Online Medical Marijuana – Medical Marijuana

On Medical Marijuana
By Ned Wicker

Over the years I have read a lot about the pros and cons of medical marijuana, and from time-to-time there is a piece on the news about it, usually profiling somebody who is in trouble with the law. The debate continues.

Marijuana is so common. It grows everywhere. During my days as a sports writer, I recall Hall of Fame baseball player Robin Yount’s hilarious story about marijuana plants growing in the outfield of the old Comiskey Park in Chicago, after the ill-fated “Anti Disco Night” fiasco between games of a double header. Fans got crazy when they lit a disco record bon fire in center field. They stormed the field and tore up the grass. The situation turned from silly to completely out of control in a matter of moments and it got so bad that the umpires ruled the field “unplayable,” forcing the White Sox to forfeit the second game. Robin said the Brewers were the next team in after the event and these “tiny little pot plants” were growing in the outfield grass.

People have been growing their own marijuana for years, or selling marijuana to earn extra money. It’s against the law, but most people sort of look the other way and don’t really care about it. They read about, or see a story about a person who is using marijuana to control pain, or for some other “medical” purpose and they think to themselves, “That’s not so bad, why don’t they leave him alone.”

I have a problem with “medical marijuana” for a couple of reasons. First and foremost, the medical or limited use of marijuana is just the tip of the iceberg, because the exceptions to the rule quickly expand. What starts out as a controlled activity ends up as either pseudo legalization, or a kind of tacit consent.

Laws concerning medical marijuana are a veil. Secondly, and more importantly, if marijuana can be grown so easily, and is so common, how can a physician prescribe marijuana with any sense that the drug will be used according to the prescription? Other drug groups such as opiates and barbiturates have strict controls, but even with those controls, the abuse is rampant. Any notion of controlling marijuana is a joke.

The fact that so many people view marijuana as harmless is bothersome. “Well, at least he isn’t drinking alcohol,” says a mother of her teenager’s marijuana use. Teenagers like to stretch their limits and test the boundaries of parental control. It’s an invitation for trouble because “limited use” turns into “unlimited use.”

The American medical network writes, “As with abuse of cocaine, opioids, and alcohol, chronic marijuana abusers may lose interest in common socially desirable goals and steadily devote more time to drug acquisition and use. However, THC does not cause a specific and unique ‘a-motivational syndrome.’ The range of symptoms sometimes attributed to marijuana use is difficult to distinguish from mild to moderate depression and the maturational dysfunctions often associated with protracted adolescence.

Chronic marijuana use has also been reported to increase the risk of psychotic symptoms in individuals with a past history of schizophrenia. Persons who initiate marijuana smoking before the age of 17 may subsequently develop severe cognitive and neuropsychological disorders, and may be at higher risk for later poly-drug and alcohol abuse problems.”

It’s a slippery slope we try to stand on when we take anything illegal and try to “pretty it up” to look legitimate. Are there legal and effective ways of helping chemotherapy patients deal with the side effects of their treatments? If chronic pain is an issue, is there no other way than marijuana for that condition? There are excellent arguments on both sides. I invite you to look at the postings on ProCon.org. There’s a lot there to read and ponder.

In closing, my objections, bottom line, are more on a moral level than a legal level. I view the legal level as a “Pandora’s box” and like so many other issues, you can get tangled up in the details and lose sight of the purpose. As for the moral objection, it is much more clearly defined for me. Marijuana is a dangerous drug from a moral perspective, because it represents the beginning of a long succession to a bad ending.

Ned Wicker is the Addictions Recovery Chaplain at Waukesha Memorial Hospital Lawrence Center He author’s a website for addiction support:

Drug-Addiction-Support.org

Drug Addiction Symptoms

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Medical Marijuana – The Debate Rages On
By Katt Mollar

Marijuana is also known as pot, grass and weed but its formal name is actually cannabis. It comes from the leaves and flowers of the plant Cannabis sativa. It is considered an illegal substance in the US and many countries and possession of marijuana is a crime punishable by law. The FDA classifies marijuana as Schedule I, substances which have a very high potential for abuse and have no proven medical use. Over the years several studies claim that some substances found in marijuana have medicinal use, especially in terminal diseases such as cancer and AIDS. This started a fierce debate over the pros and cons of the use of medical marijuana. To settle this debate, the Institute of Medicine published the famous 1999 IOM report entitled Marijuana and Medicine: Assessing the Science Base. The report was comprehensive but did not give a clear cut yes or no answer. The opposite camps of the medical marijuana issue often cite part of the report in their advocacy arguments. However, although the report clarified many things, it never settled the controversy once and for all.

