Godstud wrote:No one is claiming that marijuana is a cure-all. What is being claimed is that it can treat a variety of things and sometimes in better ways than Opioids and other much harder drugs.
No one has ever over-dosed on marijuana. The same cannot be said for other drugs, and even alcohol. It was legalized in Canada because it's NOT a dangerous drug(less dangerous than alcohol, IMO). It had already been decriminalized in most places for a long time.
There is an element of "Reefer Madness" in your posts, @XogGyux. There has been some research into medical marijuana, and the effects are known to help people, even if you don't like to admit that. Most of the even the studies were extremely limited due to the tiny amounts of marijuana they were permitted to use, so there still needs to be more study into this helpful drug.
This is often the view most people who have no knowledge of marijuana have been brain-washed into:
Please don't do that. Don't go into the "looking for motives" expedition. You won't find any.
I have said before, and you can go back to some of my posts of over 2 years ago, that I do in fact support decriminalization, and legalization of drugs. For sure marijuana and I'll go a step further and include cocaine, LSD, Ecstasy, and many others. I am a bit more on the fence regarding opioids but this one is tricky so my stance on this one is a little more woobly. As a general rule I believe prohibition does not work, it did not work for alcohol and it does not work now. People still have nearly unhampered access to all of these drugs, the money ends up going to criminals that exploit people (drug mules, prostitution, violence, child abuse, trafficking), promotes violence, fills our prisons (which btw cost us billions of dollars) while at the same time stigmatizing the very people we need to protect thus making it harder for them to receive re-habilitation.
I believe it is far more pragmatic to simply allow for a recreational market similar to that of alcohol and tobacco. Taxate heavily as to mitigate the societal problems and force the industry to alert the public of side effects (similar to the warnings on tobacco boxes).
So as for your Reefer madness theory, that is dead on arrival.
The research into "Medical marijuana" is super limited.
For instance. I just read the titles to every article in my small collection of NEJM journals published since 2015. In those 4 years worth of publications, I was able to find 2 trials regarding marijuana derivatives. Both of these are for Cannabidiol for seizure resistant children with Lennox Gastaut Syndrome and Dravet Syndrome. There are around 10-15 more articles that in one way or another mention marijuana or marijuana derivatives and those articles are one of two: Letters to the editors (basically criticism to the 2 previously mentioned trial, and criticism, btw can be positive or negative not just negative) or articles related to adverse events regarding synthetic cannabinoids. For instance, there is an article regarding the Outbreak of Cannabinoid-Associated Coagulopathy in Illinois (Volume 379 No. 13, Sept. 27/2018) and "Zombie Outbreak Caused by the synthetic cannabinoid AMB-FUBINACA in New York") (Volume 379 No. 3 January 19, 2017). There are also some opinion essays regarding legalization etc. But the important point is, that there are just 2 articles limited to 2 rare conditions and limited to patients that were resistant to existing therapy. This is hardly some overwhelming evidence for anything, it is something... but at this point is more of a spark than a flame.
These are the journals that I just reviewed (just tittle of article, I have read them in the past but I obviously did not read all 150+ of them in the last 24h
) and only 2 of them have trials (the 2 trials I just mentioned above) and only about ~12 contain any article at all that mentions marijuana-related topics (half of those are editorial responses to the 2 mentioned articles and the rest are crazy shit going on with synthetic cannabinoids.)
Here is the issue with evidence-based medicine. Until recently, medicine was not heavily practiced based on evidence. Until the 18-19th century, it was mostly a guessing game. Physicians would prescribe mercury, lead and arsenic-containing compound to their patients. Today we know this is a big no-no. In the early 20th century we had the "physiology heavy" approach. We learned quite a bit about human physiology and we would base our treatments based on the understanding of physiology. This was better than before, but still quite poor. We had doctors prescribing cigarettes to asthmatics because "warm air opens the airways".
