cannabisnews.com: Docs Leery of Prescribing Pot





Docs Leery of Prescribing Pot
Posted by FoM on November 11, 2001 at 09:27:53 PT
By Paul Cowan -- Staff Writer
Source: Edmonton Sun
The federal health minister is being told to count doctors out as pot police. The Canadian Medical Protective Association has written to Allan Rock telling him the Marijuana Medicinal Access Regulations, introduced in July, place an unfair responsibility on physicians. Patients who want marijuana have to get a doctor to sign a declaration approving the use of the drug and setting a dosage. 
"The CMPA believes the medical declarations required under the regulations place an unacceptable burden on member physicians to inform themselves as to the effectiveness of medicinal marijuana in each patient's case, as well as the relative risks and benefits of the drug and what dosage would be appropriate," said Dr. John Gray, the association's secretary treasurer in his letter to Rock. "This information is simply not available. "In medicine, knowledge is typically derived from clinical trials, of which we understand there are very few for marijuana." The association has sent its 60,000 members an information sheet telling them what to do if a patient comes to them asking to be prescribed marijuana for medicinal purposes. "The CMPA's general advice is that any physician who does not feel qualified to make any of the declarations required should not feel compelled to do so," cautions the association advisory. It warns doctors could find themselves in trouble with their professional associations if they make statements beyond their area of expertise on the forms. The Alberta Medical Association has already warned its members to be cautious about approving the use of pot. "We are asking where is the evidence. There haven't been the controlled studies on the side-effects," said AMA spokesman Ron Kustra. "Doctors can't be sure what they are prescribing." Source: Edmonton Sun (CN AB) Author: Paul Cowan -- Staff WriterPublished: November 11, 2001 Copyright: 2001 Canoe Limited PartnershipContact: sun.letters ccinet.ab.ca Website: http://www.fyiedmonton.com/htdocs/edmsun.shtmlRelated Articles & Web Site:FTE's Canadian Linkshttp://freedomtoexhale.com/can.htmMarijuana Under the Microscope http://cannabisnews.com/news/thread11312.shtmlSenators Pay a Visit To The Compassion Club http://cannabisnews.com/news/thread11304.shtml
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Comment #8 posted by Dan B on November 13, 2001 at 14:30:36 PT
The Filter As An Addiction Aide
Let me say at the outset that a tobacco smoker I am not. I was for a couple of years, but I managed to quit. At the peak of my smoking habit, I was smoking about three packs a day. For twelve years I had not had a cigarette.Several weeks ago, upset and desiring an escape, already a bit tipsy from three or four drinks, I took a walk down the street to the supermarket and bought a pack of cigarettes. I remembered the feeling I used to get when I'd drag that smoke deep into my lungs, then exhale. I wanted that feeling I got back when I was used to smoking. I opted for the strongest cancer sticks I could find:"Can I get a pack of Camels, unfiltered?""Unfiltered?" "Yeah.""Okay," the clerk said with a resigned tone.I also bought a lighter (I forgot to bring one with me), and when I got outside I removed a corner of the pack and tapped out one cig. I lit it, and the smoke was much stronger than I realized. One hit off that cigarette, and I was feeling high. Yes, high. From the nicotine.Over the next few weeks, I probably smoked six of those cigarettes, sometimes stopping after just a few puffs. Like I said, they were strong. I began to wish I had picked up the filtered version so I could handle the harsh smoke and powerful nicotine rush. That was when I realized that the unfiltered cigarettes likely kept me from returning to my habit of twelve years ago.I believe that the filter on cigarettes is a tool to make the smoke more palatable and to dampen the effects of the nicotine enough to reinforce the habit of smoking. That is, filters make the smoke weaker, and weaker smoke means that you need more to get that nicotine rush I felt on the first hit from an unfiltered cigarette. The act of tamping the pack down, tapping out a cigarette, placing it in one's mouth, lighting it, and drawing that first smoke into one's lungs becomes ritualized because of the repetition