Let’s look at the issues that support why medical marijuana should be legalized.

(1) Marijuana is a naturally occurring herb and has been used from South America to Asia as an herbal medicine for millennia. In this day and age when the all natural and organic are important health buzzwords, a naturally occurring herb like marijuana might be more appealing to and safer for consumers than synthetic drugs.

(2) Marijuana has strong therapeutic potential. Several studies, as summarized in the IOM report, have observed that cannabis can be used as analgesic, e.g. to treat pain. A few studies showed that THC, a marijuana component is effective in treating chronic pain experienced by cancer patients. However, studies on acute pain such as those experienced during surgery and trauma have inconclusive reports. A few studies, also summarized in the IOM report, have demonstrated that some marijuana components have antiemetic properties and are, therefore, effective against nausea and vomiting, which are common side effects of cancer chemotherapy and radiation therapy. Some researchers are convinced that cannabis has some therapeutic potential against neurological diseases such as multiple sclerosis. Specific compounds extracted from marijuana have strong therapeutic potential. Cannobidiol (CBD), a major component of marijuana, has been shown to have antipsychotic, anticancer and antioxidant properties. Other cannabinoids have been shown to prevent high intraocular pressure (IOP), a major risk factor for glaucoma. Drugs that contain active ingredients present in marijuana but have been synthetically produced in the laboratory have been approved by the US FDA. One example is Marinol, an antiemetic agent indicated for nausea and vomiting associated with cancer chemotherapy. Its active ingredient is dronabinol, a synthetic delta-9- tetrahydrocannabinol (THC).

(3) One of the major proponents of medical marijuana is the Marijuana Policy Project (MPP), a US-based organization. Many medical professional societies and organizations have expressed their support. As an example, The American College of Physicians, recommended a re-evaluation of the Schedule I classification of marijuana in their 2008 position paper. ACP also expresses its strong support for research into the therapeutic role of marijuana as well as exemption from federal criminal prosecution; civil liability; or professional sanctioning for physicians who prescribe or dispense medical marijuana in accordance with state law. Similarly, protection from criminal or civil penalties for patients who use medical marijuana as permitted under state laws.

(4) Medical marijuana is legally used in many developed countries The argument of if they can do it, why not us? is another strong point. Some countries, including Canada, Belgium, Austria, the Netherlands, the United Kingdom, Spain, Israel, and Finland have legalized the therapeutic use of marijuana under strict prescription control. Some states in the US are also allowing exemptions.

Now here are the arguments against medical marijuana.

(1) Lack of data on safety and efficacy. Drug regulation is based on safety first. The safety of marijuana and its components still has to first be established. Efficacy only comes second. Even if marijuana has some beneficial health effects, the benefits should outweigh the risks for it to be considered for medical use. Unless marijuana is proven to be better (safer and more effective) than drugs currently available in the market, its approval for medical use may be a long shot. According to the testimony of Robert J. Meyer of the Department of Health and Human Services having access to a drug or medical treatment, without knowing how to use it or even if it is effective, does not benefit anyone. Simply having access, without having safety, efficacy, and adequate use information does not help patients.

(2) Unknown chemical components. Medical marijuana can only be easily accessible and affordable in herbal form. Like other herbs, marijuana falls under the category of botanical products. Unpurified botanical products, however, face many problems including lot-to-lot consistency, dosage determination, potency, shelf-life, and toxicity. According to the IOM report if there is any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives. To fully characterize the different components of marijuana would cost so much time and money that the costs of the medications that will come out of it would be too high. Currently, no pharmaceutical company seems interested in investing money to isolate more therapeutic components from marijuana beyond what is already available in the market.

(3) Potential for abuse. Marijuana or cannabis is addictive. It may not be as addictive as hard drugs such as cocaine; nevertheless it cannot be denied that there is a potential for substance abuse associated with marijuana. This has been demonstrated by a few studies as summarized in the IOM report.

(4) Lack of a safe delivery system. The most common form of delivery of marijuana is through smoking. Considering the current trends in anti-smoking legislations, this form of delivery will never be approved by health authorities. Reliable and safe delivery systems in the form of vaporizers, nebulizers, or inhalers are still at the testing stage.

