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  • Zaphod Zaphod 
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    Its legal in Cali too, I dont even know anyone pretending to be medical anymore. So many pts take it, but I dont deal with it at all.

    #184666 Reply
    Liked by Tangler
    Avatar Panscan 
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    I would refer them back to the prescribing doctor.  He doesn’t want to hear from them?  How does that work?  Maybe he is in the wrong business.  Maybe they do not want to go to see him because since it is for medical marijuana the doctor cannot bill insurance and it would be another cash visit.  I would be tempted to call the doc up myself – he should not be prescribing meds he does not understand.

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    I have only encountered this with a few patients but it is the same in all 3.  They had a phone conversation with a doctor somewhere else in the state who they told what medical problems they had.  He deemed that they fit into the particular diagnosis allowed and he certified them.  After they paid the $250-300 of course.

    I have referred my patients back to these docs but the patients claim they are falling on deaf ears.  Maybe you are right and it is a money issue.  I wonder if they will charge me to call and ask questions?

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    what a scam.

     

    how does anyone allow crap like this? They’re literally just a drug dealer

    #184676 Reply
    Avatar Tangler 
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    Legal in MA, now recreational is legal too (i think). In terms of “medicine “ I think it was essentially just the route to get recreational use legal. I don’t know why americans need a drug that will increase appetite and decrease motivation, personally, I sure as heck don’t need that! I think in 30-40 years we will have a lot of data on badness from MJ. I don’t want anyone i care about using it.
    The argument I always hear is: “ it is better than getting really drunk”
    That is like running your car into a tree and saying “It is better than hitting another car”
    If choice 1 is toxic that does not mean we should be ok with choice 2, because it might be less toxic.

    Neither is a great idea, but hey, maybe i should mellow out (could need a “treatment”)

    #184711 Reply
    childay childay 
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    Neither is a great idea, but hey, maybe i should mellow out (could need a “treatment”)

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    It’d be a lot cooler if you did..

    #184712 Reply
    wideopenspaces wideopenspaces 
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    It was just legalized here. Our hospital hasn’t come up with a plan yet to deal with it. But we have been told we are responsible for side effects, drug interactions and outcomes if we certify that a patient needs it. The only psychiatric condition it is approved for here is PTSD. However the research on it is equivocal at best so I do not plan to certify anyone. There just isn’t enough evidence based research to recommend it. I do hope more research will be done but thus far we know it increases SI and psychosis so I don’t see myself prescribing it for my patients. I’m sure they will be able to find some shady doctor to do it anyway.

    #184728 Reply
    Liked by Tim, Tangler
    childay childay 
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    Our state board has also made it clear, though disciplinary hearings, that they don’t feel that rx medical THC with benzos or opiates is appropriate ever, which sometimes is an issue for patients on chronic opiates or benzos for pain/anxiety with THC coming up in their drug screens.

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    Interesting hadn’t heard about such..

    #184732 Reply
    CordMcNally CordMcNally 
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    Our state board has also made it clear, though disciplinary hearings, that they don’t feel that rx medical THC with benzos or opiates is appropriate ever, which sometimes is an issue for patients on chronic opiates or benzos for pain/anxiety with THC coming up in their drug screens.

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    Too bad they don’t have the cajones to say that benzos and opiates shouldn’t mix.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #184733 Reply
    SLC OB SLC OB 
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    Only research I know is in pregnant and breastfeeding women.

    Very BAD for both.

    Also shows long term brain damage to those under 25 years old (not just up to 18!)

     

    #184753 Reply
    Liked by Tim, Tangler
    Avatar RocketBooster 
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    Through my perspective, medical marijuana is a fantastic tool.