required to get the desired effect from a filtered cigarette, and habits are soon formed that may have as much to do with act of smoking itself as with nicotine.And think about it: how many cigarette brands out there even offer an unfiltered variety? I can think of two: Camels and Lucky Strikes (do they still make Lucky Strikes?). The addiction mechanism is attached to virtually every cigarette sold, outside those two brands. I believe that if people's first tobacco encounteres were with unfiltered cigarettes, very few would stick with it long enough to foster an addiction. That nicotine high I told you about? It made me want to puke.I don't know why I smoked five more. Perhaps it was the nicotine calling to me after all. But I do know this: after the sixth one I tossed the remaining fourteen cigarettes in the garbage. I don't know that it would have been so easy if I'd bought filtered Camels that night I took a walk to the supermarket.What does this have to do with cannabis? I believe that the government has outlawed vaporizers (as "drug paraphernalia"), even if used solely for smoking tobacco or herbal blends not associated with cannabis, for a similar reason that filters on cigarettes are deemed a-okay: they want more addicts. Addiction is profitable. Ask any representative of big tobacco if you need proof.Using a vaporizer is (from the instructions I have read, at least) more cumbersome than simply rolling and smoking a joint; thus, one would be less likely to reinforce a habit of smoking whatever with a vaporizer than with a joint. The mechanism for transfer of THC or nicotine or whatever into the system would not only be purified of harsh smoke-related chemicals, but also would make reinforcement less of a problem.  Points to ponder, at any rate.Thanks for your patience in reading this comment. I hope it makes sense, at least on some level.Dan B
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Comment #7 posted by Lehder on November 12, 2001 at 13:05:49 PT
mj and doctors
One problem that threatens to subvert the reform movement is the improper categorization of all marijuana use as either medical or recreative: Either a person must be grieviously ill in order to use marijuana or else the use is labeled a waste of time or some form of abuse or destruction. That outlook makes sense for antibiotics and other true drugs which have only medical applications or that have real negative side effects to the physical health of individuals and communities, but not for marijuana. It would be a shame to see the long efforts of reformers bring only a tyranny by health managers in place of a tyranny by the police and judiciary, so it's actually good to see the real problems of marijuana regulation by the medical profession recognized. Many people like the effects of marijuana, some don't, and no physician, especially one who has never smoked it, can really be informed about its effects or make a proper decision for anyone else about whether it should be used or not. It's a personal choice and should be respected as such.
 Most people who use marijuana for nonmedical reasons simply find their lives better with marijuana than without, and the reasons are very many. Marijuana does not need to be regulated beyond the reasonable restrictions on use by minors. It's harmless.At root of the problem with marijuana prohibition is the puritan ethic than life must consist of suffering and hard work. It's okay to take pills that have all manner of negative side effects like bleeding stomach, liver damage, stroke, abdominal pain, diarrhea. But it's not okay with the puritan that a natural herb should provide a little bit of a pleasant feeling whether used medicinally or not. A little bit of a pleasant feeling should be obtained, by the puritan standard, only by hard work, suffering and fervent prayer. Not everyone subscribes to these values, and no one is justified in imposing them. Legalize. Period.
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Comment #6 posted by goneposthole on November 12, 2001 at 07:05:56 PT
doctors mistakes
A doctor bought a car at a dealership. He asked the salesman what could be done if he got a lemon.
The salesman asked the doctor what he does with his mistakes."I bury them," was his reply.The story is true. Sometimes they just guess, too.There is no known toxic level for marijuana.Two drops of a nicotine tincture from a couple of cigarettes on the tougue will kill.
