ANOTHER VIEW: Doctor Disputes Pot Claims

By Dr. Mel Marks
Marijuana evokes feelings of euphoria for some, calmness, hunger and heightened sensations for many, and is, therefore, perceived in a positive light. Similar enjoyable effects have long lured people into using tobacco, alcohol and other legal and illegal substances to add zest, or even cope with, life and/or illness.

Marijuana, and the other substances mentioned, also represents substantial economic and political opportunities.

The media play an important role in educating society, but it has limited capability to fact-check. Hence I feel it important to share some facts, to help balance opinions (fiction), and to add information for wise decision-making in the future (forecast).

My professional colleagues have been notably silent on “medical marijuana” issues, yet, I am ashamed to note, continue to write numerous prescriptions for marijuana treatment for almost any indication.

I am writing as a pediatrician, Long Beach citizen, father, grandfather, advocate for children and their future, public health leader, and as a research scientist. A recent commentary advocating for “Medpot for Veterans” is a prime example of unbalanced opinion and prompts me to add some facts and forecasts to some of its points:

Fiction — Doctors … are prohibited from recommending marijuana for their patients.

Fact — Physicians can prescribe 2 FDA approved medications (Dronabinol and Nabilone) that contain tetrahydrocannabinol/THC, one of the many psychoactive components of marijuana.

Forecast — More cannabinoid medications are in the development phase, and will likely be FDA approved for proven effective indications in the future.

Fiction — Marijuana is effective in the treatment of PTSD.

Fact — Scientific proof of this claim is lacking. In fact, many veterans report common use of marijuana during deployment. It is unclear whether marijuana plays a role in the pathogenesis of PTSD, or in the clinical manifestations, including suicides, that result.

Forecast — Research studies will help us understand the roles of marijuana in both the development and consequences of PTSD, and will better describe the safest and most effective use of THC in the treatment of this terrible affliction.

Fiction — Cannabis lacks the negative side effects that come with many prescription drugs.

Fact — About 10% of marijuana users develop addiction to marijuana and/or other psychoactive drugs or substances.

• Patients with schizophrenia, bipolar disorder, or substance abuse are at risk from exacerbations of their condition when using marijuana.

• Effects on brain development are possible, as are risks of cognitive disorders, loss of motivation, and other psychologic disorders. Documented effects include work place absences, tardiness, accidents, workers compensation claims and job turnover.

• Some users experience nausea, fatigue, confusion, loss of balance and hallucinations (Journal of the American Medical Association June23/30, 2015)

• Marijuana use is associated with significant increases in numbers of emergency room visits.

• Marijuana use slows motor skills and response time. Drug (including marijuana)-impaired driving has supplanted alcohol in check-point and accident situations (National Highway Traffic Safety Administration, quoted in Westways/AAA- October 2015).

Fiction — Recent claims published in the Grunion, include 1. Marijuana is life-saving; 2. Marijuana is an effective pain management treatment; 3. Marijuana is a “drug.”

Fact — There are no proven life-saving nor analgesic (pain management) effects of marijuana. If marijuana is a drug, the FDA should oversee the investigation, and approval of its medical indications.

Forecast — The more these fictional claims are repeated, the more factual they appear. Although unsubstantiated, and too often unchallenged, fiction repeated enough becomes “fact.”

Many of the above facts are summarized and specifically supported by published studies at the National Institute of Health (NIH) website —http://www.drugabuse.gov/publications/drugfacts/marijuana-medicine.

Forecast — Research and experience will provide valuable information about the risks and benefits of marijuana use in the future. Hopefully these studies will facilitate more precision in prescribing and use of the chemically active components of marijuana for health purposes.

My opinion? If for medical use, marijuana drugs should be developed, FDA approved, and dispensed in pharmacies, like other medicines.

If for recreational use, marijuana should be managed and regulated in the same fashion as alcohol and tobacco.

Can you imagine what fictions, facts and forecasts would have accurately predicted the history of intended and unintended consequences of our use of alcohol and tobacco many years ago?