     

    I would BY FAR rather have a patient using MM, rather than abusing alcohol, prescription drugs/opiates/benzos, or illicit drugs. I’ve never had a stoner scream at me to fill their meds a day early, sure can’t say that about the other drugs… in fact, it happens daily at retail pharmacy world. If we can use marijuana as the opposite of a gateway drug (which was a false narrative driven by propaganda), we could actually have it potentially substitute for a lot of our far worse addictions (alcoholism, opiate/benzo addiction, etc.). This study below found a harm reduction in MM users compared with abusing other substances.

     

     

    https://www.ncbi.nlm.nih.gov/pubmed/26364922

    Abstract

    INTRODUCTION AND AIMS:

    Recent years have witnessed increased attention to how cannabis use impacts the use of other psychoactive substances. The present study examines the use of cannabis as a substitute for alcohol, illicit substances and prescription drugs among 473 adults who use cannabis for therapeutic purposes.

    DESIGN AND METHODS:

    The Cannabis Access for Medical Purposes Survey is a 414-question cross-sectional survey that was available to Canadian medical cannabis patients online and by hard copy in 2011 and 2012 to gather information on patient demographics, medical conditions and symptoms, patterns of medical cannabis use, cannabis substitution and barriers to access to medical cannabis.

    RESULTS:

    Substituting cannabis for one or more of alcohol, illicit drugs or prescription drugs was reported by 87% (n = 410) of respondents, with 80.3% reporting substitution for prescription drugs, 51.7% for alcohol, and 32.6% for illicit substances. Respondents who reported substituting cannabis for prescription drugs were more likely to report difficulty affording sufficient quantities of cannabis, and patients under 40 years of age were more likely to substitute cannabis for all three classes of substance than older patients.

    DISCUSSION AND CONCLUSIONS:

    The finding that cannabis was substituted for all three classes of substances suggests that the medical use of cannabis may play a harm reduction role in the context of use of these substances, and may have implications for abstinence-based substance use treatment approaches. Further research should seek to differentiate between biomedical substitution for prescription pharmaceuticals and psychoactive drug substitution, and to elucidate the mechanisms behind both. [Lucas P, Walsh Z, Crosby K, Callaway R, Belle-Isle L, Kay B, Capler R, Holtzman S. Substituting cannabis for prescription drugs, alcohol, and other substances among medical cannabis patients: The impact of contextual factors. Drug Alcohol Rev 2016;35:326-333].

     

    https://www.ncbi.nlm.nih.gov/pubmed/26364922

    #184838 Reply
    childay childay 
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    harm reduction

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    Using marijuana as a harm reduction tool is an interesting idea.  Is there data from actual opiate/benzo/etc prescription rates rather than patient surveys?  Again though, this does not equate to it being an effective “medicine” for treating specific conditions.

    #184911 Reply
    Liked by Panscan
    Zaphod Zaphod 
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    harm reduction 

    Click to expand…

    Using marijuana as a harm reduction tool is an interesting idea.  Is there data from actual opiate/benzo/etc prescription rates rather than patient surveys?  Again though, this does not equate to it being an effective “medicine” for treating specific conditions.

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    I doubt it will be an effective medicine for much of anything, even if it had some purpose the molecule would be isolated and made more effective singularly. It may indeed be a less harmful alternative than other things. We shall see.

    #184916 Reply
    Liked by Tangler
    Avatar Tangler 
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    saying using/abusing MJ is better than using/abusing alcohol or opioids is like saying having a giant HELOC with an adjustable rate is better than a pay day loan, or mountains of credit card debt.
    Is any of these really a good plan?
    Is this really how people should be “treated” by health care professionals ?
    Got news for you: Life is hard. Life is not fair. Being stoned, or dunk or drugged generally does not improve life and health.
    How about this as a plan: stay sober, exercise, eat right and avoid doing dumb crap, like riding motorcycles 120 mph down the center lane of interstate 5 between cars.
    How about a perscription for that!

