cannabisnews.com: Your Bias May Be Keeping Pot from Pain Patients 





Your Bias May Be Keeping Pot from Pain Patients 
Posted by CN Staff on February 04, 2004 at 22:23:41 PT
By Lynn Haley
Source: Medical Post 
Vancouver – The stigma attached to cannabis use keeps dying patients from taking advantage of the medicinal benefits of the drug, according to a study by palliative care specialist Dr. Romayne Gallagher, a professor at the University of British Columbia.The study, which drew on a survey of dying patients in palliative care units in Kelowna and Vancouver, showed these patients worried that smoking marijuana could damage their lungs, be illegal or cause addiction. They were also worried about the impact pot smoke might have on family members.
Morphine also has an enduring stigma, said Dr. Gallagher. Even though many patients are dying in a lot of pain, they are concerned about the issues surrounding drug use. Often, their fears reflect the apprehension of the physicians prescribing it, she said."What's frustrating for patients is that the physician's apprehension makes them feel they have to justify that they are in pain all the time," said Dr. Gallagher. "A GP might not be comfortable prescribing an opioid, and the patient is humiliated because he had to keep justifying that he really was in pain." Public education would help to decrease the stigma associated with cannabis use for medicinal purposes, she said.The survey posed 11 statements about cannabis, morphine and analgesics. These were drawn from perceived concerns about cannabis and from a previous study done by Dr. Gallagher in 2001 about knowledge and attitudes about palliative pain management in the general population.Patients were asked if they would be willing to use cannabis as part of a study in forms such as smoking, pill, inhaler, sublingual drops, added to food or tea, and were asked to state their preference. They were asked to rate their pain, nausea, appetite and anxiety over the past two days using a visual analogue scale of zero to 10, with zero being no symptoms and 10 being the worst pain imaginable. In addition to age, gender, ethnicity, religion and education, patients were asked if they had used cannabis before, and if they or a family member had a substance abuse disorder. A number of participants chose to enter more than one preference so there were a total of 80 responses from 66 patients. The majority felt uncomfortable with the idea of smoking pot or injecting it. Most preferred an oral form, either as a pill (32), drops under the tongue (15) or added to food (10). The smoking of cannabis was selected in only 12 responses. There were also several written concerns about the smoking of cannabis and harmful effects on the lungs. Only three responses agreed to "whatever works," suggesting the route of administration remains a significant concern for patients, even those with significant symptoms."Dying people still consider themselves alive, and therefore are afraid of harming themselves," said Dr. Gallagher. "They don't know how long they're going to live, and so they worry about smoking, about addiction, about the legality."Morphine is still the most effective drug for acute pain. Medical literature suggests the effects of cannabis are equal to that of Tylenol #3, she said."What this study taught me is that we still need to do lots of public education about the stuff we have, which works quite well," she said. "People who get the best benefit from cannabis say it's wonderful, that they're getting good pain relief and that they're not stoned. I have used it in patients, most with non-cancer illnesses in non-palliative situations, like MS."Dr. Gallagher said the properties of cannabis are not completely unknown, but information has been lost over the years.She said physicians must pay more attention to pain management, and that begins in medical school. The new generation of doctors does appear more receptive to the use of these drugs because they didn't grow up with a bias against them."There is patient concern, but then there is physician concern," she said. "They can't really address the concerns and questions of their patients. I think we have a real bias about the management of pain and about the use of these medications. "A lot of chronic patients feel subconsciously bad about taking pain medication, and it's kind of reinforced by physician bias. Would they feel that way if the patient were asking for help with antihypertensives?"Note: Patients humiliated because they have to keep justifying their pain: studySource: Medical Post (CN ON)Author: Lynn HaleyPublished: February 03, 2004 Volume 40 Issue 05Copyright: 2004 The Medical PostContact: medpost rmpublishing.comWebsite: http://www.medicalpost.com/Related Articles & Web Site:Canadians for Safe Access http://www.safeaccess.ca/Medical Pot Used by One Third of Ont. HIV Patientshttp://cannabisnews.com/news/thread17864.shtmlCanada Court Eases Medical Marijuana Rulehttp://cannabisnews.com/news/thread17494.shtmlCanada Eases Rules on Growing Medical Marijuanahttp://cannabisnews.com/news/thread17492.shtml 
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Comment #11 posted by E_Johnson on February 05, 2004 at 13:15:37 PT
C'mon you must admit
Schmeff, I understand that the government plays a huge driving role here but stoner braggadocio also has played a major role in the public's misunderstanding of the subjective mental feeling imparted by cannabis.Cheech and Chong made their whole careers out of exaggerating the marijuana high, making out like it was stupefying to the point of functional incapacitation.It didn't do us any favors for them to convince the public that marijuana puts them into a state where they can't even tie their own shoes.I think their movies misled a lot of people who were inexperienced enough to take them very seriously.I know these films really are cultural classics but there are days when I just want to burn them!