Today, you cannot go through a full cardiology lecture by an experienced cardiologist with white hair on his head (or bald
) without him pointing out that a few decades ago, his attending would smack him in the face if the attending were to find that a patient with heart failure was receiving beta blockers. You'd see, back in the days it was thought that because beta blockers slow down the heart, a patient with a bad heart that has poor pumping efficiency, should not be getting beta blockers because this essentially makes the already deficient pump weaker. Offcourse, today in retrospect we realize that precisely because the heart beats slower, it has more time to fill up with blood and pump more blood, in addition, it is during this relaxation phase that the heart's blood supply circulates (opposite to the whole body) and finally, the slower the heart goes, the less oxygen it consumes. This is protective. Today, you would have to have a very strong reason not to be on a beta blocker with heart failure.
Why do I say all of this that seems irrelevant? I am trying to make the point that modern medicine in the way we practice it today, requires a very high degree of evidence. One or two studies does not really open much door except for those very limited cases that they address (assuming that the results are overwhelmingly positive). Based on this two studies, no doctor is justified to prescribe Cannabidiol on any other seizure disorder let alone pure marijuana or a different derivative other than the one actually studied.
To put this in perspective. In the same period of ~4 years of journals, I counted well over 40 trials related to steroids and 40+ for aspirin. Both of which are very well studied medications/medication-class. In fact, in October 18, 2018 issue there were 4 different aspirin-related trials published on a single issue. This is a medication that has been around for over 100 years and we still find ways to research applications/indications and we still have plenty to figure out. You cannot tell me that this super old medication can still yield 4 articles in a single issue while marijuana derivatives only published 2 articles in the same journal over 4 years worth of issues (150+ issues checked) and that we should accept this as "decent amount of evidence". And I know you are not one of those but I can predict some of the more "conspiracy theorists" point out that there is no money in marijuana and big-pharma does not want to touch it because of it or some other excuse. Aspirin is cheap, and no patent so if it can still manage to command dozens of articles in the last few years and as many as 4 articles on the same issue of the most respected medical journal I think marijuana could also do it.
Watch this podcast for instance:
1 Slide regarding moderate-good evidence for therapeutic effects and the rest of the 1h presentation is basically saying "no evidence, little evidence, poor evidence" or... worse, "evidence of something bad".
The NEJM had an article on its "Clinical Decision" section on October 18th 2018 (VOl 379 No.16)https://www.nejm.org/doi/10.1056/NEJMclde1808149
I don't know if you will have access to the article but basically, it is a woman with chronic pain seeking for expert advise and 2 pain specialists wrote an essay. One in favor of starting marijuana-related therapy and the other in against starting such therapy. I dont want to copy and paste the whole thing because it might have copyright implications but for the Dr. writing the essay in favor of using marijuana he says: "For example, in a murine model of neuropathic pain, administration of cannabis significantly reduced allodynia in a dose-dependent manner." and "There are, however, few clinical trials focused on pain control in humans that quantify adverse effects of medical marijuana. Despite decades of campaigns that have limited the ability to conduct research in the field and federal restrictions on cannabis, trials in humans have shown measurable effects of cannabinoids in alleviating chronic pain, with an acceptable safety profile.1 Experimental research and research in animals provide reassuring support on safety.7"
The first alarm is the constant reference to animal models. This is not something that you should be doing for something for which you have a lot of evidence. I do not tell you take statin because "animal models have shown reduced cardiovascular mortality". At this point in the game, we know in humans that statins are effective. However, this expert recognizes that we only have very few studies in humans and he has to bring up animals as part of his evidence. The second expert says something along the same lines "Medical marijuana has received widespread attention as a treatment for various chronic medical conditions, including pain. Although the growing support for state legalization has led to its approval for medical use in most of the 50 states, enthusiasm for medical marijuana has been based largely on anecdotal information.
I do not claim to know 100% of all the evidence surrounding Marijuana, but I am aware of a great deal of it and it is not much. It is something but not really much.
It is still a schedule I medication that is federally regulated and illegal. This severely limits research. It might turn out to be an amazing source of drugs, it might turn out to be a complete and utter bust but at this point in time, we know very little. This ignorance that we have and the legal uncertainty almost guarantees that the vast majority of physicians don't want anything to do with prescribing it.