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January 17, 2011

The Marijuana High from a Clinical Perspective

One of the (still) unrecognized benefits of Proposition 215 is that it has allowed, for the first time ever, protected clinical contact between physicians and the hitherto closeted users of reefer, which, as “marijuana,” took then-young Baby Boomers by storm in the Sixties and soon impelled an insecure President Nixon to declare “war” on all drugs declared illegal by the US Attorney General. One of several important points lost on most observers during that turbulent era was that whatever medical evaluation of “reefer” had taken place in the past had been neither thorough nor systematic and was, in any event, woefully out of date. When a special commission appointed by Nixon himself called those facts to his attention in 1972, he buried their report and scolded its chairman for ignoring his wishes

Thus have the imagined evil effects of smoking marijuana, now known by most as getting “high,” been demonized by those opposed to its use, even as a substantial fraction of those who have tried it either continue to use it or remain willing to again if they develop certain symptoms. Thus- equally ironically- has the relief of severe symptoms remained an excuse for the harsh punishment those who choose to self medicate on the grounds that they are criminals or "addicts." for over four decades with virtually zero recognition of the incongruity.

That such a bizarre situation could have evolved shouldn’t surprise a nation that fought a bloody Civil War over chattel slavery after seventy years of existence, and then accepted that “separate” is the same as “equal” for another sixty, and still struggles with the notions of equality so eloquently stated in its founding manifesto.

To return to why marijuana’s characteristic “high” remains so misunderstood: it’s really a pharmacological phenomenon that’s far more complex than either its opponents or proponents ever imagined. The most accurate descriptive term for its unique effect is “anxiolytic,” a word (unwittingly) coined by a pharmaceutical company in the early Sixties to describe the effect of an an entirely different drug after oral ingestion. Another surprise is that smoking cannabis is an advantage because it provides the experienced user with almost instant awareness that an effective dosage level has been reached, an advantage that’s only possible when a drug can be delivered by inhalation and crosses the blood brain barrier (both of which cannabinoids do readily). Also, with respect to smoking “marijuana,” the extensive work of academic Pulmonologist Donald Tashkin, an unusually honest investigator, suggests that its carcinogenicity, like so many of its other presumed dangers, has been grossly exaggerated and may even be blunted by an anti-cancer and other beneficial effects.

The bottom line is that limited clinical evaluation (the only kind possible under the grudging restrictions that applied to how Proposition 215 could be implemented) has revealed important findings that remain either unknown to, or disbelieved by, many who should be interested. They include the current occupant of the Oval office, the family and fans of a recently deceased entertainer, and any number of other public figures whose personal drug use is sufficiently well known to allow discussion without breaching ethical canons.

Doctor Tom

Posted by tjeffo at January 17, 2011 10:09 PM

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