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Comment #10 posted by schmeff on February 05, 2004 at 10:47:50 PT
I Agree E.J.
The cannabis "high" is generally overstated. But unlike you, I DO blame the gummint...by whom I mean the prohibitionists. They seem to have cornered the terms of the debate to such an extent.... Think of it: If you have any actual experience of cannabis, you are automatically excluded from having a valid opinion, because, presumably, the "most dangerous drug in America" has left you forever mentally deficient. Thus, the debate is conducted, for the most part, by people who have no experience at all, who must rely on demonized hearsay. It's remarkable. It's like relying exclusively on people with no medical experience for a medical diagnosis, or trying to get an opinion about wine from someone who doesn't drink it. (I think Martha Stewart is using the defense: The prosecution's witness smoked !!MARIJUANA!! - his brain now looks like Swiss cheese and NOTHING he says is reliable.)People often tell me, "Oh, I tried pot a few times and it didn't do much for me", or "It made me sleepy." I never heard anyone who actually tried it say anything like, "It messed me up so bad...I got scared and quit for good."I think those people who tried pot a few times and didn't quite figure out 'what the big deal was' were expecting to discover the dangerous PSYCHOACTIVE drug the prohibitionists told them about. I'm sure a LOT of people who base their opinions on hearsay rather than experience use 'psychoactive' and 'psychedelic" interchangeabley, a trait the prohibs no doubt encourage.I believe a seasoned cannabist is no more impaired than a seasoned tobacco smoker. I don't smoke tobacco, but the few times I've tried it, its effects definitely left me impaired: nausea, dizziness, rapid pulse, etc. Nor do I drink coffee, but the first cup I tried...whooooeeee! Those who use cannabis randomly or infrequently will be more affected by it, and conversely, if one finds that it doesn't seem to be all that it used to be, just quit for a while and bring down your tolerance.
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Comment #9 posted by Hope on February 05, 2004 at 09:52:08 PT
"not stoned"
They are certainly not “stoned” or “buzzed” in the way they might likely have thought being “stoned” or “buzzed” was like. They expect something like they’ve been taught to expect from “Reefer Madness”. Perhaps, it’s possible, I suppose, that someone who was a raving lunatic or seriously unbalanced to begin with might react like the characters in the old movie. I’ve never seen it or heard of it happening, personally, but that doesn’t mean that it isn’t possible. The “stone” of marijuana usually is a very peaceful calm. The “buzz” is a stimulation of quiet thought that can be extraordinarily inspiring and rewarding. 
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Comment #8 posted by Ethan Russo MD on February 05, 2004 at 09:28:40 PT
Yes, Yes
What EJ has said is very true. For most people using clinical cannabis, there is no impairment from the high, especially employing good titration.It has also been of concern to some that the high is a necessary ingredient to improvement. I am not impugning it, but it is not a sine qua non. Almost none of the Compassionate Use Investigational New Drug patients in the USA ever have felt high, and yet it is certain from our testing that they obtain a striking antidepressant effect despite their severe chronic illnesses.There is a great deal of knowledge about cannabis, its medical effects and tolerability that will be trickling out over 2004. Just watch.
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Comment #7 posted by E_Johnson on February 05, 2004 at 09:23:25 PT
The power of suggestion
""People who get the best benefit from cannabis say it's wonderful, that they're getting good pain relief and that they're not stoned."The so-called marijuana is so blown out of proportion by the government and also by stoners that many sick people expect a much bigger deal than what they get from actually using the substance.I can cite a story told to me by someone else. His mother said she's rather he go blind than use pot for glaucoma, that's how afraid she was of the marijuana high.Then she got breast cancer and ended up using pot and said the marijuana high was no big deal at all, certainly nothing compared to what she'd been led to expect by society.People just get this idea that it's a lot more than it really is. And it's not just the government's fault that they expect marijuana to be some kind of acid trip or something.
