Pubdate: Sun, 26 Jan 2014 Source: Metrowest Daily News (MA) Copyright: 2014 MetroWest Daily News Contact: http://www.metrowestdailynews.com/ Details: http://www.mapinc.org/media/619 Author: Jill Griffin Note: Jill Griffin, M.D., practices in Northampton. THE MEDICINE IN MARIJUANA Last winter I made a house call to the home of a frail,90-year-old woman who had been suffering from severe pain for so long she wasready to throw in the towel. She asked for medical marijuana. I declined,refilled her narcotic prescription and left. When I checked on her two days later she looked and feltsignificantly better. What was different? She had begun using marijuana. And sobegan my education in the medicinal uses of cannabis. A year has passed and I now have nearly a thousand patientsin my practice who are benefiting from the regular use of medical marijuana. Mypatients use cannabis in a variety of forms. The ones who can't swallow take itas a tincture - absorbed under the tongue. Arthritic patients apply cannabissalve directly to their painful joints. Some patients inhale the smokelessvapor of the plant, others take it in food or as a highly concentrated oil. Some of my patients simply take the fresh leaves of theplant, toss them in a blender and make smoothies rich in healthy cannabinoidsthat can't get you high. Cannabis that can't get you high and you don't have to smokeit? Correct. Out of necessity, patients have devised numerousways to safely take their medicine. And speaking of safety - medicinal cannabisis the safest medication I have ever recommended. In over 2,000 individual patient encounters I have hadexactly two reports of adverse reactions to the medicine. Both were in patientsnew to cannabis who experienced the typical anxiety/paranoia reaction that iswell described in the literature, lasts for a short period and has no knownlong-term adverse effects. I had never really considered the safety profile of cannabisuntil this year, but thinking back on my career as an ER doctor, I never caredfor anyone with a marijuana-related emergency. When I compare that with thenumber of people I have pronounced dead due to the legal consumption of alcoholor narcotics, it is clear cannabis is a safer medicine. Cannabis may be the safer medical choice for some patients,but legal issues remain. I am not speaking of federal versus states' rights,I'm talking about patients in our community who have had their medication takenaway by members of law enforcement. When I inquire and try to determine the cause of the problem,the answers I receive range from an apology and the return of medication tooutright anger. One official told me that my patient was not using medicine butan illegal drug and that their department was going to "rip up every plantthey could find." I recently went to court for a patient and, based on theprosecutor's behavior it appears that once she realized that my patient wasprotected under the law, she switched to a tactic that has been used in otherstates to scare physicians away from writing recommendations for medicalcannabis - she attempted to discredit me. When other physicians hear about the legal issues thatcolleagues and patients are faced with, it is not surprising that they vote infavor of the medicine but shy away from writing the recommendation. Some physicians even prefer to avoid consulting on sharedpatients who use medical marijuana, out of fear of legal reprisal. These fearsare so widespread that it has become a standard of care to not consult with acannabis patient's primary care provider. This, quite frankly, is a bad standard and inferior medicine,but for now it is the best we have. One way to change this standard would be for physicianpractices to let patients know if they are cannabis friendly. The other optionis for patients to "come out" to their provider. Based on data collected in my practice, this is unlikely.Over 90 percent of my patients request that I not contact their treatment teamout of fear of rejection. Over the next year, as we see dispensaries opening and peoplebecoming more comfortable with the concept of cannabis as medicine, it is myhope that the issues of 2013 become a thing of the past and my patients areable to use their medicine in peace. - --- MAP posted-by: Jo-D