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Kai, (and Debbie) et. al.<BR>
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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. <BR>
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Can we focus on the facts and reasoning involved in the scientific basis for medical use of cannabis?<BR>
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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? <BR>
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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of the numerous drugs that the medical profession has prescribed, that later turned out to be so harmful they were withdrawn from the market. <BR>
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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went on the market, it has remained so without, to my knowledge, any harmful effects that have led to a demand it be withdrawn from the market.<BR>
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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.<BR>
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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. <BR>
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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.<BR>
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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 addressed, 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.<BR>
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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.<BR>
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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.<BR>
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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.<BR>
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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.<BR>
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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.<BR>
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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. <BR>
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Here is the quote again from the NAS report along with the web link it came from:<BR>
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"Until a nonsmoked rapid-onset cannabinoid drug delivery system becomes available, we acknowledge that there is no clear alternative for people suffering from <I>chronic</I> conditions that might be relieved by smoking marijuana, such as pain or AIDS wasting."<BR>
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<A HREF="http://www.nap.edu/readingroom/books/marimed/ch4.html">http://www.nap.edu/readingroom/books/marimed/ch4.html</A><BR>
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And here is the info again from Health Canada about medical cannabis, along with the web link it came from: <BR>
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<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/faq_e.html">http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/faq_e.html</A><BR>
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<B>FAQ - Medical Use of Marihuana</B><BR>
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The following are the most frequently asked questions regarding the medical use of marihuana:<BR>
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<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#1">Where does Canada stand on the issue of medical use of marihuana</A>? <BR>
<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#2">Does this legislation mean that marihuana is a legal substance</A>? <BR>
<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#3">Who is eligible to obtain an authorization to possess marihuana</A>? <BR>
<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#4">How does someone apply to possess marihuana for medical purposes</A>? <BR>
<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#5">Where does Health Canada's supply of marihuana come from</A>? <BR>
<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#6">Can patients grow their own marihuana</A>? <BR>
<A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/about-apropos/#7">Has Health Canada issued a Notice of Compliance</A>? Go to <B><A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/index_e.html">Medical Use of Marihuana</A></B></B><BR>
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<B>Where does Canada stand on the issue of medical use of marihuana?</B><BR>
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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. <BR>
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<B>Does this legislation mean that marihuana is a legal substance? </B><BR>
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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. <BR>
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<B>Who is eligible to obtain an authorization to possess marihuana? </B><BR>
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The regulations outline two categories of people who can apply to possess marihuana for medical purposes. <BR>
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<B>Category 1:</B> 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: <BR>
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Severe pain and/or persistent muscle spasms from <B>multiple sclerosis</B>; <BR>
Severe pain and/or persistent muscle spasms from a <B>spinal cord injury</B>; <BR>
Severe pain and/or persistent muscle spasms from <B>spinal cord disease</B>; <BR>
Severe pain, cachexia, anorexia, weight loss, and/or severe nausea from <B>cancer</B>; <BR>
Severe pain, cachexia, anorexia, weight loss, and/or severe nausea from <B>HIV/AIDS infection</B>; <BR>
Severe pain from <B>severe forms of arthritis</B>; or <BR>
Seizures from <B>epilepsy</B>. Applicants must provide a declaration from a medical practitioner to support their application.<BR>
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<B>Category 2:</B> 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.<BR>
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<B>How does someone apply to possess marihuana for medical purposes?</B><BR>
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An application must be submitted in writing to Health Canada. Application <A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/how-comment/index_e.html">forms and guidelines are available online</A> or by calling Health Canada toll-free, at: <B>1-866-337-7705</B>. Applicants must provide a declaration from a medical practitioner to support the application.<BR>
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<B>Where does Health Canada's supply of marihuana come from?</B><BR>
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In December 2000, Health Canada contracted Prairie Plant Systems Inc. (PPS) to cultivate and produce a safe, standardized, homogenous <A HREF="http://www.hc-sc.gc.ca/hecs-sesc/marihuana/supply-approvis/index_e.html">supply of marihuana</A>. <BR>
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V2020 Post by Ted Moffett<BR>
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