WCI on medical marijuana

[triad]

I was browsing bogleheads tonight when I came across a post from WCI talking about medical marijuana.  Here's the relevant text.

"On a side note, I get a kick out of the term "medical marijuana." If it's a medicine, what is the dose? What are the side effects? How should the dose be changed with kidney disease, liver disease, breast-feeding, or pregnancy? What medication reactions should be expected? Just because people call it "medical" doesn't mean it's actually medical.

I have no doubt that smoking pot makes a lot of people feel better about whatever medical issue they have. But let's not kid ourselves about what's going on here. It's just a half-step toward legalized recreational marijuana. I don't even care much about that, to be honest with you, but I think the whole "medical marijuana" thing is a bit ridiculous."
I was pretty surprised that a physician is discounting the medical benefits of marijuana.  Maybe I know too many potheads but I thought it was common knowledge that their were benefits of this drug when it comes to increasing appetite, pain relief, seizure disorders (see the CNN piece about this).  obviously dosage and testing is not well known because its kinda illegal to research this but certainly it has medicinal benefit that should be investigated, no?

Not to mention the health benefits if it is used as an alternative to alcohol which has plenty of nasty side effects...

[Lithium]

Most patients who want "medical marijuana" refuse to try edibles, and how many other medications that you are aware of are best delivered through smoking?

How would you design a placebo-controlled trial on marijuana?

[triad]

albuterol is delivered via the lungs pretty efficiently, isn't it?

 

designing a placebo controlled trial is easy.  one regular brownie vs a pot brownie.  the hard part is doing a study legally.

 

https://www.youtube.com/watch?v=oxrKyjeClTk

give the girl a real tincture and a fake one.

[jfoxcpacfp]

That is a VERY misleading headline.

[VagabondMD]

jfoxcpacfp wrote:

That is a VERY misleading headline.

Click to expand...

LOL! I have little doubt that this is NOT the case.

I have mixed feelings on the subject, but unless we are investing in the medical marijuana or recreational marijuana business, I am struggling to find the personal finance angle. Unless, of course, marijuana makes my asset allocation more mellow after a few bong hits.

[spiritrider]

As a non-medical professional, I have to fully agree with WCI and not you.

He and I are not disputing that there are cases where the use of marijuana has significant benefits to certain individuals with specific medical issues.

However, the reality of medical marijuana is drastically different. The vast majority of those I am acquainted with who have medical marijuana cards, have no legitimate medical basis for them.

My pothead ex-BIL and all his pothead friends have cards and not a one of them has any legitimate medical need. Their confessed need is; "Hey, they just got in some really good $h!t at the pot dispensary on High Street."

Cards are ridiculously easy to get. There are doctors for those in the know, who will write prescriptions for anyone. All you need to do is claim that your back hurts really, really bad, you can't sleep, you can't eat or you are really, really anxious all the time (because you lost your supplier). Of all the dozens of people I have run into with medical marijuana cards, maybe two or three were people who had real need (chemotherapy, etc...), by their own admission. They were just using the scam to be legal. In one specific case I know, the only reason was so he could smoke and be exempt from adverse consequences of a positive marijuana hit on his company's drug testing policy.

Rather than being; "pretty surprised that a physician is discounting the medical benefits of marijuana." I am astounded that a physician would promote the joke that is medical marijuana.

[Lithium]

.

[squirrel]

Once had a patient tell me "I am on medical marijuana."  When I asked this 22 year old in the ER why he was on disability and medical marijuana, the answer I got was "My foot hurts when I skateboard."  Seriously, those were the exact words.

 

I think the point is what the quote is trying to say, that most agree with, is the "medical marijuana" argument is used by people who just are working a soft angle to legalize it so they can get high.

 

Not sure on WCI's stance, but if this quote is from him, I kinda agree, and I too could care less if it were legal or illegal.  In fact, legalizing it and taxing it may increase tax receipts from one industry and decrease my taxes so go for it!

[PhysicianOnFIRE]

It's true -- saw this on TMZ.

[triad]

jfoxcpacfp wrote:

That is a VERY misleading headline.

Click to expand...

haha, didn't even think about that!  sorry, didn't mean to offend you, WCI

 

Do physicians believe that MM can be used to treat chronic pain?  There is an opioid crisis in this country now and if people could deal with it with pot instead of oxycodone there would be significant benefits to society.  Lots of OD's on oxy, none in the history of time on pot.

 

I'm not a huge conspiracy theorist but clearly the pharmaceuticals have an interest in seeing pot stay illegal.  So a financial connection would be to short big pharma when it looks like pot will be legalized nationally

[The White Coat Investor]

No offense taken.

I don't have much of a problem with recreational marijuana. I agree the issues with it are far less than alcohol and opiates.

I don't have a problem with people treating medical conditions with marijuana either.

The only problem I've got is the nonsense surrounding the term "medical marijuana."

[Steve]

I see this 19 yr old kid for atypical chest pain and palpitations.  We have proven he has no cardiac problems, but he still comes to see me, the cardiologist, because it makes him "feel safer."  Once he called to tell my nurse that he wanted to smoke weed, but he wanted to make sure I was OK with that.  He wanted my express permission to use marijuana. I tell this story just to show WCI that it isn't only the ER docs who get to deal with crazy.

[MrsIMDoc]

Full disclosure - I am pretty politically liberal and live in a state where marijuana is legal. However I am pretty anti-marijuana and especially "medical marijuana".

I agree that we do not have studies with dosages, etc, to show us the benefit of marijuana.  I cannot safely "prescribe" marijuana without any standardization of the dose.  Regarding the pain crisis, the goal of treatment is to improve function.  I am not going to prescribe marijuana because being stoned is not going to help you improve your function and go to work.

Marijuana also has some significant side effects for some (not all) people.  During residency, we would admit people for cyclical vomiting related to marijuana use and they simply refused to believe it was related to marijuana.  Do alcohol and opioids have side effects? Absolutely! But that does not mean I need to replace one for the other.

 

[pulmdoc]

The catch-22 here is that, because marijauna is a schedule I, doing large RCT's using MJ as, say, an opiate-sparing agent for chronic pain is impossible. So all we have right now are anecdotes that chemicals in MJ treat pain, nausea, etc. So, yes, the "medical" of medical marijauna is a bunch of BS, but it's a fixable problem.

[Zaphod]

Im sure there is a place for marijuana, however, where it has known effects there are already fda approved versions that work better for appetite/nausea for instance.

Just like during the prohibition, there was "medical alcohol", which as we all know is still a very well known and oft used treatment. Medical marijuana is very similar. While there may possibly be some use we havent fully elucidated due to research difficulties given its schedule, I think most of the "medical" demand goes away with legalization, like any other substance.

I dont think it should be illegal, it clearly doesnt work and theres no logical defense if alcohol is legal why isnt marijuana? Makes no sense but I'll be the first to admit that has a tenuous relationship with reality at best. Even if I wish people didnt use it or need it, making it illegal is very anti-facts, kinda like abstinence only sex-ed, where the idea is great but more dangerous than the alternative (states with abstinence heavy programs=highest teen pregnancy). Im all for what works, and while some hard will come to some users, thats true of everything. Legalize, regulate, tax, and do the research so we have these answers.

The issue with denying reality is it allows all this crazy bs to come about and lets hucksters and snake oil salesmen in to fill the void.

Being in a state where marijuana is legal and even before was really common, I encounter it often. I always tell people they should never smoke it, even vitamins or medications when smoked is one of the most harmful vectors imaginable. Smoking is just plain terrible.