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October 12, 2009
Lessons Learned in 8 Years as a Pot Doc
What I’ve been privileged to learn from pot smokers has been both fascinating and troubling; this is the beginning of what I hope to continue as a (more or less) organized report.After starting to screen Prop 215 applicants in 2001, the first thing I realized was that I didn’t have a clear idea of what to ask them. I was so naive that I was even surprised none of them were cannabis naive and thus began asking them when they first tried it, etc. It wasn’t too long before I also became curious about their experience with alcohol and tobacco, and later with other drugs.
The pattern that began emerging after about 4 months convinced me to organize a study by developing a menu of questions and spend more time on each interview. That led the club owner to recruit more MDs. I can say unequivocally that he supported everything I did and didn’t protest my reduced output.
In any event, information provided by all patients seen between July and December 2002 was later presented at the 2004 Patients Out of Time Meeting in Charlottesville, VA in May 2004 and eventually reported in a local Bay Area journal devoted to Proposition 215. It was at the Charlottesville meeting meeting that the strong hints of unhappiness with my work that originally surfaced in e-mail discussions became unequivocal. Nothing overt was said, but the signs were as unmistakable as the current absence of any mention of my participation from the P.O.T. website.
As the study continued, it became increasingly clear that my pot doc colleagues were resistant to incorporating similar questions in their histories, a reluctance that continues to this day. They also wouldn’t (and still won’t) engage in discussions of possible self-medication for psychotropic symptoms. I am so offended by that denial that I now avoid their company whenever possible. It was sometime around the end of 2004 that I decided to separate myself from the “movement” and simply do my own research. Somewhat ironically, it was also then that some funding became available for the creation of a database dedicated to the study. Peer-reviewed publication (November 2007) would have been impossible without the database. Equally ironically, its almost unavoidable presence on Pubmed searches involving “marijuana” made its prolonged omission from related reports all the more noticeable; however, I'm now in a position to report that the discussions I'd hoped to provoke are finally beginning to appear.
Managing a large ongoing study in a setting of professional isolation and without funding has been daunting, but it has also provided me with my biggest challenge: understanding the uncanny degree to which recognition of the obvious psychological benefits of inhaled cannabinoids was avoided by just about everyone writing on the subject. As of this writing, that avoidance finally appears to be waning, a development that should please the twenty or so patients I have contact with each week who continue to confirm that inhaled cannabis, despite the limitations imposed by its illegality, is so safe and effective they prefer it over heavily advertised pharmaceuticals.
Doctor Tom
Posted by tjeffo at October 12, 2009 04:58 PM