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Medical Marijuana and Doctors’ Head-In-The-Sand View

Medical Marijuana Deserves More Medical Respect

Discount Medical Marijuana cannabis s...

English: Discount Medical Marijuana cannabis shop at 970 Lincoln Street, Denver, Colorado. (Photo credit: Wikipedia)

I’ve written before about medical marijuana and the paradox of physician resistance to it while readily embracing far more dangerous opioid medications.

The Doctor’s Channel – a video website for physicians – currently has an explanation by medical cannabis expert Martin Lee of the challenge America’s doctors face in prescribing medical marijuana.

He notes that before 1988 – when many practicing physicians were trained – medical science still hadn’t discovered the cannabinoid receptors that are ubiquitous in the human brain. They consequently have no basis in their training for considering the efficacy, or legitimacy, of medical marijuana as a therapeutic agent.

Of course, if they kept current with the medical literature since their training, they might have a better understanding and acceptance. But most doctors are unable to stay current with the medical literature, so – as a practical matter – there’s a huge gap of missing information that constrains most doctors today regarding the still controversial subject of medical marijuana.

We’ve Been Misled

But what concerns me even more is their apparent indifference to the subject. Many dismiss it as being about “politics” – a convenient scapegoat for deferring on something they know little about.

Another post on The Doctor’s Channel dating back to last August discusses the dramatic change of heart about medical marijuana by Dr. Sanjay Gupta – CNN’s Chief Medical Correspondent. Dr. Gupta not only reversed himself but apologized to his viewing public for “terribly and systematically” misleading them with his prior criticisms of medical marijuana. In his own words…

“We have been terribly and systematically misled for nearly 70 years in the United States, and I apologize for my own role in that.”

That’s quite an admission from such a highly-regarded public figure in American medicine.

And it came about because he finally dug into the subject deeply enough to sort the wheat from the chaff – the politics from the evidence. And he’s observed – and treated – patients for whom marijuana was the only effective therapy.

While noting that early medical writings from the mid-19th century through about 1930 were favorable – citing its effectiveness for neuralgia (pain from nerve damage), appetite, and convulsive disorders – Dr. Gupta’s survey of the literature currently available through the U.S. Library of Medicine found 94% of marijuana research was aimed at potential harms vs. only 6% aimed at identifying its benefits. As Dr. Gupta put it, “That imbalance paints a highly distorted picture”.

One exception he cites is a study documenting medical marijuana’s benefits for neuropathic pain relief. Those on daily medical marijuana in the study reported twice the pain relief of those on placebo, with about a one-third reduction in pain in this difficult-to-treat patient population.

Inexplicable Indifference

Now here’s my problem with this. You might think – and reasonably expect – that when a celebrity physician of Dr. Gupta’s standing makes such a dramatic admission and reversal, it might be something doctors would share with their peers.

Yet in the almost 6 months since that article appeared on The Doctor’s Channel, it had a grand total of 4 Likes and 1 Tweet.

This drove home to me the apparent indifference of America’s medical profession to the emerging recognition of medical marijuana’s relative effectiveness and safety.  Of course, it’s really more of a rebirth in awareness, as their medical forebearers were far more attuned to its effectiveness – before it was politicized by “Reefer Madness”.

It’s no coincidence marijuana was reclassified as a class 1 drug – more dangerous than cocaine (which, of course, it isn’t) – shortly after the “reefer madness” hysteria of the 1930’s.

Get With It

And to make matters even worse, America’s medical community is perfectly comfortable continuing to rely on opioid medications for pain relief despite the damning evidence of the substantial risks of these highly-addictive and dangerous drugs (see “Medical Marijuana and Pain Reconciliation“).

This makes their apparent indifference to – and lack of intellectual curiosity about  – medical marijuana as a potential substitute for many patients all the more appalling.

Get with it, will you, guys and gals in the white coats? Your patients are suffering more than they need to – and you’re endangering them with your increasing and casual reliance on dangerous opioid drugs.

For a profession that’s obsessed with malpractice liability, you’d think this might register as the potential legal liability it represents as patients learn more about the damage opioids may be doing to them – including the potential spread of cancer (see “Medical Marijuana vs. Prescription Opioids – Misplaced Perceptions and Priorities“).

Skip the Vicodin, Oxycontin and Percocet and prescribe some relatively harmless medical marijuana for patients for whom it’s been shown effective. It’s long past time to get past the political and puritanical histrionics and catch up with the evidence on this.

Your patients deserve better.

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