Pubdate: Thu, 26 Jul 2012
Source: Los Angeles Times (CA)
Copyright: 2012 Los Angeles Times
Contact:  http://www.latimes.com/
Details: http://www.mapinc.org/media/248
Author: David Sack
Note: Dr. David Sack is a psychiatrist and addiction specialist. He 
is chief executive of Promises Treatment Centers and Elements 
Behavioral Health in Southern California.

IS MARIJUANA GOOD MEDICINE?

Many Claims About Pot's Beneficial Effects Just Don't Hold Up.

The Los Angeles City Council voted Tuesday to ban medical marijuana 
dispensaries in the city, the culmination of years of controversy 
over the sale of pot here. Meanwhile, in Oakland, a federal crackdown 
closed the nation's largest dispensary amid protests and 
demonstrations. But authorities rarely seem to address the real issue 
about marijuana in California: Is it good medicine?

Some proponents of medical marijuana argue that pot is "natural" and 
therefore better, or at least no worse, than legally prescribed 
drugs, which may be addictive and may carry dangerous side effects. 
But natural is not the standard for whether a drug is safe and effective.

Marijuana advocates also say that physicians who warn against 
marijuana merely want to push prescriptions. But just because some 
doctors practice bad medicine with legal drugs doesn't make marijuana 
good medicine. In most cases, it isn't.

Anyone who wants to get a medical marijuana card knows there are 
unscrupulous doctors who will give you a recommendation with few 
questions asked. Without doubt, medical marijuana hands a 
get-out-of-jail-free card to people who just want to get high. Those 
who get a card and indulge in the infrequent use of marijuana will 
probably experience few problems. But the situation is different with 
chronic marijuana use.

Marijuana acts on cannabinoid receptors in the brain. These 
receptors, which are the most prevalent in the nervous system, 
influence just about every bodily function, including memory, 
attention, disposition, arousal, motivation, perception, appetite and sleep.

Many chronic marijuana users insist that marijuana is not addictive 
the way alcohol and other drugs are. However, neuroscience, animal 
studies, clinical reports of withdrawal in humans and epidemiology 
all show that marijuana is potentially addictive.

As to its benefits, controlled clinical studies show they exist, but 
they are limited. Marijuana can effectively treat neuropathic pain, 
and it has been shown to improve appetite and reduce nausea in cancer 
and AIDS patients.

But other generally accepted ideas about marijuana's effectiveness 
don't hold up.

The Glaucoma Research Foundation disputes the idea that medical 
marijuana is good medicine for the disease. "The high dose of 
marijuana necessary to produce a clinically relevant effect," the 
foundation's website explains, makes it a poor choice for the 
treatment of glaucoma, especially given its "significant side 
effects" and the availability of safer effective drugs.

In addition, those who use marijuana to treat mental health symptoms 
might be surprised to learn that studies show it not only may not 
help such symptoms, it may cause them.

Increased funding for research may lead to a better understanding of 
the impact cannabis has on our bodies, but for now the claims that 
the drug is effective in the treatment of multiple disorders as 
distinct as lupus and anxiety seem farfetched at best. It seems more 
likely that for some people, getting high just makes them feel 
better, the way a drink or two might. You would be shocked, however, 
if in response to a diagnosis of lupus, your doctor suggested you 
"take two drinks and call me in the morning."

And pot's general ineffectiveness is only part of picture. It is not 
a neutral substance. Chronic marijuana use is associated with a 
number of well-documented health problems, including a variety of 
cancers in adults as well as in children who were exposed to the drug in utero.

As to its mental health effects, marijuana is linked to longterm 
psychiatric problems such as depression, anxiety and psychosis. 
"Marijuana often is regarded as a 'soft drug' with few harmful 
effects," says Dr. Joseph M. Pierre, co-chief of the Schizophrenia 
Treatment Unit at the Department of Veterans Affairs' West Los 
Angeles Healthcare Center. "However, this benign view is now being 
revised, along with mounting research demonstrating a clear 
association between cannabis and psychosis."

If the lack of health benefits and manifest risks aren't enough to 
raise doubts about medical marijuana, consider basic questions of 
quality and dose. Although medical marijuana sometimes comes from 
"cleaner" sources than say a drug cartel, independent labs have found 
mold, synthetic insecticides and other toxins in pot. Molds such as 
Aspergillus can be highly dangerous to immune-compromised patients. 
And there is no way to accurately judge what a proper dose of 
dispensary marijuana would be.

Habitual marijuana use is helpful for very few medical conditions. It 
can cause insidious changes in personality and attitude that are 
clear to everyone but the users themselves. There are nearly 400,000 
emergency room visits per year due to marijuana use. Before we 
advocate for medical marijuana, and before another person doses 
himself with it, we have to ask: Is medical marijuana making us sick?
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MAP posted-by: Jay Bergstrom