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Comment #6 posted by Nuevo Mexican on February 05, 2004 at 09:10:33 PT
Tenet lies for bush, Blair called on to resign!!!
Bush just called for the extension of the Patriot Act!!!!And now this: 'America did the right thing in Iraq!'He just dug his grave deeper, faster, and wider with this comment, he will live to regret it, if the American people have any say in their future.Which country is more Democratic, the U.K. or the U.S.?Which country downgraded Cannabis recently?The answer is obvious!As bush lies about WMDs, Blair is called on to resign!When will Sen. Kennedy call for bushes resignation?Today, I hope!As Blair falls on the sword for bush, Tenet takes a bullet for bush.This sham will not work anymore, as the White House is in full damage control, with the media completely in tow, but with the Democratic Primaries taking place, they just gave the Dems the ammo they need to finish bush off. It should be easy with the AWOL Deserter on the PR run.Can you see how scared the media is of a Kerry win, even if he is bush the lesser. (Skull and Bones remember).Their job is to make sure kerry is history by Election Day.Have at it!Kerry makes bush look like what he is, a coward, a liar, a thief, and a mad man.But wait til you see what the media has in store for John Kerry.It will happen a month before the election, the 'ace' in their deck of terrorist acts against the American People, as the Selection of bush in 2000 was a terrorist act, in a series of 'terrorist' acts designed to get the permission of the American people for the plunder of anything left of Americas resources, legacy, standing in the world, etc.A landslide against bush is coming, Kerry will have to become accountable to the Grassroots Dems to have a 'mandate' though.As much as I expect bush to steal another election, I hope he gets caught this time, red-handed, hand-cuffed and dropped in a spider-hole, no lawyers, no rights, no mommy, no daddy, held indefinately with enemy combatant status.And this would be way to good for the man-boy!I'm not angry, I'm ashamed to be an American.Howard: Blair should resign over WMD claimMichael Howard today called on Tony Blair to resign, accusing him of failing to ask basic questions before committing Britain to war.
The Tory leader's comments come after Mr Blair revealed to MPs yesterday that he was unaware that the intelligence that Iraq could launch weapons of mass destruction in 45 minutes referred only to battlefield munitions, not any missile capability. Speaking in Portsmouth, Mr Howard said: "I am accepting what the prime minister told us at face value. He said he never knew, he never bothered to ask this question."If I were prime minister and I had failed to ask that basic question before committing our country to war I would be seriously considering my position."Mr Howard's comments shift the debate over the pre-war intelligence about WMD from questions about Mr Blair's integrity to ones about his competence.http://www.guardian.co.uk/Iraq/Story/0,2763,1141657,00.htmlAl Sharpton hires GOP, initiates first attacks on Dean that sent him spiralling downward. Thanks Al, you could've attacked Kerry, but NOOOOOOO!!!!!A Bush Covert Operative Takes Over Al Sharpton's Campaign
Sleeping With the GOPWhile Bush forces like the Club for Growth were buying ads in Iowa assailing then front-runner Howard Dean, Sharpton took center stage at a debate confronting Dean about the absence of blacks in his Vermont cabinet. Stone told the Times that he "helped set the tone and direction" of the Dean attacks, while Charles Halloran, the Sharpton campaign manager installed by Stone, supplied the research. While other Democratic opponents were also attacking Dean, none did it on the advice of a consultant who's worked in every GOP presidential campaign since his involvement in the Watergate scandals of 1972, including all of the Bush family campaigns.There was no failure of intelligence: US spies were ignored, or worse, if they failed to make the case for war:On January 28, Kay appeared before the Senate to testify that there were no WMDs. "It turns out that we were all wrong," he said. President Bush, he added helpfully, was misinformed by the whole intelligence community which, like Kay, made assumptions that turned out to be false. 
