Marijuana and Medicine

[GIMD]

I have patients asking me almost every other week about prescribing marijuana for various GI ailments. I have been consistently saying no since I see too many cannabinoid-related disorders but occasionally, I will have some patients come back to tell me how it's a life changer for them etc. What your thoughts are about prescribing or recommending marijuana for patients? Do you feel that its medicinal properties (if any) outweigh potential side effects?

[Craigslist]

I used to smoke weed all the time in college and med school.

[burritos]

I used to smoke weed all the time in college and med school.

Tried it twice in med school. Inhaled. Didn't do much for me but my classmates laughed a lot. Though the bruschetta we ate afterwards tasted incredible.

[Max Power]

Isn't it recreational in basically every state by now?

Tell them to just go buy it if they want to... in their state or a neighboring.

[MPMD]

i think WCI has a good take on this (paraphrasing and hopefully not misrepresenting his views)

• clearly benefits some people
• optimal dosages/routes very unclear
• not a magic pill or silver bullet
• everyone should be skeptical of wild claims about efficacy

if i had chronic pain or nausea i would definitely experiment with it, i think it's way less harmful than a monthly rx for oxy.

[GIMD]

I was a nerd for most of my life so never got to try it in school. Perhaps, I will try some the next time I'm in Vegas.
Recreational marijuana is only legal in 18 states. It's not legal in my state so my patients want me to write them a prescription. There is a lot of research looking into marijuana fo treating all kinds of disease. I think there is a bill going through the House now to try to legalize it at the Federal level but it got killed in the Senate before so not sure if this is going to happen.

[jfoxcpacfp]

Doubt it will be a go at the federal level - ever - but have changed my views a lot. Not saying exactly where I stand, but age adds an unexpected layer of perspective. Of course, as you all know, I’m not-a-doc and defer to your expertise, with the understanding that the judgment of both posters and lurkers will vary widely.

[CordMcNally]

It’s likely a better alternative than opioids for chronic pain but probably not as good as other modalities.

I don’t buy into the cure all aspects many believe it has and time will likely tell the same, too. It’s properties as a placebo are probably it’s greatest. Of the people I hear getting a medical marijuana card it’s clear they just want a legal way to smoke weed.

[pierre]

CBD Gummies and tinctures helped a little with moms cancer pain. Certainly didn’t seem to make it go away, just more tolerable.

[Hank]

Frankly, it’s ridiculous that the Democrats have the White House and both houses of Congress and they can’t get marijuana off of Schedule 1.
Substantial majorities of Americans support legalization. Even Republicans are split about 50:50 on the topic. https://news.gallup.com/poll/356939/...cord-high.aspx

[Max Power]

It’s likely a better alternative than opioids for chronic pain but probably not as good as other modalities.

I don’t buy into the cure all aspects many believe it has and time will likely tell the same, too. It’s properties as a placebo are probably it’s greatest. Of the people I hear getting a medical marijuana card it’s clear they just want a legal way to smoke weed.

This has always been my take.

I write a LOT of opioids, tramadol, occasional gaba and benzos or muscle relax, do injects, topicals, PT, etc (nearly all for acute injury or surgery pains... turf out the chronic pain).

I have never Rx'd weed or its equivalents. I've never recommended for or against CBD stuff. The research is not there, and people have an obvious bias to it since it's 'cool' or they have used it prior or presently in rec form. I have plenty of patients who tell me it works, and I say that I'm glad. I basically treat it the same way I treat tumeric or Aspercreme... except that you can drive or take an exam just fine using those, and they don't give you lung cancer or dip your sex drive.

I am very glad marijuana's going recreational state by state. I think the medical was a load of crap. Docs don't want to Rx it since the risks almost certainly outweigh the benefits, and it put MDs in a tough ethical spot. Those 'Doctor 420 ' places that are/were Rx mills are an embarrassment and probably a detriment to their community. People can wait until it's recreational or buy it across a state border. The medical research is questionable at best, and the Rx'ing would simply get abused by many people (just like testosterone and Viagra and many other things). Once it goes recreational, it is natural selection... just like cigarettes, alcohol, fast food, etc.

At the end of the day, nobody is every going to earnestly say that a kid or adult is more likely to succeed, to do well in college, to be fit and energetic, to have motivation and sexual fitness, etc when you add weed or more weed use into their life. It is basically like alcohol or most other rec drugs... it provides an escape or a distraction from life, but that can be done in many other ways also. That is not even to mention that the potency of the 'medcal' and 'rec' weed is mind-blowing and poorly regulated in many cases. I have and will continue to leave the long term pain and psych meds to those appropriate specialists... most of whom I know do not Rx marijuana either.

[xraygoggles]

...I see too many cannabinoid-related disorders...

What is this?

Has there ever been studies showing that you can experience overdose or withdrawal from weed? It's not like heroin or cocaine, where certain neural pathways are activated and there are adverse physiological effects over the long term.

[xraygoggles]

Once it goes recreational, it is natural selection... just like cigarettes, alcohol, fast food, etc.

Out of those 4, marijuana is by far the "healthiest" (or least deleterious) option - no contest.

[CordMcNally]

What is this?

Has there ever been studies showing that you can experience overdose or withdrawal from weed? It's not like heroin or cocaine, where certain neural pathways are activated and there are adverse physiological effects over the long term.

Cannabinoid hyperemesis syndrome is supposedly rare but it doesn't seem very rare in the ED. Maybe the most frustrating part is that the solution is simple yet a majority of people refuse to quit smoking weed every day.

[Hatton]

I always thought that medical MJ was just an excuse for people to get high legally. Last year I injured my hamstring and had my SI joint come out of joint. I did several months of PT. The only thing that relaxed that hamstring was edible MJ. I have changed my views. Medical MJ has recently passed in my state. No dispensaries yet. It is much stronger than I remember from my misspent youth.