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An Open Letter to
Physicians Dear Doctor, Medical marijuana (proper name Cannabis) has been utilized throughout the world for some 12,000 years. Medical Cannabis is NOT folk medicine but a real therapeutic tool you can use in your everyday practice. No less than the National Academy of Science has gone on record that although much research remains to be accomplished, the science to date demonstrates the utility and safety of cannabis. Clinical experience has shown the efficacy of cannabis for amelioration of symptoms ranging from the nausea of chemotherapy to the spasticity of MS, the management of chronic pain, the treatment of arthritis, to the relief of wasting syndromes. Some will insist that our present formulary is adequate so why recommend a “new”drug that may have unforeseen adverse effects? Well, compared to most narcotics, neuroleptics, anti-spasmotic, etc., cannabis has an extraordinarily safe profile in most patients. Medical Cannabis is not a primary therapy but an adjunctive one that significantly assists overall patient care. Cancer and AIDS patients gain weight. Chronic pain patients can be managed with markedly reduced amounts of narcotics. Arthritis suffers find anti-inflammatory relief without the nasty side effects of NSAIDS. It is legal in California to recommend cannabis to patients. The DEA has been permanently enjoined from acting against any physician who wishes to provider recommendation of Cannabis. Patients want the relief that cannabis can provide. It is better for patients to use Cannabis under your supervision than in some clandestine fashion. Cannabis does NOT have to be smoked. Both inhalation and oral routes of delivery are available. Transdermal and sublingual delivery systems are currently being perfected. Increasingly, a safe and consistent supply of medical Cannabis strains is available providing more certainty in dosing and effect. Cloned medical Cannabis has been demonstrated to have far greater therapeutic effect with fewer side effects than the prescription drug Marinol. Cannabis is not just for the dying in hospice but also for the chronically or seriously ill. Cannabis is even being utilized to reduce the devastating inflammatory process caused by acute injury to the brain or spinal cord. I am writing you an open letter for an open mind. Most of us “snicker” when we hear the word “pot”. Most of us think that we don't need another liability in the practice of medicine forgetting that the safety of Cannabis considering it's absence of toxicity demands its consideration under fundamental medical principles. Like you, I have been trained in the reductionist model of medicine that generally spurns herbs or other preparations that have mixed actions. Yet, Cannabis provides relief from a range of medical conditions precisely because it contains a number of Cannabinoids that impact on both pain pathways, inflammatory pathways, and brain centers involved in appetite and the sense of well-being. The primary “adverse” reaction to Cannabis is euphoria which is not so negative considering the depression often associated with the medical conditions for which adjunctive therapy with Cannabis is appropriate. Clinical “caregiving” models providing adjunctive therapy with medical Cannabis are now established. These clinical models provide a range of services to address the broad spectrum of patient needs in terms of employment, disability, education, and counseling. These caregiver clinics prefer to work with local physicians who are closely following the patients primary medical needs. They provide a comprehensive network of needed referral services. They also provide safe and affordable cannabis. Will patients abuse medical Cannabis? Most certainly some patients will. These are the same patients who abuse Vicodin or Clonopin or so many other medicines that can be so useful when used responsibly. Clinical models of caregiving can markedly reduce such abuse, as harm reduction is one of the clinic models primary goals. Medical Cannabis was a mainstream preparation in American medicine and pharmacy for over 80 years until its prohibition for cultural reasons in the 1930’s.Cannabis has been rediscovered and thousands of sound research papers have been published in the past decade. Call or write us for more information, comments, or questions about the utilization of cannabis recommendations in your practice. Respectfully, Jay R. Cavanaugh,
Ph.D., |
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