Within days, Bush declared that he would, after all, appoint a commission to investigate; significantly, it would report its findings only after the presidential election. http://www.guardian.co.uk/Iraq/Story/0,2763,1141401,00.htmlA real poll can only be found in Canada:Canadians to Bush: Hope You Lose, EhAccording to a new poll, only 15 per cent of us would vote for the Presidenthttp://www.macleans.ca/topstories/politics/article.jsp?content=20040209_74911_74911 More on Iraq war toll on Lying Politicians:Howard calls for Blair to resign:
 
Hoon is meeting relatives of Red Caps killed in Iraq 
Prime Minister Tony Blair should resign because he failed to ask "basic questions" on claims made in his Iraq dossier, says the Tory leader. http://www.guardian.co.uk/Iraq/Story/0,2763,1141401,00.htmlBush goes to S.C. and lies, lies, lies....White House officials maintained their standard denials that Bush's trip had anything to do with politics. "This is an official trip. The president is making official remarks," said White House spokesman Taylor Gross. It's the second time in a week that Bush has visited a state two days after a crucial primary. Last week, he did it in New Hampshire. "There are primaries happening all over the place these days," McClellan said, adding with a smile: "I guess we could stay here in Washington, D.C., and not go anywhere." Political analysts and Democrats scoffed at the White House's refusal to acknowledge a political component. http://story.news.yahoo.com/news?tmpl=story2&u=/ap/20040205/ap_on_go_pr_wh/bush&e=4
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Comment #5 posted by goneposthole on February 05, 2004 at 07:19:55 PT
Nobody is getting any younger
That's for sure.'The stigma attached to cannabis'There was a stigma attached to cannabis. Let's be objective, as the article is.However which way you can manage your pain (aches and pains will never disappear, healthy or not), no one should object.This is a healthy return to sanity and objectiveness.
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Comment #4 posted by yippierevolutionary on February 05, 2004 at 07:17:57 PT
Reefer Madness
I have a copy of the original Reefer Madness movie on my hard drive and can set up an FTP server for anyone who wants to download it from me. E-mail me at endcp hotmail.com and we can work it out.It is hilarious, and a lot of the propoganda lines they used in that movie are still in use today only a little toned down.
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Comment #3 posted by mayan on February 05, 2004 at 06:54:05 PT
Stigma
The stigma regarding medical cannabis is quickly dying as the masses are beginning to suspect a connection between cannbis prohibition and obvious greed on the part of the pharmaceutical giants. Several states are trying to get the much cheaper prescription drugs from Canada but the pharms and certain politicians in the said pharm's pockets are doing everything they can to stop these imports. They say these drugs from Canada may be unsafe but look at all the killers the pharms have produced while fighting a plant that has never killed anyone. Anslinger and the industrial giants of his time didn't have to counter an internet. We have erased a great deal of the stigma associated with 65 plus years of reefer madness in a very short time. Just look what has happened since 1996! How many Americans had even heard of medical cannabis just ten years ago? On a level playing field we would annihilate the bone-headed prohibitionists and they know it. They are getting very desperate as the field is getting level in a hurry!The way out...Bush Bows To 9/11 Panel:
http://www.cbsnews.com/stories/2004/01/27/terror/main596208.shtmlGerman Court Acquits 9/11 Suspect:
http://www.cbsnews.com/stories/2003/12/31/terror/main590950.shtmlUpdate To The Complete 9/11 Timeline:
http://www.scoop.co.nz/mason/archive/scoop/stories/77/a4/200402041125.75906e6b.htmlInternational 9/11 Inquiry - San Francisco, March 26-28th:
http://www.deceptiondollar.com/Inquiry911.htm9/11 Truth NYC:
http://www.ny911truth.org/ 
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Comment #2 posted by Sam Adams on February 05, 2004 at 06:03:30 PT
Take care of yourself
Attention sick people: you are smart enough to learn about caring for your problems!  I know it's hard to believe, but the stodgy old rich men in white coats share the same DNA as you! You can do it! 
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Comment #1 posted by charmed quark on February 05, 2004 at 04:31:51 PT
Also Marinol
I've found that many physicians have this attitude against Marinol, a schedule 3 drug. My own doctor caled it "that pot drug" and wanted nothing to do with it. If there is this resistance against marinol in the USA, imagine the resistance against cannabis.-Pete
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