(5) Symptom alleviation, not cure. Even if marijuana has therapeutic effects, it is only addressing the symptoms of certain diseases. It does not treat or cure these illnesses. Given that it is effective against these symptoms, there are already medications available which work just as well or even better, without the side effects and risk of abuse associated with marijuana.

The 1999 IOM report could not settle the debate about medical marijuana with scientific evidence available at that time. The report definitely discouraged the use of smoked marijuana but gave a nod towards marijuana use through a medical inhaler or vaporizer. In addition, the report also recommended the compassionate use of marijuana under strict medical supervision. Furthermore, it urged more funding in the research of the safety and efficacy of cannabinoids.

So what stands in the way of clarifying the questions brought up by the IOM report? The health authorities do not seem to be interested in having another review. There is limited data available and whatever is available is biased towards safety issues on the adverse effects of smoked marijuana. Data available on efficacy mainly come from studies on synthetic cannabinoids (e.g. THC). This disparity in data makes an objective risk-benefit assessment difficult.

Clinical studies on marijuana are few and difficult to conduct due to limited funding and strict regulations. Because of the complicated legalities involved, very few pharmaceutical companies are investing in cannabinoid research. In many cases, it is not clear how to define medical marijuana as advocated and opposed by many groups. Does it only refer to the use of the botanical product marijuana or does it include synthetic cannabinoid components (e.g. THC and derivatives) as well? Synthetic cannabinoids (e.g. Marinol) available in the market are extremely expensive, pushing people towards the more affordable cannabinoid in the form of marijuana. Of course, the issue is further clouded by conspiracy theories involving the pharmaceutical industry and drug regulators.

In conclusion, the future of medical marijuana and the settlement of the debate would depend on more comprehensive and comparable scientific research. An update of the IOM report anytime soon is well-needed.

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Medical Marijuana Access Regulations in Canada
By Beverly OMalley

Canada’s initiative to decriminalize marijuana is focused on terminally ill patients who benefit from the use of medical marijuana to relieve unbearable symptoms of chronic and terminal illnesses. The Marijuana Medical Access Regulations (MMAR) lists specific rules for Canadians to follow.

The (MMAR) gives the Canadian health care system a legal method to regulate individuals who use, cultivate, or store marijuana for medical purposes. The regulations are a result of an Ontario Court of Appeals ruling in 2000 that mandated the Canadian government to create new regulations within the year that focused on the medical marijuana issue. The court order included a stipulation aimed at getting the Canadian government to move on this issue. Basically the courts said that if the Canadian government had not completed the task of setting up regulations for the use of marijuana for medical purposes within the year then the Ontario courts would not prosecute as illegal the use, growth, or storage of marijuana. This clear message from the court was the first step in creating the MMAR. By 2001, the new medical marijuana regulations were in effect.

Research into the benefits of medical marijuana by modern scientists began in the 1800’s and William Brooke O’Shaughnessy of the Medical College in Calcutta is credited with the first research and introduction of the healing properties of marijuana to the Western medical community. For the remainder of the 19th Century, the plant was widely used in Western countries as a medicine for pain relief, muscle spasms, and stomach cramps. During this time it was effective in relieving many symptoms of chronic illness. Even though research continued to show the medicinal benefits of using the plant, new laws were beginning to be enacted in many countries that focused on the use of illegal drugs. Marijuana became one of the drugs encompassed by these new rules and regulations and as a result the ability to use it for medical purposes was taken away by governments that wanted to curb the use of illegal drugs by its citizens.

By eliminating the right to use marijuana legally, it became a black market product. Even though it was key to the relief of many debilitating symptoms of chronic and terminal illnesses, these laws made it illegal to use, grow, or store the plant even for personal use. Even possession of the plant was illegal. Such was the result of the criminalization of marijuana.

Now that the MMAR is in effect, the use of medical marijuana has been decriminalized. Marijuana has not been legalized however, and continues to be illegal to anyone without the proper license or authorization from the Canadian government.

The MMAR was created to regulate the growing, distribution, and use of marijuana for medical purposes. The regulations are broken down into different segments that describe the rules to follow for users, growers, storage facilities, and access to the drug through the Canadian health care system. Each segment provides direction for how a person can get get licensed, license renewals, and the amounts of medical marijuana that can be in possession at any one time. The latest statistics kept by the Canadian government (July 2008). show there are 1476 physicians authorized to prescribe the drug, while the number of Canadians authorized to possess, grow, or store it is 2812.

