Pubdate: Sat, 23 Nov 2013
Source: Arizona Republic (Phoenix, AZ)
Copyright: 2013 The Arizona Republic
Contact: http://www.azcentral.com/arizonarepublic/opinions/sendaletter.html
Website: http://www.azcentral.com/arizonarepublic/
Details: http://www.mapinc.org/media/24
Author: Gina Mecagni
Note: Gina Mecagni has practiced emergency medicine in the Valley for 12 years.
Referenced: http://www.mapinc.org/drugnews/v13/n541/a10.html

REPUBLIC'S READERS DESERVE TRUTH ABOUT MEDICAL-POT PROGRAM

As medical students at Georgetown University, we were indoctrinated 
with the traditions and values of our attending physicians. It was 
there that I was taught how to care for patients. It was there that I 
first heard and would hear repeatedly throughout my training: Pain is 
what the patient says it is.

That value is critical to the practice of medicine. It establishes a 
foundation of trust between physician and patient. It begins the 
conversation with "I believe you," so that you can move forward to 
"How can I help you?"

That value is what made reading editorial board's comments about 
patients who use Arizona's medical-marijuana law for chronic pain 
treatment so upsetting ("Sham just a way to get high," Opinions, Nov. 12).

I have been an emergency medicine physician for 12 years. One thing 
almost every one of my patients has in common is that they are in 
pain. Pain is the warning signal our bodies use to let us know that 
something is wrong.

Many patients present to the ER with chronic pain. Old injuries 
(reflex sympathetic dystrophy, arthritis, malocclusion, poor wound 
healing), adhesions (any abdominal surgery), migraines, chest pain, 
joint and extremity pain (rheumatoid arthritis, autoimmune disorders, 
septic joints, bone spurs), pelvic pain. Chronic pain encompasses all 
of these things as well as many others.

Does that make it less real? Should I turn them away from the 
emergency room because chronic pain just couldn't be a reason someone 
would turn to a physician for help and relief? Fakers. Con artists. 
Drug addicts.

Unless you are old. Or have cancer. Right?

The 20-year-old with chronic pain due to spasticity from cerebral 
palsy. Wait. Sorry. He's 20. Couldn't be in that much pain yet. 
Faker. Con artist. Young, male recreational-drug user working the system.

According to the Institute of Medicine of the National Academies, 100 
million Americans suffer from chronic pain. Fakers. "Inherently 
dishonest" con artists. Or maybe it is that the Institute of Medicine 
is "chronically gullible," to use a phrase in editorial.

These same patients are often encouraged by their physicians to seek 
alternative therapies when it seems that Western medicine has 
explored all of its options. When Vicodin turns to Oxycontin turns to 
Fentanyl, and then you are chemically dependent and out of options.

Yet these same doctors won't write you a "recommendation." It's scary 
as a physician. I wouldn't do it. Risk my license? Be reported to the 
Arizona Department of Health Services? Scrutinized? Exposed? 
Definitely not worth losing my job! So these same doctors print out 
patient records and hand them to their patients. "Go to a 
recommendation center. I can't do it."

Will Humble, director of the ADHS, is disingenuous when he says he 
wants the primary-care physicians to write medical-marijuana 
recommendations. That will not happen as long as the physician 
receives federal reimbursement for services (e.g., Medicare) and 
fears this will be taken away. That will not happen until physicians 
can speak freely without fear of reprisal. Mr. Humble is a smart guy. 
He knows this.

The patients who jump through the hoops to get their cards are then 
sent out to the dispensaries. Usually these are located in an 
industrial area. Surrounded by chain-link fences with cameras 
following your every move while a security guard looks you up and 
down. Dispensaries are kept away from the normal daily traffic of 
people. Away from the God-fearing, upstanding citizens we must 
protect from this ... non-lethal plant.

Why can't they just go to a pharmacy where all the other drugs are? 
Simple. Because it's still federally illegal.

But Arizona voters stood up three years ago and said, "Enough." The 
federal government is wrong. The Drug Enforcement Administration is 
wrong. The propaganda of the "Reefer Madness" hysteria of the 1930s 
is just that - propaganda.

If you would do a little research, you would know there is no way to 
meaningful therapeutic research because the National Institute on 
Drug Abuse won't release the "study drug" for research that does not 
specifically address drug abuse. They are the only ones with a 
federally authorized cannabis farm!

You want a dose-controlled pharmaceutical product? Did you know that 
cannabis concentrates are currently illegal under the Arizona 
criminal code? I would guess from The Republic's uninformed editorial 
that editorial board members do not.

Please, Republic editorial board, do your readers a favor and use 
your platform responsibly. The editorial was sloppy journalism even 
as an opinion piece. If you disagree with how the Arizona Medical 
Marijuana Program works, you can at least make a respectable argument 
instead of throwing around judgments, accusations and raunchy 
references to pop culture. The readers of The Arizona Republic deserve better.
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MAP posted-by: Jay Bergstrom