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Marijuana and Medicine

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  • #31
    Live in recreational state. Had a few patients that used edibles post op tonsillectomy and had anecdotal pain relief. I don't endorse it but I let my post op patients use it.

    My take is there is something there but not a cure all.

    Think about how many conditions are either caused by or made worse due to hyperfixation/anxiety/stress. If THC/CBD helps you forget about your issue and relax your muscles I can see that being helpful for a lot of people. Not perfect but helpful

    To answer original question: There are literally (maybe even shady)people who have a full time job to provide medical cards. Send patients to a medical dispensary and let them self dose/titrate. You know they are going to come back telling you what dose/tincture works for "my body" anyways...

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    • #32
      Originally posted by Tim View Post
      The daily habit developed in high school and early college seems to have ruined motivation for two nephews and a lot of their friends. Recreational ABUSE is catastrophic on families. Basically the impact on motivation. Just observations, no data.

      “Alcohol, tobacco, opioids, cocaine/meth.” I don’t think recreational ABUSE of these means weed should be encouraged.
      The last thing i personally need is less motivation and more appetite.

      America?

      Does the typical American need more appetite?

      Less motivation?

      I don’t think so but I am not going to win that war nor fight it ( told you i lack motivation)

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      • #33
        Originally posted by CordMcNally View Post

        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.
        Agreed every time I've seen it they absolutely do not believe me even if I find something online or whatever.

        Evidence for medical use is virtually nonexistant. Medical cannabis is a sham. I would rather they legalize it than have the farce of medical cards.

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        • #34
          Originally posted by xraygoggles View Post

          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.
          No man, it's the cyclic vomiting syndrome you have to watch out for. And good luck ever convincing a patient it's caused by the weed.

          I imagine most GI docs hate it for this reason. I know emergency docs do. If you're smoking enough of it to treat chronic pain, you're smoking enough to get CVS. And if you do, best to just admit it's the weed and fine something else for your pain. Even opiates must be better than being in the ER twice a month hoping haldol will help you stop vomiting.
          Helping those who wear the white coat get a fair shake on Wall Street since 2011

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          • #35
            Originally posted by 8arclay View Post
            Honestly, Id rather a patient use a quality controlled CBD product than chronic opioids or even long term NSAIDs.
            This is like the 4th mention of CBD, it has been studied a decent amount. CBD does nothing, not a dang thing. Its legal even in states like mine where there is no rec or medical use.

            Im sure weed works decently for low key ailments/anxiety and would be a great substitute for opioids/alcohol, but like anything could be abused, safety profile is wider than alcohol though. Nothing is good to excess.

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            • #36
              Part of my PhD work focused on trying to synthesize chemicals that selectively activated CB2 receptors compared to CB1 (i.e. compounds that had similar positive effects without the high). Failed to find a useful compound, unfortunately…

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              • #37
                Originally posted by Zaphod View Post

                This is like the 4th mention of CBD, it has been studied a decent amount. CBD does nothing, not a dang thing. Its legal even in states like mine where there is no rec or medical use.

                Im sure weed works decently for low key ailments/anxiety and would be a great substitute for opioids/alcohol, but like anything could be abused, safety profile is wider than alcohol though. Nothing is good to excess.
                CBD has efficacy for 3 specific seizure disorders. I believe I heard about it on radiolab first. The types of seizure disorders are mentioned in this article-
                https://www.hopkinsmedicine.org/news...re-medications




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                • #38
                  Originally posted by Brains428 View Post

                  CBD has efficacy for 3 specific seizure disorders. I believe I heard about it on radiolab first. The types of seizure disorders are mentioned in this article-
                  https://www.hopkinsmedicine.org/news...re-medications
                  Interesting. The article you link appears to be not placebo controlled trial.
                  But FDA approval was based on several that were
                  https://www.fda.gov/drugs/drug-appro...hots-epidiolex

                  Who knows what you're getting from a "CBD" product or most supplements. Anecdotally, today my patient says "I never believed in CBD at all until I tried it" for pain. Placebo effect? Thats why we do RCTs..

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                  • #39
                    Originally posted by Random1 View Post
                    So would you accept light marijuana use in a physician or surgeon who is treating you ? Just like, maybe a little before the or to calm the nerves?
                    this is absurd. no one should practice impaired. if my surgeon smoked a joint the night before why would I care?