Medical Marijuana Users

The regulations state that an application must be made to the Canadian government, which includes personal information and identification. An authorization from a medical professional must accompany the license request, which states the types of ailments and the benefits that may be realized by the patient. The regulations also give the procedures for authorized users to follow when confronted by authorities who are inquiring about their use of the drug. All the steps involved in obtaining and maintaining a medical marijuana authorization is listed in the MMAR, and the Canadian government is bound to follow those rules until changed by new regulations or laws.

Marijuana Growers

The grower must make an application to the Canadian government with complete identification papers and plans for growing medicinal marijuana for the Canadian health care system and individual patients. Even though Canada has its own government-controlled herb growing company it is possible for private citizens to grow marijuana under the new regulations.

A plan for production and outlets for disposal must be included in the application so that the growing of the drug can be regulated and the quantity of drug can be monitored. For each license to grow medical marijuana, a limit to the amount a grower can produce is set. A license to grow medicinal marijuana does not give a grower the right to grow as much as they want. The quantity of drug produced must match the distribution points authorized by the Canadian government. All the steps in cultivation are monitored and tracked according to the new MMAR laws. The Canadian health care system is partly responsible for working with government agencies to insure that the regulations do not create a larger illegal marijuana problem by having legal growers producing too much of the drug which might find its way into the illegal markets.

The MMAR also has rules for the storage of marijuana destined for the medical community. An application must be made to the Canadian government that lists personal identification of the owner of the storage property, the property description, and the routes that the drug will take to final disposal.

While one patient may obtain the right to do all three of the regulated acts, individuals may also be able to lawfully grow or store the plant even without the right to consume it. The Canadian government took the most appropriate steps in creating rules that could be easily followed by authorized individuals pertaining to the use of medical marijuana. Now that the MMAR is in effect in Canada, other countries are looking into similar federal regulations to oversee the use of medical marijuana by their own citizens.

Beverly Hansen OMalley is a health promotion specialist and likes to write about health related topics that help people in their daily lives. She is the the owner of http://www.registered-nurse-canada.com where she explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country and what it means to have a nursing license.

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The Pros and Cons of Using Marijuana with Hepatitis C
By Nicole Cutler

Chronic Hepatitis C is a disease that deserves more attention than it’s currently receiving from both the medical community and the public. Compared to well known diseases such as HIV/AIDS, this potentially fatal liver disease gets very little notice. Hepatitis C needs to be sent to the forefront in the medical world, especially since more than 170 million people worldwide have already been infected, and the rate of infection continues to increase. Medical marijuana, primarily used to help relieve the harsh side effects of Western medicine’s standard treatments, has been somewhat of a hot topic in the medical community lately, with valid arguments from both sides of the field. In the case of Hepatitis C, it can help alleviate the unbearable side effects for those currently undergoing a round of Interferon therapy.

Genotype 1 is the most common type of HCV in the United States. However, it has the lowest success rate with Interferon therapy, meaning re-treatment may be necessary for some. One possible reason for a low success rate is that many people can’t complete their treatment due to the side effects they experience, such as headaches, fatigue, and severe depression. Although it has no affect on the virus, medical marijuana may be able to reduce the severity of these symptoms, thus helping more people finish treatment.

Those who are against the use of medical marijuana point to its ability to damage their liver further, which may negate any positive results of treatment.

Regardless of which side of this issue you’re on, there’s no denying the results of numerous studies that show the positive, therapeutic benefits that medical marijuana can have on a patient with chronic liver disease. The opportunity to complete HCV treatment without being in severe pain and discomfort during treatment is something many patients would look forward to. This controversial treatment is already being used in some states for cancer patients and those infected with HIV.

To learn more about the pros and cons of using medical marijuana to enhance the benefit of Interferon treatment for Hepatitis C, read this entire article here.

This article was prepared for Hepatitis-Central.com. Visit us to learn more about liver health.

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California’s Reefer Madness
By Michael E Jones

Simon Says “I Love Getting High”
Simon’s gaze was transfixed on an uncertain point across the room. Every now and then his eyes would give in to the strains of having to stay awake, eyelashes flittering to a close. He would silently nod off a bit then abruptly reconnect with our world, as if jolted by some unseen electric shock.

