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Posted: 5/17/2016 5:15:29 PM EDT
[#1]
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Are you saying you found a study where they gave the patients "marijuana cigarettes"? If so, that was a fucked up study from the start. Edibles, capsules, etc. are a much better way to administer cannabis and any legitimate medical study would have used ANY method other than "marijuana cigarettes." Quote HistoryQuoted:
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There must be some evidence because the US Federal Govt. has been distributing medical marijuana to a number of patients for the last thirty years or so. And, IIRC, the US Institute of Medicine studied the issue at the direction of the Drug Czar and said that marijuana meets the legal standard of a "medicine". I doubt if you could Rx it. Prescriptions aren't allowed by Federal law. I think you meant that you could "recommend" it. That's the way it works in most medical marijuana states. That's your choice if you don't want to recommend it. On the other hand, if a patient was smoking it because they thought it made them feel better (even foolishly) would you recommend that they be sent to jail or otherwise punished to cure that problem? What is the point of punishing sick people, even if you disagree with their choice of medicine? You missed the point above under the bolded part....I don't care what people do recreationally, as long as they take responsibility for their own actions.... And, the 'Federal Government distributing Marijuana to a 'number' of patients for the last 30 years' isn't very specific. What I find is that 14 people enrolled into a 'compassionate investigational drug program'..and 4 are still alive and receiving those Marijuana cigarettes. That doesn't quite fall under what I would consider a well tested drug protocol....they were enrolled because they had life threatening or life destroying illnesses and the marijuana cigarettes made them feel better....that's not a placebo vs. medication study, etc..... Are you saying you found a study where they gave the patients "marijuana cigarettes"? If so, that was a fucked up study from the start. Edibles, capsules, etc. are a much better way to administer cannabis and any legitimate medical study would have used ANY method other than "marijuana cigarettes." It wasn't a study it was/is given as medication. On Penn and Tellers Bullshit. They had one of the guys still on the program smoking a J on a bench infront of the Capitol in DC. If I remember the correctly he is shipped 300 1 gram joints grow at the U of Mississippi for free every month for micro bone spurs. But according to the DEA there if no medical purposes. https://en.m.wikipedia.org/wiki/Compassionate_Investigational_New_Drug_program |
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Posted: 5/17/2016 5:17:51 PM EDT
[#2]
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Are you saying you found a study where they gave the patients "marijuana cigarettes"? No, I was responding to the claim that 'The Federal Government has been giving Marijuana to people for 30 years, therefore they say it's OK...'. That 30 year claim is based on giving 14 people originally (down to 4 now) under a compassionate investigational drug program...not any regular distribution to some kind of a general patient population. |
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Posted: 5/17/2016 5:20:10 PM EDT
[#3]
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No, I was responding to the claim that 'The Federal Government has been giving Marijuana to people for 30 years, therefore they say it's OK...'. That 30 year claim is based on giving 14 people originally (down to 4 now) under a compassionate investigational drug program...not any regular distribution to some kind of a general patient population. Quote HistoryQuoted:
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Are you saying you found a study where they gave the patients "marijuana cigarettes"? No, I was responding to the claim that 'The Federal Government has been giving Marijuana to people for 30 years, therefore they say it's OK...'. That 30 year claim is based on giving 14 people originally (down to 4 now) under a compassionate investigational drug program...not any regular distribution to some kind of a general patient population. Where did I say "it's OK"? I said it met the legal standard of a "medicine". Do you understand the difference in those two statements? It may be down to 4, but the point stands -- the US Federal Govt. recognizes it as a medicine and has for some thirty years now. |
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Posted: 5/17/2016 5:33:51 PM EDT
[#4]
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snip.... So, essentially the New to Me patient did something illegal, got caught and comes to me with a story about how I should give them a certificate (presumably back dated, as they were arrested before they saw me, and anything I write now wouldn't have any legal weight in the eyes of the law...), and you want me to say it's OK to do that? Nope.... I have no problem helping people. Give me enough evidence and the legal ability to certify they need it, and I'll CONSIDER using that ability on a case by case basis...I certainly won't back date records or recommendations. I'd even be willing to talk to a prosecutor as an 'expert witness' if needed that it would be justified for him to use the weed....and recommend leniency based on that.... |
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Posted: 5/17/2016 5:36:51 PM EDT
[#5]
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Unlike a new pharmaceutical, you actually have Phase IV already, since you 120 million people that have used it in the the most unsupervised conditions possible. (The FDA is always fascinated by what patients do unsupervised in Phase IV, since they're worried about whether patients are ignoring the labeling, taking twice as much, taking it after alcohol (Acetaminophen!). Personally, I think that if it were descheduled, you could make a strong legal argument that the FDA didn't have authority to regulate cannibis as a drug, and instead it fell under 21 U.S.C. 321 as a dietary supplement. (Well at least labeled for consumption in an edible). Dietary supplements have absolutely no clinical data requirements in the U.S. The only issue I can see with calling it having the Phase IV requirements 'met' is getting honest answers out of the recreational users (as it was illegal while recreationally used...). Can you see it now...a phone call or survey from the US Government shows up asking if you've used Marijuana in the past.....I'm sure there's more than a few people who would be stupid enough to answer 'yes', but an awful lot smart enough to say 'no'..... |
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Posted: 5/17/2016 5:40:38 PM EDT
[#6]
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Where did I say "it's OK"? I said it met the legal standard of a "medicine". Do you understand the difference in those two statements? It may be down to 4, but the point stands -- the US Federal Govt. recognizes it as an investigational medicine and has for some thirty years now., but the most authoritative report (Institute of Medicine) recommends further study Quote HistoryQuoted:
