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February 25, 2011
The Consequences of Drug War Ignorance
Even though it has been unable to prevent half (or more) of all American teens from trying (“initiating") "marijuana" for over four decades, the federal government insists its policy of drug prohibition (always referred to officially as "control") is successful and must be continued. Au contraire, I saw President Obama’s inability to admit the drug war's many failures as a major weakness in his recent State of the Union address.That opinion is well supported by information gathered since 2001 from over six thousand Californians seeking my "recommendation" to use cannabis medically, but remains largely unknown because other physicians in a position to obtain similar data haven't done so; nor have they published their findings in the medical literature.
In any event, the aggregated histories of my applicant population could not compete with the huge volume of NIDA-approved literature that began to appear shortly after passage of the Controlled Substances Act in 1970 and has increased steadily since. Its thrust is that inhaled cannabis somehow functions as a transitional drug which induces young people to progress from (legal) alcohol and tobacco to "harder" illegal drugs such as cocaine and heroin. Quickly popularized as the "Gateway Theory" (but never confirmed by clinical data) that notion soon dominated "anti-drug" medical literature throughout the Eighties and Nineties and is summarized in a NIDA monograph on the, Gateway Hypothesis in 2002.
The critical points brought out in my interviews that NIDA-sponsored researchers either don't understand, or seem unable to believe, is that the majority had been self-medicating with inhaled cannabinoids for long intervals in stable patterns to relieve distressing emotional symptoms. Beyond that, they have been willing to do so at considerable risk to their economic, social, and legal well-being.
Apparently, most authors of peer-reviewed literature and their federal sponsors remain unaware of the impressive range of physical benefits inhaled cannabis can provide. It is a potent anxiolytic, antidepressant, antinauseant, antidiarrheal, anticonvulsant and antinocioceptive agent.
Just when I thought I'd learned a great deal about the therapeutic uses of cannabinoids, I was amazed to stumble across an untouched area of gross ignorance a few months ago, one with inportant policy implications. Although medical users are generally aware that cannabinoid effects can vary a lot depending on whether they are inhaled (the "head high") or eaten (the "body high") federal experts have remained oblivious to that important detail; thus neither side has focused on it or the mechanism responsible with the net result that a potentially important therapeutic benefit of herbal cannabis has remained nearly unknown and is still completely unstudied. A brief outline of the issue and a description of the pertinent differences follows.
Any psychotropic agent that can be smoked and crosses the blood-brain barrier will have rapid onset (seconds) which is why smoked marijuana can be titrated (measured) so accurately from the first toke. Edibles, because they are swallowed, are digested separately in the gastrointestinal (GI) tract, a process that not only takes longer, but cannot be monitored in real time. The products of digestion are then transported to the liver via the portal vein and broken down on a molecular level thus exposing the brain to very different effects from edibles than from smoke. The "high" lasts three hours or longer, arms and legs become relaxed to a point where physical activity is avoided, but relief of severe pain (neuropathic and arthritic pain in particular) is greatly enhanced.
The bottom line is that if appropriate research were to be done, the benefits of cannabis-based medicines might be further enhanced and more precisely focused; however, before that could happen, Congress would first have to admit a huge mistakes of long duration and then either repeal or change a bad law.
Thus have our species' emotional flaws been leading us into foolish and destructive behavior. By enhancing our ability to both reproduce and kill each other, Science has been a mixed blessing at best. Can this species be saved?
Doctor Tom
Posted by tjeffo at February 25, 2011 08:10 PM