Medical Merits of Marijuana

Dear Dr. Bill,
OK, OK, now try to explain away this one! Over the years you have been preaching anti-marijuana messages. Now a real bunch of scientists, namely the investigators picked by the Institute of Medicine to study marijuana, have concluded that weed is good for treating pain and nausea and appetite loss caused by treatment of advanced cancer or AIDS. What do you moralistic, so-called "scientists" have to say about that?

Vindicated Pot User

Dear Pot User,
I'm not really convinced that the report by the Institute of Medicine has really "vindicated" you whether you be user, grower or seller of the stuff...later, I will tell you why. But first, if you have been a regular reader of these columns, I would expect you to know that, like most professionals working in the field, I consider addiction to be a treatable, preventable brain disease. The essence of this illness is compulsive drug use and seeking of drugs in the face of negative health and social consequences. In columns printed last month in this paper an now on the internet at <drbill@vanostinstitute.org>, I briefly reviewed a scientific paper showing clearly that virtually all psychoactive drugs, including marijuana, have common mostly negative effects, either directly or indirectly, on a single pathway deep within the brain. I am a physician, duly credentialed in Addiction Medicine, who has been involved in the treatment of hundreds of inpatients and outpatients who have become addicted as a result of prolonged drug use including marijuana. I am not a "moralistic scientist," nor do I consider addictive illnesses as being moral problems.

Now, what did the IOM study actually report? It concluded that cannabinoids, the active components of marijuana can be useful in treating the conditions you referred to. For very ill patients with no other treatment options, investigators recommended short-term use of smoked marijuana under strict medical oversight. While some "recreational" pot users (like yourself?) Are hailing this result as some sort of "vindication," they fail to note that the report in no way gives marijuana a clean bill of health...The reporting scientists cited negative results due to toxic impurities of the whole weed, stating that marijuana's future as a medical treatment lies not in the plant but in the development of synthetic cannabinoids and new smokeless delivery systems...for example, asthma type inhalers. One investigator, when asked if there was medical use for cannabinoids, replied "with a reserved yes." I say, that calls for more research before allowing anything but severely restricted medical use as a Schedule II drug to be prescribed only by a licensed physician.

One portion of the report does give me the shivers: that there is "no conclusive evidence" that pot is a "gateway" drug nor that recommending it medicinally would increase general use. Just what is "conclusive evidence?" Even after Magellan circled the globe there were plenty of folks who still believed it was flat. It makes me wonder if any of the investigators visited treatment centers and, if so, how many? I guess Bergen County is the only place where pot is a "gateway" drug. Neither tobacco or marijuana can "cause" patients to later become addicted to cocaine or heroin unless they have the genetic components which makes them vulnerable to dependency on either of those chemicals. After tracking the drug history of patients for well over a decade, it is a rare cocaine or heroin addict who did not start on the path of addiction without first using alcohol, tobacco and marijuana, in that order, during and before reaching adolescence. You can't convince me that pot isn't a "gateway drug!"