FROM THE DESK OF DR. CRAIG KERINS
The Perils of Medical Marijuana
When the next chapter of the history of medicine is penned, the opioid crisis of the last 15 years will be a major storyline. The medical profession was duped by the Joint Commission on Hospital Accreditation into considering “Pain” to be the fifth vital sign, a problem we largely ignored as we became callous to the suffering of our patients. Pain was pseudo-measured on a scale of 1 to 10, with a score of zero being optimal.
Opioids are cheap, available, and very effective in alleviating pain…at least in the short term. Big Pharma assured us that new configurations of increasingly powerful opioids were safe, effective, and essentially non-addictive.
Add in a population of patients armed with internet satisfaction surveys and what could go wrong?
Opioids do not work well for chronic pain. The new medications turned out to be very easy to abuse and extremely addictive. The nation continues to battle an opioid epidemic of historic scale with no end in sight, and the medical profession is deservedly bearing much of the blame. We took the easy way out, and caved to Big Pharma, the Joint Commission, and short-sighted uninformed patient demands to the detriment of our profession.
We are about to do the same thing again.
Artisanal marijuana is the plant form of the drug and contains greater than 70 active ingredients, most of unknown efficacy. This combination of ingredients is being advocated by Big Marijuana for the treatment of:
• Amyotrophic Lateral Sclerosis • Autism • Cancer
• Crohn’s Disease • Epilepsy • Glaucoma
• HIV / AIDS • Huntington’s Disease • Inflammatory Bowel Syndrome
• Intractable Seizures • Fibromyalgia • Multiple Sclerosis
• Neuropathies • Parkinson’s Disease • Post-Traumatic Stress Disorder
• Sickle Cell Anemia
• Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective
• Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity
These are a combination of 18 physical diseases and mental disorders (and the list is growing), mot having absolutely nothing in common. There are virtually no scientific studies to document the efficacy of the marijuana treatment, and no one has a clue as to the mechanism of action of these ingredients in the disease or disorder process.
This isn’t science, it is Quackery, and the medical profession should shun this approach to disease.
As modern physicians we come from a background of science. Our profession strives to be evidence-based with double blind studies subjected to peer review being the gold standard for advances in treatment. Anecdotal Evidence is an Oxymoron. An anecdote is not evidence, it is hearsay. It should never, ever have a role in the treatment of human beings.
There is an alternative.
Ingredients in artisanal marijuana can be extracted, analyzed, tested, and if effective in treating disease, released for general use. This has been done with CBD, the most promising cannabinoid of marijuana. It is now readily available as epidiolex and has been proven very effective in treating some forms of pediatric seizure disorders.
This is how all other drugs are brought to market, and the medical profession will be making a monumental mistake by granting a shortcut to the marijuana industry.
Neither the efficacy nor the safety of these powerful ingredients has been established. In fact, evidence mounts, thanks to the 10 states that have already legalized the drug for recreational purposes, that the dangers have been wildly understated, with psychiatric disorders, violence and automobile wrecks leading the list of problems. And the only difference between “medical marijuana” and recreational marijuana is that the former says “medical marijuana” on the container’s label.
The really profound risks, howver, will take longer to become apparent, but they are very, very real. Teenagers, who will absolutely get this drug if it becomes widely available, and carrying a connotation of acceptability, will be destroyed by exposure to marijuana. The addiction rate is much higher in the young and damage to the immature brain is a real and present danger.
There are already enough states that have legalized marijuana and effectively made guinea pigs of their citizens. Don’t let Georgia join the mob. Stay true to the ethical basis of the medical profession and insist marijuana be treated like any other potentially beneficial medication. It is the right thing to do. Abandoning our scientific foundations will almost certainly result in another fiasco similar to what we’ve now got with opioids. We don’t want to go there again.
The 2017 Medical Association of Georgia House of Delegates unanimously passed a very reasonable resolution on marijuana which should continue as the organization’s standard.
~ Craig Kerins