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                    • #40
                      Originally posted by triad View Post

                      this is absurd. no one should practice impaired. if my surgeon smoked a joint the night before why would I care?
                      Clearly you've never woken up still high

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                      • #41
                        Originally posted by Zaphod View Post

                        This is like the 4th mention of CBD, it has been studied a decent amount. CBD does nothing, not a dang thing. Its legal even in states like mine where there is no rec or medical use.

                        Im sure weed works decently for low key ailments/anxiety and would be a great substitute for opioids/alcohol, but like anything could be abused, safety profile is wider than alcohol though. Nothing is good to excess.
                        To most people, medicine is about doing something. A lot of stuff that gets prescribed in medicine doesn’t do a whole lot or doesn’t really have much evidence. If people watched what they ate, loss some weight, and got more active, I think they’d find that they would magically feel better in multiple ways.

                        The 5’7” 325lb dude with back pain doesn’t want to hear, “hey, I bet if you lost some weight and did some core strengthening then your back would probably start feeling better and wouldn’t hate you all the time”. He wants his pain to magically disappear. He inevitably gets multiple medicines that have zero to minimal benefit and time does it’s thing until his back decides it’s had enough again a few weeks/months later and we start the cycle over.

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                        • #42
                          Originally posted by CordMcNally View Post

                          To most people, medicine is about doing something. A lot of stuff that gets prescribed in medicine doesn’t do a whole lot or doesn’t really have much evidence. If people watched what they ate, loss some weight, and got more active, I think they’d find that they would magically feel better in multiple ways.

                          The 5’7” 325lb dude with back pain doesn’t want to hear, “hey, I bet if you lost some weight and did some core strengthening then your back would probably start feeling better and wouldn’t hate you all the time”. He wants his pain to magically disappear. He inevitably gets multiple medicines that have zero to minimal benefit and time does it’s thing until his back decides it’s had enough again a few weeks/months later and we start the cycle over.
                          yeah, my view is its recreational (for the great majority that talk medical even, though could be something, ppl want recreational and others arent even a rounding error), alcohol had touted "medicinal" benefits as well prior to legalization, its how we approach it.

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                          • #43
                            Originally posted by F0017S0 View Post
                            Part of my PhD work focused on trying to synthesize chemicals that selectively activated CB2 receptors compared to CB1 (i.e. compounds that had similar positive effects without the high). Failed to find a useful compound, unfortunately…
                            even if you did, no one would want them haha

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                            • #44
                              weed is better than alcohol in almost every way.

                              Hangover :Better (I would prefer my surgeon to have smoked the night before than drank)
                              Chronic use is safer
                              not teratogenic
                              more fun?(maybe not in all situations)
                              less violence
                              food tastes better
                              movies are funnier
                              great for GI issues


                              What are the pros of alcohol besides decreasing my inhibitions?
                              80% of my bad decisions in my life probably revolve around alcohol

                              I guess eating more is def a downside of marijuana but who didnt late night eat after a night of drinking?

                              All the negatives you guys say of marijuana, alc is way worse. You think drinking alcohol makes me more motivated?

                              Clearly im not biased

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                              • #45
                                Originally posted by Bdoc View Post
                                weed is better than alcohol in almost every way.

                                Hangover :Better (I would prefer my surgeon to have smoked the night before than drank)
                                Chronic use is safer
                                not teratogenic
                                more fun?(maybe not in all situations)
                                less violence
                                food tastes better
                                movies are funnier
                                great for GI issues


                                What are the pros of alcohol besides decreasing my inhibitions?
                                80% of my bad decisions in my life probably revolve around alcohol

                                I guess eating more is def a downside of marijuana but who didnt late night eat after a night of drinking?

                                All the negatives you guys say of marijuana, alc is way worse. You think drinking alcohol makes me more motivated?

                                Clearly im not biased
                                Maybe, sure.

                                But unless you encounter someone with methanol poisoning who just so happens to be in a bar and/or nowhere near a hospital, then nobody is suggesting alcohol as medical treatment.

                                The comparison of marijuana to alcohol is completely irrelevant, medically.

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