Tuesday, 30 August 2016

The stark difference in how doctors and the government view marijuana




Nathaniel P. Morris is a resident physician at Stanford Hospital specializing in mental health. He recently penned a strongly worded op-ed for ScientificAmerican.com on the differences between how some in the medical community view marijuana and how the federal government regulates it.

"The federal government's scheduling of marijuana bears little relationship to actual patient care," he wrote in the essay published last week.

"The notion that marijuana is more dangerous or prone to abuse than alcohol (not scheduled), cocaine (Schedule II), methamphetamine (Schedule II), or prescription opioids (Schedules II, III, and IV) doesn't reflect what we see in clinical medicine."
Here's Morris' money quote:
For most health care providers, marijuana is an afterthought.
We don't see cannabis overdoses. We don't order scans for cannabis-related brain abscesses. We don't treat cannabis-induced heart attacks. In medicine, marijuana use is often seen on par with tobacco or caffeine consumption — something we counsel patients about stopping or limiting, but nothing urgent to treat or immediately life-threatening.
He contrasts that with the terrible effects of alcohol he sees in the emergency room every day, like car crash victims and drunk patients choking on their own vomit. Morris points out that excessive drinking causes 88,000 deaths per year, according to the CDC.
The medical and research communities have known for some time that marijuana is one of the more benign substances you can put in your body relative to other illicit drugs. A recent longitudinal study found that chronic, long-term marijuana use is about as bad for your physical health as not flossing.

Compared to alcohol, it's virtually impossible to overdose on marijuana alone. On a per-user basis, marijuana sends fewer people to the emergency room than alcohol or other drugs.

The scientific consensus was best captured in a 2010 study in the Lancet, which polled several dozen researchers working in addiction and drug policy. The researchers rated commonly used recreational drugs according to the harm they pose to individuals who use them, as well as the harm they pose to society as a whole. Here's what their results looked like:
The experts rated marijuana as less harmful to both users and to society than either tobacco or alcohol, or indeed than many other recreational drugs, such as heroin, cocaine or methamphetamine. Alcohol was, by far, the most socially harmful drug the committee rated, as well as one of the most harmful drugs to individual users.

Research like this is one reason surveys have shown a substantial majority of doctors support the use of medical marijuana. And although big medical groups, such as the American Medical Association, haven't shifted gears on marijuana, other groups, such as the California Medical Association, are now openly calling for marijuana legalization.

This year has also seen the formation of the nation's first doctor's group devoted to legalizing marijuana, Doctors for Cannabis Regulation. The group views marijuana legalization primarily as a public health issue.

None of this is to say, of course, that marijuana is completely "safe" or "harm-free." As with any drug, using too much weed can lead to dependency on it. And as with any other drug, marijuana can have particularly harmful effects on young, developing minds.

But the federal approach to marijuana has stood at odds with the science on the drug for decades. As far back as the 1970s, an expert report commissioned by Richard Nixon recommended that the federal government decriminalize marijuana use, given the drug's mild effects.

Nixon, of course, ignored the report's findings. In the years since, there have been hundreds of thousands of arrests for marijuana possession each year, people have lost their homes and their property over suspicion of marijuana use, and decades of racially biased policing tactics have decimated many minority communities.

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