My patients often ask if I think medical marijuana might be helpful. We’ve had some widely ranging conversations about the risks and benefits of this drug. As a naturopathic physician I may not prescribe cannabis even though it is legal for medical use here in Oregon; it is not in the ND formulary. The fact that I cannot prescribe it does not prevent me from discussing it. The issue will not go away, regardless of the laws and the war on drugs. Cannabis is ubiquitous, even though it is federally illegal with varying levels of state permissiveness.
Just last month Colorado and Washington were the first states in America to approve the legalization of marijuana for recreational use. Those who fear it as a gateway drug, and those who advocate its medical use or broader legalization, are all making noise about it. The politics often plays more loudly than the facts. Marijuana is the #1 drug brought our way by Mexican drug cartels, and Mexican weed is likely to contain pesticides and other toxins. Synthetic cannabinoids are being imported from Asia labelled as bath soaps and sold in convenience stores. The war on drugs highlights our incarceration problem and the ugly politics of race. Reasonable medical questions remain unanswered.
Our own government propagated a lot of disinformation back in the 1930’s when the Federal Bureau of Narcotics was created and cannabis was classified as a narcotic (against the advice of the American Medical Association). The original Greek meaning of “narcotic” was any psychoactive substance that induces sleep, but in more recent times it has come to mean opiates and any drug derived from them. Opiates are addictive and are carefully regulated by the DEA. Cannabis is pharmacologically a world apart from opiates, and is no longer thought of as a narcotic, but it is still plagued by the negative reputation engendered by federal prohibition and propaganda, and the War on Drugs. Cannabis was federally prohibited in 1933, the same year that the prohibition on alcohol was rescinded.
In 2009 the AMA did a review of the scientific literature on cannabis and found a few legitimate clinical trials with a grand total of less than 300 study participants. The DEA has refused to grant permission to universities or pharmaceutical companies to research it. The drug is approved by 18 states for medical use, but we have very little scientific information on which to base clinical applications. Anecdotal information about the indications of various strains guide the choices of medical users. The federal ban is still in effect, and current federal enforcement efforts are focused on importers and distributors and not on small scale possession (like they were under Reagan). Employers are within their legal rights to require drug testing. Law enforcement budgets rely on asset forfeitures (police can seize any cash or items likely to be related to drug trade without proof of guilt) which is incentive for police forces to continue to pursue small scale dealers. Medical cannabis programs provide a front for a new domestic black market. That the issue is contentious is an understatement; it is explosive. And we still don’t know what it is good for.
A future email newsletter will focus on known and theoretical risks and benefits of cannabis use. Sign up for the monthly missive here.
Just last month Colorado and Washington were the first states in America to approve the legalization of marijuana for recreational use. Those who fear it as a gateway drug, and those who advocate its medical use or broader legalization, are all making noise about it. The politics often plays more loudly than the facts. Marijuana is the #1 drug brought our way by Mexican drug cartels, and Mexican weed is likely to contain pesticides and other toxins. Synthetic cannabinoids are being imported from Asia labelled as bath soaps and sold in convenience stores. The war on drugs highlights our incarceration problem and the ugly politics of race. Reasonable medical questions remain unanswered.
Our own government propagated a lot of disinformation back in the 1930’s when the Federal Bureau of Narcotics was created and cannabis was classified as a narcotic (against the advice of the American Medical Association). The original Greek meaning of “narcotic” was any psychoactive substance that induces sleep, but in more recent times it has come to mean opiates and any drug derived from them. Opiates are addictive and are carefully regulated by the DEA. Cannabis is pharmacologically a world apart from opiates, and is no longer thought of as a narcotic, but it is still plagued by the negative reputation engendered by federal prohibition and propaganda, and the War on Drugs. Cannabis was federally prohibited in 1933, the same year that the prohibition on alcohol was rescinded.
In 2009 the AMA did a review of the scientific literature on cannabis and found a few legitimate clinical trials with a grand total of less than 300 study participants. The DEA has refused to grant permission to universities or pharmaceutical companies to research it. The drug is approved by 18 states for medical use, but we have very little scientific information on which to base clinical applications. Anecdotal information about the indications of various strains guide the choices of medical users. The federal ban is still in effect, and current federal enforcement efforts are focused on importers and distributors and not on small scale possession (like they were under Reagan). Employers are within their legal rights to require drug testing. Law enforcement budgets rely on asset forfeitures (police can seize any cash or items likely to be related to drug trade without proof of guilt) which is incentive for police forces to continue to pursue small scale dealers. Medical cannabis programs provide a front for a new domestic black market. That the issue is contentious is an understatement; it is explosive. And we still don’t know what it is good for.
A future email newsletter will focus on known and theoretical risks and benefits of cannabis use. Sign up for the monthly missive here.
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