October 2, 2014
Dear Friends and Colleagues,
Medical marijuana is an important and controversial subject, on which views vary and I’ve been asked to share mine. In the spirit of full disclosure, let me weigh in with my opinion, as a doctor and hospital administrator of many years. In candor, I believe medical marijuana is a solution for a problem which does not exist. I fear its general acceptance will bring more unforeseen problems for a nation already plagued with an epidemic of opioid overdoses and deaths.
The Drug Enforcement Agency (DEA) classifies marijuana as a Schedule I substance, stating on its website:
“Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Schedule I drugs are the most dangerous drugs of all the drug schedules with potentially severe psychological or physical dependence. Some examples of Schedule I drugs are:
heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote.” (http://www.justice.gov/dea/druginfo/ds.shtml)
Medical marijuana was first legalized in California in 1997. Since then, 20 other states have legalized the drug. The danger in general allowance of “medical” marijuana is that it could act as a starter drug in our nation, which has already suffered from a quadrupling of deaths from overdoses of prescription opioids between 1999 and 2010, exceeding the combined death toll from cocaine and heroin overdoses. (http://jama.jamanetwork.com/article.aspx?articleid=1653518)
Why do I say medical marijuana, which has been shown to decrease nausea due to medications used to treat cancer, is unnecessary? Here’s why: There are already existing, safe, and easy to take anti-nausea and vomiting medications readily available and prescribed by oncologists and other physicians. Medical marijuana has also been lauded as a pain reliever or an adjunct to existing pain medication—both narcotics and non-narcotics. Again, there are many safer and easier to administer adjuncts, such as Tylenol or aspirin or other non-steroidal medications, which supplement stronger pain relievers.
Glaucoma, for example, is already generally well treated by current safe and effective medications. The dose of medical marijuana needed to control glaucoma would need to be administered about every three hours; thus, clearly causing other problems, such as confusion or hallucinations, particularly in the elderly who are more likely to suffer from glaucoma.
Treating neurological problems—such as multiple sclerosis, epilepsy, and movement problems—with marijuana has also been studied with inconclusive results and no objective post-treatment changes. Patients may have temporary euphoria, which is the same feeling that leads to addiction.
Sadly, we have an existing epidemic of prescription opioid overdosing. The costs associated with addiction in terms of loss of life, impairment of well-being, family disruption, societal malaise, economic ruin, and general deterioration cannot be over-stated. The causes of addiction are complex, and adding easy access to medical marijuana will only exacerbate the problem. Treating those who need help and support non-pharmacologically—with support, encouraging intact families, and well-being for the entire population—is the answer to helping people live longer, happier, and healthy lives. Medical marijuana is simply not the answer.
Allen S. Weiss, M.D., President and CEO
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