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Are you saying you found a study where they gave the patients "marijuana cigarettes"? No, I was responding to the claim that 'The Federal Government has been giving Marijuana to people for 30 years, therefore they say it's OK...'. That 30 year claim is based on giving 14 people originally (down to 4 now) under a compassionate investigational drug program...not any regular distribution to some kind of a general patient population. Where did I say "it's OK"? I said it met the legal standard of a "medicine". Do you understand the difference in those two statements? It may be down to 4, but the point stands -- the US Federal Govt. recognizes it as an investigational medicine and has for some thirty years now., but the most authoritative report (Institute of Medicine) recommends further study Edited for you. Recognizing something as an investigational medicine isn't the same as saying 'it's OK to prescribe this'...there are several steps between those statements..... |
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Posted: 5/17/2016 5:42:55 PM EDT
[#7]
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So, essentially the New to Me patient did something illegal, got caught and comes to me with a story about how I should give them a certificate (presumably back dated, as they were arrested before they saw me, and anything I write now wouldn't have any legal weight in the eyes of the law...), and you want me to say it's OK to do that? Nope.... I have no problem helping people. Give me enough evidence and the legal ability to certify they need it, and I'll CONSIDER using that ability on a case by case basis...I certainly won't back date records or recommendations. I'd even be willing to talk to a prosecutor as an 'expert witness' if needed that it would be justified for him to use the weed....and recommend leniency based on that.... Quote HistoryQuoted:
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snip.... So, essentially the New to Me patient did something illegal, got caught and comes to me with a story about how I should give them a certificate (presumably back dated, as they were arrested before they saw me, and anything I write now wouldn't have any legal weight in the eyes of the law...), and you want me to say it's OK to do that? Nope.... I have no problem helping people. Give me enough evidence and the legal ability to certify they need it, and I'll CONSIDER using that ability on a case by case basis...I certainly won't back date records or recommendations. I'd even be willing to talk to a prosecutor as an 'expert witness' if needed that it would be justified for him to use the weed....and recommend leniency based on that.... You have again assumed something I didn't say. My example assumed a patient you knew well, so you had no real question about the facts. Also, nobody asked you to backdate recommendations or anything else. Please stick to what I say, rather than what you wished I said. The purpose of my question was to set up a very clean situation for a decision -- the harms of marijuana use versus the harms of prosecution. Assume a patient you knew well, long history with them, they haven't been a malingerer before. The only issue is that they are getting a placebo effect from marijuana and they want to avoid the bad health effects of jail. You know as a doctor (or firmly believe to the best of your professional abilities) that the only significant health issue caused by the marijuana is the bad effects of prosecution. Would you issue the recommendation? |
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Posted: 5/17/2016 5:46:16 PM EDT
[#8]
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Edited for you. Recognizing something as an investigational medicine isn't the same as saying 'it's OK to prescribe this'...there are several steps between those statements..... Quote HistoryQuoted:
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Are you saying you found a study where they gave the patients "marijuana cigarettes"? No, I was responding to the claim that 'The Federal Government has been giving Marijuana to people for 30 years, therefore they say it's OK...'. That 30 year claim is based on giving 14 people originally (down to 4 now) under a compassionate investigational drug program...not any regular distribution to some kind of a general patient population. Where did I say "it's OK"? I said it met the legal standard of a "medicine". Do you understand the difference in those two statements? It may be down to 4, but the point stands -- the US Federal Govt. recognizes it as an investigational medicine and has for some thirty years now., but the most authoritative report (Institute of Medicine) recommends further study Edited for you. Recognizing something as an investigational medicine isn't the same as saying 'it's OK to prescribe this'...there are several steps between those statements..... IIRC, the IOM report said that it was clearly a medicine, and it was the only medicine suitable for some people -- which is the same reasoning reached in the court cases that led to the Government shipping out to sick people. That is, pretty much a "necessity" defense. As for "prescribing" it -- that really isn't the major issue. The major issue is what benefit we achieve by punishing people just because we disagreed with their choice of medicine. If people weren't being punished for it, prescribing it (or recommending it) wouldn't even be an issue. |
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Posted: 5/17/2016 6:17:41 PM EDT
[#9]
Quote HistoryQuoted:
You have again assumed something I didn't say. My example assumed a patient you knew well, so you had no real question about the facts. Also, nobody asked you to backdate recommendations or anything else. Please stick to what I say, rather than what you wished I said. The purpose of my question was to set up a very clean situation for a decision -- the harms of marijuana use versus the harms of prosecution. Assume a patient you knew well, long history with them, they haven't been a malingerer before. The only issue is that they are getting a placebo effect from marijuana and they want to avoid the bad health effects of jail. You know as a doctor (or firmly believe to the best of your professional abilities) that the only significant health issue caused by the marijuana is the bad effects of prosecution. Would you issue the recommendation? Quote HistoryQuoted:
You have again assumed something I didn't say. My example assumed a patient you knew well, so you had no real question about the facts. Also, nobody asked you to backdate recommendations or anything else. Please stick to what I say, rather than what you wished I said. The purpose of my question was to set up a very clean situation for a decision -- the harms of marijuana use versus the harms of prosecution. Assume a patient you knew well, long history with them, they haven't been a malingerer before. The only issue is that they are getting a placebo effect from marijuana and they want to avoid the bad health effects of jail. You know as a doctor (or firmly believe to the best of your professional abilities) that the only significant health issue caused by the marijuana is the bad effects of prosecution. Would you issue the recommendation? So I knew the patient well, but didn't know they were smoking marijuana until they got caught? Or, I knew they were smoking it, had at least some tacit approval that it might be helping from prior visits..then they got caught smoking it? Let's look at your Hypothetical Situation: But let's suppose a hypothetical situation. A patient comes to you with a disease that you wouldn't wish upon your worst enemy. The patient tells you that they smoke pot because they think it helps their pain and/or other symptoms. You examine them, and all the research, and, as near as you can tell, the patient is only having a placebo reaction. That is, the only reason it is helping them is because of the placebo effect.
