Some Good News
on Medical Marijuana
and Bad News on Doctor Hygiene
This week’s report in The New England Journal of Medicine revealing its polling results of physician attitudes toward medical marijuana should encourage its advocates. Fully 76% of physician respondents supported some kind of patient access to medical marijuana, although many were highly qualified endorsements – basically “after all else fails”.
Still, that’s a three-to-one margin in favor – an impressive showing given all the hand-wringing in healthcare circles about the potential “risks” of medical marijuana. In my own comment there I noted how silly this all seemed given the well-known actual risks of long-term opioid medications that doctors freely prescribe for chronic pain – something I’ve written about here as well (see “Medical Marijuana and Pain Reconciliation“).
Here’s how the two doctors reporting these results summarized the pros and cons as reported by the responding physicians:
“Physicians in favor of medicinal marijuana often focused on our responsibility as caregivers to alleviate suffering. Many pointed out the known dangers of prescription narcotics, supported patient choice, or described personal experience with patients who benefited from the use of marijuana. Those who opposed the use of medicinal marijuana targeted the lack of evidence, the lack of provenance, inconsistency of dosage, and concern about side effects, including psychosis.”
Of course, many of the concerns of the nay-sayers apply to all medications (see Our Healthcare Sucks). And the evidence of harm from many routinely-prescribed medications – like the potential for opioids to promote the spread of cancer cells – are simply ignored as “inconvenient truths”.
The patient in the case study used for this survey had metastatic breast cancer. Would these same doctors prefer she be prescribed opioids that might exacerbate the spread of her cancer rather than medical marijuana with some early evidence of benefit for cancer prevention?
Medical Marijuana As Neuro-Protectant?
Then there’s this week’s news that Israeli researchers have found that extremely low doses of THC found in marijuana can help prevent cognitive damage from injuries to the brain, including those suffered during open heart surgery when the brain may be deprived of its oxygen supply. Here’s an excerpt from the report at Science Daily:
“Low doses of the drug had a big impact on cell signalling, preventing cell death and promoting growth factors. This finding led to a series of experiments designed to test the neuroprotective ability of THC in response to various brain injuries…
“Previous studies focused on injecting high doses of THC within a very short time frame — approximately 30 minutes — before or after injury. (The) current research, published in the journals Behavioural Brain Research and Experimental Brain Research, demonstrates that even extremely low doses of THC — around 1,000 to 10,000 times less than that in a conventional marijuana cigarette — administered over a wide window of 1 to 7 days before or 1 to 3 days after injury can jumpstart biochemical processes which protect brain cells and preserve cognitive function over time…
“This treatment, especially in light of the long time frame for administration and the low dosage, could be applicable to many cases of brain injury and be safer over time.”
Keep Cheech-and-Chong Out Of It
Note the extremely low doses required for this protective effect and the absence of any “high” experienced by patients. If we could only divorce the debate about medical marijuana from the Cheech-and-Chong context in which it seems to always get ensnared, we might be able to seriously advance its use for medicinal purposes.
Instead, if you search for “medical marijuana” on Youtube you’re as likely to get a video of a twenty-something stoner as a legitimate discussion of the real pros and cons of this ultra-promising medical treatment. This is a real disservice to the millions of patients – current and future – who might truly benefit from a more enlightened, and informed, debate that improves access to a treatment regimen with a far lower risk profile than the opioid drugs it might replace.
All this incessant mixing of medical marijuana with recreational marijuana does is fuel the uninformed prejudices of the prohibitionist “Reefer Madness” crowd. And who does that benefit?
Oh yeah, maybe the manufacturers of opioid medications, for starters.
And Wash Your Damn Hands Already!
This may seem unrelated – because it is, but only in part. This week’s healthcare news also included a report in The New York Times about U.S. hospitals beginning to crack down on doctors, nurses and hospital workers who refuse to wash their hands to prevent infections to vulnerable hospitalized patients. Seriously.
This isn’t Bangladesh, folks, this is right here in what many seem to believe is still the world’s best healthcare system. Yet despite the overwhelming evidence that one of the simplest ways to lower our exorbitant rate of hospital-produced infections and patient harm is for doctors and nurses to wash their hands between contact with patients, there’s still a subset of them who resist doing so.
Their “To hell with patient safety” behavior extends even to sneaking under sensors to avoid detection. This grade-school defiance – this “Don’t tell me what to do because I’m a doctor” attitude – is beyond childish. It’s downright stupid and should form the basis for dismissal of such medical miscreants.
Unfortunately, doctors are who generate hospital revenues, so it’s a delicate matter for our profit-driven healthcare system in America.
But it does make you wonder, doesn’t it?
How much overlap is there, do you suppose, between these dimwits and the 24% of doctors responding to the medical marijuana poll in opposition?
We’ll never know, but my take on it is the medical profession would be far better served – as would its patients – with less hand-wringing over medical marijuana and more hand washing to protect patient lives they’re sworn to protect.