As the cultural sands dramatically shift in America we are witnessing a halting, erratic movement toward the legalization of marijuana.
Unfortunately, the medical profession is being drawn into the middle of this controversy.
This is not good.
The vehicle used to entrap the medical profession in this culture war is the application of “medical marijuana.”
Beware! This is not a scientifically produced, carefully controlled medication extracted from a plant.
It is the plant – actually, the same stuff people are smoking to get stoned. It is called artisanal marijuana, and it is a plant with the composition determined by where it was grown, when it was grown, and who grew it. The plant contains approximately 70 active ingredients, and there is no control of the relative proportions of these substances.
The artisanal plant contains varying amounts of THC, which is psychotropic, potentially addictive, and can permanently alter information processing in young people. When consumed frequently over years, it has been shown to significantly decrease I.Q. (something few of us need). It also contains CBD, a substance showing great promise in the control of some serious pediatric seizure disorders.
Current applications of “medical marijuana,” now the law of the land in many states, allow the use of this artisanal substance for 19 unrelated “serious medical conditions.” Stated bluntly: a substance containing 70 active ingredients, of unknown proportions, containing chemicals known to be mind-altering and addictive, can be prescribed for a laundry list of ailments.
There are no recommended dosages or frequencies, no firm indications or contraindications, and no clear concept of risks.
This is not a modern medicine. This is a modern snake oil. It is quackery!
Artisanal marijuana certainly does contain chemicals of much therapeutic value. They need to be isolated, purified and studied through clinical trials – just like any other medication. They then need to be released with clear indications and dosages so physicians can help their patients with their eyes wide open.
If the FDA is too sluggish in processing drugs to market, then change the FDA, but don’t start treating patients with a witches brew of chemicals on the recommendation of urban legends, entrepreneurs, and legislators.
The general public does often not understand the scientific process, and is easily manipulated by heart-wrenching anecdotal stories. The scientific peer review system is required to separate fact from fiction. The truly effective medicines in marijuana need to be purified, tested, and dosed before they can be responsibly and effectively used by physicians.
This can be a slow and frustrating process, but it has been the path this country has followed to the finest medical treatments in the world. Shortcuts are usually disastrous.
In my opinion, legalization of marijuana is a bad idea, but then cigarettes are legal and so is alcohol – both drugs of comparable risk. But the medical application of artisanal marijuana is unequivocally a terrible, dangerous plan which physicians should all oppose.
Isn’t it high time we protect our profession from its manipulation by commercial and legislative power sources that have agendas other than improving the health of our patients?
Craig Kerins, M.D.
The writer is a retired orthopedic surgeon.