Then they tell you that they have just been busted for weed and they ask you for a recommendation because the recommendation will allow them to avoid having criminal charges against them. You make an objective assessment and, even though you don't agree with them smoking weed, you realize that the effects of being dragged through the criminal justice system are going to be far more devastating to this patient than any weed they smoke. Being sick, they are vulnerable in a lot of ways, including the fact that they might wind up homeless and bankrupt (among other things) if the prosecution goes through. You see no sign or indication that the patient is distributing weed to others or doing anything else that might harm others. So from your hypothetical, I knew they had a disease that was painful (and/or symptomatic). They were a prior patient, but weren't honest enough to tell me that they were using Marijuana for their symptom management. Then they tell me they got caught using it.... Not too much trust there. Then you throw out how I know there's no side effects (which I don't, and the Institute of Medicine report specifically mentioned respiratory effects and that smoking is a poor delivery vehicle)...so regardless of the Placebo effect, not much safety there.... So, my earlier answer stands...I'd maybe talk to the prosecutor about it, or even be an expert witness for the patient if needed (but would be honest about both sides of the coin), but I wouldn't write a blanket recommendation. AFARR |
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Posted: 5/17/2016 6:21:00 PM EDT
[#10]
Quote HistoryQuoted:
IIRC, the IOM report said that it clearly had some potential efficacy as a medicine but needed further study, and it was possibly the only medicine suitable for some people in a suitable form and delivery vehicle -- which is the same reasoning reached in the court cases that led to the Government shipping out to sick people. That is, pretty much a "necessity" defense. Edited for you to more closely reflect the IOM report as I read it. And unless I'm mis-remembering it...there was one case (a Glaucoma case) that led to that Compassionate, Investigational use of the Marijuana Cigarettes. The judge said to the effect...since he's going blind anyway and the government didn't show me enough evidence of potential problems with the cigarettes, he can have them (and dismissed the criminal charges against him). |
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Posted: 5/17/2016 6:22:40 PM EDT
[#11]
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I don't know why so many politicians fail to revise this. The only group that is against it is the elderly. Quote HistoryQuoted:
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Protip: There's no political divide on the recreational enjoyment of marijuana. I don't know why so many politicians fail to revise this. The only group that is against it is the elderly. They just want a monopoly on driving like that. |
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Posted: 5/17/2016 6:33:13 PM EDT
[#12]
Quoted: I've said for a long time that the sooner Ohio (and the other swing states) legalize Marijuana, and keep ballot initiatives at bay, the better, but this is about the most cynical, half-assed, restrictive scheme possible, from not letting people possess or smoke actual marijuana plants of any sort, to having prescriptions expire in 90days. |
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Posted: 5/17/2016 7:00:47 PM EDT
[#13]
Who cares about medicinal properties? How bout this?
What a grown adult puts in their bodies is their business. And if it kills them slowly, good for them. Worry about yourself. What you guys are really arguing is if the state owns your body or not. That is the crux of the argument. Not double blind bullshit this and that. And a pathetic many argue that the state does and defend it proudly. Does Marijuana have medicinal properties? I dont know and I dont care. But I do know its not the governments role to get involved. Thats not what was defined by our constitution as a legitimate role of the government. Simple as. Ill never understand why some of you guys proudly spend so much time and money on a war that gives you absolutely zero in return. |
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Posted: 5/17/2016 7:02:57 PM EDT
[#14]
Quote HistoryQuoted:
What you guys are really arguing is if the state owns your body or not. That is the crux of the argument. Not double blind bullshit this and that. And a pathetic many argue that the state does and defend it proudly. They do. The question is whether they should. It's not a terribly interesting question though, as they will continue to. |
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