Although we have dramatically improved health and doubled our life expectancy in the last 150 years, there is still so much suffering. It is reasonable for patients to try something experimental for conditions that have failed best current medical practices - experimental, but preferably plausible. Homeopathy and energy healing (like Reiki) are examples of implausible therapies. Marijuana, on the other hand, acts through a know mechanism; a drug is ingested or inhaled, travels by circulation to a target receptor, and stimulates the receptor. Other successful medicines work in this fashion; therefore, in theory, it is plausible that marijuana, which stimulates the cannabinoid receptor, could work.
The health benefits of marijuana have been presented by some, however, as a cure-all with no side effects - a panacea. Everything from cancer, to Crohns, to seizures. Eventually, with time and proper clinical trials, this hype will be replaced by the reality of human physiology. A drug stimulates a receptor and has a cascade of many effects - some of them good and some of them bad. And maybe, if we are really lucky, the benefits of the drug will outweigh its harms in a few selected conditions. This is the fate of drugs, medicines, herbs and supplements. Only a few pass running through the gauntlet of evidence.
I would like to give the option of medical marijuana to my patients that have failed more proven therapies. Last weekend I took a course given by the FMA (Florida Medical Association) that gives me the right to prescribe medical marijuana in the state of Florida. But, before you get your bongs out and line up in my office, there are several important messages the Florida Medical Association wants to convey.
First, patients must suffer from one of these “qualifying medical conditions”:
Cancer
Epilepsy
Glaucoma
HIV+
Acquired immune deficiency syndrome
PTSD
ALS
Crohn’s disease
Parkinson’s disease
MS
A terminal condition
This is a rather limited list when compared with other states that have legalized medical marijuana. Furthermore, if a doctor in the state of Florida prescribes medical marijuana to a patient without a qualifying medical condition, the doctor can be punished with a misdemeanor including up to a year in jail.
But it gets worse, the next half of the course describes in detail the conflict between the federal and state governments. Starting with the current view of marijuana held by the DEA:
“Marijuana is properly categorized under Schedule I of the Controlled Substances Act (CSA), 21 U.S.C. § 801, et. seq. The clear weight of the currently available evidence supports this classifcation, including evidence that smoked marijuana has a high potential for abuse, has no accepted medicinal value in treatment in the United States, and evidence that there is a general lack of accepted safety for its use even under medical supervision.“
This is followed by several pages detailing how writing a prescription for medical marijuana violates the laws of the federal government. Below is the concluding statement I photoed directly from the course syllabus.
For now, it appears that the federal government still holds it's reefer madness opinion of marijuana; and the Florida government and medical boards are discouraging doctors from prescribing marijuana because of this. I will keep you all abreast of the situation. However, I will not be prescribing medical marijuana and will await until the laws change. I would like to apologize to any patients who are suffering and wanted to try medical marijuana. My attorney has advised me not to say anything more. 😀
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