    #185058 Reply
    triad triad 
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    saying using/abusing MJ is better than using/abusing alcohol or opioids is like saying having a giant HELOC with an adjustable rate is better than a pay day loan, or mountains of credit card debt.
    Is any of these really a good plan?
    Is this really how people should be “treated” by health care professionals ?
    Got news for you: Life is hard. Life is not fair. Being stoned, or dunk or drugged generally does not improve life and health.
    How about this as a plan: stay sober, exercise, eat right and avoid doing dumb crap, like riding motorcycles 120 mph down the center lane of interstate 5 between cars.
    How about a perscription for that!

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    what percentage of your patients consume alcohol?  I predict that the (vast?) majority do.  sure, ideally, no one would use booze or opioids but we live in the real world.  MJ is clearly better for society then the alternatives.  It’s just not rational for booze (or benzos/opiods) to be legal and pot to be a schedule 1 drug.

    #185064 Reply
    Liked by Zaphod
    Avatar Panscan 
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    Joined: 03/18/2017

    saying using/abusing MJ is better than using/abusing alcohol or opioids is like saying having a giant HELOC with an adjustable rate is better than a pay day loan, or mountains of credit card debt.
    Is any of these really a good plan?
    Is this really how people should be “treated” by health care professionals ?
    Got news for you: Life is hard. Life is not fair. Being stoned, or dunk or drugged generally does not improve life and health.
    How about this as a plan: stay sober, exercise, eat right and avoid doing dumb crap, like riding motorcycles 120 mph down the center lane of interstate 5 between cars.
    How about a perscription for that!

    Click to expand…

    what percentage of your patients consume alcohol?  I predict that the (vast?) majority do.  sure, ideally, no one would use booze or opioids but we live in the real world.  MJ is clearly better for society then the alternatives.  It’s just not rational for booze (or benzos/opiods) to be legal and pot to be a schedule 1 drug.

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    can you provide data to back up this statement? It’s possible you’re right I just think it’s strange there is so much backing behind medical marijuana when we have little to no research that successfully defends it.

    If you want to legalize recreational marijuana that is one viewpoint. If you think it has medical benefit that is another. Important distinction.

    #185067 Reply
    Zaphod Zaphod 
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    Status: Physician, Small Business Owner
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    Joined: 01/12/2016

    saying using/abusing MJ is better than using/abusing alcohol or opioids is like saying having a giant HELOC with an adjustable rate is better than a pay day loan, or mountains of credit card debt.
    Is any of these really a good plan?
    Is this really how people should be “treated” by health care professionals ?
    Got news for you: Life is hard. Life is not fair. Being stoned, or dunk or drugged generally does not improve life and health.
    How about this as a plan: stay sober, exercise, eat right and avoid doing dumb crap, like riding motorcycles 120 mph down the center lane of interstate 5 between cars.
    How about a perscription for that!

    Click to expand…

    What does this have to do with anything?

    We live in the real world. People do what they will, and we can certainly pass judgement about relative risks. People also shouldnt eat things like fried foods, etc…but Im not going to stop doing that. What about caffeine? Where on the spectrum do we say one drug is safe to liberally consume and another needs regulation and others are too dangerous. The spectrum exits but you cant honestly put MJ on the ‘too dangerous’ side without railing against legal things no one speaks much about at all.

    Alcohol for sure has one of the worst safety profiles and it is a ridiculous hypocrisy that its legal and marijuana isnt. Its not based on rationality or danger. Just because we call it a drug doesnt make it evil. It certainly hasnt been productive and has caused a lot of pain and suffering. The cost has been enormous. Not saying there wont be issues, but I’d rather it be legal, regulated, studied than the alternative. Its your choice whether to partake.

    More people die from alcohol than marijuana, for sure. Maybe that changes in the future. Its a hard thing to be addicted to as well, and for everyone around them as well. I dont know if you have hangovers and stuff from mj, but its probably not as hard on your body, especially if taken other ways than smoke (which is always a bad vector).

    #185072 Reply
    Liked by portlandia

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