[Vision2020] Cannabis: Debbie & Kai Misunderstand, It Seems

[Tbertruss at aol.com]

Kai, (and Debbie) et. al.

The issue I am addressing is the rational empirical basis for legal medical 
use of cannabis under a doctors care.  You appear to believe that if cannabis 
is legal for medical use, legal use for other various nefarious purposes will 
inevitably result, and the barbarians will storm the gates, or some such dire 
consequence.  

Can we focus on the facts and reasoning involved in the scientific basis for 
medical use of cannabis?

It seems that both Debbie Gray and Kai have misunderstood the current 
scientific status in the medical profession for the medical benefit and legal use of 
cannabinoids (found in cannabis) in medicine.  Correct me if I am wrong, both 
Debbie and Kai, but you both seem to be arguing that the medical profession is 
still debating the legitimacy of the use of cannabinoids for valid medical 
treatment in terms of whether the public should have prescribed access to 
cannabinoids under a doctors care?  Is this your position?  

While of course there is still debate about the use of cannabinoids, and 
further studies are called for, just as there is with many currently available 
prescribed medicines found on the market, the medical profession has already 
spoken on this issue that indeed cannabinoids have legitimate medical use, if we 
believe that the medical profession would not allow drugs to be prescribed that 
were useless or harmful, though this assumption would be questioned by many, 
especially in light of the numerous drugs that the medical profession has 
prescribed, that later turned out to be so harmful they were withdrawn from the 
market.  

Since Marinol, the pill form of cannabinoids available by prescription, went 
on the market, it has remained so without, to my knowledge, any harmful 
effects that have led to a demand it be withdrawn from the market.

Therefore the question is not can cannabis in smoked form have any useful 
medical benefit, it is only are there enough medical drawbacks to delivering 
cannabinoids via the smoking of cannabis to render this method not worth the 
benefits that can result from the cannabinoids delivered by this method?  Cannabis 
contains the same cannabinoid compounds that are in Marinol, a legal pill form 
of cannabinoid delivery, and unless smoking cannabis as a method of delivery 
destroys the cannabinoids, which it does not, or results in some other effect 
which neutralizes the effects of cannabinoids, smoking cannabis will result in 
some of the same medical benefits that can already be obtained from the legal 
prescription drug Marinol.

So what are the drawbacks to smoking cannabis that may render the medical 
benefits of the cannabinoids delivered not worth the risk or harmful effects?  Of 
course, inhaling a burned plant can release numerous other compounds not 
related to the medical effect desired, which is one reason many in the medical 
profession dislike in principle the whole idea of legitimate use of smoked 
cannabis in medicine.  It violates the assumption that the best method of delivering 
a drug (indeed some insist that to violate this principle undermines the 
whole practice of medicine) is in a controlled purified form with exact dosages.  
You find the same argument against herbal medicine of all kinds.  And of 
course there is the potential for lung damage and/or other effects not specifically 
related to the medical effects desired.  The damage to the lungs or other 
damaging effects of smoking cannabis would need to be weighed against the 
beneficial effects that can be gained.  

This is the same kind of balancing act that goes on in medicine every day 
with numerous drugs that have dangerous harmful side effects yet are still used 
due to their positive benefits.

Numerous legal drugs used in medicine that are in purified form have numerous 
side effects that are also not related to treating the medical problem being a
ddressed, and can have serious negative consequences.  This problem is almost 
impossible to avoid in drug use in medicine.  People undergoing chemotherapy 
will accept the nausea and loss of hair, etc., which are side effects that 
would be best avoided, but the results of saving a life from cancer outweigh 
these extremely unpleasant and harmful effects.

Therefore I think that to argue that smoking cannabis, where there are 
unwanted side effects, and the consumption of numerous compounds not needed for the 
desired medical effect, IN PRINCIPLE negates the very idea it could have 
medical benefits worth the risk, is not valid.

Numerous purified drugs have rather serious side effects and real medical 
dangers, yet they are still allowed on the market due to their possible medical 
benefit in some people.

The main medical argument for the smoked cannabis form of delivery of 
cannabinoids is based on the fact that currently there is no "rapid-onset cannabinoid 
drug delivery system," and here I again use the same quote from the National 
Academy of Sciences report I quoted earlier.  This means that smoking cannabis 
is currently the only delivery method to deliver cannabinoids quickly, which 
is beneficial in some medical uses.

The only rational fact based argument required to allow legal medical use of 
cannabis based on a medical argument is one type of medical situation for 
which "there is no clear alternative," and again I quote from the same quote from 
the NAS report on medical cannabis.

If an alternative method is found to deliver the cannabinoids quickly and 
with the same effectiveness as smoking cannabis, there would no longer be any 
argument for legal smoked cannabis use in medicine, except perhaps an economic 
one, which has some validity, given the outrageous costs of prescription drugs.  
But this is not strickly a medical argument.