I had barely recognized him yesterday in the controlled chaos of this emergency room. Two years ago when I saw him, he was a frightened and suicidal 17-year-old living in the grips of a mentally ill mother and a devoted Scientologist father. Back then he’d been “rescued” by a squad of Scientology nuts who circled him and demanded his release. One of them was a suit who described himself as John Travolta’s lawyer. In any event, his forlorn and helpless expression spoke volumes that his mouth could not that day. The Cruise cadets scooped him up and carried him away. “He’ll be back,” I muttered to a colleague So here he was, a bit older and a lot sicker. “I just love getting high, man,” he bellowed at me, his grinning face lit up with pride. “See, look,” he said, his stained fingers digging around in a front pocket of his once-blue jeans. He produced a tattered and four-folded set of photocopies and handed them to me.

They were his physician’s statements for procuring medical marijuana. The copies bore the logo of a “Family Practice” pot clinic and some auspicious language explaining that Simon needed to get high for a “medical problem.” What, I wondered, could this generally healthy 19-year-old be carrying that requires the use of dope.

“I have insomnia and lack of appetite,” Simon said.
“Pretty common side effects of smoking crystal meth for days on end, as you have been doing,” I pointed out.
“Oh, yeah,” he stammered and chuckled, closing his eyes again .

We Voted for This?
When millions of us Californians voted for Proposition 215 in 1996 legalizing medical marijuana, we did so with images of gaunt and pained terminally ill patients. Pot, we were told, would be used to help the most desperate of our brothers and sisters gain weight and feel better. Instead, it has degenerated into little more than a front for legalized drug dealing.

That medical marijuana isn’t being used as we voters intended is almost a foregone conclusion. NORML, the National Organization for Reform of Marijuana Laws, has itself reported, according to the US Department of Justice, that medical marijuana is used for the following conditions:

40% Chronic Pain
22% AIDS-Related
15% Mood Disorders
23% All other categories

What happened to all the morbidity and mortality?

When we witness delirious 18 to 20-something year-old burn-outs parading through our emergency rooms and offices brandishing prescriptions for pot, it doesn’t take a rocket scientist to figure out something’s up. It didn’t take authorities long to figure it out, either.

Just a few weeks ago, on August 22, California’s Bureau of Narcotics enforcement busted two men in Los Angeles for the illegal possession, transportation and sale of marijuana in connection with a marijuana dispensary, Today’s Healthcare, in Northridge, CA. The men were making a healthy profit off of dealing “medical” marijuana to a clientele between the ages of 18 and 29.

The problem in California has gotten so enormous that Attorney General Edmund Brown had to issue guidelines last month just to give some shape to an otherwise out-of-control system.

What’s the Prescription?
Applying a psychological overlay to all of this yields, for me, a different conclusion than my initial knee-jerk, oh-my-God-isn’t-this-awful reaction. A cornerstone of psychological theory is the splintering of the whole person into acceptable and unacceptable parts. One who recognizes perverse sexual impulses within themselves might defend against these urges by becoming rigidly religious, for instance.

Extrapolated to a societal level, one could argue that we are so collectively unnerved by our love of chemicals and pleasure that we don’t just enforce laws against it, we declare war on it. If we’re defeated, we might try to rationalize and make excuses, much like cousin Boudreau drinks himself into a nightly stupor because of his “bad back.”

The degree of our defensiveness is proportional to our degree of investment in the self image we like to propogate. Are we as a collective determined to prove ourselves righteous by battling the demon to our own death? Or are we prepared to declare, as Simon did, “I just love getting high, man”?

Quite frankly, I think we in California have reached the intermediate stage of rationalization. I don’t believe there is enough will in the Golden State to stem reefer madness. We can drown in a sea of data about the destructive effects of marijuana, protest loud and long about the evils of getting high, but it is still, to many, “only weed.” God grew it so it’s more trustworthy than anything man-made.

What would the healthy social response be to this dilemmes? I suggest that we stop tip-toeing around the issue and legalize pot for once and for all. Then regulate it and tax it as we do with every other “sin.” Here’s what that might look like:

1. No one under 18 may purchase marijuana. For any reason. Period.
2. Tax sales at a rate of 20%.
3. Only state-licensed businesses may sell it, and only in certain geographic areas.
4. Illegal sales will be deterred by significant increases in the penalties for them.
5. Tax revenues will be divided among state healthcare programs, drug education and intervention efforts and will help close the state’s yawning budget gap.
6. Finally, revenues will fund free medical marijuana to those truly in need of it.

That’s the honest, and pragmatic, solution to the issue. But are we ready to reconnect with that pleasure-seeking spirit we once disowned?

Michael Jones, LMFT, BCPC is a licensed and Board Certified psychotherapist in Glendale, CA. For an appointment, call (818) 974-2158 or visit him at http://www.psych247.com

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