The dope on dope…

Leaf 2

I started this blog because I wanted to further the development and adoption of multiple EMR systems in New Brunswick.   One particular vendor, endorsed by the New Brunswick Medical Society and the Department of Health, had been saturating the market with cleverly written promotional material, and ignoring the fact that we do still have choice in this province.   I don’t think that is right, and this blog is one way of raising awareness of other options that are available.

I’m still not sure anyone is listening, but you have to try, right?

Today I would like to tackle something completely different.  It’s an issue which has been gnawing at me for a number of months, and which is important to the medical community because of legislation changes that are going to affect all family practice physicians and GP’s, as well as some specialists.

The issue is “medical marijuana.”

I use the parentheses because I disagree with the term.   I would be agreeable to “medicalized marijuana” because that is what it really is.   A recreational drug which has been medicalized.

Marijuana is a dried leaf that some people use to feel better.  I have no argument with that.   I also agree with classifying it as a drug, because it is a substance that may be eaten or smoked which has a physiologic effect on a living organism.  That’s what defines a drug.  And anyone who has watched even part of a Cheech and Chong movie knows that people who use marijuana act differently.

As of April 1st, new regulations for “medical marijuana” will be in effect.  You can find them here, if you are really interested:  http://www.hc-sc.gc.ca/dhp-mps/marihuana/index-eng.php

Any patient will now be able to come to their family doctor and request “medical marijuana.”  All they need to do to qualify is say that tylenol is not working for their back pain.   Or they can’t stand putting in eyedrops for glaucoma. Or nothing else works for controlling PTSD flashbacks and they are tired of skulking around trying to buy it on the street.

All legitimate concerns, in the vast majority of cases.   However, there will be some people who use the medical system to obtain marijuana for recreational purposes.  I understand this.   If you really enjoy smoking marijuana and have a choice of getting if from your doctor (and possibly having Blue Cross pay for it), or hanging around seedy bars and street corners in order to buy it from a friend of a friend who spends half his time glancing furtively over his shoulder, fearing he could be busted at any moment, what are you going to choose?

I think anyone who wants to use marijuana should be able to do so, just like anyone who cares to have a beer can have one.   There should be age limits.   There should be penalties for doing stupid or reckless things while under the influence of marijuana.   You definitely should not drive a car, run a chain saw, or chase criminals while under the influence of marijuana and, as it is with any intoxicant, you should no be permitted to use marijuana at work.  What you do on your own time is your own business, as long as you are not harming someone else.

There is the question of whether marijuana is a gateway drug.   I don’t buy that argument for one second.   I went to university in the 70’s.   I knew hundreds of people who smoked marijuana.   I can’t think of a single person for whom marijuana was a stepping stone to addiction with stronger drugs.  No doubt there are some marijuana users who wound up using stronger drugs, but it is a classical error in logic to conclude that post hoc ergo propter hoc.  Almost everyone I know who smoked marijuana in their twenties stopped by the time they hit 30’s, and faced the reality of work and family.

I believe there are addictive personalities, and these are the people at risk for progressing to marijuana addiction and addiction to other drugs, gambling, alcohol and so on.   These people are putting their health and the safety of others at risk, and clearly they need medical help.  Even for them, marijuana is not a “stepping stone,” it’s just another stone.

For most marijuana users, it’s just a way to relax and maybe get some relief from the aches and pains they suffer for one reason or another.

So why has marijuana been medicalized?

Answer:  government cowardice.

People who want to be (re)elected abhor controversy above all.   No politician, no matter how well intentioned, wants to be painted as promoting the use of street drugs.   Just ask Justin Trudeau.   In the political arena, there is a heavy price to pay for honesty.   But to be honest, marijuana is no worse than alcohol, and in fact, is in many ways much more benign.

Personal use of marijuana needs to be decriminalized and at the very least sold to the public just like we sell alcohol.   Preferably people who want it would just grow their own.   It does NOT need to be medicalized.

I don’t want to be the gatekeeper of what is essentially a herbal remedy.   I don’t have the training to do it, and the product is too variable in it’s active ingredient concentration to be prescribed like other pharmaceuticals, at least in my opinion.

I will never prescribe “medical marijuana.”

Prime Minister Harper, when you are finished lashing Justin Trudeau with that hemp cat-o-nine tails, would you please do the right thing and decriminalize the personal production and use of marijuana?

Thank you so much.  Now get out of my clinic.

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