I trust my analysis of this subject has clarified the primary issues in this 
debate.  And again I would like to post the info from and web link to Health 
Care Canada on how the medical profession in Canada is dealing with the legal 
medical use of cannabis.  I find it hard to imagine that the Canadian health 
care system would allow the legal prescribed use of cannabis under a doctors 
care if there was not a sound basis for the use of cannabis in medicine.  But no 
doubt, as with many medical drugs in use in many countries in the world, some 
countries decide a drug is valid to make available by prescription, and some 
others do not, and they all think they have their valid scientific basis for 
making these decisions.  This state of affairs calls into question the objective 
scientific basis of the practice of medicine.  No doubt politics and religion 
is involved in medicine, and this influences, sadly, the decisions that the 
medical profession can make that should be based solely on the science 
involved. 

Here is the quote again from the NAS report along with the web link it came 
from:

"Until a nonsmoked rapid-onset cannabinoid drug delivery system becomes 
available, we acknowledge that there is no clear alternative for people suffering 
from chronic conditions that might be relieved by smoking marijuana, such as 
pain or AIDS wasting."

http://www.nap.edu/readingroom/books/marimed/ch4.html

And here is the info again from Health Canada about medical cannabis, along 
with the web link it came from:   

http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/faq_e.html

FAQ - Medical Use of Marihuana

The following are the most frequently asked questions regarding the medical 
use of marihuana:


Where does Canada stand on the issue of medical use of marihuana? 
Does this legislation mean that marihuana is a legal substance? 
Who is eligible to obtain an authorization to possess marihuana? 
How does someone apply to possess marihuana for medical purposes? 
Where does Health Canada's supply of marihuana come from? 
Can patients grow their own marihuana? 
Has Health Canada issued a Notice of Compliance? Go to Medical Use of 
Marihuana

***

Where does Canada stand on the issue of medical use of marihuana?

On July 30, 2001, Health Canada implemented the Marihuana Medical Access 
Regulations, which clearly define the circumstances and the manner in which access 
to marihuana for medical purposes will be permitted. The Regulations contain 
three main components: Authorizations to possess dried marihuana; licences to 
produce marihuana, which include Personal-Use Production Licences and 
Designated Person Production Licences; and access to supply of marihuana seeds or 
dried marihuana. 

Does this legislation mean that marihuana is a legal substance? 

No. Marihuana is categorized as a controlled substance. It is not legal to 
grow or possess marihuana except with legal permission by Health Canada. The 
Marihuana Medical Access Regulations allow access to marihuana to people who are 
suffering from grave and debilitating illnesses. It is important to note that 
the Regulations deal exclusively with the medical use of marihuana. They do 
not address the issue of legalizing marihuana. 

Who is eligible to obtain an authorization to possess marihuana? 

The regulations outline two categories of people who can apply to possess 
marihuana for medical purposes. 

Category 1: This category is comprised of any symptoms treated within the 
context of providing compassionate end-of-life care; or the symptoms associated 
with the specified medical conditions listed in the schedule to the 
Regulations, namely: 


Severe pain and/or persistent muscle spasms from multiple sclerosis; 
Severe pain and/or persistent muscle spasms from a spinal cord injury; 
Severe pain and/or persistent muscle spasms from spinal cord disease; 
Severe pain, cachexia, anorexia, weight loss, and/or severe nausea from 
cancer; 
Severe pain, cachexia, anorexia, weight loss, and/or severe nausea from 
HIV/AIDS infection; 
Severe pain from severe forms of arthritis; or 
Seizures from epilepsy. Applicants must provide a declaration from a medical 
practitioner to support their application.

Category 2: This category is for applicants who have debilitating symptom (s) 
of medical condition (s), other than those described in Category 1. Under 
Category 2, persons with debilitating symptoms can apply to obtain an 
Authorization to Possess dried marihuana for medical purposes, if a specialist confirms 
the diagnosis and that conventional treatments have failed or judged 
inappropriate to relieve symptoms of the medical condition. While an assessment of the 
applicant’s case by a specialist is required, the treating physician, whether 
or not a specialist, can sign the medical declaration.

How does someone apply to possess marihuana for medical purposes?

An application must be submitted in writing to Health Canada. Application 
forms and guidelines are available online or by calling Health Canada toll-free, 
at: 1-866-337-7705. Applicants must provide a declaration from a medical 
practitioner to support the application.

Where does Health Canada's supply of marihuana come from?

In December 2000, Health Canada contracted Prairie Plant Systems Inc. (PPS) 
to cultivate and produce a safe, standardized, homogenous supply of marihuana. 

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V2020 Post by Ted Moffett
    

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