although the cannabis plant contains 80 cannabinoids and 400 other compounds, including carcinogens such as tar, the two main substances that contribute the vast majority of drug effects of marijuana are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

These substances have been approved by the U.S. Food and Drug Administration for recognized uses as Schedule III drugs. These are available on the prescription of a physician, much as a painkiller or an antibiotic.

Marinol and Cesamet are two drugs that offer THC in varying doses. Epidiolex contains CBD only and is meant for use in epilepsy. Sativex is a combination of THC and CBD.

It is not yet available in the U.S. and is being tested for conditions of muscle spasticity. Cost of medical marijuana is comparable to the street price. Insurance plans may cover these costs.

This prescription method places the decision to use “medical” marijuana securely in the hands of the patient and his doctor, who can determine the need and the dose.

Considering this availability, marijuana plant growing facilities with the need for tracking of plants, potential of diversion and other law enforcement problems, do not appear to be necessary.

Sabi ‘Doc’ Kumar is a Surgeon and State Representative from District 66, Robertson County.