Tuesday, August 11, 2009

Medical Marijuana, I'm Skeptical About a Ban.

One week from today the State Board of Pharmacy of Iowa will hold a public hearing on medicinal use of marijuana. This is an issue that has vexed me for many years. As a physician who treats patients with severe pain syndromes I have seen many a patient get addicted to legal prescription pain medication while still suffering. This is because the legal pain medication is not the best medication to treat a pain syndrome called neuropathic pain. How I explain it to my patients is that narcotic pain medications will knock you out and as you're drifting off you are still experiencing pain. There are multiple studies which have documented good pain relief with smoking marijuana for neuropathic pain syndromes. There are many other proven uses for medical marijuana. However, our prejudices prevent us from using a proven remedy.

Marijuana has a history that is a mixture of myths and falsehoods that make it problematic for opponents to change their attitude. If you haven't seen the film 'Reefer Madness' you should. It is available free on the web if you look for it. This is the beginning of many of the myths. Regardless of how you feel about those myths, and I'm not going to debunk them in this piece, it is important to put marijuana in perspective to both legal over the counter products (alcohol and tobacco) and prescription products (Morphine, Vicodin, Methadone, and many others).

Marijuana has shown no adverse health effects when compared to either alcohol or tobacco. I think you all know the terrible health effects of both alcohol and tobacco. Alcohol and alcoholism causes 85,000 deaths each year from a combination of direct medical problems or traffic related deaths. Tobacco causes 430,000 deaths each year. In Britain, official government statistics listed five deaths from cannabis in the period 1993-1995. "Tetrahydrocannabinol is a very safe drug. Laboratory animals (rats, mice, dogs, monkeys) can tolerate doses about 5,000 times more than is required to produce a high." (from a British government report). When compared to tobacco there are equal or less effect on the lungs.

Alcohol and tobacco are two of the most addictive products in our society. Millions of people are addicted to both. There are questions about the true physical addiction potential of marijuana but most experts agree it is less then either of the two legal products. So if it is purely the addictive potential alcohol and tobacco should be banned and medical marijuana should be approved. Now the real question is, since we are only talking about medical marijuana, how addictive is it compared to prescription pain and anti-nausea medication. All the evidence points to marijuana is far less addictive then almost all prescription pain medication.

So let us get over our paranoia and allow our patients to have the best treatment available for certain conditions.


  1. Given the known health risks of smoking, shouldn't we prefer other forms of taking the drug, such as ingestion, nasal aerosols, or trans-dermal patches? I think it should all be legal, but the medical claims seem a little odd given that we never prescribe opiates or coca derivatives in smokable forms and always prefer other forms of medication delivery.

  2. What does the route have to do with it. If smoking is most effective then go for it.

  3. Do you know who subsidezed "Reefer Madness?"


    At that time Monsanto was a growing mega conglomerate trying to get government contracts for their fiber. They wanted to make military uniforms, which were then being made from hemp. By spending millions in convincing the public that the only marijuana was a bad marijuana, and having it outlawed, was like money in their pocket. They got the contracts.