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Comment #5 posted by Lehder on November 12, 2001 at 06:41:14 PT
physicians butt out
Legalize. Period. As far as my experience with physicians goes, medicine, as practiced by most, is hardly a substantial discipline. Most physicians are more businesspeople and bureaucrats rather than medical practitioners. They typically imagine that a medical vocabulary lends intelligence and, as they have been taught in medical school, imagine themselves as deities compared to "ordinary" people. I have yet to hear of a physician who would address a Ph.D. as "Doctor", though they all expect the same accorded to them. The indisputable fact is that fully one-third of deaths in the U.S. are attributed to medical misdiagnoses. If the head physician makes an incorrect diagnosis, then all the other physicians are often too timid and worried about office politics to contradict him with a more competent diagnosis. Meanwhile, the patient suffers. Whenver I or mine are ill, if I am able, I go to the medical library and try to narrow down the list of possible afflictions and read up on each of them, symptoms and treatments. I was at first, but am no longer, surprised at how little physicians know about any particular illness. This in itself would not bother me at all, but the typical physician's inability to admit his ignorance and take the trouble to look up the needed information rather than adhere stubbornly to his initial faulty diagnosis is dangerous to many patients. More than once, a cure was effected only by my carefully guiding the physician who had access to medical tests and treatments. Even then, I had to keep in mind that the physician had a very fragile ego and had to take care to allow him to imagine that he himself had made the diagnosis.My attitude is hardly unique. There are more nightmare stories in the news every day: women who were given mastectomies after incorrect diagnoses of cancer, people who die from the side effects of unnecessarily prescribed drugs, and the 30% of people entering a hospital who there contract very stubborn infection and wind up having to stay weeks longer than they should have. I also very much resent the large signs you see in the offices of every doctor and dentist advising that "The Doctor Must be Paid Immediately." Your visit begins by your being made to feel like a deadbeat.Physicians make a profitable business more out of their unique access to drugs and treatments than from any personal competence in medicine. Yet even these are abused. For example, much is made of the over use of antibiotics. Yet this over use is the result of over prescribing them. Rather than taking a culture and determining the cause of infection or the proper antibiotic - if one is called for at all - most physicians will just prescribe a broad spectrum antiobiotic without any real diagnosis at all. Patients are essentially hostage to them, like desert dwellers are to the owner of the only well for a thousand miles. Medicine is a racket. Let's not add marijuana to the list of abuses.
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Comment #4 posted by p4me on November 12, 2001 at 04:27:08 PT:
leave out the physicians
If you involve the physicians it is just another $90 to get a prescription. It only goes from one mess to another. Treat it as an herba supplement like kava kava or St. John's Wort. Sure the doctor should be informed, but you guys are acting like this is a really dangerous thing. I know people that have smoked regularly for 30 years and they are no more stupid today than they were when I meet them. Their lungs are damaged some, but then if the government actually came out and said "You 71 million people that have smoked marijuana need to use a vaporizer" people might figure out that they should get their friends and relatives that smoke cigarettes to use vaporizers too. Then the inquiring mind would wonder why not one of the states undertook any such campaign with their billions in the tobacco settlement. The inquiring mind might think that the government wants them to die before they collect any Social Security because the government has already spent that money on "The War On Drugs."It also completely ignores the fact that millions of people want to use it recreationally and its value there. If people are willing to pay $40 for a quarter ounce and risk being arrested, searched, drug tested, and lose the job they have and the career they have, it sure well seems to me that they value what it does for them as a mood adjuster.Everybody is just not being honest. Besides the laws, the expense, the hassle, and the lung problem, just what is it that makes this one particular plant so feared? If you will explain it to me in plain and direct English, I am very open to finding the true reality. Could it be the hundreds of millions of manhours that are required to be worked to pay the current level of use at the current price would be missed by the factories and businesses that are controlled by the 1% that own 38% of the wealth? It seems to me like the tool used in South Africa to get the people to work the diamond mines. As long as they left the natives alone they could live off the land. When they put what was basically an existance tax on them that required them to come up with cash to give the government, then they had to take to the mines to take what money Cecil Rhodes wanted to pay them.Print this out and discuss it with your teacher and see what he/she has to say. It sure seems like it would help young people to think or is that even important. I am writing a book and I want to be truthful.FoM, I am through for the day.Vote against all incumbents. Buy a vaporizer for someone you love.
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Comment #3 posted by Ethan Russo MD on November 11, 2001 at 10:53:43 PT:
Thanks
These links are valuable. I will write to the agencies involved and offer them resources to aid in physician education.
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Comment #2 posted by puff_tuff on November 11, 2001 at 10:45:31 PT
The CMPA
From the Canadian Medical Protective Association website*NOTE* These are PDF FilesMedical marijuana: An open letter to the federal health minister
http://www.cmpa.org/cmpaweb/public/english/pdf/Rock_letter-e.pdfCMPA Information Sheet on medical marijuana
http://www.cmpa.org/cmpaweb/public/english/pdf/web_marij-e.pdf
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Comment #1 posted by Ethan Russo MD on November 11, 2001 at 10:11:27 PT:
Physician Education on Cannabis
There is obviously a desperate need for education for Canadian physicians on clinical cannabis and alternative delivery systems. I would be anxious to help, and repeat my previous offer to aid Health Canada in any manner they deem appropriate.Patients Out of Time is organizing a Clinical Cannabis Conference, tentatively set now for the University of British Columbia, Vancouver, BC for May 10-11. I hope that the turn-out will be good for this valuable event.
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